Name: Wang.

Sex : Female.

Age: 63 years.

Occupation: A music teacher.

Chief Complaint: Repeated cough and asthma for 4 years. History of Present Illness: Four years ago, the patient go cough, rhinorrhea and expectoration because of a cold. At the beginning, there were not asthma and chest pain but less whitish mucoid sputum. Then she went to the local hospital and was treated by some antibiotics, the rhinorrhea disappeared, but he cough wasn't relieved, the expectorated mucoid whitish sputum couldn't be reduced either. Furthermore, the sputum became profuse in amount and looked like whitish froth. Sometime sever cough would be followed by asthma and chest pain. In the past 4 years, there was frequent recurrence of cough, asthma am expectoration. Moreover, it's always aggravated by weather changing and accompanied with intermittent fever. "Through many times examination of chest roentgenogram, it was diagnosed as "Chronic Bronchitis" in the local hospital. In the past years, it could be slightly relieved by the treatment of using some antiboitics such as "Penicillin, Erythromycini," but he cough, expectoration and asthma couldn't be stopped all along. Because she continuously expectorated all day and night, she had to take a big bottle with her in order to hold the profuse sputum that she expectorated. In the past 4 years, she dare not leave the bottle even for a few minutes. After the sickness came on, her stools were dry and costive, her urine was yellow and her appetite was normal. While her sleeping was disturbed by the constant expectoration thoughout night. There was not other cornplaint.

Physical Examination: The patient was conscious with a normal general condition. The pulse was taut and thready. The tongue was red with a thick layer of white fur. The respiratory sounds were harsh, some bubbling sounds and scattered dry rales could be heard in the lungs. There was not other abnormal sign.

Examination of Chest Roentgenogram: It showed that the

lung-markings were increased and disorderly. There was not other abnormal sign.

Diagnosis: Chronic Bronchitis.

Differentiation: It was caused by obstruction of pathogenic sthenic heat in lungs, which prevented the lungs from taking charge of purifying and descending function normally, then there was accumulation of pathogenic dampness phlegm in lungs and the patient got the cough, expectoration and asthma. Additionally, the permanent cough and asthma would aggravate consumption of kidney qi, then there was a failure of kidney to govern reception of air. So that it became more difficult to cure this illness.

Therapeutic Principle: Clearing away heat evil from the lungs and regulating qi, expelling phlegm dampness and restraining the excessive consumption of kidney-qi, invigorating spleen and inducing diuresis.

Recipe:

DangShen,Pilose Asiabell Root 20g

ShengDiHuang,Dried Rehmannia Root 20g

HuangLian,Coptis Root 12g

HuangQin, Scutellaria Root 10g

JieGeng, Platycodon Root 15g

SangBaiPi, Mulberry Bark 10g

DiGuPi,Wolfberry Bark 10g

ChuanBeiMu,Sichuan Fritillary Bulb 15g

XingRen,Bitter Apricot Seed 10g

MaHuang, Ephedra 8g

BaiJieZi,White Mustard Seed 15g

BaiQian,Swallowwort Rhizome 15g

YiYiRen,Coix Seed 20g

WuWeiZi,Schisandra Fruit 20g

ShengGanCao, Raw Liquorice Root 10g

All the above drugs were to be decocted in water for oral taking,5 doses were prescribed.

Effect Observation: After taking the decoction, her cough, asthma and expectoration were all relieved greatly, the profuse sputum got less in amount, there was not expectoration at night any more. Her sleeping became normal. It's unnecessary for her to take a big bottle with her in order to hold the expectorated sputum. All these signs indicated the used recipe was suitable for the illness, then the next therapeutic principle should be continuing the original treatment. Because the illness was in chronic period for many years, it's necessary to use pills slowly

in order to cure it completely. Then she was told to take 5 doses of the above prescription to make pills, taking 8g of the pills each time,3 times a day.

After 1 year's follow-up, the patient was in good health all along, there was not recurrence of the illness. Only in cloudy days, she coughed occasionally. Then she was told to pay attention to nursing herself well and protect herself from catching a cold. Then it's ending.