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Xiao (Asthma with whooping sound) and chou (stridor) refer to conditions where the throat produces sounds like sawing wood or the croaking of a waterfowl (e.g., bullfrog). If breathing is rapid, continuous, and unable to sustain normal respiration, it is termed Chuan (Wheezing/Dyspnea). Xiao is named for its characteristic sound, whereas Chuan is described by the state of breath. A snoring-like sound in the throat indicates a Deficiency pattern, while a waterfowl-like croak indicates an Excess pattern. Zhu Danxi stated: In treating Xiao, one must adhere to a bland diet, focusing primarily on phlegm. It is appropriate to use emetic drugs extensively; vinegar should be added frequently to these emetics. One should not rely solely on cold-natured herbs but should also incorporate exterior-releasing agents, as this condition often involves "cold wrapping heat" (exterior cold with interior heat). There are cases of deficiency where emesis is contraindicated; caution is required. Generally, this arises from phlegm-heat郁结 (stagnation/depression) internally constrained by wind-cold externally, or it may result from excessive consumption of salty and sour foods, allowing pathogenic factors to invade the couli (interstitial spaces). The treatment method requires assessing whether the condition is new or chronic, and whether it presents as excess or deficiency.

A three-year-old child surnamed Zhu suffered from severe asthma attacks, with sounds audible to neighbors, persisting for two to three days. He presented with fever and sweating. A physician administered Guntan Wan (Rolling Phlegm Pills) to induce purgation. After two or three bowel movements, his condition worsened significantly. His six pulses were flooding and rapid; his chest and hypochondrium heaved with respiration; he supported his abdomen and raised his shoulders while breathing; he had no rest day or night; he could not eat a single grain of rice; sweat poured from his head like rain; he had not slept for several days; the situation was critical. He then sought my treatment. I said, "This was a misdiagnosis/mistreatment." Sound originates from the qi passage in the throat. Continuous wheezing for several days has already damaged the Lower Yuan (Kidney Qi/Essence). Now, harsh purgative drugs have been used, passing through the food pipe, injuring the innocent healthy qi, causing the Lower Yuan to become extremely deficient. Hence, the ominous signs of supporting the abdomen and raising the shoulders appear. I prescribed Ren Shen (Ginseng Root), Mai Dong (Ophiopogon Tuber) each 1 qian, Wu Wei Zi (Schisandra Berry) 7 grains, and Rou Gui (Cinnamon Bark) 3 fen, decocted in water and taken warm, two doses per day. After administration, the wheezing sound decreased immediately, but recurred at night. I visited him the next day and said, "This is because there is insufficient Yin to anchor the Yang." I then prescribed Ba Wei Di Huang Wan (Eight-Ingredient Pill with Rehmannia) modified with Niu Xi (Achyranthes Root), Mai Dong, and Wu Wei Zi. I increased the dosage of Shu Di Huang (Prepared Rehmannia Root) to 5–6 qian per dose, and used Gui (Cinnamon Twig) and Fu Zi (Aconite Lateral Root) at 4 fen each per dose. The decoction was taken cold, one dose before noon and one after noon. After taking the medicine, he fell into a deep sleep. Upon waking, his appetite improved significantly, and the wheezing ceased completely. I visited again the next day, and both wheezing and fever had resolved. However, slight wheezing persisted after physical exertion, due to the incomplete recovery of Yuan Qi (Primordial Qi). After regulating with Sheng Mai Yin (Generate the Pulse Drink) for three to four days, his spirit and energy fully recovered.