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(Luo Er Shou, Fa Shi Liu Tiao, Lü Liu Tiao)

Yu Chang said: Regarding the syndrome of coughing (Ke), if one consults the *Huangdi Neijing* (Yellow Emperor's Inner Canon), the content is extensive yet lacks the essential key points; if one consults the *Jinkui Yaolue* (Essential Prescriptions of the Golden Cabinet), it only attaches five formulas after Phlegm-Fluids (Tan Yin), without any dedicated discussion. Reluctantly seeking guidance in the works described by later sages, although they are as dazzling as jade and non-stop scattered on the desk, ultimately each expresses their own insights with little convergence. If I do not transmit absurd and vague theories to future generations, what else can I say? I have repeatedly reviewed the text of the *Huangdi Neijing*. The Yellow Emperor asked Qibo: "What causes the lung to make a person cough?" Qibo replied: "All five zang organs and six fu organs are sufficient to cause coughing, not just the lung." This statement pushes open the view of lung-specific coughing, seemingly involving too abrupt a generalization. If at that time, lung cough had been stated first and then gradually detailed, there would be no doubt, and later generations would have established methods to follow. It is not so. The establishment of words by sages merely expands upon the text to reveal profound meanings, slightly opening the beginning. If one insists on detailing everything, it does not conform to the style of capturing the essence in few words. Therefore, reading the *Huangdi Neijing* values self-discovery of its essentials. Grasping the essence allows one to conclude with a single word; failing to grasp it leads to infinite dispersion. Is this not true only for the syndrome of coughing? In the words where the Yellow Emperor instructed Leigong, it says: "Not knowing analogy (Bilei) is sufficient to confuse oneself, insufficient to clarify oneself." It is indeed known that the method of analogy is sufficient not only to cover the meaning of the *Huangdi Neijing* but also to cover the meaning of the infinite and boundless. Just as looking at the sky through a tube or measuring the sea with a ladle, the texts overlooked by the *Huangdi Neijing* over thousands of years, once analogy is understood, can be verified as consistent in one hall. When facing complex diseases, handling them with ease is taken for granted. Let me elaborate further. Although Qibo stated that all five zang and six fu organs can cause coughing, his emphasis lies entirely on the lung. Observing the following text: "The skin and hair are the exterior correspondence of the lung. When pathogenic factors first invade the skin and hair, they enter the interior through this correspondence. Cold food entering the stomach travels up along the stomach meridian to the lung, causing lung cold. Lung cold results in the combination of internal and external pathogenic factors, which then lodge in the lung, resulting in lung cough." This cites one aspect of damage to the lung due to external cold exposure and cold beverages to explain the initial cause of coughing. The four characters "combination of internal and external pathogenic factors" (Neiwai Hexie) capture the essence; the method of analogy emphasizes this point. The human body has external pathogens, internal pathogens, combined internal and external pathogens, cases where external pathogens are gone but internal ones remain unresolved, and cases where internal pathogens are cleared but external ones are not fully eliminated. With simple analogy, these become clear. Why not distinguish them early and allow them to brew deep troubles? "Formal cold" refers to external contraction of wind-cold. "Drinking cold" refers to internal injury from diet. Formless pathogenic factors like wind-cold entering the interior combine with tangible pathogenic factors from diet, inevitably lingering. Treatment requires expelling external pathogens outward and internal pathogens downward, but one cannot treat both exterior and interior simultaneously. The five formulas in the *Jinkui Yaolue* generally do not go beyond modifications of Xiao Qinglong Tang (Minor Blue Dragon Decoction). Thus, the *Huangdi Neijing* has its discussion, and the *Jinkui Yaolue* has its formulas. For what is absent in both, seeking it through analogy, where should one start? Proceeding to explore damp-heat (Shushi), damp-heat pathogenic factors are also sufficient to cause coughing. Generally, when external damp-heat enters the interior, it must combine with pre-existing heat pathogens, increasing vexatious coughing. One should use acrid-cool dispersing methods, changing the example of Xiao Qinglong Tang to Baihu Tang (White Tiger Decoction), and additionally using formulas such as Tianshui San (Heavenly Water Powder) and Wuling San (Five苓 Powder). Proceeding to explore fire pathogens, there is a combination of Ministerial Fire (Xiang Huo) and Sovereign Fire (Jun Huo), but no combination of internal and external pathogens, yet ten out of eight or nine cases of causing coughing arise from this. Since the heart and lung reside together above the diaphragm, heart fire easily controls lung metal. However, sovereign fire governs without action and rarely moves spontaneously. Sometimes laboring the heart causes coughing, and resting the heart stops the cough naturally, which is not yet a disaster of peeling skin. Only ministerial fire rises from below, carrying the majesty of sovereign fire to punish the lung. Upper and lower pathogenic combinations cause the most severe harm. Treatment can also be analogized to the example of combined internal and external pathogens, either guiding down or reducing down to suppress the fire, preventing it from spreading like a prairie fire. Among these, coughing with vexation and resentment, with rebellious kidney qi, also belongs to upper-lower combination. However, turbid yin qi invades clear yang upwards, blocked by the diaphragm and huang, allowing the vexation to persist without emergence. Only by driving down the turbid yin will the cough stop. Proceeding to explore dryness (Zao), internal and external, upper and lower, initially have no fixed attribution. It may be due to excessive sweating or vomiting causing fluids to escape outward; or prolonged diarrhea causing yin loss downward; or deficient nutritive blood failing to nourish sinews; or exhausted essence and marrow failing to fill bones. This leads to daily drying of lung metal, inability to resist invading fire, and ceaseless coughing. At this time, urgently generating fluids, nourishing blood, and supplementing essence and water can still save the situation. Missing this opportunity to treat, in a blink, jars become empty and cups dry, hair becomes brittle and complexion deteriorates, sinews contract and nails wither, cough pulls chest and back, hypochondriac pain hangs, lung qi stagnates, various wasting-thirst syndromes, wheezing, and vomiting occur, throat obstruction and bloody stool appear, and various critical signs follow sequentially. What method remains to moisten this scorched dryness? The Classic states that if coughing persists and white blood is expectorated, death ensues. Is this not because the lung is fried by dryness-fire and rots, and its blood transforms according to metal properties becoming white? As for coughing from all five zang and six fu organs, which the *Neijing* does not exhaustively describe, they can essentially be understood through analogy and integration. My limited knowledge, starting from the aspect of formal cold and cold beverages damaging the lung, analogizing to damp-heat, fire, and dryness, is merely a rough aid to inspire intelligence. Deep theoretical discussions from the root must await future generations.