Manifestations and Treatment Methods of Cold Asthma During Attacks

Asthma is a stubborn, recurrent, hard-to-treat disease, and it is also easily contracted during infancy and early childhood. When some children reach puberty, their kidney qi gradually becomes sufficient, and with treatment, when vital qi is abundant, there is hope of full recovery. In middle and old age, some people, due to prolonged illness and weakened constitution, and others due to decline of kidney qi, may experience continuous severe attacks and repeated episodes of asthma, which are not easy to cure.

Asthma attacks also progress over time and worsen due to improper treatment and other reasons. If there is rapid breathing with flaring of the nostrils, high chest and rapid breathing, open mouth and raised shoulders, sweating and cold limbs, cyanotic complexion, and restlessness, this belongs to a critical condition and requires prompt emergency rescue. As for how to treat it, Danxi long ago stated that "when not yet, tonify vital qi as the main approach; once, expel pathogenic qi as the priority," with the basic principle of "treat the branch when, treat the root when not."

In terms of etiology and pathology, there are differences between cold asthma (cold-type asthma) and heat asthma, and there are also differences in symptoms. Cold asthma has a wheezing sound like a water chicken, with rapid breathing, panting and qi counterflow, chest and diaphragm fullness and oppression as if blocked, not severe coughing, little sputum that is difficult to expectorate, white and mostly frothy, no thirst or thirst with preference for hot drinks, aversion to cold and fear of cold, easily triggered by cold weather or exposure to cold, dusky complexion, white and slippery tongue coating, and wiry tight or floating tight pulse. The pathogenesis is cold phlegm lurking in the lungs, triggered upon exposure, with phlegm rising and qi blocked, and the lungs failing to diffuse and descend freely.

Treatment should warm the lungs and disperse cold, transform phlegm and calm wheezing. The main formulas may be Mahuang Tang (Ephedra Decoction) or Xiao Qinglong Tang (Minor Green Dragon Decoction) with modifications, in order to warm the lungs and transform fluids, stop wheezing and calm panting. Mahuang Tang places emphasis on directing qi downward and calming wheezing, corresponding to acute attacks in patients with wheezing, coughing, and no obvious exterior signs; Xiao Qinglong Tang with modifications emphasizes releasing the exterior and dispersing cold, and can be used in cases with exterior cold and interior fluids, and with more severe cold signs. Regarding modifications, if exterior cold is obvious with chills, fever, and body pain, add Guizhi (cinnamon twig) and Shengjiang (fresh ginger); if phlegm surges and qi counterflows, making it impossible to lie flat, add Tinglizi (Semen Lepidii) and Suzi (Perilla seed) to purge the lungs and direct qi downward, and appropriately add Xingren (apricot seed), Baiqian (Cynanchum glaucescens), Jupi (tangerine peel), and others to transform phlegm and regulate qi, and so on.