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As long as one examines the *Waitai Miyao* (Secret Essentials of the Outer Hall) authored by Wang Tao of the Tang Dynasty, it divides cough into ten types: The first is called Wind Cough (Feng Ke), characterized by the inability to finish speaking due to coughing. The second is called Cold Cough (Han Ke), caused by drinking cold water or consuming cold-natured foods, which酿s the cough syndrome.

The third is called Branch Fluid Retention (Zhi Yin), where fluid retention obstructs the chest and diaphragm; its symptoms include hardness and fullness below the heart, pain radiating to all four limbs during coughing, and a pulse that appears slow (Chi). The fourth is called Liver Cough (Gan Ke), where coughing pulls and causes pain in both hypochondriac regions. The fifth is called Heart Cough (Xin Ke), accompanied by hemoptysis, because it stimulates the Shaoyin Heart meridian.

The sixth is called Spleen Cough (Pi Ke), where saliva flows from the mouth continuously during coughing, pulling downward to the lower abdomen. The seventh is called Lung Cough (Fei Ke), where coughing pulls on the neck and throat, causing frequent spitting of saliva without cessation. The eighth is called Kidney Cough (Shen Ke), characterized by deafness (inability to hear), with pulling sensations in the waist and umbilical region. The ninth is called Gallbladder Cough (Dan Ke), where coughing pulls to cause headache and bitter taste in the mouth. The tenth is called Jueyin Cough (Jueyin Ke), where coughing pulls on the root of the tongue. [Note: "Ke" is the ancient character for modern "Cough". Editor's note.] These ten types of cough diseases have different etiologies and distinct symptoms; thus, their treatment methods each have their own specific approaches and formulas. One absolutely cannot confuse them or shift treatments arbitrarily. I would like to ask Western physicians: You research bacteria as the primary cause of cough, whereas we in the Tang Dynasty already divided cough into ten types. Now, how many types of cough-causing bacteria have you classified? If you cannot classify them into types, then treating Cold Cough, Heat Cough, Lung Cough, and Kidney Cough with the same medication would be disastrous, would it not? Since you have discovered bacteria, please continue your relentless efforts and research to further categorize these cough-causing bacteria; only then would it be acceptable.

If one argues that because foreigners have not invented something, Chinese people dare not propose other theories, that is a servility drilled into the bones, incurable.

The more foreigners have not invented something, the more we must study and strive. "People compete for a breath of pride, Buddhas compete for an incense stick." To publish what outsiders have not published and clarify what they have not clarified, I invite all Western physician gentlemen to base yourselves on TCM books and become astonishing great inventors.

I will now introduce Mr. Gao Shizong’s *Treatise on Cough* from the Qing Dynasty. Mr. Gao stated that folk sayings hold that various diseases are easy to treat, but cough is difficult to cure. The reason cough is difficult to cure is that its origins are numerous, extending beyond just the Lung. Currently, when encountering cough, it is simply labeled as a Lung disease, and dispersing, phlegm-resolving, cooling, and lung-moistening medications are immediately administered. As medications are taken daily, the cough worsens daily. The diseased meridians do not receive proper treatment, while healthy meridians suffer undeserved harm. If unresolved after one month, a deficiency syndrome will form; if unresolved after two months, the deficiency syndrome is established; if dragged out to one hundred days, although life may not yet be lost, the person has entered a category of incurable conditions.

The *Suwen·Treatise on Cough* states: "All five zang organs and six fu organs can cause cough, not just the Lung." Therefore, at the onset of cough, some originate from the Kidney, some from the Liver, some from the Spleen, some from the Pericardium, some from the Stomach, some from the Upper and Middle Jiao, and some from the Lung. Treatment must investigate the source. The method for investigating the source lies in examining symptoms. If there is itching in the throat leading to cough, this is due to flaming heat qi rushing upward. Just as smoke rises before fire ignites, smoke rising against the throat causes itching and cough. In early wind-cold invasion, a slight itch in the throat that feels relieved by swallowing hot drinks indicates cold congealing in the Upper Jiao, causing throat dysfunction and cough. Whether cold or heat, the Upper Jiao should be treated. If there is itching in the chest, this indicates internal deficiency of fluids and blood in the Middle Jiao, causing throat dysfunction and cough. Whether cold or heat, the Middle Jiao should be harmonized. This describes cough with throat itching belonging to the Upper and Middle Jiao. If qi rushes upward causing cough, this is due to Liver and Kidney deficiency. The Heart and Lungs reside above; the Liver and Kidneys reside below. The Kidney is the Water Organ, paired with the Bladder Fu organ. Following the Taiyang Qi, it emerges through the skin and hair to connect with the Lung. The Lung represents Heaven; Water and Heaven are one Qi, circulating endlessly. Now, if the Kidney is internally deficient and cannot coordinate with the Water Fu organ to circulate through the skin and hair, Kidney Qi rushes upward from the Central Earth. Upward rushing causes cough; this upward-rushing cough belongs to the Kidney. Furthermore, the Liver stores Blood, and the blood of the Chong and Ren seas is governed by the Liver. When blood is hot and fills the skin, flowing through the hair follicles, upon lying down, blood returns internally to the Liver. Now, if the Liver is internally deficient and fails to coordinate the Chong and Ren blood to emerge through the skin and pores, Liver Qi rushes upward from the Pericardium. Upward rushing causes cough; this upward-rushing cough belongs to the Liver. There are also cases of vomiting blood followed by cough. Vomiting blood damages the Liver internally, and the Pericardium becomes deficient, causing Pericardium Fire to attack Lung Metal. The Pericardium governs blood vessels; when blood vessels are deficient, fever occurs at night and coughing during the day, potentially progressing to coughing and fever both day and night. This is consumptive cough, where blood is injured first, then Qi, leading to exhaustion of both Yin and Yang and deficiency of both Qi and Blood. Nourishing Yin medications are appropriate, while warming and tonifying medications are inappropriate. Such coughs rarely survive; this type belongs to the Pericardium. Hand-Taiyin belongs to Lung Metal, representing Heaven; Foot-Taiyin belongs to Spleen Earth, representing Earth. In Six Qi theory, Earth generates Metal; in Zang-Fu relations, Heaven and Earth interact. Now, if Spleen Earth is internally deficient, Earth cannot overcome Wood, causing phlegm and saliva to surge upward. First, Spleen disease prevents Earth Qi from ascending, thereby causing Lung disease as Heaven Qi fails to descend. Cough must be accompanied by wheezing; this cough belongs to the Spleen and Lung. The Stomach is the Sea of Water and Grain; its Qi belongs to Yangming. Foot-Yangming governs the Stomach, Hand-Yangming governs the Large Intestine. Above Yangming, Dryness Qi governs, and its Qi moves downward. Now, if Yangming Qi does not move downward, either excessive dryness leads to flaming fire, or loss of dryness leads to fluid retention. Coughing up yellow sputum indicates Stomach dryness-heat; internal accumulation of phlegm-fluid indicates Stomach deficiency-cold. This is Gastrointestinal Cough. Although the cough may not resolve immediately, it does not lead to death instantly. Treatment should focus on resolving phlegm and dissipating fluid retention; this cough belongs to the Stomach. Phlegm gathers in the Stomach and must exit via cough; thus, the *Xiaolun* states that phlegm gathers in the Stomach and affects the Lung. If one does not understand the source of cough and merely treats with Lung-clearing, phlegm-resolving, wind-dispersing, and Qi-promoting methods, it harms oneself. For wind-cold cough, if initial treatment with clearing and dispersing medications fails, this is Deficient Wind-Cold. It strictly forbids cold-natured dispersing agents; with appropriate prescription, gradual recovery is possible. In winter, if Kidney Qi is insufficient and Water fails to generate Wood, leading to internal Liver Qi deficiency, runny nose and uncontrolled nasal discharge occur, indicating deficiency. Wind-cold also forbids dispersing; with appropriate prescription, by spring when warmth thaws the ice, nasal discharge stops and nasal passages clear. This covers the general principles of cough. Grasping the intent and extending it, one might succeed.

Mr. Gao Shizong’s *Treatise on Cough* divides cough among the Five Zang and Six Fu organs. I ask: Can bacteria distinguish between the Five Zang and Six Fu organs? Does the Lung have Lung bacteria, the Liver Liver bacteria, the Stomach Stomach bacteria, and the Intestines Intestine bacteria? Any field of study benefits from finer and more precise differentiation, especially medicine, which concerns human life and death. If one does not differentiate Zang-Fu, does not distinguish Cold-Heat, and does not辨 Deficiency-Excess, but relies on a generalized concept of "one type of bacteria" with arrogance, is this not sufficient to stop?

Regarding Winter-Warmth Disease: This condition differs from other Warm Diseases. Other warm diseases usually result from contracting seasonal pathogens, with illness appearing immediately upon infection. Winter-Warmth, while related to seasonality, does not arise from sudden contraction. Instead, pathogens lie dormant deep within for a long time. When winter climate becomes abnormal (too warm or too cold), even a slight external trigger can activate them. The sudden pathogen activates the latent pathogen, creating an internal-external synergy that is uncontrollable once released, like foreign invaders approaching while rebels rise everywhere. Treating external invaders is easier; treating hidden rebels is hardest. Neither sweating nor purging methods are applicable; the three methods of sweating, vomiting, and purging are all contraindicated.

Good and bad plants grow together; virtuous and wicked people mix. Treating Winter-Warmth requires a clear plan, neither激 nor passive. One must clear internal heat and protect Yin fluids while using light, clear, and mobile substances to guide pathogens outward. Ensure pathogens leave without damaging healthy Qi. Ancient masters Ye Tianshi and Wang Mengying were saints in treating warm diseases; we should take them as our standard. This year, winter climate was excessively warm, leading to many Winter-Warmth cases. I deeply hope patients recognize the nature of their illness and do not seek quick fixes that lead to major errors.

Record of the TCM Friend Voice Society: Mr. Cheng Diren and Mr. Yu Tongfang of the TCM Friend Voice Society, observing academic groups in Shanghai (Haishang), particularly in the TCM community, noted that everyone focused on the "Society/Association" aspect rather than the "Learning/Scholarship" aspect, which seemed of little benefit to academic progress. Thus, they wished to organize a pure academic group dedicated solely to scholarship. They consulted me, and I enthusiastically agreed, naming it the "TCM Friend Voice Society."

The society’s organization has no hierarchy; all members are equal. Difficult cases are discussed openly, relying on experience and knowledge, with rigorous debate until issues are thoroughly resolved.

Members examine patients with meticulous attention to Inspection, Auscultation/Olfaction, Inquiry, and Palpation, never tiring of detail. Viewing patient suffering as their own, they seek the root cause before prescribing. Any doubts are raised within the society for discussion to advance scholarship.

Daily radio broadcasts share TCM common sense with society. Renting the Yan Studio at the Great World, representatives speak from 6:45 PM to 7:30 PM. Three representatives rotate: Cheng Diren discusses gastrointestinal diseases, Yu Tongfang discusses women’s diseases, and Shi E discusses the Medical Consultant Encyclopedia. Each serves five days, twice a month, rain or shine.

Members cooperate harmoniously, meeting every five days to discuss only academics, avoiding politics and economics. This brings us comfort.

Regarding the TCM Regulations: The National Government promulgated them on January 22, Year 25 (1936). Shanghai TCM groups celebrated joyfully under the leadership of the Shanghai TCM Branch Office. With legal protection, TCM practitioners can now live and work securely, stable as Mount Tai and firm as a rock.

However, my private view is that TCM’s existence holds true value, impervious to destruction, shaking, or disruption by external forces.

The drug properties explained in the *Bencao*, the pulse signs and syndromes detailed in the *Shanghan Lun*, and the prescribed treatments have proven effective hundreds, thousands, and millions of times. For five thousand years, they have penetrated people’s hearts. Therefore, we today must inherit this virtue, carefully studying Zhang Zhongjing’s works, seeing the unwritten in the written, balancing pulses and differentiating syndromes, exploring roots and sources. Using Zou Run’an’s *Benjing Shuzheng* as a research method, we must be grounded, ensuring every word has a source, seeking no novelty, adhering to the great and correct path, aiming for practical utility.

If TCM achieves this, diseases untreatable by foreign doctors will be curable by TCM. TCM’s reputation and achievements will spread worldwide. I believe nations will abandon their固有 studies to learn TCM. Strive on, TCM colleagues.

On Liu’s Interpretation of the *Shanghan Lun*: Liu Zhongmai of Liuyang wrote *Yishu on the Shanghan Zabing Lun*. Liu had profound mastery of the *Shanghan*, unlike those who seek fame.

Liu valued pulse signs most, supplementing any unclear pulse descriptions in the original text.

For difficult-to-understand clauses, Liu deleted, modified, and supplemented them, attributing changes to secret ancient editions, differing significantly from Ke Yunbo’s bold direct acceptance.

Where the original text had syndromes but no formulas, Liu supplied them, borrowing from *Jingui Yaolue* or creating new ones, modifying original formulas. His supplements were more appropriate than Shu Chi Yuan’s.

In discussing Summer-Heat and Warmth, he forged multiple clauses mimicking the original style, attributing them to secret ancient editions. I consider this book Liu’s *Shanghan Lun*, not Zhongjing’s, as it rigidly dictates interpretations, contrary to Zhongjing’s flexible wisdom.

To read Zhongjing’s book, one must study meticulously like Mr. Zou Run’an of Wujin to see his true face; other theories are largely superfluous. This is my view, submitted to scholars nationwide.

Overseas TCM (Curing Chronic Illness in America): Once disregarded by outsiders, TCM is gradually gaining attention in the US. Many overseas Chinese, despite westernized lifestyles, prefer Chinese medicine over Western diagnosis when ill. Thus, in dense Chinese communities in New York, Boston, Chicago, and San Francisco, many TCM practitioners reside. Since few non-Chinese seek their care, US authorities have not mandated registration. Estimates suggest 100–130 practitioners across 48 states. While some practice full-time, at least two-thirds are merchants practicing part-time. Fees vary widely, from $1 to $5 per visit. Some operate pharmacies; others send prescriptions to partners’ pharmacies.

Mr. Lobinson, an American in San Francisco, suffered severe stomach disease. Despite famous doctors, his condition worsened. By last spring, he could barely work and contemplated suicide. A Chinese friend suggested consulting his uncle in Chicago, a merchant proficient in medical theory. Initially skeptical, Lobinson tried it out of desperation. After careful diagnosis, he took bitter herbal decoctions and coarse gray-black pills for a week, then dark brown pills for another week. His appetite increased, weight gained 14 pounds, and he recovered suddenly. Another San Francisco resident, Charles, suffered neurasthenia resistant to all medicines. He visited a TCM doctor he had met once. The doctor provided massage at 10 AM and 10 PM daily, plus a medicinal juice once daily. After ten days, symptoms greatly reduced; fully cured after one month.

Newspapers commented on these cases. Physicians in New York and San Francisco analyzed the remedies but found no special components. Researchers requested raw materials for further analysis. Simultaneously, pharmacologists studied Chinese herbs, acknowledging that certain plant roots and barks contain substances superior to mineral drugs, a fact recognized by the local medical community. (Zhu Ying) Shi E comments: TCM and Western Medicine differ in starting points and treatment means. TCM focuses on Six Channels, Triple Burner, and mutual rooting of Yin and Yang—concepts unknown to Western Medicine. TCM treatment emphasizes formula organization, not individual drug temperature/nature. It combines diverse drugs in one pot to reach the disease site directly. Western Medicine dissects one drug into dozens of components to understand its use. Moreover, TCM treatment varies by disease, individual, and environment, leading to diverse methods. Western Medicine’s attempt to analyze this with rigid chemical methods is like carving a mark on a boat to find a sword (seeking reality in illusion) or waiting by a stump for a hare (passive rigidity)—how can it succeed?

Reading the *Shanghan Lun*: The text states: "After purgation, followed by sweating, if the patient is restless and unable to sleep during the day but quiet at night, without vomiting, thirst, or exterior signs, with a deep and faint pulse, knowing there is no significant heat, Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) is indicated." Interpreters often swallow this whole without chewing. "After purgation" implies interior signs existed before purgation. "Followed by sweating" implies exterior signs existed before sweating. Logically, one cannot have interior signs first and exterior signs later; thus, the initial disease had both exterior and interior aspects. When both exterior and interior are involved, Zhongjing prioritizes treating the exterior first; only after the exterior resolves can the interior be attacked. Unskilled doctors ignore this sequence, making mistakes and creating complicated disorders. Daytime restlessness with nighttime quietness indicates extreme Yang deficiency. The patient relies on daytime Heavenly Yang to feel restless; at night, Yin dominates, making restlessness impossible. This is a pure Yin, no Yang presentation.

"Why 'no vomiting, no thirst, no exterior signs'?" Vomiting is a Shaoyang sign; the text says "vomiting with fever indicates Chaihu Tang syndrome." "No vomiting" rules out Shaoyang. Thirst is a Yangming sign; the text says "thirst belongs to Yangming." "No thirst" rules out Yangming. "No exterior signs" rules out Taiyang. An old story tells of a man hiding thirty taels of silver under a threshold, fearing theft. He told his neighbor, a thief named A-Er, to warn him, writing "No Silver Under Here." A-Er stole it anyway, replacing the sign with "Neighbor A-Er Did Not Steal." Though allegorical, this shows "no vomiting, no thirst, no exterior signs" cannot be ignored casually. If vomiting, thirst, or exterior signs were present, different treatments would be needed. Deep pulse indicates lack of Yang; faint pulse indicates Qi deficiency. Significant heat would require different treatment. Absence of significant heat confirms Yang decline, hence Ganjiang and Sheng Fuzi are used to urgently rescue Yang. All *Shanghan Lun* clauses should be read with such depth.