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Jieguo stated: Cough (Ke Sou) results from dampness (Shi) injured in autumn, accumulating in the Splein Meridian. It is said that "autumn injury by dampness leads to cough in winter." Generally, the qi of early autumn should be clear and肃 (solemn/clearing). If disturbed by contrary factors, the qi must rush upward, causing cough; if severe, it moves with dampness to transform into phlegm (Tan). Thus, it is known that if the Spleen has no retained dampness, even if the Lung Qi is injured, phlegm will not be produced. For coughs with phlegm, cold patterns are few while heat patterns are many; treatment should follow the differentiation of the Five Zang Organs. For example, dampness in the Liver Meridian is called Wind-Phlegm (Feng Tan); dampness in the Heart Meridian is called Heat-Phlegm (Re Tan); dampness in the Spleen Meridian is called Damp-Phlegm (Shi Tan); dampness in the Lung Meridian is called Qi-Phlegm (Qi Tan); dampness in the Kidney Meridian is called Cold-Phlegm (Han Tan). Treatment should be adapted to the specific pattern.

For cough without phlegm, acrid-sweet herbs should be used to moisten the Lung. For cough with phlegm, treating phlegm is the priority. Therefore, Tian Nan Xing (Arisaema Rhizoma) and Ban Xia (Pinellia Rhizoma) are used to overcome phlegm, so that cough heals spontaneously; Zhi Qiao (Immature Bitter Orange) and Chen Pi (Tangerine Peel) are used to promote Qi movement, so that phlegm descends naturally.

Commentary: This discussion points out that cough is caused by dampness staying in the meridians leading to phlegm production and cough, which can occur in all five Zang organs. This can be said to have revealed the secrets of the *Neijing* (Inner Canon). However, when cough is caused by Qi stagnation and failure of fluids to descend, or by retained water/fluid retention (Yin), or by Kidney Qi deficiency with fire flaming upward and drying up fluids, causing fluids to surge as phlegm-saliva above, these belong to diseases of Qi/fluid dynamics and True Zang organs, not diseases caused by retained dampness in various meridians. Therefore, Yilao (Zhang Yuansu) said: "Ban Xia can only drain the branch (biao) of phlegm but cannot treat the root (ben) of phlegm." This is correct. Examining the aforementioned statement about using Zhi Qiao etc. to promote Qi and descend phlegm, this is likely not Yilao's original words.

Danxi stated: Cough in the first half of the day belongs to Fire in the Stomach; cough in the afternoon belongs to Yin Deficiency; frequent cough at dawn (Wu Geng) indicates Food Accumulation (Shi Ji) in the Stomach. At this time, food stagnation obstructs Lung Qi, making it unsmooth, affecting various pathogens or phlegm similarly. In Spring, it is due to Spring Ascending Qi; in Summer, Fire flaming upward is most severe; in Autumn, Damp-Heat injures the Lung; in Winter, Wind-Cold comes from outside.

*Yuan Bing Shi* states: People who are thin have loose interstices (Cou Li) and sweat easily, leading to blood deficiency and dryness-heat, thus they often suffer from Laborious Cough (Lao Sou).

Danxi stated: Cough without phlegm is a syndrome of Fire Depression (Huo Yu), where phlegm is depressed and Fire pathogen is in the middle. Combined with Jie Geng (Platycodon Root) to open and lift, and below, use Yin-nourishing and Fire-descending herbs. If this does not work, it becomes Consumption/Laborious Disease. This condition is often seen in those who are frustrated or dissatisfied.

Carefully noted: Cough without phlegm is originally due to Lung Qi injury and lack of clarity. Prolonged cough causes phlegm to depress in the center, unable to emerge upward. Therefore, herbs should be used to open and lift. For Excess patterns, the Dispersion method (Xuan Fa) can also be applied.

In cases of chronic cough, there may also be blood mixed in the phlegm, or streaks of blood. Those with Dryness-Heat and Blood Deficiency should seek the source of transformation (Hua Yuan). Therefore, it is said that Nourishing Yin and Descending Fire for Dryness-Heat Laborious Cough should be discussed and treated together.