Library

[General Principle]
Xiao (Wheezing) is a condition of Tan Chuan (Phlegm-Panting) that has persisted for a long time and frequently recurs. It occurs because there is Qi stagnation and obstruction internally, non-seasonal pathogenic factors externally, and tenacious, fixed Phlegm in the diaphragm. These three factors combine to block and reject the airway, causing sound as Qi strikes against it, thereby developing into Xiao disease. (From *Zhengzhi Huibu*)

[Etiology (Internal Factors)]
The skin and hair are the exterior correspondence of the Lung. (From *Neijing*) The Lung meridian harbors latent Fire pathogen, and the pores are often loose, making it easy for Wind pathogen to enter. This is termed "Cold Enveloping Heat". (From *Yuce*) This arises from Phlegm-Fire郁结 (stagnating) internally and Cold-Wind binding externally; or due to sitting and lying in cold-dampness, or excessive consumption of sour and salty flavors, or steaming by accumulated heat. The root of the disease becomes deep-seated and difficult to eradicate immediately. (Li Zhongzi, courtesy name Jiebin)

[External Manifestations]
Xiao (Wheezing) is similar to Chuan (Panting), but unlike Panting which involves much open-mouth exhalation, Wheezing is characterized by a "ya-xia" sound. "Xia" refers to an open mouth, and "Ya" refers to a closed mouth. Whether the mouth is open or closed, there is always phlegm-rattling sound. The combination of the sounds "Xia" and "Ya" forms the character "Xiao" (Wheezing), because Phlegm knots in the throat and strikes against the Qi. (From *Jingyue Quanshu*)

[Differentiation between Xiao and Chuan]
Xiao (Wheezing) refers to the sound, while Chuan (Panting) refers to the breathing effort. Furthermore, if panting is rapid and accompanied by a sound like a water hen in the throat, it is called Xiao. If breathing is rapid, continuous, and unable to pause, it is called Chuan. (From *Yixue Zhengzhuan*)

[Therapeutic Principles]
Some cases require warming and dispersing Lung Cold, some require venting and draining Diaphragm Heat, some require inducing sweating to expel pathogens, and some require inducing vomiting to expel Phlegm-Saliva. (From *Zhengzhi Huibu*) Avoid wind and cold, and moderate rich and strong flavors. Cold-natured formulas are contraindicated, lest the Wind pathogen be difficult to resolve. Hot-natured formulas are contrainddicated, lest Phlegm-Fire rise easily. Regulating Qi and dispersing Wind, without forgetting to address the root cause, is the proper approach. (From *Leijing*)

[Differentiation by Deficiency and Excess]
Excess pathogens causing Xiao should indeed be dispersed and expelled. However, there are also patients with weak constitutions and thin bodies, or those who have undergone dispersing treatments and repeatedly used attacking and purging methods, resulting in a deficient pulse and emaciated form. Treatment should involve tonification and regulation, combined with clearing the Lung and promoting Qi flow. (From *Zhengzhi Huibu*)

[Differentiation by Lung and Spleen]
Although Xiao is a Lung disease, Lung Metal considers Spleen Earth as its mother. Therefore, turbid Phlegm in the Lung originates from Damp-Heat in the Spleen. If the Spleen Qi is turbid, it transports turbid fluids upward, which all transform into thick Phlegm. How can the Lung remain pure and clear? Thus, the method of clearing the Spleen is even more important than clearing the Lung. (From *Zhengzhi Huibu*)

[Medication]
The primary formula is Er Chen Tang (Two-Aged Decoction), added with Qian Hu (Peucedani Radix), Zi Su (Perillae Folium), Zhi Ke (Aurantii Fructus), Jie Geng (Platycodonis Radix), Xing Ren (Armeniacae Semen Amarum), and Sang Pi (Mori Cortex). For warming dispersion, use Xi Xin (Asari Radix et Rhizoma); for clearing fire, use Shi Gao (Gypsum Fibrosum); for dispersing, add Ma Huang (Ephedrae Herba); for inducing vomiting, use Gua Di (Cucumeris Fructus); for inducing sweating, use Hua Gai San (Flower Canopy Powder).
For Xiao occurring in early winter, there are two patterns. One belongs to Cold inside and out; this is Li Dongyuan's Shen Su Wen Fei Tang (Ginseng and Perilla Warming Lung Decoction), a quick method for expelling Cold-Phlegm. The other belongs to Cold Enveloping Heat; this is Zhang Zhongjing's Yue Bi Ban Xia Tang (Yuebi Pinellia Decoction), a method of dispersion. Ancient practitioners suggested using Da Cheng Qi Tang (Major Order the Qi Decoction) to purge accumulated Heat before the cold season (August-September). By winter, when it is cold, there is no Heat to envelop, so Xiao does not occur. However, this is only applicable to robust individuals in the North. For those with weak constitutions who have been repeatedly purged and now present with a deficient pulse and insufficiency, Liu Jun Zi Tang (Six Gentlemen Decoction) added with Sang Pi (Mori Cortex) and Jie Geng (Platycodonis Radix) should be used.

[Selected Formulas for Xiao Disease]
Er Chen Tang (See Tan Syndrome section)
Shen Su Wen Fei Tang (See Chuan Syndrome section)
Yue Bi Ban Xia Tang (See Cough section)
Wu Hu Tang (Five Tiger Decoction): As effective as magic for Phlegm-Xiao. However, it is a harsh purgative and should not be taken for long. Contraindicated for deficient persons with spontaneous sweating.
Ingredients: Ma Huang (Ephedrae Herba), Xing Ren (Armeniacae Semen Amarum), Shi Gao (Gypsum Fibrosum), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sang Pi (Mori Cortex), Xi Xin (Asari Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens).

Bai Guo Tang (Ginkgo Nut Decoction): Treats asthma with abundant phlegm.
Ingredients: Ban Xia (Pinelliae Rhizoma), Ma Huang (Ephedrae Herba), Kuan Dong Hua (Farfarae Flos), Sang Pi (Mori Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma) (3 qian each), Bai Guo (Ginkgo Semen) (21 pieces), Huang Qin (Scutellariae Radix), Xing Ren (Armeniacae Semen Amarum) (1.5 qian each), Su Zi (Perillae Fructus) (2 qian), Yu Mi Qiao (Papaveris Pericarpium) (1 qian).
Usage: Decoct in water, divide into two doses.

Da Cheng Qi Tang (Major Order the Qi Decoction)
Ingredients: Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas), Zhi Shi (Aurantii Fructus Immaturus), Hou Po (Magnoliae Officinalis Cortex) (equal parts).
Usage: Decoct in water, add Mang Xiao, boil briefly, strain, and take.

[Quick Remedy Formulas]
Use equal parts of Luo Bo Zhi (Radish Juice), Sheng Li Zhi (Pear Juice), Ou Zhi (Lotus Root Juice), and Jiang Zhi (Ginger Juice). Add wine, cook thoroughly, bury in the earth to remove fire toxicity, and take at any time.
For pediatric Xiao, scrape Hai Piao Xiao (Sepiae Endoconcha) into fine powder, dip in sugar, and consume. Immediate cure. Repeat if symptoms recur.
For stubborn Phlegm asthma, take one Qing Pi (Citri Reticulatae Pericarpium Viride), split open, remove the pulp, insert one Jiang Zi (Crotonis Fructus), tie tightly with hemp thread, burn over fire until smoke disappears, retain the charred nature, grind into powder, and wash down with Ginger Juice mixed with wine.
For Wind-Phlegm causing Xiao, slightly crack an eggshell, soak in urine for three to four nights, then boil and eat.

[Secret Formula for Treating Xiao]
Take Yi Qian Jian (Light Mercury/Calomel, wrapped in silk), along with Chuan Huang Lian (Coptidis Rhizoma) 3 qian. Decoct in water until dry. Then add Shi Zhong Huang (Stalactitum) 3 qian, E'er Bu Shi Cao (Herba Siegesbeckiae) 3 qian, and Jiangxi Dan Dou Chi (Sojae Semem Praeparatum) 1 liang. Grind into pills the size of mung beans. Take 5 pills per dose with warm plain boiled water.