bronchospasm rather than obstruction from phlegm and that this was the result
rather than the cause of asthma. Dr Henry Hyde Salter in fact said: "The fact is,
Dr Bree mistook the effect [i.e. phlegm] for the cause".4(111) As far back as 1786
some doctors perceived the allergic nature of asthma even though they could not
explain it fully. Dr William Withering (who pioneered the use of foxglove
extracts for congestive cardiac failure) wrote in 1786 that asthma might be cured
by living in large rooms from which curtains and feather beds had been
removed.5(112)
Two other elements which are not consistent with Phlegm being the main factor
in asthma are the tongue and the pulse. If Phlegm were the main pathological
factor in asthma, then the tongue should be Swollen with a sticky coating and the
pulse Slippery. This is very often not the case. In early-onset asthma, the tongue
is not usually Swollen (it is often Thin) and the pulse not Slippery (it is often
Tight).
Another factor that rules out Phlegm as a pathogenic factor in asthma is the fact
that, in between attacks, an asthmatic person is often quite normal. Indeed, there
are some athletes who are asthmatic. If Phlegm obstructs the Lungs, however,
wheezing and breathlessness are constant and they persist until Phlegm is
completely eliminated. Thus doctor Ye Gui in "Case Reports for Clinical
Practice" (1766) correctly says: "If the pathogenic factor is expelled,
breathlessness [Chuan] stops and will never return ... In wheezing [Xiao], the
pathogenic factor is hidden in the Interior and in the Lungs, it is sometimes active
and sometimes quiescent, and there are frequent episodes over many
years".6(113) This confirms that Phlegm is the main causative factor in
Breathlessness (Chuan): once Phlegm is eliminated, the breathlessness goes
completely. In Wheezing (Xiao), which is closer to asthma, the pathogenic factor
is hidden in the Lungs and it becomes active in bouts causing asthma attacks.
What is the pathogenic factor in asthma then? Basically, it is Wind: not exterior
Wind as such invading the Lungs, nor interior Wind, but a kind of chronic
(exterior) Wind lodged in the bronchi and periodically leading to bronchospasm.
The attacks are elicited by exposure to allergens or cold weather or by emotional
stress. The nature of this Wind as a pathogenic factor in asthma will be expanded
on shortly.
It is also interesting that X-rays have no diagnostic value in asthma. This seems to
confirm that Wind, and not Phlegm, is the main pathogenic factor in asthma.
Wind is a non-substantial pathogenic factor and, as such, it naturally would not
show on an X-ray whereas Phlegm, a substantial pathogenic factor, would.
Of course, in a person with early-onset asthma, after many years the pathology
becomes more complicated and other factors, including Phlegm, may play a role.
This happens under the influence of several aetiological factors such as overwork,
emotional stress, excessive sexual activity and irregular diet, all factors which are