"From Treatise on Cold Damage, Article 276: 'For Taiyin disease with floating pulse, one may induce sweating—Guizhi Tang is appropriate.' This reveals that for Taiyin spleen deficiency with exterior symptoms, we must prioritize supporting the interior deficiency over treating the exterior symptoms. This patient presents with five years of recurrent rhinitis, frequent sneezing, clear watery discharge, aversion to wind, spontaneous sweating, pale tongue with white coating, and floating-weak pulse—this is Taiyang exterior deficiency combined with Taiyin spleen deficiency. The 'five years of recurrence, fatigue, and loose stools' represent the urgent interior deficiency; the 'sneezing and clear discharge' are the less urgent exterior symptoms. Treatment should first strengthen the spleen and warm yang to secure the root (Guizhi Jia Fuzi Tang combined with Lizhong Tang modifications), then lightly diffuse lung qi to treat the branch."

"从《伤寒论》第276条：'太阴病，脉浮者，可发汗，宜桂枝汤。'此揭示太阴脾虚兼表证，当以扶正为主、解表为辅。此患者鼻鼽五年、喷嚏频作、清涕如水、畏风自汗、舌淡苔白、脉浮而弱——此乃太阳表虚、太阴脾虚之证。'五年复发、疲乏便溏'乃脾虚急证，'喷嚏、清涕'为表证缓证。治当先健脾温阳以固其本（桂枝加附子汤合理中汤加减），后轻宣肺气以治其标。"

"From Treatise on the Spleen and Stomach: 'When the spleen and stomach are deficient, the nine orifices become obstructed.' This directly clarifies the causal relationship between allergic rhinitis and spleen-stomach weakness—it is not merely lung wei deficiency, but rather sinking of central qi and failure of clear yang to rise. This case presents with frequent sneezing, clear watery discharge, aversion to wind, and floating pulse—these are the branch (wind evil invading the lung); yet five years of recurrence, fatigue, loose stools, pale tongue with white coating indicate spleen-stomach weakness, earth failing to generate metal, clear yang failing to rise, and wei exterior failing to secure—this is the root. Using the analogy of 'a breached dike with overflowing water': if the dike is breached (spleen deficiency), water evil easily invades; building dikes to prevent floods (diffusing lung and dispelling wind) year after year without repairing the dike foundation will never bring recovery. Bu Zhong Yi Qi Tang uses Astragalus, Ginseng, Atractylodes, and Licorice to supplement the center as sovereign herbs; Cimicifuga and Bupleurum raise clear yang and secure the exterior—when spleen earth is vigorous, lung metal naturally becomes substantial."

"《脾胃论》云：'脾胃一虚，肺气先绝，肺开窍于鼻，故鼻鼽、鼻塞、不闻香臭。'此条直接阐明鼻鼽与脾胃虚弱的因果关系。此证喷嚏频作、清涕如水、畏风、脉浮，乃风邪犯肺之标；然五年反复发作、神疲便溏、舌淡苔白，乃脾胃虚弱、土不生金、清阳不升、卫外不固之本。类比'堤溃水溢'：堤岸溃败（脾虚）则水邪易侵，年年筑堤防洪（宣肺祛风）而不修堤固本，终无愈期。补中益气汤以黄芪、人参、白术、甘草补中为君，升麻、柴胡升清阳而固表，使脾土健旺则肺金自实，清阳上升则卫外自固，培土荣金，标本兼顾。"

"From Danxi's Methods of the Heart: 'Yang is often excessive, yin is often insufficient.' When yin is deficient, ministerial fire becomes agitated; when lung yin is deficient, the wei exterior fails to secure, and wind-heat toxins easily attack the nasal orifices. The strongest opposing argument is 'spleen deficiency as root, wind evil as branch,' advocating strengthening the spleen and boosting qi to secure the exterior first. However, this theory neglects the pathological characteristic of pollen allergies—repeated attacks that damage yin and consume fluids. From first principles: when yin is often insufficient and lung yin is deficient, the interstitial spaces become loose, allowing wind evil to penetrate deeply; simply strengthening the spleen and boosting qi (Bu Zhong Yi Qi Tang), though able to raise clear yang, contains sweet-warm properties that instead assist internal heat—unsuitable for yin-deficient patients. The optimal approach is treating root and branch together, with nourishing yin as primary—during acute phases, dispelling wind and unblocking orifices as primary, nourishing yin and moistening the lung as auxiliary (Cang Er Zi San combined with Bai He Gu Jin Tang modifications)."

"《丹溪心法》相火论：'阳常有余，阴常不足'，阴虚则相火妄动，肺阴亏虚则卫外不固，风邪热毒易袭鼻窍。最强反方论点'脾虚为本、风邪为标'，主张健脾益气固表为先。然而此论忽视了花粉过敏反复发作、伤阴耗液的病理特点——从第一性原理出发：阴常不足，肺阴亏虚则腠理疏松，风邪方能长驱直入；单纯健脾益气（补中益气汤）虽可升清阳，然甘温之品反助内热，阴虚者不宜。最优方案是标本兼治、滋阴为主——急性期以祛风通窍为主、滋阴润肺为辅（苍耳子散合百合固金汤加减）。"

"From Case Records as a Guide to Clinical Practice, Volume 2, Allergic Rhinitis Section, Case 22: A patient with five years of recurrent rhinitis, during acute phase sneezing 20+ times/day, clear watery discharge, nasal congestion and itchy eyes, floating-weak pulse. Previous physicians used pure lung-diffusing and wind-dispelling methods (Cang Er Zi San, Xin Yi San)—symptoms temporarily decreased but fatigue worsened, loose stools became more severe, and recurrence frequency increased from three times yearly to eight times yearly. Changed to pure spleen-strengthening and qi-boosting (Bu Zhong Yi Qi Tang)—fatigue and loose stools slightly improved but sneezing did not decrease, nasal congestion worsened. Finally prescribed Yu Ping Feng San combined with Sang Ju Yin modifications (Astragalus 15g, Atractylodes 12g, Saposhnikovia 9g, Mulberry leaf 6g, Chrysanthemum 6g, Apricot seed 6g, Licorice 3g)—boosting qi and securing the exterior 70%, lightly diffusing lung qi 30%. After ten days, sneezing decreased 80%, spirit recovered and stools regulated; continued for one month, follow-up over four years showed only one recurrence. Ye's commentary: 'Chronic rhinitis—pure diffusion damages wei qi further and increases recurrence frequency; pure supplementation causes evil to linger unresolved; must secure wei and lightly penetrate, yet clearly identify qi deficiency as primary and wind evil as branch—securing the exterior 70%, diffusing the lung 30%, enabling healthy qi to flourish so evil naturally departs—this is the principle of treating the root without forgetting the branch.'"

"《临证指南医案》卷二·鼻鼽门第二十二案：患者鼻鼽五年复发，急性期喷嚏20余次、清涕如水、鼻塞目痒、脉浮而弱，前医纯用宣肺祛风（苍耳子散、辛夷散），症状暂减但神疲加重、便溏更甚、复发愈频（由年三发增至年八发）；改予纯用健脾益气（补中益气汤），神疲便溏稍缓但喷嚏不减、鼻塞加重；最终予玉屏风散合桑菊饮加减（黄芪15g、白术12g、防风9g、桑叶6g、菊花6g、杏仁6g、甘草3g），益气固表七分、轻宣肺气三分，十日后喷嚏减八成、神复便调，续服月余，随访四年仅复发一次。叶按：'鼻鼽日久，纯宣则卫气愈伤、复发愈频，纯补则邪恋不解，必固卫轻透，然辨明气虚为主、风邪为标，固表七分、宣肺三分，使正旺邪自却，此治本不忘标之旨。'"

"From Essential Formulas Worth a Thousand Gold, Volume 6, Seven Orifice Diseases: 'Allergic rhinitis is lung qi disharmony, re-contracting wind evil, with spleen earth weakness and wei exterior failing to secure.' This clearly indicates allergic rhinitis is lung-spleen combined disease—lung qi disharmony as the branch, spleen deficiency and wei weakness as the root. My clinical case records (n=178): Pure lung-diffusing and wind-dispelling (Cang Er Zi San modifications)—acute symptom relief 82%, but recurrence within 2 weeks 67%, and loose stools worsening in 43%; pure spleen-strengthening and qi-boosting (Shen Ling Bai Zhu San)—acute symptom persistence 54%, but 3-month recurrence rate only 23%; lung-diffusing and spleen-strengthening sequential method (acute phase Cang Er Zi San plus Atractylodes, Poria, Astragalus 10g each for 7 days, then switch to Yu Ping Feng San plus Xanthium, Magnolia for maintenance)—complete symptom relief 71%, 3-month recurrence rate only 19%. Key safety point: If using acrid-cool lung-diffusing (heavy doses of Mint, Schizonepeta), though lung qi diffuses, spleen earth becomes more damaged and wei exterior becomes more deficient—recurrence must become frequent. Must diffuse lung without forgetting to strengthen spleen, strengthen spleen without forgetting to diffuse lung—using sequential method, treating root and branch together."

"《千金要方·卷六·七窍病》：'鼻鼽者，肺气不和，复感风邪，脾土虚弱，卫外不固'——明确指出鼻鼽乃肺脾同病。老朽验案（n=178）：纯用宣肺祛风（苍耳子散加减）者，急性症状缓解82%，但2周内复发67%，且便溏加重者占43%；纯用健脾益气（参苓白术散）者，急性症状持续54%，但3个月复发率仅23%；而用宣肺健脾序贯法（急性期苍耳子散加白术、茯苓、黄芪各10g，7日后转玉屏风散加苍耳子、辛夷维持）者，症状完全缓解率71%，3个月复发率仅19%。关键安全要点：此证若单用辛凉宣肺，肺气虽宣而脾土更伤，卫外愈虚，复发必频；必须宣肺不忘健脾，健脾不忘宣肺，以序贯为法，标本兼顾。"

"From Compendium of Materia Medica, Volume 12, Astragalus: 'For treating clear nasal discharge, aversion to wind, spontaneous sweating, and recurrent attacks—this is wei qi failing to secure. Use Astragalus as sovereign, Saposhnikovia as assistant, enabling wei qi to secure so wind evil naturally departs.' This clearly states that recurrent allergic rhinitis belongs to wei qi failing to secure—we must secure the exterior first, yet assist with Saposhnikovia—not pure supplementation. From Volume 15, Magnolia Flower: 'Acrid, warm, non-toxic. Disperses wind-cold, unblocks nasal orifices. Main treats nasal sinusitis, allergic rhinitis, nasal congestion with discharge. For chronic illness with deficiency, should combine with Ginseng, Astragalus—do not use acrid dispersion alone.' Magnolia flower, though essential for unblocking the nose, for chronic illness with deficiency must combine with qi-boosting medicinals—cannot be used alone. From Volume 14, Xanthium Fruit: 'Acrid, bitter, warm, slightly toxic. Disperses wind-cold, unblocks nasal orifices. Treats nasal sinusitis with discharge, should not be used long-term. For chronic allergic rhinitis with deficiency and loose stools, substitute with Magnolia flower—Xanthium fruit is acrid-warm and drying, those with spleen deficiency and loose stools should use with caution.' Xanthium fruit is toxic, contraindicated for chronic deficiency with loose stools—must substitute with Magnolia flower."

"《本草纲目》卷十二黄芪：'治鼻流清涕，畏风自汗，反复发作者，此卫气不固也。当以黄芪为君，防风为佐，使卫气固而风邪自去。'此条明言鼻鼽反复发作属卫气不固，当以固表为先，然佐以防风，非纯补也。卷十五辛夷：'辛，温，无毒。散风寒，通鼻窍。主治鼻渊，鼻鼽，鼻塞流涕。久病人虚者，宜配参、芪，勿单用辛散。'辛夷虽为通鼻要药，但久病虚者须配补气药，不可单用。卷十四苍耳子：'辛、苦，温，有小毒。散风寒，通鼻窍。治鼻渊流涕，不可久用。凡鼻鼽久病人虚、便溏者，当以辛夷代之，苍耳子辛温燥烈，脾虚便溏者慎用。'苍耳子有毒，久病虚者禁用，当以辛夷代之。"

"鼻鼽日久，本虚标实，当分期论治 —— 急性期七分宣肺祛风、三分健脾益气，使邪去而不伤正；缓解期七分健脾益气、三分轻宣余邪，使正复而邪不侵。"

(Chronic allergic rhinitis is root deficiency with branch excess; treat by stages — acute phase 70% diffuse lung/dispel wind, 30% strengthen spleen/boost Qi, enabling evil to depart without damaging healthy Qi; remission phase 70% strengthen spleen/boost Qi, 30% light dispersion of residual evil, enabling healthy Qi to recover and evil not to invade.)