Sputum is an acute and chronic tracheobronchial – bronchitis, cough, sputum, wheezing and inflammation are common main signs of lower respiratory tract infection. Sputum is mucopurulent should be differentially diagnosed from the following symptoms: 1. lumpy sputum: Patients with old chronic bronchitis combined with emphysema sometimes have severe infections that cause excessive tracheal mucus, inflammatory exuded leukocytes and shed epithelial cells, forming a large amount of lumpy sputum, thus blocking the airway and causing asphyxia. When this happens, family members should immediately press the patient’s tongue with the handle of a dinner spoon and reach for his larynx with gauze-wrapped fingers to pick out the blocked sputum for the purpose of first aid. 2.Frequent spitting of mucus: Carcinoma of esophagus is a malignant tumor mainly originated from squamous epithelium and columnar epithelium of esophagus, with squamous carcinoma accounting for about 90% and adenocarcinoma accounting for about 10%. The most typical clinical manifestation of esophageal cancer is progressive dysphagia. In the early stage of esophageal cancer, the local lesions are in relatively early stage, the symptoms may be caused by local lesions stimulating esophagus causing abnormal peristalsis or spasm, or due to local inflammation, tumor infiltration, esophageal mucosal erosion and superficial ulcer, the symptoms are generally light, short duration, often recurrent, sometimes light and sometimes heavy, there may be asymptomatic interval, the duration can be 1~2 years or even longer. Later symptoms: dysphagia is a typical symptom of esophageal cancer, which is often intermittent at the beginning, with a general tendency of persistence and progressive aggravation; reflux esophageal cancer infiltration and inflammation reflexively cause increased mucus secretion from esophageal glands and salivary glands, patients can show frequent vomiting mucus reflux can also cause choking and coughing, and even aspiration pneumonia; pain behind the sternum or persistent pain in the interscapular region of the back often indicates that esophageal cancer has infiltrated outward; other tumors invade large blood vessels, especially the thoracic aorta and cause lethal hemorrhage. 3.Pus sputum: With the aggravation of cough, the sputum will gradually become thicker and become mucopurulent sputum with the appearance of yellowish lumps, mostly caused by bronchitis, bronchopneumonia or mixed lung infection, tuberculosis, etc. It is also common in acute and chronic pharyngitis or purulent tonsillitis. If the disease is further aggravated, yellow-purulent sputum, mostly in the form of yellow-green sticky lumps or opaque pus-like, will appear, at which time it is necessary to suspect lung abscess, chronic bronchitis, bronchiectasis, cavitary tuberculosis combined with serious infections and other diseases. Chronic bronchitis is a chronic non-specific inflammation of the trachea, bronchial mucosa and surrounding tissues. The main clinical symptom is recurrent episodes of cough, sputum or with shortness of breath, lasting for 3 months per year for more than 2 years. Early symptoms are mild, mostly occurring in winter and remitting in spring and summer. In the late stage, due to the aggravation of inflammation, the symptoms can exist all year round. 4. Coughing up foamy mucus sputum: Sputum is a respiratory secretion, and healthy people usually have sputum. However, if suffering from respiratory diseases, infected by disease-causing microorganisms will produce a large amount of phlegm. Chinese medicine classifies phlegm into cold phlegm, wind phlegm, hot phlegm, damp phlegm and dry phlegm. Chronic bronchitis in the elderly starts insidiously, mostly in middle-aged and young people, but also in old age. Patients mostly develop cough and sputum in the cold season, especially in the morning, and the sputum is white mucus foamy.