1. CHRONIC GASTRITIS GENERAL CONSIDERATION
     Chronic gastritis is usually classified on the basis of mucosal histology and/or the anatomic portion of the stomach involved. Although endoscopic and adiologic criteria for classifying chronic gastritis have been reported, gastric mucosal biopsy is the most reliable means of diagnosis. Biopsies should be obtained from reliable means of diagnosis. Biopsies should be obtained from several different areas, since chronic gastritis may be a localized disease.
     Histologically, chronic gastritis is divided into superficial gastritis, atrophic gastritis, and gastric atrophy. When inflammatory cells (neutrophils, lymphocytes, plasma cells, and a few eosinophils) are limited to the gastric pits and upper lamina propria, gastritis is classified as superficial. In atrophic gastritis, inflammatory cells invade deeper into the lamina propria and glandular epithelim. Lymphoid follicles may also be seen. As the disease progresses, thinning of the mucosa occurs with loss of glandular elements. In some patients intestinal metaplasia develops with loss of parietal and chief cells and development of goblet cells, absorptive cells, and intestinal villi. Finally, in patients with gastric atrophy, parietal and chief cells are absent,  mucosal thickness is reduced markedly, and only a small number of inflammatory cells are present.
     Chronic atrophy gastritis has been divided into Type A and Type B, based
primarily on the anatomic portion of the stomach involved and the presence or
absence of parietal cell antibodies. In Type A gastritis, the fundus and body of the stomach are involved, whereas the antrum is relatively normal. Parietal cell antibodies are tbund in a large percentage of patients, and pernicious anemia may develop. On the other hand, in Type B gastritis the antrum is involved primarily. Although inflammation is found frequently in the fundus and body, parietal cell antibodies do not occur.
     In traditional Chinese medicine, there is no equivalent term for chronic gastritis and this condition is described as disharmony of the function and coordination, of the liver and the stomach, due to stagnation of dampness caused by deficiency of the slleen.
CLINICAL MANIFESTATIONS
     The vast majority of persons with chronic gastritis do not have symptoms.
Gastrointestinal symptoms, if they occur, may include anorexia, epigastric pressure
and fullness, heartburn, nausea, vomiting, specific food intolerance, a peptic ulcerlike syndrome, and anemia or gross hemorrhage. Physical findings are often absent or consist only of mild epigastric tenderness.
DIAGNOSIS
     Essentials of diagnosis.
     ? Symptoms, if present, consist of vague, nondescript upper abdominal distress.
     ? Mild epigastric tenderness or no physical findings whatever.
     ? Gastric biopsy is the definitive diagnostic technique.
TREATMENT
I. Treatment in Western medicine.
     The treatment of chronic gastritis, except in those cases associated with pernicious anemia or iron deficiency anemia, is not very successful. A peptic ulcer
regimen-elimination of possible aggravating factors such as alcohol, salicylates and other nonsteroidal anti-inflammatory drugs and caffeine-anticholinergic drugs and mild tranquilizers may give symptomatic relief.
II. Treatment in traditional Chinese medicine.
     1. Herb therapy
     A. For stagnation of dampness due to deficiency of the spleen and the pathologic
changes due to the retention of water and transmissive functions of the spleen. The
main symptoms are anorexia, epigastric distress, abdominal distension, loose stools, nausea, no thirst, or preference for hot drinks, general anasarca, lassitude and
weakness, thick glossy coating of the tongue, slow and formicant pulse, etc. The most effective formula is Ping Wei San Jia Jian.
     Constituents:
     Chinese atractylodes 15g
     Large-headed atractylodes 15g
     Bark of official magnolia 12g
     Dried old orange peel 12g
     Pinellia 12g
     Tuckahoe 15g
     Wrinkled ianthyssop 15g
     Fruit of hawthorn 30g
     Medicated leaven 30g
     Malt 30g
     Fruit of citro or trifoliate 15g
     Rhizoma xorydalis 10g
     Dangshen 12g
     Nutgrass 15g
     Fructus amomi 12g
     Decoction and dosage: All the above herbs make a dose and six to ten doses are
prescribed with one dose daily. Each dose is simmered twice and then the broth of
each mixed, half of the mixed broth each time, twice a day.
     B. For depressed liver due to the deficiency of spleen. The typical symptoms of this type are hypochondriac pain, anorexia, mental depression, dizziness, weakness, loose stools, whitish tongue coating, stringy pulse, etc. The following formula is prescribed to reinforce and strengthen Qi and clean the liver.
     Xiao Yao San Jia Jian.
     Constituents:
     Chinese angelica 15g
     Unpeeled root of herbaceous peony 13g
     Root of herbaceous peony 15g
     Chinese thorowax 10g
     Tuckahoe 10g
     Large-headed atractylodes 15g
     Nutgrass flatsedge 15g
     Root-tuber of aromatic turmeris 12g
     Rhizoma corydalis 10g
     Zedoary turmeric 18g
     Malt (baked) 30g
     Licorice root 6g
     Decoction and dosage is the same.
     C. For retention of food in the stomach. Improper and irregular meals cause
retention of foodstuff in the stomach and impair proper digestion, leading to such
symptoms as distension and pain of the epigastrium, eructation, vomiting, anorexia,
regurgitation of acid, thick and rough coating of the tongue. The pulse is usually
smooth. The formula for this is Bao He Wan Jia Jian.
     Constituents:
     Fruit of hawthorn (baked) 30g
     Medicated leaven (baked) 30g
     Malt (baked) 30g
     Weeping forsythia 20g
     Chinese radish seed 15g
     Dried old orange peel 12g
     Membrane of chicken gizzard 10g
     Pinellia 12g
     Tuckahoe 10g
     Betal nut 12g
     Fruit of citron or trifoliate orange 15g
     Licorice root 6g
     Decoction and dosage is the same.
     2. Acupuncture therapy
     Main points: CV12 Zhongwan, P6 Neiguan, $36 Zusanli and B21 Weishu.
     Auxiliary points: $25 Tianshu and CV6 Quchi for abdominal