The symptomologies in this category are extremely common, and yet not treatable by current biomedicine ( or for menopausal symptoms estrogens must be used ). Physician's  herbal formulas can replenish energy or free up the blocked circulation of energy and blood, and restore the proper functioning of autonomic nervous system.

This article will be supplied with further details. See the herbal formulas or remedies in Autonomic nerve

#1 misconception: " The symptoms of all kinds are caused by biomedical diseases, which are defined as the abnormal morphological changes in micro and macroanatomy. All one needs to do as a doctor is to run a series of tests, including the blood tests and imaging studies to arrive at a diagnosis and the treatment plan will follow naturally to heal the patients ". Nothing can be further from the truth as the above statements. First,the  majority of symptoms are found idiopathic after a series of tests, and often the patients are labelled to have idiopathic symptoms, some of which may be thought to be neurosis caused i.e. not caused by diseases. In fact, most diseases are asymptomatic until quite advanced. All the myriad of symptoms confronting most medical doctors are better explained and often much well healed by the holistic bioenergetic theories of eastern herbal system of medicine.

#2 misconception: " Cough is a simple, reflex defensive mechanism expelling out the unwanted substances, endogenous, or exogenous, out of respiratory trees." It follows that to treat cough, one has to identify the stimulants of cough reflex, but when the stimulants are not identifiable or unavoidable ( such as exposure to dry, cold air ), then one has to use the medication that suppresses the cough reflex despite all the side effects. But every cough is caused by the patient constitution as well as the cough stimulants, and if one can treat the personal makeup, then the healing of cough would be more complete. Clinically there are subtypes of chronic coughers with heightened cough receptor sensitivities: one is the category of the hyperproducers of phlegms, and the other is the category of the underproducers of defensive mucus with " heat " in the respiratory trees. The current biomedicine does not explicitly recognize the existence of such categories with heightened cough receptor sensitivities, but physicians herbal formulas for cough offers multiple different, cutting edge herbal remedies for many subcategories of heightened cough receptor sensitivities, and thereby treat the root causes of cough.. Read Cough  

#3 misconception: " Dizziness is more or less the same as vertigo, which is mostly caused by inner ear disorder. It is treatible only by ear exercises that reposition the dislodged otoliths in the semicircular canals, and if this does not work ( which are the most cases), one has to resignate oneself to sedative drugs such as antivert and suffer until the attacks are over or live with chronic daily dizziness." 

Dizziness have multiple subcategories, and vertigo is only one of them. Chronic dizziness, especially in elderlies, are caused by insufficient  Qi ( bioenergy ) and blood flows to the appropriate regions of brain in response to increased demands ( its mechanism is imperfect autoregulation of blood flows ). Vertigo can be one expression of the whole spectrum of dizziness, caused by low blood flow to the inner ear or brainstem and in fact, can briefly occur with room spinnings in the middle of continual perception of a dizzy spell. Physicians herbal formulas for dizziness can treat chronic dizziness or vertigo, by supplying " Qi and blood " to the brain and restoring proper autoregulation of blood flows. Read Dizziness

More examples of common misconceptions will follow in near future.

The short answer is that most dieseases, defined as anatomical abnormalities, have NO SYMPTOMS, until advanced. Most symptoms are " functional " sensory interpretations of brain, and do not have diseases underlying them. Then, how does modern medicine explain the plethora of symptoms? Pathophysiological theories, but still Many symptoms are unexplained after multiple tests for abnormal patholphsiologies. Why? Modern medicine is more of scientific methodologies, and not final answers. Most people forget about this fact and think that modern medicine has the final bottomline answers. But, All the theories are incomplete hypothesises needing expansion of concepts. This does not mean that the theories should be nullified at all. Later, Our blogs will attempt to explore this by offering wider biomedical concepts for common symptoms.

How about chinese herbal medicine? She is a body of clinical knowledge built on experiences of thousands of years. A " syndrome" is either deficiency of Qi, Blood, Yin, or Yang ( 4 different aspects of " Bioenergy " flowing through us ), or an imbalance/ obstruction of bioenergies. A syndrome can be diagnosed by observing set of physical signs ( facial signs, tongue appearances, pulse characters, etc ) and most importantly, interpreting a cluster of symptoms ( which our web site focuses on ). Always, the symptoms of an individual are explained by a syndrome. Whether it is treatible or not is a separate issue which chinese herbal medicine makes clear ( Dying is a process of separation of yin and yang, and not treatible ). But when treatible, it is treatible, and this is the beauty of chinese herbal medicine, especially in managing many chronic symptoms for which modern medicine have only hypothesies and no good treatments except for neuromodullators and sedatives.

Eventually modern medicine will arrive at a new horizon of awakenings by incorporating clinical informations from herbal medicine. But this plateau will be much beyond deciphering genomes or identifying all the chemicals in biocellular reactions.

To promote Herbal Formulas, we will explain the basic difference between biomedicine and chinese herbal medicine and what advantages herbal remedies have. We do not favor either one of these medicines, and practice both, but we know in what symptoms Physicians Herbal Formulas are more or most effective, with thoughtful modifications for complex symptomologies of modern men and women which differ from easterners in agricultural, extended family based society based on obligations and virtues of Confucianism.

Biomedicine is built on the paradigm of Disease causing sickness. A Diease is abnormally changed macro and microanatomy( cells ), and clinical medicine dependent on pathology attempts to ameliorate pathological changes by drugs. A drug lowers blood pressure by relaxing the smooth muscles within the arterioles.

The patients come to a medical doctor often for Symptoms. It is assumed by everyone that the symptoms are caused by Diseases, which are diagnosed by observing abnormal anatomy by Tests. However, so often the symptoms are unexplained after tests and the clinical medicine must resort to reassuring the patients that they have no diseases or to suppressing the symptoms by " calming " the nervous system. Often the patients are labelled as having " Psychosomatic " disorders.

The chinese herbal medicine is not based on the paradigm that the symptoms are caused by diseases. She does not hold concepts of diseases. There are only Syndromes causing the symptoms, and thousands of years of clinical trials and errors have resulted in effective remedies for many symptoms which biomedicine cannot manage as well. Further trials have borne fruits to Physicians herbal formulas for modern times.

History of human knowledge is progressive restructuring of Paradigms. For Medicine to leap higher to true MODERN MEDICINE, Biomedicine based on pathology needs to incorporate traditional herbal medicine, and stop the reductionist paradigm that the symptoms are caused by diseases or else are all psychogenic.

PHYSICIANS herbal formulas are holistic, modern medicine and heals the syndromes behind the symptoms.

Physicians Herbal Formula is not a pharmaceutical drug with one major chemical effective for a symptom. What is the point for a herbal remedy if one can isolate the main ingredient for a symptom ? Can you isolate the active ingredient that makes your mother's beef stew so full of flavors ? Our Formulas are exquisite cuisines bringing wholesome flavors, but with no one active ingredient. True that many drugs are derived from herbs, but these " active ingredients" isolated from a single herb treat only the biomedically well defined diseases( i.e. Digitalis for atrial fibrillation ), but not the chronic symptoms without specific diagnosis. ( a single " active metabolite" cannot treat idiopathic dry mouth, dizziness,,) .

Our Herbal remedies treats a whole person. Also do not search for that single magical herbal remedy that heals all with the same symptom, for there is none. Choose the best formula for managing the syndrome behind the symptom. Our web site uniquely offers # different formulas or herbal remedies for dry mouth, for cough, for dizziness,etc with clear cut explanations.

Physicians herbal formula will be a vital part of transformation of restructuring paradigms for true healing modern medicine. View all the pages in our web site to maximize the benefits of herbal formulas for your well being, often neglected by biomedicine and simplistic home remedies.

Modern biomedicine in clinical practice in Modernized Korea whose Sam Sung or Hyundai corporations produce the state of the art cell phones and cars. Obviously, Herbal formulas are cherished and valued as much as the high tech gears and modern biomedicine. koreans routinely spend hundreds of dollars per month for herbal remedies willingly. Are the Koreans superstious or zealous about herbal remedies? like the Jewish persons about Torah or belivers in Islamic faith about Khoran or Christians about Trinity God or typical American patients about antibiotics and steroids for all conceivable symptoms? Our thoughts on this matter will be coming.

Let us look at the usage of herbal remedies in Korea. Case #1) A young married couple gives birth to a new baby. The son's mother hurries to their home not only to help take care of the baby, but also to inspect the daughter in law's health. She finds that the postpartum mother appears weak and sweating easily. " Gosh! you look so weak with pale and sallow face. I am sure that you have seen your medical doctor. What does he say?". The daughter in law responds, " I feel weak and tired, and sweats a lot with even mild exertion.My limbs also feel cold. My 양의사 (western doctor) has examined me carefully and did blood tests and ultrasounds , and told me that I am perfectly healthy, and needs to rest a few days." The mother in law reflexively responds, " You need Chinese Herbal formula, and I know the best herbalist in this town. Let us see him right away, before your health deteriorates further." They ride a taxi cab to the herbalist, who listens to the symptoms and examines the face, tongue, and the pulse of the postpartum lady, and then declares, " Dear mother in law and the daughter in law; Your daughter in law had spent too much "Qi" during pregnancy and labor. She is suffering from " Post partum Qi Deficiency with mild Yang loss as well". 가미황기탕 ( Huang Qi Tang, modified )is the best formula for this syndrome. ( This formula is similar to our " Day time Sweating& Weariness", see Sweating category) The mother in law pays the herbal pharmacy 50 만원 ( $ 500 usd ) for decoction packs for a supply of 21 days. So the postpartum lady takes the formula for 10 days, is completely free of sweating, and her western biomedical doctor responds," See. I told you that nothing is wrong with you."

Herbal Medicine is the epitomy of eastern culture which can impart valuable legacies to western society. She is many notches above popular chinese dishes. With more than 2500 years of rich clinical wisdom and philosophical underpinnings, she is the most effective medicine for many symptoms, some of which even modern medicine cannot manage. Under the hands of a truely learned herbalist, Nearly wondrous results can be born, unimaginable from the perspectives of simple natural home remedies. Eastern herbal medicine is a complete system of knowledge that cannot be mastered without decades of clinical experiences and cannot be transmitted via an internet.( One cannot transmit the true heart of the paintings of Picasso by internet! ) Being both a western medical doctor and an experienced herbalist, Physicians herbal formula understands the exact merits and deficiencies in each system, and knows in what symptom complexes the eastern medicine is more effective or work together with western drugs. Physicians herbal formulas made thoughtful modifications and additions to classic herbal formulas to most effectively manage the complex symptomologies of modern men and women.

Physicians Herbal Formula believes that altered gastric motility is one of the major mechanisms of dyspepsia. There are 2 major kinds. 1) Deficient Bioenergy ( Stomach and Spleen QI ) is caused by years of faulty diet, chronic emotional and mental spending such as worrying or overthinking, etc. Deficient Qi ( including autonomic nervous system output) is supplied to gastric submucosal microvessels, neuronal circuitry, and smooth muscles. This shortage of supply of bioenergy results in hypotonia of gastric muscles and hypocontractility and hypoproduction of pepsinigens, and indigestion and bloating. 2) Blocked Bioenergy flows are caused by A) stagnation of Qi ( activation of sympathetic nervous system causes gastric hypomotility and increased spincter tones,etc, B) phlegm damp pathogens ( disturbed water and electrolytes metabolism results in gastric submucosal edema or inflammation and interferes with secretions of acids and pepsinogens and motility of smooth muscles ) ,C) cold or hot external pathogens ( eating a huge quantity of ice creams or peppers alarms the visceral sensory receptors and produce vasoconstrictions or vasodilation with local heat.),

There are 2 other biomedical mechanisms producing functional dyspepsia. 1) Abnormal Reflux of Bile Acids into the stomach : This is thought to occur mainly in postgastrectomy or postcholecystectomy or with a large antral ulcer. According to eastern herbal medicine, reflux of bile acids occur often in persons with normal anatomy, causes gnawing epigastric pain, nausea, vomitting, indigestion, bitter taste, and yellow sticky tongue coating. The pathogenesis is Stagnant Liver Qi invading Stomach and Spleen causing dyspepsia, and even cancer of esophagus/ stomach if years of liver Qi stagnation develops into blood stagnation. 2) Atrophy of gastric mucosa and intestinal metaplasia is thought to be the outcome of years of H. Pylori induced chronic gastritis or pernicious anemia related autoimmune gastritis. However, many elderlies have mucosal atrophy and metaplasias with hypoproduction of protective mucus, hypochlorhydria ( low production of acids), digestive enzymes,etc, and have indigestion ,vague epigastric pain, and dry mouth with lack of coatings on the tongue. This is Stomach Yin Deficiency whose dyspepsia will not respond to proton pump inhibitors( nexium, prilosec,), because of hypochlorhydria.

representsthe majority of chronic dizziness, including psychogenic and psychophysiologic dizziness.

2)Presyncopewith feelings of passing out due to hypoperfusion of oxygen or sugar to brain from sudden low blood pressure from slow autonomic nervous system response ( orthostatic hypotension, cough or micturition syncope, etc ), or cardiac response ( heart failure, aortic valve stenosis, brady or tachyarrthymias ), or metabolic disturbances including hypoglycemia.

3)Vertigowith sensations of spinning inside the head or of the surroundings due to inner ear disorders ( The favorite diagnoses for dizziness includingBenign positional vertigo, Menieres disease, vestibular neuonitis,the top 3's, and central vertigo from accoustic neuroma or cerebrovascular ischemia or stroke). Dizziness is not the same as vertigo. Vertigo is only one subcategory of dizziness, and is not even the most common subcategory of dizziness. Terms Dizziness and Vertigo should not be used interchangibly.

4)Dyseqilibriumwith unsteadiness. from drugs, cerebellar disorder, or neuropathy with muscular weakness.

Significant Dizziness is found in 18 % of adults and 30 % of elderlies, roughly. But the majority of chronic dizziness belong to category 1) lightheadedness, vaguely described 

more as wooziness and sometimes as spinning sensations inside one's head and usually not accompanied by other clear symptoms and signs. The major signs which clinicians always look for when confronted with a dizzy person are a) signs of presyncope: hypotension, orthostatic hypotension, cardiac abnormalities,or abnormal autonomic nervous system, b) vertigos from vestibular dysfunctions with nystagmus, hearing losses, or neurological deficits ,and c) dysequilibrium with gait ataxia or sensory neuropathy. However, these signs are missing more often than not, but because of frequent mentioning of mild spinning in the head, the diagnosis of benign paroxysmal positional vertigo ( BPPV ) is given despite the absence of nystagmus, and is the 2nd commonest etiology of dizziness, behind psychosomatic dizziness. If the criterion of nystagmus is strictly adhered to, then BPPV is not a common clinically important cause of dizziness at all. Even if BPPV is loosely attributed to be the cause of dizziness, still in 40 % of all chronic dizziness, Psychogenic make up is deemed to be the major etiology. At any rate, Antivert is the drug mostly prescribed despite ineffectiveness except in cases of genuine inner ear dysfuntion. If the criterion of nystagmus is strictly adhered to, then BPPV is not a common clinically important cause of dizziness. In short,most chronic dizziness belong to 1) light headedness/ wooziness with occasional spinning in the head, and no full biomedical explanation and drugs are available.

According to chinese herbal medicine, dizziness occurs 1) when the brain is malnourished( from qi,blood, yin, or yang deficiency ), 2) whenpathogenetic factors block the nourishments from reaching the brain( mental phlegms, blood stasis, uprising liver yang or heat ) or finally,3) bya combination of 2 above mechanismsof deficiency and excess. Biomedically translated, chronic dizziness is a symptom of chronic, recurrent and relativelytransient insufficency of oxygen and sugar to all parts of brain including the brainstem and inner ear, caused by evolutionarily IMPERFECT AUTOREGULATION OF CEREBRAL BLOOD FLOW, EITHER FUNTIONAL OR DUE TO ARTERIOSCLEROSIS, in response to surge of demandswhich is not demonstrable by MRI or MRA or lab measurements. Chronic dizziness is analogous to chronic exertional angina caused by insufficient blood flow to the heart muscles, when the demand for oxygen is increased above the threshold of compromised coronary circulation, as with excess exercise or emotional outbursts. Thismodel of demand and supply of brainexplains well why most oftendizziness flares up after strenuous mental exertionrequiring lots of oxygen and sugar. This also is why to control chronic dizziness, one needs to reduce the demands by mentally resting, whileherbal remedies work on the supply sideby 1)nourishing the brain with Qi and Blood, 2) getting rid of pathogenetic factors blocking the supply, and thereby improving the responsiveness of autoregulation of cerebral blood flow. In most chronic dizziness, one feels fine in AM after a goog night sleep, and dizziness appears after EXERTION ,especially mental, and one can even guess when dizziness will appear ( like reading a complex book for 2 hours). There is a Dizziness THRESHOLD for most chronically dizzy people, and our herbal formulas will elevate this threshold over time ( one may read on theories of mathematics for 4 hours instead of 2 hours before the onset of dizziness).

Dizziness is a commonsymptom for which biomedicine has little to offer except meclizzine( antivert)which is mildly effective for vertigo, butdoes not get to " the roots" of dizziness, which took decades to develop. OUR HERBAL REMEDIES CAN BE MORE EFFECTIVE,but for chronic dizziness, one is better taking the right formula(s) for a long term to heal or manage the root syndrome causing the particular dizziness. We can testify to our Korean elderlies whose chronic dizziness with spinnings and easy falls are well controlled with usage of our formulas.

ASimplified Guidefor choosing the appropriate formula for your kind of dizziness.The best herbal remedyforacute or flare of dizzinessisDIZZY/VERTIGO( Itcured our chihuahua's vertigo with severe nystagmus. Take 6 capsules 2 to 3 times daily for 1 to 2 weeks or chronically as necesary).

Chronic mild dizziness often has the same roots as chronic fatigueaccording to chinese herbal medicine. If one's fatigue is the major symptom, and dizziness is only a minor symptom ( Dizziness, nevertheless, alarms people much more, while many in American culture tend to resign easily to chronic moderate fatigue ), then one may take our formula for chronic fatigue for mild chronic dizziness, i.e. Fatigue & Blurry is an excellent formula for the middle aged with much fatigue and mild dizziness.

Chronic Diarrhea is diarrhea lasting > 3 to 4 weeks. Biomedicine proposes 5 different causative mechanisms.

#1) Secretory diarrhea is abnormal fluid and electrolyte transport across mucosa of small intestine and colon, with large volume loose stools which usually persist despite fasting. Its causes are a) laxative abuse, or b) decreased funtional surfaces for absorption ( crohn's disease, resection of intestines, chloridorrhea or chloride rich watery diarrhea due to defective CL/HCO3 mucosal exchange, and hormones from tumors causing production of intestinal secretagogues ).

#2) Osmotic Diarrhea means that osmotically active solutes enter colon and draws fluids exceeding the resorptive capacity of colon ( which may be 3.2 liters/day, and thus,this type of diarrhea is not severe unless the colonic transit time is very shortened usually from autonomic dysfuntion). Its causes are a) osmotic laxatives ( Magnesium), b) lactase deficiency.

#3) Fat malabsorption with greasy stools and nutritional deficiency are usually diagnosed.

#4) Inflammatory mechanisms include mucosal exudation, hypersecretion of electrolytes and fluids, and hypermotility of colon. Its most common cause is inflammatory bowel disease including ulcerative colitis, and are usually diagnosed.

#5) Dysmotility of bowel with rapid transit due to visceral autonomic neuropathy ( " diabetic diarrhea" ),or disordered neurohormonal regulation of colonic and anorectal function ( " Irritable bowel syndrome" ).

Chronic Idiopathic Diarrhea is functional diarrhea where all the biomedical diseases and over usage of medications are ruled out, and are quite common. Biomedical treatments are permanent usage of opiodlike drugs such as imodium or peptobismol, and may not work.Chronic diarrhea can be explained by the theory of physicians herbal formula combining the concepts of eastern herbal medicine and pathophysiology. She can also be diagnosed and healed by eastern herbal medicine.

According to eastern herbal medicine, chronic diarrhea is caused by 2 major categories of mechanisms. #1) is chronic retention of pathogenic factors in bowels which cause hypersecretory mucosa, exudative inflammatory mucosa, and disordered motility of colon.

1A), called damp heat in colon, causes foul smelling yellow diarrhea with frequency, abdomenal discomfort, and burning anus. Treated by Acute Diarrhea ( it treats also chronic diarrhea due to damp heat)

1B), called blood stasis often shows blood in stools. Not a common syndrome.

1C), called liver Qi stagnation with some heat in colon, treated by Irritable Bowel

#2) category is Qi / Yang ( "bioenergy and warming bioforce" )deficiency of spleen, stomach,or kidney. Deficiency of bioenergy is manifested by the hypofuntioning of enteric and autonomic nervous system. Submucosal nervous plexus which controls absorption and secretion of electrolytes and fluids are devoid of energy, and fail to control chloride ion channels and produce watery diarrhea. Sympathetic nervous system ( "active Qi/ Yang" )which provide inhibitory control on the smooth muscles of colon may fail and hypermotility of colon ensues.

2A) called Spleen Qi deficiency results in chronic loose or watery stools and fatigue. Treated by Chronic Diarrhea

2B) called Kidney and spleen Yang deficiency is not a common cause of diarrhea in western

culture, except in very elderlies.

This article will be supplied with further details.

Why does Jenny cough so oftener than Tom in dry weather? Jenny is a good singer at a casino who uses her voices a lot, and whenever she gets a cold with a sore throat and fever,she has persistent cough, with dry throat, and ticklish cough with a scant amount of yellow phlegm which is difficult to expectorate for many weeks, and the symptoms get worse after a concert in Las Vegas in summer. Her medical doctor prescribes her dextromorphan, and even phernegan with codeine syrup which makes her drowsy and constipated. Even worse, her dry cough becomes worse.

Why does John cough up so much phlegms after catching a cold when he does not even smoke? John is a middle aged man who has always liked wine, cheese, and alcoholic parties with women as a successful business man, has chronic catarrhea with nasal congestion and discharge, and after a minor cold, gets frequent bronchitis with expectoration of sticky, yellow phlegms rattling in the throat and the chest with fever, barking coughs, and chest oppression. John is prescribed levaquin ( an antibiotic ) and prednisone by his internist, but he often gets edema of face, elevated blood sugar and hypertension from the steroids as well as upset stomach and bitter taste from levaquin, but he is told that these are the minor side effects that are necessary to cure his bronchitis and asthma. Both Jenny and John are crying out, " Aren't there any herbal remedies that are more effective? without the side effects of modern drugs? Jenny is vaguely aware that her singing occupation is making her treacheas and bronchus drier and predisposes her to frequent dry coughs, but John does not know that all that alcoholic drinks and pizzas and cheeses are making him the hyperproducer of phlegms , and making him a target for productive bronchitis/asthma by exterior wind pathogens and viruses. Both Jenny and John visit the medical office of Physicians Herbal Formula in L.A., are explained both biomedical and eastern herbal theories on pathogenesis of persistent cough: Jenny takes Dryish Cough, and within a few days, all her dry coughs are healed. John takes Cough,Yellow Phlegm, and seeing the great responses, throws away the antibiotics and prednisones, and after becoming free of yellow phlegms within a few days, he also vows to cut down alcohol and excess cheese parties.

Tales of Hypersecretors of phlegms and hyposecretors of mucus

We explain 1) the biomedical model of pathogenesis of cough, 2) discuss some unanswered issues in that model, 3) propose a new expanded model, 4) describe how this model fits not only pathological model of modern medicine but also fit with the languages of Chinese herbal medicine, and 5) finally describe briefly the workings of the herbal remedies.

Pathogenesis of cough according to biomedical model

Cough is a reflex defense mechanism for clearing the trachea and bronchial tree of secretions and foreign materials to protect the lungs. Irritation of bronchial mucosa by any materials causes activation of sensory receptors of the afferent limb within the nasopharynx and the bronchial trees. The efferent limb consists of the recurrent laryngeal nerve and the spinal nerves causing the forced expiration of cough. Other possible stimulants of the afferent sensory nerves include 1 ) sudden changes in humidity and temperatures in some susceptible persons and 2) constriction of small airways in some asthmatic persons. So there are numerous stimulants, endogenous and exogenous, which can trigger cough.

Finding the cause of cough is identifying what are the stimulators of the sensory receptors of the afferent limb of reflex, according to biomedicine. But in chinese herbal medicine, the individual pecularities and sensitivities of not only the bronchial trees but also other organ systems are considered in finding the cause of cough. The kinds of material stimulants of the afferent limb of cough vary among individuals; For instance, why does cold air or dry air cause cough only in some individuals? Biomedicine rarely discusses the factors depending on the individual differences in constitution, except in the case of cough among the asthmatics. Chinese herbal medicine explains that cough with exposure to cold air is due to wei ( defensive ) qi deficiency or weak lung and kidney yang in those individuals. Translated into biomedical language, cold air caused cough is due to weak or altered immunity with Ig E mediated hypersensitivity or T cell defects.

In sum, Cough is thus initiated by multiple stimuli, but is also dependent on individual sensitivities.

1. airway irritants by inhalation ( smoke, dust, fumes), or aspiration ( postnasal drip, gastroesophageal reflux , aspiration of stomach contents ), or by phlegms ( mixture of mucosal cells and inflammatory debris from airways ). Some persons have overproduction of phlegms independent of smoking or exposure to irritants, and are prone to flares of bronchitis with cold. Only some phlegms are from smoking induced inflammation and bacterial infection of the airways. Chinese herbal medicine is emphatic that the hypersecretors of phlegms, due to altered fluid metabolism in the whole body, have weak spleen Qi, or Lung Qi, or stagnation of liver Qi often, and are most prone to productive cough from minor colds.

2. Any diseases with inflammation or constriction of airways ( viral and bacterial bronchitis, bronchiectasis meaning dilation of bronchi by scarring, whooping cough, asthma, tumors, parenchymal lung diseases, and congestive heart failure ),

3. Exposure to very dry or damp air, or sudden changes of temperature in susceptible persons ( a small category, with “ heightened cough reflex “; otherwise, everyone in Alaska or in Sahara deserts would have significant cough ),

4. Sudden Constriction of small airways ( asthma or Cough variant asthma meaning asthma with cough as the only symptom )

5. Hyperirritability of respiratory epithelium, sometimes with unidentified irritants or minor stimuli; a subgroup is called heightened cough reflex, ( Postviral bronchial hyperreactivity, ACE inhibitor induced cough )

Acute cough is defined as cough lasting less than 3 weeks, while chronic cough is cough lasting more than 3 weeks. Acute cough is most often caused by viral infections including the common cold.

There are5 major categories of chronic cough according to the biomedical model.

1)Chronic Bronchitisis clinically definedas 3 or more months of cough productive of sputum for at least 2 years,and is mostly presentin smokers.

2)Postnasal Drip( 34 % of chronic cough in nonsmokers ) from rhinitis or sinusitis.

3)Cough Variant Asthma ( Cough is the only manifestation of asthma )supposedly causes 28 % of chronic cough in nonsmokers.

4)PostViral Bronchial Hyperreactivity ( 18 % ) is persistent cough after viral infection.

5)Gastroesophageal Reflux supposedly cause 18 % of chronic cough. This is likely an overrated reason for clinically significant chronic cough. Half the people suspected to have reflux caused cough do not have the classic symptoms of reflux such as heartburn, acid regurgitation, or dysphagia. Often clinicians suspect this diagnosis when the searches for chronic cough turn out negative. However, intensetreatment of reflux with antiacids and proton pump inhibitors such as nexium or prilosec is usually not effective for relieving chronic cough. Biomedicine says that one needs to treat this category of chronic cough for at least 12 weeks.

Similarly cough variant asthma is oversited as a cause of chronic cough, because such cough is rarely longstanding. If cough poorly responds to asthma medications, it is not asthma, and usually clinicians prescribe inhalers for asthma at the first hint of chronic cough. Then, why are there so many cases of chronic cough due to hidden asthma?

Finally, there is a new category called "CHRONIC IDIOPATHIC COUGH" with heightened cough reflex recognized by lung specialists. This may be a large category, which may include a large percentage of chronic coughers who are labeled with gastroesophageal reflux induced cough or cough variant asthma, but do not respond to biomedical treatments.

Importantly, there arecommon etiologies for cough which are not fully discussed in biomedical textbooks. These etiologies include 1st) the exposure to dry hot air or cold air,( many lay persons without asthma have experienced cough due to this, and yet the pulmonologists mention this factor more as a minor trigger of asthma or of cough variant asthma, but not as the normal, usual sensory trigger of cough reflex like the mechanical stimulants of foreign particles or postnasal drip ). It can cause cough in not just asthmatics but a category of individuals with heightened cough reflex,

And2nd and foremost) isDRY BRONCHIAL AIRWAYS IN SOME INDIVIDUALS WITH RELATIVE UNDERPRODUCTION OF DEFENSIVE MUCUS BY RESPIRATORY EPITHELIUM. After all, there are dry skin, dry eyes, dry nasal cavities, dry mouth, throat, and treachea with dry cough , and dry, atrophic stomach with thinned out mucosa,etc. Respiratory epithelia are a continuous layer from nasal cavities with mucosal layer into the small airways, and there is no reason to envision a perfect mucosal layer in susceptible individuals. The pathogenesiswould be 1) moderate to extensive sqamous metaplasiaof mucosa from normal ciliated respiratory epithelia needed to brush away the irritants from the bronchial trees, 2)Atrophy of mucus producing glands and goblet cellsgiving rise to thinner mucosal surface, analogously to chronic atrophic gastritis, 3) A novel concept of "Deficient Heat in lung " , according to chinese herbal medicine, causing arteriolar dilation in submucosa and causing relative desication of mucosal surface of respiratory trees, analogously to dried up red tongue with little saliva and cracks associated with chronic dry mouth. The reason why2nd etiology for cough is not discussedis that it is hard to study such phenomenon of mild to moderate hyposecretion of mucus by lab measurements on human beings ( hard to see this by microscopy of tissue biopsies in formalin or by bronchoscopy which cannot enter small airways, but hyposecretion of mucus has been demonstrated in cystic fibrosis model pigs, in vitamin A deficient mice, and in human subjects during acute repreparatory phase of acute injury in chronic obstructive lung disease ).

The underproduction of mucus is a " fertile ground" for chronic dry cough or chronic heightened cough reflexwhich is postulated to cause not only idiopathic cough but also a large proportion of chronic cough explained otherwise. In another word, in our newly proposed biomedical model, a category of individuals may have relatively" dry respiratory mucosa" predisposing them to heightened cough reflex from cold, viral infections, or any other triggers of cough reflex. In the language of chinese herbal medicine, these are most often the individuals withlung , or lung and kidney yin deficiency with lack of moistening the lungs.Our natural herbal remedies for cough, especially Dryish Cough, Persistent Cough & Cold, and Very Dry Cough moisten the lungs, enrich the immunological mucus layer, and decrease the heightened cough reflex, and treat chronic dry cough with sticky phlegms.

We also proposed a category of individuals with hypersecretion of phlegms causing heightened cough reflex with mild attacks of cold, or any airway irritants. In chinese herbal medicine these are the individuals with spleen Qi or lung Qi deficiency producing abudant phlegms with slightest triggers. Our formulas White Phlegm Cough and Yellow Phlegm Cough decrease the endogenous production of sputums, reduce the inflammations in the airways, and fight off the infections, thereby calming the productive coughs.