children and the stagnation in the Middle Burner predisposes the child to retention of Phlegm in
the Upper Burner. It is thus beneficial to relieve stagnation of food with digestive herbs such as
Mai Ya Fructus Hordei vulgaris germinatus, Gu Ya Fructus Oryzae sativae germinatus, Lai Fu
Zi Semen Raphani sativi, Shan Zha Fructus Crataegi, Shen Qu Massa Fermentata Medicinalis
and Ji Nei Jin Endothelium Corneum gigeraiae galli.

Late-onset asthma in adults stands somewhat in between the previous two types in terms of
prognosis: it is easier to treat than allergic asthma, but more difficult than non-allergic
early-onset asthma in children. Late-onset asthma in adults is usually characterized by a
deficiency of Lungs, Spleen, or Kidneys or a combination of these, and retention of Phlegm. The
treatment principle is therefore based on treating the Root (i.e. tonifying the body's Qi) and the
Manifestation simultaneously (i.e. resolving Phlegm and restoring the descending of Lung-Qi).
The treatment will take several months at least. In some cases asthma is caused by Liver-Qi
stagnation or Liver-Fire (from emotional strain) obstructing the descending of Lung-Qi. This
type of asthma is usually easier to treat and is discussed in Chapter 5.

As for prevention, this also differs according to the condition causing wheezing.

Acute bronchitis cannot really be prevented as it is due to an invasion of exterior Wind.

The main way of preventing chronic bronchitis is to avoid the set of circumstances leading to the
vicious circle outlined above. This means that any acute invasion of Wind should never be
underestimated and should be treated promptly, preferably avoiding antibiotics. The patient
should also avoid dairy products and greasy foods which facilitate the formation of Phlegm. He
or she should also regulate their eating habits so that meals are taken at regular times.

As for asthma, preventive measures for allergic asthma will be described in the chapter on
"Asthma" (Chapter 5) and these apply to other types of asthma as well.

Western Differentiation

A wheezing sound is a sign of bronchiolar narrowing by spasm, oedema of the epithelium,
retained mucus, or all three acting together. Wheezes are therefore like musical sounds produced
by the rapid passage of air through a narrowed bronchus.

Wheezes appear in obstructive lung diseases. They usually occur on exhalation but may also
appear on inhalation. The state of bronchiolar narrowing on expiration can be diagnosed by
measuring the maximum volume of air which can be blown out in a second. This is called Forced
Expiratory Volume (FEV) and is a way of assessing the respiratory disability in diseases such as
asthma, emphysema or chronic bronchitis. If a peak-flow meter is not available, a simpler test
can be carried out by asking the patient to blow out a lighted match without pursing the lips. A