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Although asthma (asthma syndrome) presents with differences between cold and heat patterns, its root lies in the Kidney, while its branch manifestation is in the Lung. The reason for Qi rebelling upward originates in the Stomach; therefore, treatment should prioritize descending Qi and resolving stagnation.

For heat patterns, clear them; for cold patterns, warm them; for chronic illness, astringe them; for acute illness, disperse them; and for severe cases, guide them according to their nature. This constitutes the general principles for treating asthma.

Clinical Case 1
A patient suffered from severe asthma preventing sleep. This was due to Cold congealing and Qi stagnating in the Upper and Middle Jiao, with Water and Fire clashing, causing Lung asthma. Shanyao (Dioscoreae Rhizoma) and Fuling (Poria) were used to regulate the Middle Jiao, allowing the Lung to receive vital energy. Sugen (Perillae Caulis) was used to open stagnation, Xingren (Armeniacae Semen Amarum) to facilitate Qi flow, Jiang (Zingiberis Rhizoma Preparatum), Rougui (Cinnamomi Cortex), and Wuyu (Evodiae Fructus) to constrain floating Fire and direct it downward to warm the Kidney. Once the Kidney is warmed, the Lung becomes warm and executes its descending function, and the asthma subsides.

A patient experienced daily morning asthma accompanied by spontaneous sweating. This indicates Lung deficiency leading to insufficient Yang Qi. In the morning, after stomach residue is digested, the Lung lacks nourishment from grain essence, so Qi cannot execute its descending function, rebelling upward to cause asthma. Since the Lung governs the skin and hair, failure of the skin and hair to consolidate results in spontaneous sweating. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was administered with Fuzi (Aconiti Lateralis Radix Preparata), Paojiang (Zingiberis Rhizoma Preparatum), and Wuweizi (Schisandrae Fructus).

A patient with asthma showed no improvement after taking drugs that clear Heat and resolve Phlegm. This indicated deficiency-cold in the Middle Qi, where Yang failed to ascend and turbid Qi failed to descend. Renshen (Ginseng Radix), Paojiang, Baizhu (Atractylodis Macrocephalae Rhizoma), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparatum), and Baishao (Paeoniae Radix Alba) were each prescribed at one qian, Wuweizi at five fen. If sweating was present, Rougui was added; if absent, Mahuang (Ephedrae Herba) was added. The treatment was effective.

A woman suffered from seasonal asthma attacks throughout the year, desired drinking cold water, experienced generalized swelling, and chest fullness. Physicians treated her as Phlegm-Fire, which worsened her condition, leaving her ill for two years. Chronic asthma is typically Lung deficiency, not excess. Sijunzi Tang (Four Gentlemen Decoction) was used with Banxia (Pinelliae Rhizoma), Wuweizi, Baishao, Xingren, Paojiang, Rougui, Mahuang, and Zhike (Aurantii Fructus). One dose stopped the symptoms. Recurrence was also halted by subsequent doses, yielding miraculous results.

Cough arises from various causes. For Wind etiology, use acrid-cool dispersants such as Qianhu (Peucedani Radix), Zisu (Perillae Folium), Fangfeng (Saposhnikoviae Radix), and Gegen (Puerariae Lobatae Radix). For Cold etiology, use acrid-warm diaphoretics such as Mahuang, Qianghuo (Notopterygii Rhizoma et Radix), and Xixin (Asari Radix et Rhizoma). For Dampness etiology, use drying methods like Liujunzi Tang (Six Gentlemen Decoction), or Banxia, Sangpiao (Mori Cortex), or Erchen Tang (Two Aged Things Decoction). For Fire etiology, use clearing and moistening agents such as Maidong (Ophiopogonis Radix), Ziwan (Asternis Radix), Huafen (Trichosanthis Radix), and Yuanshen (Scrophulariae Radix). For Deficiency etiology, use tonics such as Renshen, Huangqi (Astragali Radix), or Baoyuan Tang (Preserve the Origin Decoction), Sijunzi Tang, or Liujunzi Tang. For Qi rebellion, use clearing and descending agents such as Xingren, Suzi (Perillae Fructus), Chenpi (Citri Reticulatae Pericarpium), and Baihe (Lilii Bulbus). For Phlegm etiology, treat excess by draining and deficiency by tonifying; for flooding water, warm and astringe. Generally, the Lung belongs to Metal. If Metal is scorched by Fire, body fluids are concentrated into Phlegm; thus, clear the Fire, and once extinguished, the Phlegm dissipates. If Cold prevails, the Lung fails to descend, and Lung fluids accumulate into Phlegm; thus, warm the Kidney, and once the Water is warm, the Lung's descending function resumes, and the Phlegm dissipates. These are the general principles for treating cough. Profound understanding depends on distinguishing the cold, heat, deficiency, and excess in pulse and symptom patterns.

Cough accompanied by joint pain and inability to walk indicates Lung Qi insufficiency failing to control Liver Wood. Consequently, Liver pathogenic factors become vigorous, causing Wind-Phlegm to overflow. The Liver governs sinews; sinew injury leads to stiff movement. The Liver overacts on the Spleen; Spleen injury leads to dampness accumulation and disease. Furthermore, the Liver governs Wind; Liver excess causes Wind overflow and Phlegm stagnation. Thus, Lung Qi insufficiency is the root of the disease, while the strength or weakness of the Liver and Spleen is the branch. Sijunzi Tang was used to tonify Spleen and Lung deficiencies, plus Chenpi to vent Liver Qi excess, thereby awakening the Spleen and resolving Phlegm. This is the orthodox treatment method.

Clinical Case 2
A patient with cough had black stools. Physicians attributed this to Fire. I prescribed Guizhi (Cinnamomi Ramulus) and Fuzi to warm the Lower Jiao, resulting in recovery. Diseases have Yang and Yin aspects. In Yin patterns, although stool may be soft, it sinks in water, hence the black color. Warming the Lower Jiao restores Yang to its origin, stopping the cough and eliminating the black stool. Diagnosing this as Fire would be highly misguided.

A patient with cough experienced throat tightness, gradual hemoptysis, and intestinal wind (hematochezia) for half a year. I diagnosed chronic Spleen injury: the Spleen's moistening Qi failed to ascend to the Lung, causing Lung Qi to fail to descend and generate Fire, leading to cough and throat tightness. Spleen failure to control blood caused hemoptysis and intestinal wind. Baizhu (two qian) and Gancao (one qian) were used to tonify the Spleen; Chenpi (one qian) to regulate Qi; and Wei Jiang (Baked Ginger, two qian) to scatter Fire. After five doses, symptoms halved. Subsequently, Bu Zhong Yi Qi Tang (Ten doses) was used to lift Qi. Finally, Bazhen Tang (Eight Treasures Decoction) with Banxia and Chenpi was used to harmonize Qi and Blood and resolve Phlegm, curing the patient in two doses.

A patient contracted dysentery in October. Half a month later, asthma and cough developed, with hoarseness, foul breath, and profuse head sweating. Treated as Fire pattern without improvement until Spring. The pulse was large, slow, and powerless, indicating chronic illness with Yang deficiency and Spleen deficiency failing to control blood. Baizhu and Fuling (each two qian), Renshen (three qian), Gancao, Paojiang, Baishao, and Shengdi (Rehmanniae Radix, each one qian), Banxia (one qian five fen), and Wuweizi (five fen) were prescribed. Full recovery occurred after three doses.

A woman developed fever, cough, and expectoration of foul-smelling bloody sputum, chest fullness, and back distension following anger. This was constrained Fire, requiring dispersion. Zisu, Gange (Puerariae Radix), Jiegeng (Platycodonis Radix), Qianhu, Zhike, Banxia, Xingren, Wuweizi, Baishao, Gancao, Yiyiren (Coicis Semen), and Shengjiang (Fresh Ginger) were prescribed. Cure was achieved after one dose.

A patient with internal injury suffered severe knee pain. This indicated Blood deficiency preventing Yang Qi from reaching the lower limbs. Siwu Tang (Four Substances Decoction) was taken with Hezhong Wan (Harmonize the Middle Pill). As Yuan Qi circulated and Blood warmed, pain ceased. Ten days later, diarrhea, fever, headache, and cough appeared. Internal injuries often manifest as Cold below and Heat above, due to constrained Fire scattering upward and Cold descending. Buzhong Yiqi Tang with Fuzi was used to warm Yang Qi and scatter Fire pathogens. Recovery occurred after two doses.