bubble_chart Concept

Sneezing, commonly known as "da penti," is described in Suwen Xuanji Yuanbingshi as: "A sneeze is the sound made when air is expelled from the nose due to itching." Lingshu．Kouwen states: "When yang qi is harmonious and beneficial, it fills the heart and exits through the nose, hence causing a sneeze." This indicates that sneezing is a manifestation of the body's yang qi being invigorated to resist evil. Frequent sneezing accompanied by other discomforting symptoms is a sign of illness. However, sneezes caused by stimuli such as foreign objects or irritating gases, or occasional one or two sneezes, are not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Invasion of the Lung by External Pathogens︰Its clinical manifestations include sneezing, possibly accompanied by nasal congestion and runny nose, or cough and panting, fever and chills, headache, body fatigue, floating pulse, and other symptoms. This syndrome is mostly caused by wind evil invading the lungs, leading to impaired lung function and nasal obstruction. The invasion of wind evil into the lungs can vary in terms of cold or heat predominance. In cases with cold predominance, the phlegm and nasal discharge are clear and thin, there is no thirst, aversion to cold is severe, and fever is mild. In cases with heat predominance, the phlegm and nasal discharge are yellow and thick, there is thirst, fever is severe, and aversion to cold is mild. For wind evil invading the lungs, treatment should focus on dispersion. For cold predominance, disperse wind-cold, ventilate the lungs, and release the exterior. Fistular Onion Stalk, Fermented Soybean Decoction can be selected and modified with Dahurian Angelica and Patchouli for treatment. For heat predominance, disperse wind and clear heat, ventilate the lungs, and release the exterior. Modified Lonicera and Forsythia Powder can be chosen.
2. Lung Qi Deficiency︰The clinical manifestations include sneezing, nasal itching, fatigue and lack of strength, shortness of breath with a weak voice, spontaneous sweating, a pale tongue with thin white coating, and a weak pulse. This syndrome is caused by deficiency of lung qi, resulting in the nose failing to receive nourishment and nasal obstruction. Therefore, in addition to sneezing, symptoms such as fatigue and lack of strength, shortness of breath with a weak voice, spontaneous sweating, and a weak pulse are also observed. The treatment should aim to tonify the lung and consolidate the exterior, and the prescription selected is Jade Screen Powder with modifications.

The symptom of sneezing first requires differentiation of whether there is an exterior pattern. If there is an exterior pattern, it is caused by the lungs and should be treated by releasing the exterior pathogens; if there is no exterior pattern but the sneezing recurs frequently, it is mostly due to lung qi deficiency and should be treated primarily by tonifying the lungs and replenishing qi. Those with lung qi deficiency are prone to invasion by wind pathogens, so the two aforementioned symptoms and signs may also appear together, and treatment should differentiate between the primary and secondary, root and branch, urgency and severity.

bubble_chart Documentation

1. Suwen-Liuyuan Zhengji Da Lun: "Yangming causes sneezing and runny nose."
2. Suwen-Zhizhenyao Da Lun: "When Shaoyin returns, internal heat arises, leading to irritability, sneezing, and runny nose."
3. "Essentials of Clinical Practice in Traditional Chinese Medicine": "In cases of chronic illness with yang deficiency, sudden sneezing indicates the recovery of yang qi, suggesting an improving trend, as mentioned in Neijing—'when yang emerges from yin, sneezing occurs.'"