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Huangdi asked: How can they be distinguished? Qibo replied: The manifestations of Lung Cough (Fei Ke) include coughing with wheezing and audible sounds, and in severe cases, expectoration of blood. The manifestations of Heart Cough (Xin Ke) include heart pain upon coughing, a sensation of obstruction in the throat as if something were stuck, and in severe cases, sore throat and throat obstruction (Hou Bi). The manifestations of Liver Cough (Gan Ke) include pain under both hypochondria upon coughing, inability to turn the body in severe cases, and fullness under both hypochondria when turning. The manifestations of Spleen Cough (Pi Ke) include pain in the right hypochondrium upon coughing, radiating to the shoulder and back, inability to move in severe cases, and exacerbation of cough upon movement. The manifestations of Kidney Cough (Shen Ke) include pulling pain between the lower back and waist upon coughing, and expectoration of saliva in severe cases.

Since the locations of the five Zang organs differ and their meridians circulate differently, the specific symptoms vary depending on which organ is affected by pathogenic factors. By distinguishing these symptoms, one can identify the location of the pathogen and treat accordingly. The affected Zang organ is the root (Ben), while the Lung is the branch (Biao). Eliminating the root leads to the resolution of the branch and cessation of the cough. It is no wonder that modern practitioners who only treat the Lung often fail to achieve efficacy.

Chronic cough of the five Zang organs may transmit to the six Fu organs. If Spleen Cough persists, it transmits to the Stomach; the manifestation of Stomach Cough (Wei Ke) includes coughing with vomiting, and in severe cases, expulsion of roundworms (Chang Chong). If Liver Cough persists, it transmits to the Gallbladder; the manifestation of Gallbladder Cough (Dan Ke) includes coughing with vomiting of bile. If Lung Cough persists, it transmits to the Large Intestine; the manifestation of Large Intestine Cough (Da Chang Ke) includes coughing with involuntary defecation. If Heart Cough persists, it transmits to the Small Intestine; the manifestation of Small Intestine Cough (Xiao Chang Ke) includes coughing with flatus, where gas loss occurs simultaneously with coughing. If Kidney Cough persists, it transmits to the Bladder; the manifestation of Bladder Cough (Pang Guang Ke) includes coughing with urinary incontinence. If chronic cough persists, it transmits to the San Jiao (Triple Burner); the manifestation of San Jiao Cough (San Jiao Ke) includes coughing with abdominal fullness and loss of appetite. All these conditions involve pathogenic accumulation in the Stomach and involvement of the Lung, causing excessive phlegm and saliva, facial edema, and rebellious Qi.

When Zang diseases persist, they transmit to the Fu organs, and their respective coughs present distinguishable symptoms. "Chang Chong" refers to roundworms. Bile is bitter fluid. The San Jiao envelops the exterior of the Zang and Fu organs, hence the disease transmits to the San Jiao last. The Stomach is the sea of the Zang and Fu organs, and the Lung governs the Qi of the whole body. Therefore, although the disease originates in various Zang and Fu organs, it inevitably accumulates in the Stomach and involves the Lung to form a cough. If it did not involve the Lung, it would not cause cough but other diseases. Normally, the Spleen's Qi scatters the essence of food and drink upward to the Lung, where fluids are distributed throughout the body and transported downward to the Bladder. Chronic cough damages Lung Qi, impairing its ability to distribute fluids; thus, fluids follow the rebellious Qi upward, resulting in excessive phlegm and saliva, facial edema, and rebellious Qi.