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General Overview
The *Bingji Shi Yao* (Essentials of Pathogenesis) states: When the Lung is diseased, coughing occurs, characterized by phlegm and sound, resulting from Lung Qi injury stirring up Spleen dampness. If there is only sound without phlegm, it is termed "Ke" (Cough), indicating Lung Qi injury and lack of clear descending function. If there is phlegm without sound, it is termed "Sou" (Phlegm-rattling), caused by Spleen dampness generating phlegm. Although both belong to Lung diseases, they are differentiated into Lung Cold and Lung Heat, as well as Food Stagnation and Wind-Cold. Physicians must distinguish them carefully.

Lung Cold Cough
Cold-type cough arises because the Lung is inherently deficient and prone to consuming cold/raw foods, leading to Cold Evil injuring the Lung and triggering cough. Symptoms include a pale complexion, abundant phlegm, and thin, clear nasal discharge. Initially, Shenghui Jupi San (Holy Benefit Tangerina Peel Powder) should be used as the primary formula. If the cough persists for a long time, Bufe Ejiao San (Tonify Lung Donkey-Hide Gelatin Powder) is required to regulate Qi, resolve phlegm, and calm the cough.

Lung Heat Cough
Fire-type cough is caused by Fire-Heat harassing the Metal of the Lung, leading to frequent coughing, flushed face, dry throat, yellow and foul-smelling sputum that is thick and sticky. For those with loose stools, Jiawei Xiebai San (Modified Draining White Powder) is the main treatment. For those with hard stools, Jiawei Liangge San (Modified Cooling Diaphragm Decoction) is decocted and taken; this clears heat and purifies Qi, stopping the cough naturally.

Food Stagnation Cough
This condition results from food stagnation in children generating phlegm, with Heat steaming upward, causing rapid Lung Qi and phlegm obstruction, leading to frequent coughing. If stools are loose, Qumai Erchen Tang (Qu Mai Erchen Decoction) is used. If stools are dry, Sutting Guntan Wan (Suting Rolling Phlegm Pill) is used to purge downward.

Wind-Cold Cough
When children expose themselves to cold by removing clothes, Wind-Cold invades, affecting the Lung first. This causes Qi to rebel upward, blocking the throat and inducing cough. Symptoms include sneezing, runny nose, nasal congestion with heavy voice, and excessive salivary phlegm. First, disperse and release Wind-Evil using Shenru Yin (Ginseng and Perilla Drink). Subsequently, clear phlegm and cough using Jinfei Tang (Golden Boiling Decoction). If Cold Evil is obstructive, dispel the Cold using Jiawei Huagai San (Modified Huagai Powder); once Wind-Evil is resolved and the Qi pathway is unobstructed, the cough heals.

General Overview on Asthma/Wheezing
Asthma/Wheezing (Chuan Zheng) is characterized by急促 breathing and outward signs such as raising shoulders and protruding abdomen. Wheezing (Xiao) is characterized by sounds in the throat. However, the origins of disease vary. In Excess-Heat cases, there is coarse breathing, chest fullness, thick phlegm, constipation, and wheezing. In Deficiency-Cold cases, there is weak Qi, faint breath, inability to sustain respiration, and wheezing. There are also cases of asthma due to Wind-Cold obstruction, phlegm-fluid rebellion, and Ma Pi Feng (Horse Spleen Wind), which is the most critical emergency. Physicians must treat these distinctly and clearly.

Fire-Heat Asthma/Wheezing
When Fire Evil attacks Lung Metal causing wheezing, symptoms include dry mouth and tongue, thirst, flushed face, and red lips. If caused by Lung Heat, Liangge San (Cooling Diaphragm Powder) is the main treatment. If caused by Stomach Heat, Baihu Tang (White Tiger Decoction) clears it. If Heart Fire attacks Lung Metal, Daochi San (Guiding Red Powder) is appropriate. If Kidney Deficiency Fire scorches Lung Metal, Zhibo Dihuang Tang (Anemarrhena and Rehmannia Decoction) is the most effective treatment.

Lung Deficiency Asthma/Wheezing
In Deficiency Asthma/Wheezing, Qi is weak and voice is short and rough. Jiegu Huangqi Tang (Jiegu Astragalus Decoction) treats this most swiftly. If deficiency is complicated by phlegm causing panting, Baihe Gujin Tang (Lily Preserving Metal Decoction) is used. If deficiency is complicated by Heat, Ben Shi Fang Huangqi Tang (Ben Shi Formula Astragalus Decoction) is decocted and taken.

Wind-Cold Asthma/Wheezing
The Lung governs skin and hair. Once invaded by Wind-Cold, internal Lung Qi is injured, causing Qi rebellion and failure to descend, leading to急促 breathing, exterior heat, and anhidrosis. Huagai San (Huagai Powder) should be used to induce sweating and dissipate the pathogen. If Lung Qi is originally deficient and further injured by Wind-Evil, Zisu Yin (Perilla Drink) tonifies and dissipates. If Lung is deficient but free from external Wind-Evil and internal phlegm-fluid obstruction, with only Qi rebellion and急促 breathing, Jiajian Suzi Jiangqi Tang (Modified Perilla Seed Descending Qi Decoction) descends the rebellious Qi, and the wheezing resolves spontaneously.

Phlegm-Fluid Asthma/Wheezing
When children have excessive phlegm-fluids causing Qi rebellion and wheezing, the sound resembles tidal waves or sawing wood. Urgent attack on phlegm-fluids is needed using Sutong Guntan Wan (Sutong Rolling Phlegm Pill). If retained fluids cause急促 breathing and inability to lie flat, fluids must be drained and Qi descended using Sutong Wan (Perilla and Thladiantha Pill).

Ma Pi Feng (Horse Spleen Wind)
Sudden severe wheezing in children is commonly known as Ma Pi Feng. It occurs when Cold Evil lodges in Feishu (BL13), transforms into Heat, and blocks the Lung Meridian. Symptoms include elevated chest,急促 breathing, Lung distension and fullness, flaring costal margins creating depressions, alar flaring, and confused spirit. Upon initial encounter, administer Wuhu Tang (Five Tigers Decoction) urgently, followed by Yiniang Jin (One Finger Gold) to purge. If Qi opens, the effect is most potent. If infants under 100 days present this, the prognosis is mostly poor.