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[Ping An]: This chapter, from beginning to end, is found in Volume 10, Chapter 38 "Treatise on Cough" (Ke Lun) of the *Suwen* (Basic Questions), and also in Volume 9, Chapter 3 of the *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion).

The Yellow Emperor asked Qibo: Why does the Lung cause cough? Qibo replied: All five Zang organs and six Fu organs can cause cough; it is not exclusive to the Lung. (The pathogenic factors of all five Zang and six Fu organs transmit to the Lung, so people call cough "Lung cough," yet every Zang and Fu organ has its own form of cough.) The Yellow Emperor said: I wish to hear about its manifestations. Qibo said: The skin and hair are the exterior correspondence of the Lung. Pathogenic factors first affect the skin and hair, and the Qi follows this correspondence inward; if cold food and drink are consumed, upon entering the Stomach, the coldness follows the Lung meridian upward to inject into the Lung, causing Lung cold. When external and internal pathogenic factors combine and lodge within, [it develops into] Lung cough. (The Lung corresponds to the skin and hair, thus when the skin and hair are affected by cold pathogenic factors, they internally connect with the Lung. The Hand Taiyin Lung Meridian originates in the middle Jiao of the Stomach, descends to connect with the Large Intestine, returns along the stomach opening, ascends through the diaphragm [and enters] the Lung. Cold drinks and food enter the Stomach, and cold Qi ascends via the Lung meridian into the Lung. External and internal cold pathogenic factors combine; since the Lung dislikes cold, a disease of Lung cough arises. [Ping An]: In the *Suwen* and *Jiayi Jing*, "Mao xian shou xie qi cong qi he" is written as "Pimao xian shou xie qi, xie qi yi cong qi he"; the word "yinshi" (food and drink) is not repeated; "shun feimai" is written as "cong feimai"; "shang zhu yu fei" is written as "shang zhi yu fei"; "fei han, wai nei he" is written as "ze fei han, fei han ze wai nei he". One character is missing here in the text; the *Suwen* and *Jiayi Jing* use "ze", while Yuan's edition uses "fa". Below "ge" (diaphragm) in the commentary, one character is missing; Yuan's edition uses "gu", which is inconsistent. I speculate that based on the classic text, it should be "zhu" (inject/flow), read together with "fei" (Lung).) Each of the five Zang organs contracts disease during its respective ruling season; if it is not the ruling season, the disease is transmitted from other organs to correspond with it. (Each Zang organ contracts cold damage during its prosperous season; the Lung is affected first, transmitting to become cough of the five Zang organs. If it is not the ruling season, it is because another Zang organ contracted cold, which then transmits to it. Thus, the disease of Lung cough transmits to the remaining organs, called cough of the five Zang organs.) Humans correspond with Heaven and Earth, so each Zang organ governs a specific time. Contracting cold leads to disease; mild cases result in cough, while severe cases result in diarrhea or pain. ([Regarding] "each governs a time," it means each Zang organ during its prosperous season. [Regarding] "contracting cold," it means contracting cold damage. Contracting cold damage varies in severity; mild cases manifest as cough, severe cases as diarrhea and painful obstruction. [Ping An]: "Gu zang ge zhi shi" in the *Suwen* and *Jiayi Jing* is written as "Gu wu zang ge yi zhi shi".)

The Yellow Emperor asked: What is the nature of cough of the five Zang organs? Qibo said: Long-standing cough of the five Zang organs will transfer to the Fu organs. (The following discusses how Lung cough transmits to become Zang and Fu cough. Cough of the five Zang organs, if recent, has not yet caused deficiency; if long-standing, it transmits to become cough of the six Fu organs. [Ping An]: The *Suwen* and *Jiayi Jing* do not contain this paragraph; the two sentences "Wu zang zhi jiu ke, nai yi yu liu fu" appear above "Pi ke bu yi" later in the text.) The Lung is affected first by pathogenic factors. In Spring, when Liver Qi is prosperous, the Liver is affected first; in Summer, when Heart Qi is prosperous, the Heart is affected; in Late Summer (Zhi Yin), when Spleen Qi is prosperous, the Spleen is affected; in Winter, when Kidney Qi is prosperous, the Kidney is affected. (The Lung dislikes cold; if the Lung first contracts cold, and encounters the Spring season when Liver Qi is prosperous, the Liver is affected, resulting in Liver cough. If the Lung first contracts cold and encounters Late Summer, it results in Spleen cough. If the Lung first contracts cold and encounters Winter, it results in Kidney cough. [Ping An]: In the *Suwen*, the phrase "Cheng qiu ze" (In Autumn, then...) appears before "Fei xian shou xie". The New Correction states: "According to Quan Yuanqi's edition and the *Taisu*, there are no three characters 'Cheng qiu ze'; it is suspected that this text erroneously added them.")

The Yellow Emperor asked: How can they be distinguished? (The following discusses the symptoms of cough of the five Zang organs.) Qibo said: The manifestation of Lung cough is cough accompanied by wheezing and audible sounds; in severe cases, blood is expectorated. (This describes the symptoms of Lung cough.) The manifestation of Heart cough is cough accompanied by heart pain, a sensation of something stuck in the throat like a foreign body, and in severe cases, swelling of the throat and tongue. ("Jiejie" refers to the feeling of Qi stagnation in the throat as if choked. [Ping An]: In the *Jiayi Jing*, "jiejie" is written as "hehe". "Geng" (choked) is written as "geng" (blockage) in the *Suwen* and *Jiayi Jing*. "Yan hou zhong" (swelling of throat) is written as "yan zhong hou bi" (swollen throat and throat obstruction) in the *Suwen* and *Jiayi Jing*.) The manifestation of Liver cough is cough accompanied by pain in both hypochondriac regions; in severe cases, turning the body is impossible, and the hypochondriac regions feel full. The manifestation of Spleen cough is cough accompanied by pain under the right hypochondrium radiating to the shoulder and back; in severe cases, movement is impossible, and movement exacerbates the cough. (" " is written as "xie" (hypochondrium) in some editions. [Ping An]: "Liang xia tong" is written as " Tong" in the *Jiayi Jing* and "Liang xie xia tong" in the *Suwen*. "Liang xia yi man" is written as "Zhuan ze Liang Tong man" in the *Suwen*, and "Tong" is written as "xie" in the *Jiayi Jing*. "Yin jian shang" has the characters "yinyin" in the *Suwen* and *Jiayi Jing*. "Ze ke xia" has the character "ju" (severe) in the *Suwen*.) The manifestation of Kidney cough is cough accompanied by pulling pain between the waist and back; in severe cases, profuse saliva is coughed up. ("Yan" sounds like "xian" (saliva), referring to Kidney fluid. It means coughing up saliva. [Ping An]: "Yan" is written as "xian" in the *Suwen* and *Jiayi Jing*.)

The Yellow Emperor asked: What is the nature of cough of the six Fu organs? From where does the disease originate? Qibo said: If Spleen cough persists, the Stomach becomes affected. The manifestation of Stomach cough is cough accompanied by vomiting; in severe cases, roundworms are expelled. (The following Q&A describes the symptoms of Fu cough. Cough of the six Fu organs all result from long-standing Zang cough transferring into the Fu organs to become Fu cough. The Fu organs do not initiate cough and then transfer to the Zang organs; rather, skin contraction of cold pathogens reaches the Lung internally, where external and internal cold pathogens in the Lung cause cough, which then transfers to the five Zang organs, and only subsequently reaches the Fu externally. Therefore, it does not transfer from Fu to Zang. Thus, long-standing Spleen cough transfers to become Stomach cough. Changchong refers to roundworms. [Ping An]: The *Suwen* and *Jiayi Jing* have the two sentences "Wu zang zhi jiu ke, nai yi yu liu fu" before "Pi ke bu yi".) If Liver cough persists, the Gallbladder becomes affected. The manifestation of Gallbladder cough is cough accompanied by vomiting of bile. (Vomiting bile occurs because cough affects the Gallbladder, leading to bitter taste in the mouth. [Ping An]: "Ou ou dan zhi" is written as "Ke ou dan zhi" (cough and vomit bile) in the *Suwen* and *Jiayi Jing*.) If Lung cough persists, the Large Intestine becomes affected. The manifestation of Large Intestine cough is cough accompanied by involuntary defecation. (Yishi occurs because cough affects the Large Intestine, leading to loss of bowel control. [Ping An]: "Shi" is written as "shi" (loss) in the *Suwen*; the New Correction notes that the *Jiayi Jing* writes "yi shi" as "yi shi".) If Heart cough persists, the Small Intestine becomes affected. The manifestation of Small Intestine cough is cough accompanied by flatus, which is expelled along with the cough. (The Small Intestine is located superiorly; cough affects the Small Intestine, so flatus is emitted with the cough. [Ping An]: "Ke er qi, qi zhe yu ke ju chu" is written as "Ke er shi qi, qi yu ke ju shi" in the *Suwen* and *Jiayi Jing*.) If Kidney cough persists, the Bladder becomes affected. The manifestation of Bladder cough is cough accompanied by urinary incontinence. (Cough disturbs the Bladder, leading to urine leakage. [Ping An]: In the *Jiayi Jing*, "yi ni" is written as "yi niao".) If long-standing cough persists, the Sanjiao (Triple Burner) becomes affected. The manifestation of Sanjiao cough is cough accompanied by abdominal fullness and lack of appetite. (The Sanjiao has no separate Zang organ association but combines with the Bladder; thus, persistent Bladder cough leads to abdominal disease and fullness, and loss of desire for food and drink.) All these conditions gather at the Wei Guan (Stomach opening/esophagus) and relate to the Lung, causing excessive phlegm and drool, facial edema, and rebellious Qi. (These six types of Fu cough all result from Qi gathering in the Stomach, affecting the Lung superiorly, causing facial congestion and edema, rebellious Qi, and cough. [Ping An]: The *Suwen* and *Jiayi Jing* do not have the character "guan" after "wei".)

The Yellow Emperor asked: How should they be treated? Qibo said: To treat cough of the Zang organs, treat their Shu (Transport) points; to treat cough of the Fu organs, treat their He (Sea) points; for edema, treat their Jing (River) points. The Yellow Emperor said: Excellent. (To treat cough of the five Zang organs, it is appropriate to treat the third Shu point of the Zang meridians. To treat cough of the six Fu organs, it is appropriate to treat the sixth He point of the Zang meridians. For those with edema, one should not treat the Luo (Connecting) points, but rather the Jing points. [Ping An]: "Shu" is written as "Yu" in the *Suwen* and *Jiayi Jing*.)