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The Five Tones: Gong (宫) belongs to Earth, Shang (商) belongs to Metal, Jue (角) belongs to Wood, Zhi (徵) belongs to Fire, and Yu (羽) belongs to Water. The Liver corresponds to Jue in the five tones and to "Hu" (shouting/calling out) in vocalizations; the Heart corresponds to Zhi in the five tones and to "Xiao" (laughter) in vocalizations; the Spleen corresponds to Gong in the five tones and to "Ge" (singing) in vocalizations; the Lung corresponds to Shang in the five tones and to "Ku" (crying/weeping) in vocalizations; the Kidney corresponds to Yu in the five tones and to "Shen" (groaning/moaning) in vocalizations. This is the correspondence between the five tones and the five Zang organs. However, in cases of disease, this may not always hold true. Nevertheless, the five tones are encompassed by Yin and Yang, and Yin and Yang are encompassed by Dryness and Dampness. Mr. Chunshan's method of distinguishing between Ping (level/flat tone) and Ze (oblique/accented tone) contains profound truth. Dryness pathogen causes dryness and astringency; voices often fall into the Ze category, manifesting as dry hiccups or retching, hoarse or suppressed cough sounds, pain radiating upon coughing, continuous dry coughing, or frequent sighing with shortness of breath (when Dryness is severe, it causes spasms and tension in the meridians; due to the desire for relief from tension, sighing is prevalent); if Dryness transforms into Fire, there is excessive talking, and in severe cases, delirium and mania occur, with voices sounding broken or hoarse, presenting an image of dryness and obstruction. Dampness pathogen is heavy and turbid; voices must be low and flat, obstructed and unventilated, as the ancients described it like sounds made from within a jar. Patients may be silent and reluctant to speak, drowsy and fatigued, have frequent coughing with much phlegm, hear rattling sounds of phlegm in the throat, hear fluid retention sounds below the heart, or experience frequent belching (due to Dampness obstruction preventing free flow, belching is common). They suffer from generalized soreness and pain, heaviness, and difficulty moving freely; if Dampness transforms into Fire, it steams upward affecting the Heart and Lung, causing mental confusion, muttering to oneself, deep coma and sleep, presenting a picture of heaviness and turbidity, evident in respiration. Other examples include: speaking loudly and vigorously, starting light and becoming heavy, indicates Exogenous Disease (Wai Gan); speaking lazily and timidly, starting heavy and becoming light, indicates Internal Injury (Nei Shang). Delirious speech (Chan Yu) involving hallucinations and nonsensical talk is Excess (Shi). There are also two conditions: delirium due to Spirit deficiency and restlessness resembling mania due to Deficiency; these must be judged by combining pulse, symptoms, and tongue coating, and must not be mistaken for Excess. Speech that cannot continue is Zheng Sheng (repetitive mumbling due to exhaustion); speaking alone without anyone present is Du Yu (soliloquy); these mostly belong to Deficiency. Speaking faintly, only speaking again after a whole day, indicates Duo Qi (loss of Qi); inability to dress properly, speaking without distinguishing good from bad or avoiding relatives from strangers, indicates disorder of the Shen Ming (Spirit/Mind); both are critical conditions. For instance, when Phlegm obstructs the Lung collaterals and cough sounds are suppressed, it is "Metal Solid, No Sound" (Jin Shi Wu Sheng), caused by Lung Qi excess; when consumption diseases (Lao Zhai) cause hoarseness, it is "Metal Broken, No Sound" (Jin Po Wu Sheng), caused by Lung Qi and Yin deficiency. An abdomen that is distended and large, feeling hard and solid upon percussion, is Excess; an abdominal wall that is tense, sounding hollow upon percussion, is Deficiency.

Thus, can Dryness/Dampness, Exterior/Interior, and Excess/Deficiency not all be known through listening? And it does not stop here. Voice originates from the Lung but is rooted in the Kidney. Voices lacking resonance, sounding like crow calls, indicate impending failure of Lung and Kidney Qi, where Metal and Water do not interact, so voice cannot originate from or return to the Dan Tian, resulting in direct sound without echo! However, this may also be caused by Phlegm blocking the Lung orifices; in such cases, one should use Pungent-Moistening and Clear-Moistening methods to resolve Phlegm and open the orifices, and should not immediately declare it incurable. Regarding the syndrome of panting and shortness of breath (Chuan Cu), careful differentiation is especially important. The Lung is the commander of Qi, and the Kidney is the root of Qi. The Lung governs exhalation, and the Kidney governs inhalation. When Yin and Yang interact harmoniously, breathing is balanced. If the functions of excretion and reception, ascending and descending become abnormal, panting occurs. Real Panting (Shi Chuan) is attributed to the Lung, while Deficient Panting (Xu Chuan) is attributed to the Kidney. In Real Panting, the chest is full, the voice is coarse, and the breath is long and sufficient. In Deficient Panting, exhalation is long and inhalation is short, with rapid and insufficient breathing. In Real Panting, exhalation is not smooth; in Deficient Panting, inhalation produces sounds. Real Panting may be caused by Water Pathogen shooting into the Lung, Phlegm-Fluid obstructing the Lung, or Guest Pathogens (Six Qi pathogens, all capable of causing panting) invading the Lung, leading to Upper Jiao Qi stagnation; treatment should focus on dispersing and draining. Deficient Panting is due to the Kidney failing to grasp Qi, with isolated Yang lacking a root; treatment should focus on consolidating and securing. Differentiating between Excess and Deficiency leads to different paths, and treating Yin and Yang differently highlights the importance of the art of listening to diagnose. Thus, the Classics state: "To know through hearing is called Sage."