Cough with upward qi flow, this is lung distension, where the person wheezes, eyes bulge as if about to pop out, and the pulse is floating and large, Spleen-Qi Effusing plus Pinellia Decoction is prescribed.

bubble_chart Note

Cough with upward qi flow, this is lung distension, characterized by shoulder-heaving wheezing and protruding eyes as if about to pop out. Now, with a floating and large pulse, it is known that floating indicates wind, while large indicates excess. Therefore, Spleen-Qi Effusing plus Pinellia Decoction is prescribed to externally disperse the skin and hair and internally descend rebellious qi.

bubble_chart Collected Annotations

• Zhao Liang said: Cough with upward qi flow indicates that the qi is surging and not descending; the continuous coughing indicates that it is all caused by lung distension. Pathogens entering the lungs cause qi stagnation, and qi stagnation inevitably leads to wheezing. Only when wheezing is extreme do the eyes bulge as if about to pop out, which is the extreme manifestation of lung distension and wheezing. A floating pulse indicates pathogens. Combined with largeness, it signifies pathogenic excess, which harms the lungs without end. Therefore, it is necessary to use acrid and hot herbs to expel pathogens from the exterior, supplemented with sweet and cold herbs to dissolve long-accumulated pathogens like melting ice—how could this not be swift? However, how can long-retained fluids be discharged? Thus, Pinellia is specifically added to Spleen-Qi Effusing Decoction, which is a definitive method.
• You Yi said: External pathogens and internal fluids congest the lungs, causing distension, wheezing, and cough with upward qi flow. Spleen-Qi Effusing Decoction excels at dispersing pathogens but is less effective at eliminating fluids, so Pinellia is added to supplement its shortcomings. Minor Bluegreen Dragon Decoction is not used because the pulse is floating and large, indicating yang heat, making acrid and cold herbs suitable, not acrid and hot ones. Eyes bulging as if about to pop out is due to qi congestion.

bubble_chart Formula

Spleen-Qi Effusing plus Pinellia Decoction Recipe
Ephedra 6 liang, Gypsum half a catty, Fresh Ginger Rhizome 3 liang, Chinese Date 15 pieces, Liquorice Root 2 liang, Pinellia half a catty
Boil the six ingredients in 6 sheng of water, first boiling Ephedra to remove the foam, then adding the other herbs. Boil until 3 sheng remain, and divide into three warm doses.

bubble_chart Collected Explanations

• Li Wen said: The spleen transports water and grains, primarily responsible for circulating body fluids, humble as a servant. The name "Spleen-Qi Effusing" refers to the action of mobilizing spleen qi and promoting the flow of body fluids. Now, to treat lung distension, Ephedra disperses exterior pathogens, Gypsum clears internal heat, Liquorice Root and Chinese Date nourish the righteous and moderate the pathogenic, while Pinellia and Fresh Ginger Rhizome disperse rebellion and lower qi.