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To treat a condition where there is pre-existing heat accumulation in the chest, compounded by an external contraction, resulting in extreme restlessness and oppression in the chest, rapid and forced breathing, a pulse that is floating, large, and forceful but not firm upon deep pressure, and a white tongue coating that has not yet turned yellow.

Sheng Shigao (Raw Gypsum Fibrosum, 2 liang, finely crushed) Gancao (Licorice Root, 3 qian) Mahuang (Ephedrae Herba, 2 qian)

The above three herbs are decocted with distilled water for two or three boils. Take one large bowl of the clear decoction and take it warm in six divided doses. For the first three doses, administer once every hour; for the last three doses, administer once every one and a half hours. Discontinue administration when the disease is cured; it is not necessary to finish the entire dose. If coolness is felt in the lower jiao (lower abdomen), administration should also be stopped. In remote areas where distilled water is unavailable, Ganlan Shui (Sweet Ripple Water) may be used as a substitute.

Method for preparing Ganlan Shui: Fill a large basin with water. Use a ladle to scoop and throw the water back into the basin repeatedly. After prolonged tossing, several bubbles will form on the water surface. An assistant nearby uses the ladle to collect these bubbles from the surface; this collected water is called Ganlan Shui.

If treating similar conditions within the context of Warm Diseases (Wen Bing), Mahuang should not be used. Instead, Aspirin (1 grain) dissolved in the decoction may be used as a substitute. If Aspirin is unavailable at pharmacies in remote areas, Bohe Ye (Menthae Haplocalycis Folium, 2 qian) can be used as an alternative.

A woman surnamed Qian from Fengtian suffered from a Cold Damage (Shang Han) syndrome in mid-winter. For four or five days, she experienced severe asthma preventing her from lying down, extreme restlessness and oppression in the chest, frequent calling out, and a desire to open her chest manually. Upon palpation, her pulse was floating, large, long, and not firm upon heavy pressure; her tongue coating was thick and white. It was determined that although the syndrome had entered the Yangming stage, the Taiyang exterior syndrome had not yet resolved (the chest region belongs to Taiyang). At this time, using Xiao Qinglong Tang (Minor Green Dragon Decoction) to treat the asthma would be too heating. Using Baihu Tang (White Tiger Decoction) to treat the irritability and heat would neglect the Taiyang pathology, leaving the asthma unresolved. After much deliberation, this formula was prescribed. The light and ascending nature of the distilled water helps guide Shigao upward to resolve the chest heat. Gancao’s sweet and moderating property retains Shigao, preventing it from descending prematurely, thereby focusing its ascending action. A small amount of Mahuang is added to dissipate residual pathogens of the Taiyang stage and to assist in draining Lung heat and calming asthma, thus removing chest fullness and oppression. After decoction, the patient is instructed to take the medicine slowly in six divided doses. Since the disease is located in the Upper Jiao, administering it all at once might cause the medicinal force to descend, passing beyond the site of the disease, which could prevent recovery. After the third dose, slight sweating occurred in the chest area, and the condition improved significantly. After finishing the entire dose, the condition was cured by 80-90%. Upon re-examination, the pulse at the Guan position still appeared floating and large, but the asthma had ceased. However, the accompanying cough persisted. Subsequently, Xuanshen (Scrophulariae Radix, 1 liang), Xingren (Prunus Armeniaca Seed, peeled, 2 qian), Lou Ren (Trichosanthis Semen, 3 qian), and Niubangzi (Arctii Fructus, 3 qian) were prescribed. Two doses resulted in complete recovery.