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Cough is a disease of the Lung. When the body is exposed to cold and cold food and drink are ingested, it results in Lung cough; however, all Zang and Fu organs can cause cough.

The disorders of the five Zang organs are related to the Lung, while those of the six Fu organs gather at the Stomach, each having its own treatment method.

The Yellow Emperor asked: Why does the Lung cause cough?
(This question arises from the understanding that all coughs originate from the Lung.)

Qibo replied: All Zang and Fu organs can cause cough, not just the Lung.
The Lung governs the hundred vessels; the Qi of all Zang and Fu organs passes through the Lung. Therefore, all Zang and Fu organs can cause cough, not solely the Lung.

The Yellow Emperor said: I wish to hear about their manifestations.
(I wish to hear the specific manifestations of cough caused by the Zang and Fu organs.)

Qibo said: The skin and hair (Pimao) are the exterior correspondence of the Lung. When the skin and hair are first attacked by pathogenic factors, the pathogens enter the Lung via this correspondence. If cold food and drink enter the Stomach, the coldness travels up along the Lung meridian to the Lung, causing Lung cold. When the Lung is cold, external and internal pathogens combine, lodging in the Lung, thereby forming Lung cough.
When the skin and hair are first attacked by pathogens, it constitutes external cold; when cold from diet enters the Lung, it constitutes internal cold. The combination of external and internal cold lodges in the Lung, resulting in Lung cough. This explains how exposure to cold and ingestion of cold drinks/food lead to Lung cough.

Each of the five Zang organs contracts disease during its respective season; if not during its season, the disease transmits to other organs causing cough.
The Qi of the five Zang organs corresponds to the four seasons. Disease contraction occurs according to these seasons. When contracting disease during the season governed by the organ's ruling Qi, but manifesting later when it is no longer that ruling season, the disease transmits to other organs causing cough.

Humans correspond with Heaven and Earth. Thus, each Zang organ contracts disease when exposed to cold during its governing season. Mild cases result in cough, while severe cases result in diarrhea or pain.
"Zhi" (governing) implies "Zhu" (master). Humans correspond with Heaven and Earth, so each Zang organ has a governing season. Contracting cold during the governing season leads to disease. Mildly, the Hand-Taiyin Lung channel contracts cold causing cough; severely, the Foot-Taiyin Spleen channel contracts cold, leading to diarrhea and pain.

In autumn, the Lung is first attacked by pathogens; in spring, the Liver; in summer, the Heart; in late summer (Extreme Yin), the Spleen; in winter, the Kidney.
This clarifies the meaning that each Zang organ contracts disease during its governing season. Although cough belongs to the Lung, autumn is cited first. The Liver, Heart, Spleen, and Kidney may be initially affected, but the pathology ultimately transmits to the Lung causing cough. The Spleen is the Extreme Yin within the Yin, and its ruling period exists across the four seasons. "Cheng Zhiyin" refers to this ruling period.

The Yellow Emperor asked: How can they be distinguished?
Since diseases from all Zang organs transmit to the Lung causing cough, and the specific manifestations of various organ coughs are not yet fully understood, the question is raised on how to distinguish them?

Qibo said: The manifestation of Lung cough is coughing with wheezing and audible sounds; in severe cases, blood is spat out.
The Lung governs voice and respiration. Thus, Lung cough manifests as coughing with wheezing and audible sounds; prolonged severe wheezing leads to spitting blood.

The manifestation of Heart cough is cough accompanied by heart pain, a sensation in the throat as if something were stuck (Jiejie), and in severe cases, swelling of the throat and Hou Bi (obstruction of the throat).
The Heart meridian originates in the heart, ascends alongside the throat, returns from the heart system to connect with the Lung, and its Qi communicates with the throat. Thus, Heart cough manifests as cough with heart pain, a stuck sensation in the throat, and in severe cases, throat swelling and Hou Bi.

The manifestation of Liver cough is cough accompanied by pain under both hypochondria; in severe cases, turning is impossible, and turning causes fullness under both hypochondria.
The Liver meridian spreads over the hypochondrium and ascends to inject into the Lung. Thus, Liver cough manifests as cough with pain under both hypochondria; severe pain makes turning impossible, and turning causes fullness under both hypochondria.

The manifestation of Spleen cough is cough accompanied by pain in the right hypochondrium, radiating faintly to the shoulder and back; in severe cases, movement is impossible, and movement aggravates the cough.
Spleen represents Earth Qi; Lung represents Heaven Qi. Heaven Qi rotates left and descends to meet Earth; Earth Qi rotates right and ascends to meet Heaven. Thus, Spleen cough manifests as cough with pain in the right hypochondrium, faintly radiating to the shoulder and back; in severe cases, pain in the right hypochondrium and shoulder/back makes movement impossible, and movement aggravates the cough.

The manifestation of Kidney cough is cough accompanied by pulling pain between the waist and back; in severe cases, saliva is coughed up.
The waist is the external indicator of the Kidney. Thus, Kidney cough manifests as cough with pulling pain between the waist and back; in severe cases, Water Qi rebels upward causing coughing of saliva. These points clarify that the manifestations of cough from the five Zang organs differ.

The Yellow Emperor asked: What about cough from the six Fu organs? From where do they contract disease?
Asking about cough from the six Fu organs based on the five Zang, and from where they contract disease.

Qibo said: Prolonged cough from the five Zang organs transfers to the six Fu organs. If Spleen cough persists, the Stomach is affected. The manifestation of Stomach cough is cough with vomiting; in severe cases, roundworms (Changchong) are vomited out.
Changchong refers to Ascaris lumbricoides (roundworm). Generally, diseases transfer from Fu to Zang, but cough transfers from Zang to Fu. Thus, prolonged cough from the five Zang organs transfers to the six Fu organs. Cough diseases of the five Zang organs all return to the Lung, so Lung cough is listed first; cough diseases of the six Fu organs all return to the Stomach, so Stomach cough is listed first. The Stomach is the Fu organ of the Spleen; thus, if Spleen cough persists, the Stomach is affected. Cough with vomiting indicates rebellion of Stomach Qi. Vomiting roundworms in severe cases is due to cold in the Stomach.

If Liver cough persists, the Gallbladder is affected. The manifestation of Gallbladder cough is cough with vomiting of bile.
The Gallbladder is the Fu organ of the Liver. Thus, if Liver cough persists, the Gallbladder is affected. Cough with vomiting of bile indicates rebellion of Gallbladder Qi, vomiting bitter fluid.

If Lung cough persists, the Large Intestine is affected. The manifestation of Large Intestine cough is cough with involuntary defecation.
"Shi" (arrow) is synonymous with "Shi" (feces); old texts erroneously used "Shi" (lose), corrected here. The Large Intestine is the Fu organ of the Lung. Thus, if Lung cough persists, the Large Intestine is affected. Cough with involuntary defecation indicates failure of the Large Intestine's function.

If Heart cough persists, the Small Intestine is affected. The manifestation of Small Intestine cough is cough preceded by passing gas, with gas passing occurring simultaneously with cough.
The Small Intestine is the Fu organ of the Heart. Thus, if Heart cough persists, the Small Intestine is affected. Cough with passing gas indicates leakage of lower Qi. Leakage of lower Qi alleviates cough, so gas passing occurs simultaneously with cough. "Shi" implies dispersion.

If Kidney cough persists, the Bladder is affected. The manifestation of Bladder cough is cough with urinary incontinence.
"Niao" (urine) is pronounced with the departing tone. The Bladder is the Fu organ of the Kidney. Thus, if Kidney cough persists, the Bladder is affected. Cough with urinary incontinence indicates loss of Bladder constraint and leakage of Water Qi.

Prolonged cough not resolving affects the Sanjiao (Triple Burner). The manifestation of Sanjiao cough is cough with abdominal fullness and lack of desire to eat or drink.
The *Ling Shu: Ben Shu* chapter states: The Sanjiao is the Fu organ of the middle channels; it belongs to the Bladder system. Thus, if Kidney cough persists, initially the Bladder is affected; prolonged cough affects the Sanjiao. The Qi of the Sanjiao cannot descend smoothly through the middle, causing cough and abdominal fullness; it cannot ascend from the middle, causing lack of desire to eat or drink. These are the manifestations when prolonged cough from the five Zang organs transfers to the six Fu organs.

All these conditions gather at the Stomach and relate to the Lung, causing excessive phlegm/saliva and facial edema, due to rebellion of Qi.
This summarizes the preceding text. The six Fu organs take the Stomach as their root; the five Zang organs prioritize the Lung. Thus, regarding cough from the Zang and Fu organs, these conditions gather at the Stomach and relate to the Lung. Gathering at the Stomach causes excessive phlegm/saliva and facial edema; relating to the Lung causes rebellion of Qi.

The Yellow Emperor asked: How should they be treated?
With pathology gathering at the Stomach and relating to the Lung, how should it be treated?

Qibo said: To treat Zang diseases, use Shu (Stream) points. To treat Fu diseases, use He (Sea) points. For edema, use Jing (River) points.
The Yellow Emperor said: Excellent.
Relating to the Lung and treating Zang diseases involves using Shu points. The Shu points of the five Zang organs are located on the back, such as Feishu (BL13), Xinshu (BL15), Ganshu (BL18), Pishu (BL20), and Shenshu (BL23). Gathering at the Stomach and treating Fu diseases involves using He points. The He points of the six Fu organs are located near the elbows and knees. For example, the Stomach He point is Zusanli (ST36), the Gallbladder He point is Yanglingquan (GB34), the Large Intestine He point is Quchi (LI11), the Small Intestine He point is Xiaohai (SI8), the Bladder He point is Weizhong (BL40), and the Sanjiao He point is Tianjing (TE10). If Zang and Fu organs are simultaneously diseased, and edema is present, Jing points are used. Jing points are meridians connecting Zang and Fu organs. Mentioning edema encompasses symptoms like excessive phlegm/saliva and Qi rebellion. By mastering the principles of treating with Shu, He, and Jing points and applying them broadly, treating cough becomes manageable. Hence, the Yellow Emperor praised it as "Excellent."