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Xiao Chuan

“Xiao” in Chinese medicine indicates a wheezing sound which may resemble that of whistling, snoring, or sawing. “Chuan” means “to pant” in Chinese. This syndrome includes difficult or labored breath, shortness of breath, breathing with an open mouth, lifting of the shoulders while breathing, and inability to lie down. “Xiao” and “Chuan” are two different diseases, but in clinic they often manifest simultaneously, so we treat them as one condition. It often presents as bronchial asthma, asthmatic bronchitis, pneumonia, bronchitis, emphysema or cardiac asthma.

Excess type: acute onset, deep and long breath, relieved by exhaling, harsh and loud volume, accompanied with a loud cough with phlegm.

Differentiation

Symptoms

Formula

E x c e s s	wind cold invading the Lungs	chills and fever without sweating; wheezing or breathlessness, cough with thin white sputum, a feeling of oppression of the chest, headache, runny nose, a floating and tight pulse	Ma Huang Tang
	exterior cold with heat in the Lung, or wind heat in the Lung	wheezing or breathlessness, coughing, labored breathing, fever, thirst, hot sensation in the chest, maybe with slight chills; red tongue with thin yellow coating; rapid and forceful, or slightly floating pulse	Ma Xing Shi Gan Tang
	excess heat accumulation in the Lung	high fever with profuse sweating, labored breathing, severe thirst, irritability, red face, rapid and forceful pulse	Bai Hu Tang
	phlegm in the Lung	breathlessness, difficulty in exhaling, heavy and full sensation in the chest, cough with profuse thin white sputum, nausea or vomiting, a white thick tongue coating, slippery pulse	Er Chen Tang
	wind cold in the exterior with phlegm heat in the interior	wheezing with loud sound, breathlessness; coughing with copious, thick, yellow sputum; labored breathing, may be accompanied by chills and fever; a red tongue with a yellow greasy coating, slippery and rapid pulse	Ding Chuan Tang
	dry phlegm in the Lung	wheezing, dry and sore throat, cough with deep-seated sputum that is difficult to expectorate, dry lips and mouth, a dry thick tongue coating, slippery pulse	Bei Mu Gua Lou San
	Liver attacking the Lung	wheezing or breathlessness which is induced or aggravated by emotional stress, a sensation of fullness or distention in the chest and hypochondriac region, wiry pulse	Si Ni San, or Xiao Chai Hu Tang, modified

Xiao Chuan, cont.

Deficiency type: chronic onset; short, shallow and difficult breathing; relieved by inhalation; low and weak volume, induced or worsened by exertion.

Differentiation

Symptoms

Formula

D e f	Lung Qi deficiency		chronic wheezing, short and shallow breath which is induced by exertion; spontaneous sweating, aversion to wind, recurrent colds, pale tongue with deficient pulse	Si Jun Zi Tang with Yu Ping Feng San
	Lung Qi and Yin deficiency		wheezing, shortness of breath which is induced by exertion, spontaneous sweating or night sweating, thirst, dry mouth, malar flush; pink and dry tongue with scanty coating; deficiency pulse	Sheng Mai Yin
	Kidney Yang deficiency		chronic wheezing and shortness of breath, worse with exertion, exhalation stronger than inhalation; shallow, difficult or irregular respiration; possibly so shallow as to become difficult to hear or feel; edema, cold limbs, pale tongue with moist white or black coating, deep weak pulse	Jin Gui Shen Qi Wan or Si Ni Tang
Excess with deficiency		Kidney Qi deficiency with phlegm	wheezing, shortness of breath which is more labored during the inhalation than the exhalation, coughing with watery, copious sputum, a stifling sensation in the chest, low back and knee weakness, deep and weak pulse	Su Zi Jiang Qi Tang
Excess with deficiency		Kidney Yang deficiency with water accumulation	difficult breathing, especially when lying down, worse at night or during the winter, copious and water sputum, palpitations, a feeling of oppression in the chest, aversion to cold, edema, cold limbs; pale, swollen moist tongue; deep, weak, and slow pulse	Zhen Wu Tang or Si Ni Tang