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Tu Weisheng stated: "Chuan" (Asthma/Wheezing with shortness of breath) refers to the state of breath; when breathing is rapid, continuous, and cannot be sustained smoothly, it is called Chuan. "Xiao" (Wheezing with sound) refers to the sound; when there is a sound in the throat resembling a sawing noise or the call of a water chicken, it is called Xiao.

Chuan syndrome is mostly deficiency and rarely excess; Xiao syndrome is mostly excess and rarely deficiency. Chuan usually does not accompany Xiao, but Xiao often accompanies Chuan. Although both are related to the Lung, Chuan ultimately has distinctions of deficiency, excess, cold, and heat. For example, after severe or chronic illness, or following prolonged vomiting and diarrhea, when all signs of collapse appear, sudden open-mouthed gasping occurs. This indicates depletion of the Lower Yuan (Kidney essence and Qi), with floating and scattering of True Qi. Since respiration fails to return to its root, imminent collapse is at hand. Rapid application of tonifying methods may save the patient; otherwise, life is lost, and even Ginseng and Deer Antler will be ineffective. If caused by Lung Qi deficiency, Dushen Tang (Single Ginseng Decoction) is suitable. If accompanied by Cold, add Ganjiang (Dried Ginger); if accompanied by Heat, add Mudong (Ophiopogon Tuber). If caused by Kidney Qi deficiency, Ginseng and Deer Antler should be used together. If caused by initial Kidney Yin deficiency leading to unrooted Kidney Yang resulting in Chuan, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) added with Ginseng and Deer Antler is suitable. If accompanied by Cold, add Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root); if accompanied by Heat, add Zhimu (Anemarrhena Rhizome) and Huangbai (Phellodendron Bark). This outlines the general principles for Deficiency Chuan.

Excess-Cold Chuan is either due to Wind-Cold blocking the Lung orifices or due to Fluid Retention rushing up to the Lung. If due to Wind-Cold, it must present with fever and aversion to cold, red lips and flushed face, nasal obstruction, and normal bowel movements. Mahuang Tang (Ephedra Decoction) or Jingfang Gegen Tang (Schizonepeta, Saposhnikovia, and Kudzu Decoction) should be used to release the exterior. If due to Fluid Retention, symptoms worsen upon drinking water, and sleep is impossible due to dyspnea. Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung) and Xiaobanxia Tang (Minor Pinellia Decoction) should be used.

Regarding Heat-type Chuan, the deficiency type was discussed above. The excess type is either due to Food Stagnation or excessive Heat. Accumulated Heat attacks, causing urgent Qi reversal upward; the body is robust without emaciation. Erchen Tang (Two-Aged Decoction) added with Zhike (Bitter Orange Peel), Houpo (Magnolia Bark), Shanzha (Hawthorn Fruit), Shenqu (Medicated Leaven), and Maiya (Germinated Barley Fruit) treats stagnation; Renshen Baihu Tang (Ginseng and White Tiger Decoction) added with Zhimu, Huangbai, Huangqin (Scutellaria Root), and Huanglian (Coptis Rhizome) treats Heat. As for Xiao syndrome, refer to Zhou Mengjue's explanation.

**Dushen Tang (Single Ginseng Decoction)**
Renshen (Ginseng Root)
Use only one herb, Renshen. Determine the dosage strength based on the child's size and constitution. Decoct strongly to extract the juice and administer. If family poverty makes purchase difficult, or remote location makes acquisition hard, Luzhenshen (Pseudostellaria Root from Lu) can be used as a substitute. Although Luzhenshen is weaker than Renshen, large doses can achieve strong effects.

**Zhongjing Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia by Zhang Zhongjing)**
Shengdi (Rehmanniae Radix Preparata) - 1 qian
Yurou (Corni Fructus) - 1 qian
Shanyao (Dioscoreae Rhizoma) - 1 qian
Danpi (Moutan Cortex) - 1 qian
Fuling (Poria) - 1 qian
Zexie (Alismatis Rhizoma) - 1 qian

**Zhongjing Mahuang Tang (Ephedra Decoction by Zhang Zhongjing)** (See previous Shanghan formulas)

**Jingfang Gegen Tang (Schizonepeta, Saposhnikovia, and Kudzu Decoction)**
Gegen (Puerariae Lobatae Radix) - 1 qian
Jingjie (Schizonepetae Spica) - 1 qian
Fangfeng (Saposhnikoviae Radix) - 1 qian
Jiegeng (Platycodonis Radix) - 1 qian
Zhike (Aurantii Fructus Immaturus) - 6 fen
Xingren (Armeniacae Semen Amarum) - 1 qian
Baishao (Paeoniae Radix Alba) - 1 qian
Gancao (Glycyrrhizae Radix et Rhizoma) - 1 qian

**Zhongjing Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung by Zhang Zhongjing)**
Tinglizi (Descurainiae Semen Lepidii Seminis) - 1 qian
Dazao (Jujubae Fructus) - 1 piece
First stir-fry Tinglizi until yellow, crush and grind into powder. Then boil Dazao for several boils, add the Tinglizi powder, decoct together, extract the juice, and administer.

**Erchen Tang (Two-Aged Decoction)** (See previous Ke cough formula)

**Renshen Baihu Tang (Ginseng and White Tiger Decoction)** (See previous Wenbing warm disease formula)

Zhou Mengjue stated: "Neijing" contains descriptions of Chuan but not Xiao. It was not until Han dynasty formulas that Asthma and Wheezing were discussed together. The origins of Chuan are diverse, whereas the origin of Xiao is solely cold-phlegm entering the Lung orifices. The Lung is a delicate organ, possessing a clear and empty nature, intolerant of any obstruction, suspended in the chest. Its orifice faces upward; once an object enters, it cannot exit. Eating fruits and drinking water accumulate into cold-phlegm, which infiltrates internally, becoming the "mother of phlegm." Objects attract similar objects; once phlegm-turbidity surges upward, the Lung orifices become blocked, and respiration becomes chaotic. Chaotic respiration leads to the intermingling of symptoms across the twenty-seven meridians. When triggered by Cold, Cold interacts with Cold, causing phlegm to surge due to Cold. When triggered by Heat, Cold is steamed by Heat, causing phlegm to surge due to steaming. One must wait until extreme oppression occurs, coughing out a small amount of phlegm shaped like fish brain, for the syndrome to heal and the pulse to normalize. Materia Medica teaches that among herbs with fierce properties, only Mahuang (Ephedra Herb) and Pishi (Arsenic Trioxide) can open the gates and劫 (rob/drive out) the phlegm. Mahuang induces sweating; however, in Xiao syndrome, even in midsummer, sweating is not induced. Pishi harms people; however, in Xiao syndrome, even for frail bodies, it does not cause harm. There is a specific disease and a specific medicine, yet they cannot eradicate the root. Mahuang opens the path for cold-phlegm but cannot uproot the nest where phlegm resides. Pishi destroys the followers of phlegm but cannot annihilate the chief phlegm lying in ambush. This is why the condition resolves upon medication but recurs later. I have seen youths suffering from consumption (Lao), coughing blood, emaciated with rapid pulses, showing signs of collapse. Upon inquiry, they had a history of Xiao. While consumption was incurable, treating their Xiao with these two herbs cured several individuals. I have also seen elderly patients with upper Qi rebellion, coughing, wheezing, rapid pulse, insomnia, and extreme exhaustion. Upon inquiry, they had a history of Xiao. While Qi disorders were incurable, treating their Xiao with these two herbs also cured several individuals. "Ancient ice and snow of Yaochi, the Lung holds congealed cold phlegm." This statement is apt.

**Method for Preparing Pishi (Arsenic Trioxide):**
Dry Jiangshi (Sojae Semen Praeparatum / Fermented Soybean) in the sun, grind into powder (1 liang). Mix with Pishi (1 qian). Form pills using rice paste.