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Wang stated: Cough (Ke) with sound indicates that the Lung Qi is injured and lacks clearness; Sough (Sou) with phlegm indicates that Spleen dampness stirs up and generates phlegm. This is the origin of coughing. However, one must treat based on the specific cause to hit the mark accurately. Why? For coughs caused by external pathogens: if due to Wind, it initially presents with nasal congestion, heavy voice, spontaneous sweating, and aversion to wind; the treatment method should be to release the exterior. If due to Cold, it initially presents with aversion to cold, absence of sweating, clear voice but robust breath; the treatment method should be to disperse Cold. If the exterior syndrome is severe, manifesting as headache or fever, one should induce sweating to resolve the exterior; this is the treatment for coughs due to external contraction.

For coughs due to internal injury: Phlegm-Fire cough worsens in the early morning; the treatment method should be to clear phlegm and descend fire. Fire floating in the Lung causes cough to worsen at dusk; the treatment focuses on clearing Metal (Lung). Stagnation of Earth and food accumulation causing cough worsens during the deep night; the treatment focuses on resolving stagnation and regulating the Spleen. As for cough due to Yin deficiency, the presentation is different, with various signs available for verification. The cough necessarily worsens in the afternoon, or is accompanied by various bleeding symptoms, tidal fever, night sweats, seminal emission, and sliding discharge. Its treatment method differs vastly from other types of coughs. The key lies in clearing Metal (Lung) to benefit the Water source (Kidney), strengthening Water to control hyperactive fire, and suppressing Wood to prevent Spleen deficiency. In this way, the five Zang organs will not suffer from excessive dominance, allowing the source of transformation and generation to resume its function and the mechanism of life to continue. With appropriate care and regulation, one might escape the valley of cold and reach the realm of harmonious Yang. Otherwise, indiscriminate and reckless treatment leads people to a state of extreme distress, which is killing them with an invisible blade—how tragic!

The Sage said: Pathogens of the Six Excesses (Six Evils) approaching the Lung cause cough; dampness accumulating into phlegm and saliva obstructing the throat causes sough. These two are diseases of the Spleen and Lung. However, for cough caused by Consumption (Lao Zheng/Tuberculosis), the cause is different. Fire becomes increasingly prosperous daily; Metal (Lung) is refined/burned by Fire, becoming dry and fierce. Thus, a single fire injures both Metal and Water, affecting both mother and child organs. Therefore, when hemoptysis, hoarseness, and sore throat occur, can the method of supplementing Water and clearing Metal be delayed? At this juncture, three of the five Zang organs are already diseased; only Liver and Spleen remain un-hyperactive. Yet, since Metal has been attacked by Fire and Earth is ruined, if there are no strategies to suppress excess and tonify deficiency, but instead treatment is reversed and chaotic, then the deficient Qi will become more deficient, and the hyperactive Qi will become more hyperactive. The inevitable result will be inability to eat, diarrhea, emaciation, and muscle wasting. How can one avoid this fate?