Library

Remove Shaoyao (Paeoniae Radix Alba) from Guizhi Tang (Cinnamon Twig Decoction), and follow the previous method for the remainder.

Remove Shaoyao (Paeoniae Radix Alba) from the Guizhi Tang (Cinnamon Twig Decoction) formula, add one Pao Fuzi (Prepared Aconite Root, peeled and broken into eight pieces), and follow the previous method for the remainder.

In Taiyang disease (disease of the Taiyang channel characterized by exterior syndrome), if purgation is mistakenly applied and slight wheezing ensues, it indicates that the exterior pathogen has not yet been resolved; Guizhi Jia Houpo Xingren Tang (Guizhi Decoction with Magnolia Bark and Apricot Kernel) should be administered. For patients with a chronic history of wheezing who develop wheezing upon contracting wind-cold, administering Guizhi Tang (Cinnamon Twig Decoction) supplemented with Houpo (Magnolia Bark) and Xingren (Apricot Kernel) is optimal.

[Annotation]
Taiyang disease (disease of the Taiyang channel) should be treated with sweating methods, but if purgation is mistakenly used, resulting in diarrhea, rapid pulse, wheezing, sweating, and absence of aversion to cold, this indicates the pathogen has sunk inward with heat in the Yangming stage, constituting a Ge Gen Huang Qin Huang Lian Tang (Kudzu, Scutellaria, Coptis, and Phellodendron Decoction) pattern. In the current case, Taiyang disease (disease of the Taiyang channel) was mistakenly purged without causing diarrhea but resulting in slight wheezing; this signifies the pathogen has sunk into the chest without entering the stomach, and the exterior remains unresolved. Therefore, Guizhi Tang (Cinnamon Twig Decoction) is still used to release the muscle layer and exterior, while adding Houpo (Magnolia Bark) and Xingren (Apricot Kernel) to direct rebellious Qi downward and calm wheezing. "Chuanjia" (Wheezing-prone person) refers to individuals with a pre-existing condition of wheezing; when they contract wind-pathogen and wheezing recurs, Guizhi Tang (Cinnamon Twig Decoction) is appropriate, and adding Houpo (Magnolia Bark) and Xingren (Apricot Kernel) is preferable.

[Collected Annotations]
Fang Youzhi stated: Wheezing is caused by rebellious Qi moving upward, leading to difficult breathing and impaired respiration. "Slight" implies slow respiration, unlike the urgency of severe wheezing. Since the exterior pathogen persists, failing to resolve the exterior will not stop the wheezing; thus, Guizhi Tang (Cinnamon Twig Decoction) is used to release the exterior, while Houpo (Magnolia Bark) regulates Qi and Xingren (Apricot Kernel) descends Qi, making them essential herbs for calming wheezing.

Yu Chang stated: This outlines the major principle for treating wheezing caused by mistaken purgation of wind-pathogen. If cold-pathogen is mistakenly purged leading to wheezing, Ephedrae Herba (Mahuang, 麻黄), Xingren (Apricot Kernel), Shigao (Gypsum Fibrosum), and Gancao (Licorice Root) should be used; this can be extrapolated. He further noted that slight wheezing with an unresolved exterior indicates that the exterior pathogen has reversed upward due to mistaken purgation, which differs from deficiency patterns.

Cheng Yingjing stated: The symptom of wheezing involves both exterior and interior aspects that must be distinguished. After purgation, if sweating and wheezing occur, the wheezing is likely severe, belonging to interior heat obstruction and rebellious Qi driven by fire. After purgation, if only slight wheezing occurs with minimal sweating, it belongs to exterior pathogen constriction causing Qi rebellion; Guizhi Tang (Cinnamon Twig Decoction) should still be used to release the exterior, supplemented internally with Houpo (Magnolia Bark) and Xingren (Apricot Kernel) to direct Qi downward.

Wei Litong stated: Whenever a patient with a pre-existing wheezing condition contracts an external pathogen, wheezing is inevitably triggered; hence such individuals are termed "Chuanjia" (Wheezing-prone persons).