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Cough (sou) and coughing (ke) constitute a single syndrome. Later generations sometimes classified sou as Yang and ke as Yin, but this lacks evidentiary basis. Moreover, the chapter "Ke Lun" (Treatise on Cough) in the *Neijing* exclusively discusses sou, without using the character ke. Therefore, ke is sou, and sou is ke. The *Yin Yang Ying Xiang Da Lun* states: "Injury by dampness in autumn leads to cough in winter." The *Wu Zang Sheng Cheng Pian* states: "Cough with rebellious Qi." The *Zhen Yao Jing Zhong Pian* states: "Acupuncture at the Autumn Equinox point in spring may cause pain around the Huan Tiao acupoint and induce cough." The *Shi Cong Rong Pian* states: "Cough accompanied by vexation and resentment is due to rebellious Kidney Qi." In the *Suwen*, the term "cough" (kesou) appears together only four times; in other chapters, only "ke" is mentioned, not "sou". Thus, it is known that cough constitutes a single syndrome. Some argue that sou is a distinct syndrome, such as the "rebellious cough" described in the *Shanghan* texts, characterized by a ladder-like sound in the throat. This view contradicts the *Neijing*, which does not distinguish sou from ke. The *Sheng Qi Tong Tian Lun* states: "Autumn injury by dampness causes rebellious Qi leading to cough." The *Ying Xiang Da Lun* has similar meaning but omits the character sou, confirming clearly that ke is indeed sou. I have labored to discuss this because Confucius said: "Must rectification of names be undertaken first?"

The disease of cough has traditionally been attributed to the Lung, an assertion that remains unchangeable. The *Suwen* states: "Lung disease manifests as wheezing, cough, and rebellious Qi." It also says: "Cough with rebellious Qi involves rebellion in the chest, affecting the Hand Taiyin and Hand Yangming meridians." Among the twelve meridians in the *Lingshu*, only the Taiyin Lung Meridian mentions: "Lung distension, fullness, and wheezing cough"; other meridians do not mention this. Although the *Suwen · Ke Lun* states that all five Zang and six Fu organs can suffer from cough, the Lung remains primary. The *Suwen* states: "The skin and hair are the exterior correspondence of the Lung. Pathogenic factors first invade the skin and hair." The commentary notes: "Pathogen refers to cold qi." The classics further state: "Pathogens enter via their corresponding exterior." If cold food and drink enter the Stomach, they travel up the Spleen meridian to the Lung, causing Lung cold. When internal and external pathogens combine and lodge in the Lung, it results in Lung cough. Later practitioners, seeing these statements, concluded that cough is solely caused by cold, ignoring other chapters. They failed to realize that all six climatic factors can cause cough. If cough were only due to cold pathogen, how could we explain cases where "excessive Fire year, prevalent heat and summer heat, injure Metal and Lung, causing people to suffer from cough"? Or when Wood deficiency allows Heart Qi to lag, allowing Upper Jiao to overcome Lung Metal, resulting in cough and nasal obstruction? In the Cong Ge cycle, Metal deficiency leads to sneezing and cough. In the Jian Cheng cycle, Metal excess leads to cough. When Shaoyang governs the year, Fire descends, Lung Metal follows, causing cough, sneezing, and epistaxis. With Shaoyang governance and excessive Fire, symptoms include cough, hemoptysis, and heart vexation. With Shaoyang governance and dominant win, chest fullness and cough occur. Shaoyang climate causes heat stagnation above, leading to cough, rebellious Qi, and vomiting. During the third period, intense heat arrives, causing cough and vomiting. At the final period, failure of Yang Qi to store leads to cough. In Shaoyang recurrence, dryness and vexatious heat cause palpitations, cough, and epistaxis; severe cases involve rebellious cough with hemorrhage. When Shaoyin governs, heat arises above, cold air below, and cold-heat conflict in the middle, causing cough and wheezing. During the third period, heavy fire spreads, residual fire blocks internally, swelling above leads to cough and wheezing, potentially hemorrhage. With Shaoyin governance and victorious guest pathogen, nasal obstruction and sneezing occur, progressing to cough and wheezing. In Shaoyin recurrence, internal heat moves Qi from the left to the right, causing cough, skin pain, lung involvement, and rhinitis. Such cases arise from Fire and Heat. How can one attribute them solely to Cold? If cough were only due to Heat and Fire, consider Jueyin governance: victorious guest pathogen causes tinnitus, dizziness, and severe cough. These arise from Wind. How can one attribute them solely to Heat and Fire? If cough were only due to Wind, consider Taiyin governance: excessive Dampness causes cough with bloody sputum. In Taiyin recurrence, Dampness transforms, fluid retention occurs internally, causing cough and wheezing with sounds. These arise from Dampness. How can one attribute them solely to Wind? If cough were only due to Dampness, consider Metal depression onset: people suffer cough, rebellious Qi, and costal pain. Excessive Metal year brings Dryness, injuring Liver Wood, causing cough, wheezing, rebellious Qi, and severe vomiting of blood. When Yangming governs, Metal and Fire combine, causing cough and throat obstruction. With Yangming governance and excessive Dryness, cough and borborygmus occur. With Yangming governance and returning clear Qi remaining internally, cough, epistaxis, throat obstruction, and chest heat occur. Persistent cough with eye bleeding indicates death. Yangming victory causes clear Qi to emerge internally, leading to blockage and cough. Yangming recurrence sees abundant clear Qi, causing cough, hiccups, and heart vexation. These arise from Dryness. How can one attribute them solely to Dampness? If cough were only due to Dryness, consider Taiyang governance: victorious guest pathogen causes chest discomfort, clear nasal discharge, and cough upon cold exposure. These arise from Cold. How can one attribute them solely to Dryness?

Furthermore, Lung Wind presents with profuse sweating, aversion to wind, pale complexion, intermittent cough and shortness of breath, improving during the day and worsening at night; this is Wind cough. Lao Feng (Labor-induced Wind) presents with coughing up green-yellow sputum resembling pus, size of a pill; this is also Wind cough. Loss or unfulfilled desires cause Lung resonance, leading to Lung heat and scorched lung leaves; this is Heat cough. Yangming reversal causes wheezing, cough, and fever; this is Heat cough. Onset of One Yang causes shortness of breath and frequent coughing; this is Fire cough. Wheezing and cough due to Water Qi combining with Yangming is Damp cough. Feng Shui (Wind-Water) inability to lie flat causes cough; this is Damp cough. Kidney Qi disease with abdominal distension, leg edema, wheezing, cough, and heaviness is Damp cough. Pi Bi (Spleen Obstruction) with flaccid limbs, coughing with vomit, and upper body cold is Cold cough. The six types of cough can indeed be distinguished by their respective presentations.

When Wind attacks the Lung, there is relentless coughing day and night, sweating, headache, and difficult expectoration of phlegm; is this not Wind cough? When Heat attacks the Lung, there is rapid wheezing and coughing, red face, tidal fever, and cold hands and feet, common in nursing mothers; is this not Summer-Heat cough? When Fire attacks the Lung, there is coughing, wheezing, upward congestion, bloody sputum, and in severe cases, bleeding from the seven orifices; is this not Fire cough? When Dryness attacks the Lung, there is Qi stagnation, internal joint pain, sweating on head and face, alternating chills and fever, dry skin, small itchy sores, constipation, thick sticky sputum; is this not Dryness cough? When Cold attacks the Lung, due to physical cold exposure, cold drinks, sitting/lying on wet ground in winter, or exposure to cold wind/water in autumn/winter, there is urgent coughing and wheezing; is this not Cold cough?

Treatment methods are as follows: For Wind cough, use Tongsheng San added with Banxia and Daren Shen Banxia Wan; for severe cases, induce sweating. For Summer-Heat cough, use Baihu Tang, Xi Xin San, Liangge San, taken with honey. For Fire cough, use Huanglian Jiedu Tang, Xi Xin San, Sanhuang Wan; for severe cases, use salty-cold purgatives strongly. For Damp cough, use Wuling San, Guiling Ganlu San, and Baizhu Wan; for severe cases, use Sanhua Shenyao Wan to purge. For Dryness cough, use Muxing Tingli San, Dahuang Huanglian Ejiao Wan; for severe cases, use salty-cold purgatives strongly. For Cold cough, use Ningshen San and Ningfei San; if cold phlegm is in the upper jiao, use Guiti San to induce vomiting. Although this method is nearly comprehensive, patients vary in age, strength, deficiency/excess, and constitution, requiring flexible adjustment. Diseases change, and formulas must change accordingly. However, the misuse of drugs like Kufan, Ganjiang, Wumei, and Yingsuke has caused significant harm. Alas! I have seen countless cases of lifelong chronic cough that did not lead to death, and countless cases of acute cough in youth leading to death within months. Have these patients not taken Ningshen San or Ningfei San? Those who died did not recover because their condition was not Cold cough. Those who stubbornly persist with Kuandonghua and Erercao until death deserve to be shunned. During the Cao Wei period, military officer Li Cheng suffered from severe cough, insomnia, and expectoration of pus and blood. Hua Tuo stated, "The material coughed up does not originate from the Lung," and prescribed a bitter emetic (2 qian bi), resulting in the expulsion of over 2 sheng of pus and blood, leading to recovery. Such cases of cough must be understood.