Expelling wind and relieving spasm, also known as relieving wind and relieving spasm, is one of the important treatments for asthma, which is a method for treating lung and symptoms. The author analyzes the origin of the method of dispelling wind and relieving spasm in the treatment of asthma, with the aim of promoting the development of the theory of dispelling wind and relieving spasm in the treatment of asthma in TCM. Fan Changzheng, Department of Respiratory Medicine, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, China1 Basic meaning of the method of dispelling wind and relieving spasm Dispelling means “getting rid of”, dispelling wind is to get rid of external evil, so that the lung qi can be opened up; relieving also means “eliminating”, relieving spasm is to release the contracture of the trachea, so that the lung can be opened up. The wind is the first of the six evil spirits, “good at moving and changing”, with the characteristics of light, rising and dispersing, upward and outward, and opening and venting, and its active nature is the longest of all diseases. Su Wen – Tai Yin Yang Ming Lun said: “Therefore, those who are injured by wind will be affected by it first”. Su Wen – Yin Yang Ying Xiang Da Lun said: “Wind is active when it wins”. The “clinical guide to medical cases” said: “cover the six qi, but the wind can be full five qi. Such as both cold is said to wind cold, both summer is summer wind, …, it is said that the length of the hundred diseases.” Diseases caused by wind have the characteristics of wandering, unpredictable and rapid onset; asthma has the characteristics of occasional onset, occasional cessation and recurrence, which are consistent with the characteristics of diseases caused by wind. The theoretical origin of the method of dispelling wind and relieving spasm is that the main factor in the development of asthma is “wind”, which is the pathological basis for the dispelling of wind and relieving spasm. Asthma attacks are consistent with the characteristics of wind, with many sudden onset and stopping, and repeated attacks. The Su Wen – Wind Theory says: “Wind is good at moving and changing”; the Nei Jing says: “Those who are injured by wind will be affected by it first.” Nei Jing – Yu Ji Zhen Zang Lun” cloud: “Therefore, the wind, the long of all diseases. Now the wind and cold guest injury in the human … to treat, the disease into the lung, called lung paralysis, cough on the gas.” Chinese medicine believes that “wind” includes certain allergic factors, such as inhalation of pollen, smoke and dust, odorous gases, etc., which can affect the propagation of the lung, resulting in the coagulation of fluid, phlegm and turbidity, which disturbs the airway and causes spasm of the airway smooth muscle, leading to asthma. Therefore, Chao Yuanfang of the Sui Dynasty said, “If the evil is strong in the lung, the lung becomes distended, the lung becomes unfavorable, and the airway becomes astringent, so that the gas is rebellious and the breath is inaccessible”.3 Establishment of the dominance of the method of dispelling wind and relieving spasm in the treatment of asthma
As a major treatment for asthma, the method of dispelling wind and relieving spasm has been continuously enriched and improved by successive generations of physicians. The main cause of asthma is phlegm, so it is appropriate to use the method of vomiting. There are also deficiencies that cannot be vomited. The treatment of roaring must be thin in taste, and is mainly concerned with phlegm. It is necessary to use a big vomit, and the vomit medicine should be more sweet, not all cool medicine, and must bring the table to disperse.” Ming Li {“Introduction to Medicine: Roaring”) says: “It is necessary to bring the table with water cold” and “all roaring must avoid dry medicine and should not be purely cold, but must always bring the table”. Ming Liu Mo, “The Hundred Questions of Treatment”: “Where wind and cold are first felt, the disease is in the lung and the evil is in the surface. Lung orifice for wind-cold phlegm accumulation closed suppression, and there is through, then the snot and tears unclear nose breath unfavorable, wheezing and coughing, two inches of the pulse must float tight, or floating slippery. First, it is appropriate to disperse the medicine to treat it urgently. This is the beginning of the standard disease with surplus.” Qing Dynasty: Jiang Baosu, “The Medical Case of Qingshai”: “Asthma repeatedly occurs, when the onset of the wind to disperse the main.” Qing Lin Qin, “The treatment of asthma”: “In short, when asthma starts, the main thing is to disperse the evil; when asthma is fixed, the main thing is to support it.” Shen Jin’ao also believes: “The treatment of croup needs to be dispersed.” 4 The treatment of asthma with the method of dispelling wind and relieving spasm has undergone practical verification and deepening of understanding
The effectiveness of dispelling wind and relieving spasm in the treatment of asthma has been verified in the clinical practice of medical practitioners over the ages. In the Jin Kui Yao Yao, it is said that “for cough with upper air and watery chicken sound in the throat, shoot dry ephedra soup is the mainstay.” The formula is based on Ephedra as the ruler, treating wind as the mainstay, supplemented by almonds, half-xia, and dong hua to treat phlegm. The “Classical evidence of treatment” cloud: “The lung is the master of qi… If the lift and lower of the lung is out of order, the asthma will continue”, indicating that the treatment of asthma should be based on the regulation of qi; Zhu Danxi believes that “those who are good at treating phlegm, do not treat phlegm but qi.” The treatment of qi includes the treatment method of dispelling wind and dispersing external evil; “Wenzhi Zhuanzhi” says: “Treating the upper jiao like a feather is not light but not lifting.” It contains the idea of dispelling wind and relieving spasm, and is commonly used to dispel wind, relieve spasm, and calm asthma, to dissolve phlegm and open the ligaments, and to dispel wind and relieve spasm with cicada, and to lightly clear the cough; “Introduction to Medicine – Cough” says: “When the wind rides on the lung, the nose is stuffy, the voice is heavy, the mouth is dry and itchy, and the words are coughing before the end.” The treatment should be to dredge the wind to promote the lung, relieve the spasm and stop the cough; Qin Jingming’s “The Cause of the Disease: Croup” summarizes the treatment of croup: “If the body is feverish, there is a cold outside, so first relieve the surface, Qian Hu Su Zi drink, Fang Feng Di Bai San, together with the medicine to resolve phlegm…”. Asthma is a symptom that mostly occurs in spring and winter, with obvious seasonality; before the attack there are mostly aura symptoms such as itchy nose, itchy eyes, sneezing, runny nose and cough; the onset is rapid, stopping at times, with repeated attacks; the characteristics of phlegm and shortness of breath during the attack are very similar to those of wind. “Wind is the key pathological factor in asthma, and the contracture of the airway, unfavorable lung ducts, and phlegm congestion and phlegm sound are the pathological results of wind attacking the body. When wind attacks the lung, the lung loses its ability to promote and control, and the fluid accumulates as phlegm. As stated in the “Disease Causes and Treatments”: “The cause of wind and phlegm is the external wind evil, which attacks the muscular surface and binds the fire of its internal depression, which cannot be released, and the external evil spreads to the internal, internal and external fumigation, then the evidence of wind and phlegm is made”. Phlegm as a secondary pathogenic factors, and can impede the lung’s propagation, the lift of Qi, by dispelling wind and relieving spasm, so that the wind dissipates, phlegm stagnation dispersed, the airway is flat, the veins and collaterals are open, the cardinal machine, restore the propagation of the lung function, then the air flow is smooth, and asthma since the calm. In conclusion, the Chinese medical literature is rich in records on the treatment of asthma by the method of dispelling wind and relieving spasm, and a series of discussions on the concept and clinical application of the method of dispelling wind and relieving spasm have been made by successive generations of doctors, which have laid the foundation for an in-depth understanding of the method of dispelling wind and relieving spasm. Therefore, the method of dispelling wind and relieving spasm is based on a comprehensive understanding of the etiological and pathological characteristics of asthma, and is consistent with the essential characteristics of asthma.