1. ACUTE UPPER RESPIRATORY TRACT INFECTION  GENERAL CONSIDERATION 
     Infection of the respiratory tract is perhaps one of the most common human ailments and is a source of discomfort, disability and loss of time for most average adults. It is also a substantial cause of morbidity and serious illnesses in young children and in the elderly, including inflammation of nasal tract, nasopharynx, pharynx and larynx. Most cases are caused by virus such as rhinovirus, para influenza, respiratory syncytial virus, adenovirus, influenza A, B and C virus, etc., but some by bacteria such as pneumococcus, hemolytic streptococcus, hemophilus and staphy lococcus. Many of these viral infections run their natural course in older children and in adults without specific treatment and without great risk of bacterial complications. In young infants and in the elderly, or in persons with impaired respiratory tract function, bacterial superinfection increases morbidity and mortality rates.
      In. traditional Chinese medicine, this condition is often called seasonal disease or external affection, which refers to the disease or the symptoms caused by the six pathogenic factors, namely wind, cold, summer-heat, dampness, dryness, fire, as well as malignant infections and pathogenic factors.
CLINICAL MANIFESTATIONS
      Acute upper respiratory tract infections generally are divided into the following five types:
      Common cold. This familiar syndrome is characterized mainly by nasal obstruct tion with discharge, sore throat, sneezing, hoarseness, varying degrees of malaise,  cough, sinusitis and otitis. Fever is usually absent in adults but may be present in small children.
      Croup (Laryngotracheobronchitis). This is most commonly a parainfluenza  virus infection of small children with anatomic location in the subglottal area. It  produces hoarseness, a "seal bark" cough and signs of upper airway obstruction with inspiratory stridor xiphoid and suprasternal retraction, but no pain on swallowing.
      Herpangina. This disorder is commonly a coxsackie A virus infection of small children with sore throat and fever. The epiglottis is markedly swollen with a cherry red appearance.
      Pharyngo conjunctival fever. The causes of this disorder are adenovirus, coxsackie and influenza A, B and C virus, and it is characterized mainly by fever, sore throat, increased discharge in the eyes, photophobia and congestion of conjunctiva.
     Bacterial pharyngotonsillitis. The most common cause of the illness is hemolytic-streptococcus, pneumococcus and staphylococcus. Its features are abrupt onset with chills and fever, and marked congestion of the pharynx. The temperature is above 39℃ and the tonsil is enlarged with yellowish exudate on the superficial mucosa.
DIAGNOSIS
     Essentials of diagnosis are:
     . Abrupt onset with fever, chills, malaise, cough, coryza and muscle aches.
     . Pain, fever and catarrhal symptoms.
     . Secondary bacterial infection with increased white blood cell.
     . Chest x-ray is normal.
TREATMENT
     Bed rest is important to reduce complications, and analgesics and sedative cough mixture may be used. Antibiotics should be reserved for treatment of bacterial complications. Antihistamines are of value only in allergic or vasomotor rhinitis.
     In traditional Chinese medicine, herbal therapy and acupuncture therapy are very effective for this disease, and the disorder is recognized as two different types caused by wind and cold, and wind and heat.
     Flu caused by wind and cold shows the chief symptoms such as fever, chills, headache, nasal obstruction and thin nasal discharge. The patient usually does not feel thirsty, but has a superficial and tense pulse. The tongue is found covered with a thin whitish coating. The general rules for the treatment of this type are to use strong sudorific drugs pungent in taste and warming in property to dispel wind and cold in external symptom-complex. The most effective formula is Jin Fang Bai Du San Jia Jian.
     Constituents:
     Jingjie (herb)  12g
     Fangfeng (root) 12g
     Chinese thorowax 15-30g
     Root of purple-flowered peucedanunm  15g
     Notopterygium 12g
     Angelica (root)  10g
     Chuanxiong (rhizome) 12g
     Apricot kernel 12g
     Tatarian aster 20g
     Common coltsfoot flower 10g
     Licorice root 6g
     Decoction and dosage. Put all the above herbs together to be simmered twice, then the broth of each mixed, half of the mixed broth each time, twice a day.
     If high fever has continued for two days, 30 grams of gypsum is added to the above formula.
     If cough attacks very often, tendril-leaved fritillary bulb (10g) and Pinellia (tuber) (10g) are put on the formula.
     If headache is frequent, root of herbaceous peony (12g) and Ligusticum (rhizome) (12g) are increased in the formula.
     Flu caused by wind and heat usually manifests fever, headache, perspiration, chilly sensation, thirst and pain of the throat. The pulse is superficial and rapid and the tongue is covered with thin, white or slightly yellowish coating with red edge and tip. The rules for treatment are the same as those for wind and cold type. The effective formula is Yin Xiao San Jia Jian.
       Constituents:
       Honeysuckle flower 15-30g
       Weeping forsythia  15-30g
       Bamboo leaves 10g
       Jingjie (herb) 12g
       Achene of great burdock 10g
       Peppermint (herb) 10g
       Common reed rhizome 30g
       Root of balloonflower 30g
       Root of Zhejiang figwort 15-30g
       Tuber of dwarf lilyturf 18g
       Fresh or dried root of rehmannia 18g
       Gypsum 30g
       Licorice root  6g
       Decoction and dosage is the same.
       If the patient has high fever, the dose of Gypsum should be doubled and root
of Zhejiang figwort (30g) is added.
       If the patient complains of sore throat, boat-fruited sterculia (seed) (4 Pieces) is added.
       Besides, some herb pills such as Yin Xiao Jian Du Pills, Lin Xiao Jian Du Pills, Jiu Wei Jiang Huo Pills, Qiang Li Yin Xiao Tablet, and Sang Ju Gan Mao Tablet are also the effective herbal drugs.
      Acupuncture therapy is proved to be especially effective for this disord