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It is known that the Lung causes cough, but it is not understood that all five Zang and six Fu organs can cause cough, not just the Lung. The skin and hair are the exterior correspondence of the Lung; when the skin and hair are first invaded by pathogenic factors, the pathogens enter following this correspondence. (The pathogenic factors refer to wind-cold. When the skin and hair are first affected, the pathogens enter the Lung, hence described as entering via its exterior correspondence.) If cold food and drink enter the Stomach, they travel up along the Lung meridian to the Lung, causing Lung cold. With Lung cold, internal and external pathogens combine, lodging in the Lung, thus forming a Lung cough. (The Lung meridian originates from the middle Jiao, follows the stomach opening, passes through the diaphragm, and connects with the Lung; therefore, the cold from dietary intake in the Stomach travels up to the Lung via the Lung meridian. This is what is meant by "external cold on the body and cold drinks injuring the Lung.") Each of the five Zang organs becomes diseased during its respective season; if it is not that season, other organs transmit the disease to it. (For example, the Liver should become diseased in Spring, as it is its ruling season. However, the Liver may also become diseased outside the Wood season precisely because the Lung was first invaded by pathogens and transmitted them to it. The principle applies similarly to all other Zang and Fu organs becoming diseased out of season. Thus, although all five Zang and six Fu organs can produce cough, none occurs without involvement of the Lung.) Humans correspond with Heaven and Earth; therefore, when each of the five Zang organs contracts cold during its ruling season, it becomes diseased. Mild cases result in cough, while severe cases result in diarrhea or pain. ("Ruling season" refers to the time when a specific Qi governs. The aforementioned combination of internal and external pathogens corresponds to these symptoms. Mild pathogens remain superficial and in the exterior, resulting in cough; severe pathogens penetrate deeply into the interior, resulting in diarrhea or pain.) In Autumn, the Lung is first invaded; in Spring, the Liver is first invaded; in Summer, the Heart is first invaded; during the late summer (extreme Yin), the Spleen is first invaded; in Winter, the Kidney is first invaded. (This refers to contracting disease during the ruling season; thus, the organ corresponding to that season is inevitably affected first.) How can they be distinguished? (The following differentiates the coughs of the five Zang organs.) The manifestation of Lung cough includes coughing with wheezing and audible sounds; in severe cases, hemoptysis occurs. (The Lung governs Qi and respiration; thus, wheezing with sounds and hemoptysis occur随 the cough, indicating the pathology resides in the Lung, differing from hematemesis.) The manifestation of Heart cough includes heart pain upon coughing, a sensation of obstruction in the throat as if something were stuck, and in severe cases, sore throat and glottal obstruction. (The Heart and Lung meridians originate from the Heart, belong to the Heart system, and ascend alongside the pharynx; thus, pathology manifests as a feeling of obstruction in the throat, sore throat, and glottal obstruction. "Jie jie" describes the sensation of being obstructed or hindered.) The manifestation of Liver cough includes pain under both hypochondria upon coughing; in severe cases, turning the body is impossible, and turning exacerbates fullness under both hypochondria. (The Liver meridian spreads over the hypochondriac region, hence such pathology. "Dai" refers to the area under the axilla and hypochondrium.) The manifestation of Spleen cough includes pain under the right hypochondrium upon coughing, dull pain radiating to the shoulder and back; in severe cases, movement is impossible, and movement aggravates the cough. (The Spleen meridian ascends through the diaphragm and flanks the pharynx; its branch diverges from the Stomach, ascends through the diaphragm, hence causing pain under the hypochondrium and dull pain radiating to the shoulder and back. The Spleen corresponds to Earth, whose nature is quiet; thus, in severe cases, movement is impossible, and movement increases severity. Spleen cough causing right hypochondriac pain is because Yin Earth Qi corresponds to Kun, emerging from the southwest. The great Luo vessel of the Stomach is named Xuli, piercing the diaphragm and connecting with the Lung, emerging below the left breast; does this not indicate that Yang Earth Qi corresponds to Gen, emerging from the northeast? This reflects the correspondence between humans and Heaven and Earth.) The manifestation of Kidney cough includes pain in the waist and back radiating to each other upon coughing; in severe cases, salivation is coughed up. (The Kidney meridian penetrates the spine and is connected to the waist and back, hence the radiating pain. Its straight branch enters the Lung, follows the throat; thus, in severe cases, saliva is coughed up, as the Kidney is the Water organ governing saliva and fluids.) From where do the coughs of the six Fu organs arise? (The following differentiates the coughs of the six Fu organs.) Coughs of the five Zang organs, if prolonged, transfer to the six Fu organs. (If Zang cough persists, the disease extends to the Fu organs, transferring via their exterior-interior relationships.) If Spleen cough persists, the Stomach is affected. The manifestation of Stomach cough includes coughing and vomiting; in severe cases, roundworms are expelled. (The Spleen and Stomach are exterior-interior paired; thus, persistent Spleen cough inevitably affects the Stomach. The Stomach cannot accommodate, leading to rebellious Qi and vomiting. Chang chong refers to roundworms, residing in the intestines and stomach; severe vomiting expels them upward with the Qi. "Hui" is pronounced like "hui".) If Liver cough persists, the Gallbladder is affected. The manifestation of Gallbladder cough includes coughing and vomiting bile. (Bile is a bitter fluid.) If Lung cough persists, the Large Intestine is affected. The manifestation of Large Intestine cough includes coughing with fecal incontinence. ("Shi" means stool.) If Heart cough persists, the Small Intestine is affected. The manifestation of Small Intestine cough includes coughing with flatus, where gas is lost simultaneously with coughing. (Below the Small Intestine lies the Large Intestine. The Qi of the Large Intestine derives from the transformation by the Small Intestine; thus, when the Small Intestine is invaded and coughs, there is downward rushing and loss of gas.) If Kidney cough persists, the Bladder is affected. The manifestation of Bladder cough includes coughing with urinary incontinence. (The Bladder is the reservoir of fluids; thus, when pathogens reside within, coughing accompanies urinary incontinence.) If chronic cough persists, the San Jiao is affected. The manifestation of San Jiao cough includes coughing with abdominal fullness and loss of appetite. (Chronic cough affects the upper, middle, and lower San Jiao; excretion, intake, ascending, and descending functions lose harmony, resulting in abdominal fullness and inability to eat or drink.) All these coughs gather at the Stomach and relate to the Lung, causing excessive nasal discharge and saliva, facial edema, and rebellious Qi. (The following summarizes the symptoms of various coughs and touches upon treatment. All coughs gather at the Stomach and relate to the Lung because the Stomach is the root of the five Zang and six Fu organs, and the Lung is the exterior correspondence of the skin and hair. As mentioned earlier, "skin and hair first invaded by pathogens" and "cold food entering the Stomach" are signs of Lung and Stomach pathology. the Yangming meridian originates at the nose, converges on the face, and emerges from the mouth, hence causing excessive discharge and facial edema; the Lung is the canopy of the organs and governs Qi, hence causing cough and rebellious Qi.) To treat Zang diseases, use Shu (Stream) points; to treat Fu diseases, use He (Sea) points; for edema, use Jing (River) points. (Where the pulse notes is the Shu point, where it enters is the He point, and where it flows is the Jing point. This applies to all Zang and Fu organs. Cough pathology must involve the Lung, yet "all five Zang and six Fu organs can cause cough"; it is also said "each Zang organ becomes diseased in its season, and others transmit to it," indicating it is not solely in the Lung. Generally, coughs are divided into internal injury and external contraction. There are cases transmitting from the Lung to the Zang organs, and from the Zang organs to the Lung. For instance, wind, cold, summer-heat, and dampness invading externally first strike the skin and hair; since the skin and hair are the Lung's exterior correspondence, unresolved pathogens transmit from the Lung to other Zang organs. Conversely, labor, desire, and emotional injuries internally damage Zang Qi, starting from the Yin aspect affecting the Upper Jiao, transmitting from other Zang organs to the Lung. Pathogens entering from the exterior affect the Yang aspect; thus, treatment should disperse from the exterior using acrid and warm methods to identify the pathogen's nature and scatter it, clearing Lung Qi and resolving cough. Pathogenesis arising internally injures the Yin; deficiency of Yin below leads to floating Yang above, drying up water and withering Metal, causing Lung dryness. Dryness causes itching, which perpetuates cough. Treatment here should use sweet flavors to nourish Yin and moistening agents to nourish the Lung, restoring water and Qi to calm the Lung. Generally, drugs treating exterior pathogens should not be static; stagnation allows pathogens to linger and transform into other diseases, so cold and astringent agents are strictly contraindicated. Drugs treating interior syndromes should not be dispersing; dispersion unsettles deficient fire, prevents restoration of true Yin, and worsens dryness and itching, aggravating the disease, so acrid and aromatic Yang-assisting agents are strictly contraindicated. However, while treating exterior syndromes requires dispersal, if both constitutional Qi and pathogenic Qi are deficient, one must tonify Middle Qi and assist with warm-diffusing herbs; exclusive dispersal may weaken Lung Qi further, loosen interstices, allow external pathogens to invade due to deficiency, and worsen the condition. While treating interior syndromes requires stillness to nourish Yin, if Mingmen Yang deficiency fails to grasp Qi, herbs like Ginseng, Ginger, Cinnamon Twig, and Aconite Root are necessary; otherwise, Qi cannot transform fluids, ultimately failing to aid Yin. For heat pathogens, clear heat; for damp pathogens, promote diuresis; for phlegm, descend phlegm; for Qi stagnation, regulate Qi. Although medical texts list many categories, the root causes are only wind-cold and exhaustion. Wind-cold is attributed to Yang excess; exhaustion is attributed to Yin deficiency. This is the guideline for cough syndromes. Other symptomatic treatments merely adjust based on observed symptoms and are not root-treating methods. For elderly patients with chronic cough, having depleted primordial Qi, complete cure is difficult; warming and nourishing the Spleen and Lung, or combining symptomatic treatment, is preferred, aiming only to prevent emaciation and debility. Seeking miraculous effects through aggressive attack is inadvisable.)