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33. In wheezing, the throat produces a "he-he" sound, and the mouth opens frequently; in shortness of breath, it resembles asthma but without shoulder elevation. Rapid breathing with difficulty in distributing breath indicates an excess syndrome (Excess Syndrome), while shortness of breath with inability to sustain respiration is viewed as a deficiency syndrome (Deficiency Syndrome). Internal causes involve fluid retention or phlegm-heat; external causes require differentiation based on Yin-Yang and exterior-interior levels. If accompanied by fixed staring, coma, sweating that makes hair damp and oily, faint pulse, and cold limbs, life is difficult to save.

[Annotation] Wheezing refers to rapid breathing, a "he-he" sound in the throat, frequent opening of the mouth, shoulder elevation, and abdominal retraction during inspiration; this is asthma. Shortness of breath resembles asthma but is not true asthma, characterized by no mouth-opening or shoulder-elevation. Both conditions belong to Qi disorders in the chest. The Lung governs Qi, so these are attributed to the Lung. Whether rapid asthma or shortness of breath, if breathing is rapid, obstructed, and unable to distribute breath smoothly, it is an excess syndrome (Excess Syndrome) due to surplus. If breath is short, empty, and unable to continue, it is a deficiency syndrome (Deficiency Syndrome) due to insufficiency. Internal causes refer to lung injury from drinking cold fluids or due to phlegm-heat. External causes refer to body cold injuring the exterior; the exterior governs skin and hair, which are the exterior connections of the Lung. When pathogens affect the skin and hair, they subsequently spread to the skin, muscles, chest, abdomen, and stomach, all causing asthma. One must examine Yin-Yang and exterior-interior patterns and treat according to the transformation of the disease. Asthma and shortness of breath, when combined with fixed staring, coma, sweating making hair damp and oily, faint pulse, and cold limbs, are signs of death. If seen together with Cold syndromes of the Three Yin channels, it is called Yin Asthma, suitable for Sini Tang (Four Reversal Decoction) added with Xingren (Apricot Seed) and Wuweizi (Schisandra Fruit); increase Renshen (Ginseng) for deficiency. If seen together with Heat syndromes of the Three Yang channels, it is called Yang Asthma, suitable for Baihu Tang (White Tiger Decoction) or Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction). If seen together with Taiyang Exterior syndromes, it is called Exterior Asthma: use Mahuang Tang (Ephedra Decoction) for no sweat, Da Qinglong Tang (Major Green Dragon Decoction) for irritability, and Guizhi Jia Houpo Xingzi Tang (Cinnamon Twig Decoction Added with Magnolia Bark and Apricot Seed) for sweating. If seen together with Yangming Interior syndromes, it is called Interior Asthma, suitable for Dachengqi Tang (Major Order to Yield the Decoction); if combined with Jie Xiong (Chest Binding), Daxiexion Wan (Major Chest-Breaking Pill) is suitable. If combined with Water Qi, for Exterior Excess, Xiaolongtan Tang (Minor Green Dragon Decoction) is used; for Exterior Deficiency and unfavorable urination, Wuling San (Five-Poria Powder) added with Tinglizi (Lepidium Seed) is suitable. For Interior Excess, Tingli Dazao Tang (Lepidium and Jujube Decoction) is suitable; for hardness and pain in the abdomen and hypochondrium, Shizao Tang (Ten Date Decoction) is suitable. For Interior Cold, Zhenwu Tang (True Warrior Decoction) is suitable. If the pulse is faint and fine, and breath is short and weak at the mouth and nose, without other Yin-Yang or exterior-interior syndromes, this is Qi Deficiency Asthma, suitable for Baoyuan Tang (Protect Origin Decoction) added with Wuweizi (Schisandra Fruit) and Xingren (Apricot Seed). If asthma is accompanied by spitting thick, sticky phlegm and a gurgling sound in the throat, this is Phlegm Asthma. Severe cases suit Guiti San (Melon Pedicle Powder) or Mengshi Gun Tan Wan (Mica Rolling Phlegm Pill); mild cases suit Erchen Tang (Two-Aged Decoction) added with Ku Tinglizi (Bitter Lepidium Seed) and Suzi (Perilla Seed).