The disease is a chronic inflammation of bronchi due to infection, physical and chemical irritations and allergic agents. The majority of the patients are of over middle age. It is characterized by chronic course and recurrent episodes. In some chronic cases, the disease may progress to chronic obstructive emphysema and chronic pulmonary heart disease. In TCM, this disease is related to the categories of "ke sou" (cough), "tan yin" (phlegm retention), "xiao chuan" (asthma) and so on.

Main Points of Diagnosis
1. Long-term cough, sputum production and dyspnea which attack repeatedly and fluctuate are worse in autumn and winter. There may be fever, exacerbation of cough and mucopurulent sputum production, and dyspnea is more marked if acute concurrent infection is present.
2. Chronic bronchitis usually persists for many years. It can be classified into 3 stages, acute episodic stage, chronic persistent stage and clinically remissive stage. The last stage may last for a period of time and an attack may be induced by infections or catching a cold. Based on the clinical manifestations, the disease can be divided into simple chronic bronchitis and chronic asthmatic bronchitis. In the former, cough and sputum production are predominant. In the latter, in addition to the above symptoms, there are dyspnea and wheezing, indicating that the spasm of the smooth muscles of bronchi and bronchioli is an important pathogenic factor.
3. On auscultation, moist rales can usually be heard. Wheezes can be heard in patients with asthmatic bronchitis. In patients with chronic bronchitis of long duration, a complicating obstructive emphysema is commonly present. In such cases, the respiratory sounds are diminished, heart sounds become faint, intercostal spaces are widened, the thorax is barrelshaped, and there is hyperresonance on percussion.
4. On radiographic examination the lung-markings are increased in the lower lung fields. Pulmonary functional tests show no change in the early stage, but in the late stage residual volume is increased, maximal ventilatory equivalent and time vital capacity are decreased.
Differentiation and Treatment of Common Syndromes
1. Interior Retention of Phlegm with Exopathic Cold
Main Symptoms and Signs: Cough with whitish thin sputum, dyspnea, or accompanied with chills and headache, whitish and moist fur of the tongue, string-like and tight or floating and tight pulse.
Therapeutic Principle: Relieving exterior syndrome and warming the interior organs, ventilating the lung to resolve phlegm retention.
Recipe: Modified Minor Decoction of Green Dragon.
ephedra
cinnamon twig
schisandra berry
white peony root
asarum herb
pinella tuber
dried ginger
coltsfoot flower
licorice root
All the above herbs are to be decocted in water for oral administration.
The disorder is marked with absence of exterior syndrome, manifested as cough with profuse sputum which is whitish and mucous, feeling of fullness and distress in the chest, anorexia, abdominal distension, all these suggest that the accumulation of phlegm-dampness is in the lung. The principle of treatment should be aimed at eliminating dampness and removing phlegm. The above recipe can be modified for treatment with the exception of ephedra, cinnamon twig and white peony root, and with the addition of 12 grams of red tangerine peel, 15 grams of poria, 10 grams of perilla seed, 10 grams of magnolia bark and 10 grams of atractylodes rhizome.
2. Stagnation of Phlegm-Heat
Main Symptoms and Signs: Bad cough with thick yellowish sputum, thirst, dry throat, yellow-colored urine, constipation, reddened tongue with yellow fur, slippery and rapid or taut and rapid pulse.
Therapeutic Principle: Removing pathogenic heat and resolving phlegm.
Recipe: Modified Prescriptions of Lung-Heat Expelling Powder combined with Decoction for Clearing Away Lung-Heat and Dissolving Phlegm.
mulberry bark
wolfberry bark
scutellaria root
anemarrhena rhizome
Sichuan fritillary bulb
bitter apricot kernel
stemona root
trichosanthes seed
honey fried loquat leaf
platycodon root
All the above herbs are to be decocted in water for oral administration.
Besides, 20 grams of gypsum are added for the case with high fever; 15 grams of clam shell powder for the case with profuse sputum which is difficult to cough out; 20 grams of lily bulb and 20 grams of dried rehmannia root for treating the case of yin deficiency of both the lung and kidney marked by nonproductive cough or little sputum, hot sensation in the palms and soles, night sweat, reddened tongue with little fur, fine and rapid pulse.
3. Deficiency of Both Lung and Spleen
Main symptoms and Signs: Weak cough, spontaneous perspiration, shortness of breath, tendency to catch cold, exacerbation of cough in contact with wind-cold, or anorexia and loose stools, thin whitish fur of tongue, and deep fine pulse.
Therapeutic Principle: Nourishing the lung by reinforcing the function of the spleen.
Recipe: Modified Decoction for Tonifying the Lung.
codonopsis root
astragalus root
schisandra berry
aster root
coltsfoot flower
white atractylodes rhizome
poria
honey-fried licorice root
All the above herbs are to be decocted in water for oral administration.
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua city, Hunan province
China