Definition

A paroxysmal condition marked by dyspnoea and rale.

Causes and Pathological Mechanisms

Endogenous Evils:

• The root of asthma – accumulation and retention of Phlegm in the Lung
• Cold Phlegm: frequent and repetitive Wind Cold attack and excessive intake of cold and raw food impair Lung Qi causing Phlegm formation; long-term illnesses cause Lung Qi weakness and the formation of Phlegm.
• Hot Phlegm: excessive intake of spicy and greasy food fermented into Heat and Phlegm; Cold Phlegm transforms into Hot Phlegm; long-term illnesses cause Lung Yin Deficiency or constitutionally Excessive Yang result in Hot Phlegm formation.
• Lung, Spleen and Kidney Deficiencies – Weakened Genuine Qi and formation of Phlegm.

Exogenous Evils:

• Invasion of exogenous evils: sudden change of climate/weather (Wind, Cold, Summer Heat, Dampness and Dryness, etc); inhalation of pollens, smoke, dust and other irritating smells;
• Improper Diet: addiction to particular food; excessive intake of greasy food, sweets and sea food; red meat; nuts etc.
• Emotions: drastic change of emotions
• Overwork and stress

Patterns

Lung Cold

• Symptoms: Breathing difficulty and wheezing with white phlegm, choking sensation in chest and hypochondria, slight cough, grey and blue complexion, no thirst for drink or prefer hot drink, predisposed by cold, aversion to cold, cold limbs, headache and fever.
• Tongue: White and moist tongue coating
• Pulse: Wiry and Tight pulse or Floating and Tight
• Treatment strategy: Warm lung and dispel cold, resolve phlegm and stop asthma
• Formula: She Gan Ma Huang Tang and Xiao Qing Long Tang

Lung Heat

• Symptoms: Breathing difficulty and wheezing, coarse respiration, roaring rale, frequent cough, chest and hypochondriac distension, restlessness, yellow or thick white phlegm with difficulty in expectoration, perspiration, thirst for cold drink, flushed face, bitter mouth, no aversion to cold, fever and headache.
• Tongue: Red tongue with yellow and greasy coating
• Pulse: Slippery and Rapid pulse or Wiry and Slippery
• Treatment strategy: Facilitate lung function and clear heat, removing phlegm and stop asthma
• Formula: Ding Chuan Tang and Yue Bi Jia Ban Xia Tang

Lung Qi Deficiency

• Symptoms: Aversion to wind, spontaneous perspiration, susceptible to cold, Asthma predisposed by climate change, stuffy nose with clear rhinorrhea, short of breath, low voice, faint wheezing with clear and white phlegm and a pale complexion.
• Tongue: Pale tongue with thin white coating
• Pulse: Thready and Weak or Large and Weak
• Treatment strategy: Tonify lung Qi, reinforce wei and the exterior
• Formula: Yu Ping Feng San

Spleen Qi Deficinecy

• Symptoms: Poor appetite, epigastrium distension, loose faeces, diarrhoea especially after intake of greasy food. Asthma predisposed by improper diet, abundant amount of phlegm, short of breath and lassitude.
• Tongue: Pale tongue with white and moist or greasy coating
• Pulse: Thready and Weak
• Treatment strategy: Strengthening spleen and resolve phlegm
• Formula: Liu Jun Zi Tang

Kidney Qi Deficinecy

• Symptoms: Short of breath aggravated by slight exertion, difficulties in inhaling, palpitation, dizziness, tinnitus, weak and achy lower back and knees, weariness and lassitude. Asthma predisposed by overstrain, overwork and stress. Yang Deficiency: Aversion to cold, cold limbs, spontaneous perspiration, pale complexion, bulgy pale tongue, deep and thready pulse. Yin Deficiency: vexation, flushed cheeks and sticky sweat.
• Tongue: Red tongue with little fluid
• Pulse: Thready and Rapid
• Treatment strategy: Tonify kidney to receive Qi
• Formula: Jing Gui Shen Qi Wan or Qi Wei Du Qi Wan