五音∶宫属土，商属金，角属木，征属火，羽属水。肝在音为角，在声为呼；心在音为
征，在声为笑；脾在音为宫，在声为歌；肺在音为商，在声为哭；肾在音为羽，在声为呻。
此五音之应五脏也，若病则有不尽然者。独是五音不外阴阳，阴阳不外燥湿。春山先生分平
仄看法，实有至理。燥邪干涩，声多属仄，或干哕，或咳声不扬，或咳则牵痛，或干咳连声
，或太息气短（燥甚则经络拘急，拘急求伸，故善太息）；化火则多言，甚则谵狂，其声似破
似哑，听之有干涩不利之象。湿邪重浊，声必低平，壅塞不宣，古谓如从瓮中作声者然，或
默默懒言，或昏昏倦怠，或多嗽多痰，或痰在喉中漉漉有声，或水停心下 有声，或多噫
气（湿阻不宣，故多噫气），周身酸痛，沉重难展；化火则上蒸心肺，神智模糊，呢喃自语，
或昏沉迷睡，一派皆重浊不清之象，流露于呼吸之间。他如出言壮厉，先轻后重者，外感也
；出言懒怯，先重后轻者，内伤也。妄见妄言为谵语，无稽狂叫为狂言，实也。又有神虚谵
语、虚烦似狂二证，当以脉、证、舌苔参之，断不可误以为实。若语不接续为郑声，无人始
言为独语，此属虚居多。又有言而微，终日乃复言者，此夺气也；衣被不敛，言语善恶不避
亲疏者，此神明之乱也，二者皆属危候。又如痰壅肺络，咳声不扬，金实无声也；劳瘵音哑
，金破无声也。腹形充大，鼓之板实者，实也；腹皮绷急，鼓之 者，虚也。
然则燥湿、表里、虚实，不皆可闻而知之乎？而犹不止此。声出于肺而根于肾，其有无
还声如鸦声者，乃肺肾将绝，金水不交，声音不能发自丹田，亦不能还至丹田，故声直而无
回音耳！然亦有痰闭肺窍使然者，又当以辛润、清润开痰利窍，不可竟作不治论。至喘促一
证，尤当辨认。肺为气之统，肾为气之根，肺主出气，肾主纳气，阴阳相交，呼吸乃和，若
出纳升降失常，斯喘作焉。实喘责在肺，虚喘责在肾。实喘者，胸满声粗，气长而有余；虚
喘者，呼长吸短，息促而不足。实喘者，出气不爽；虚喘者，入气有音。实喘，有水邪射肺
，有痰饮遏肺，有客邪（六气之邪，皆能致喘）干肺，上焦气壅，治宜疏利；虚喘为肾不纳气
，孤阳无根，治宜固摄。虚实分途，阴阳异治，然则闻声之道，顾不重哉！经故曰闻而知之
之谓圣。
五音：宫音属土，商音属金，角音属木，徵音属火，羽音属水。肝脏在五音中对应角音，在声音表现上对应呼；心脏在五音中对应徵音，在声音表现上对应笑；脾脏在五音中对应宫音，在声音表现上对应歌；肺脏在五音中对应商音，在声音表现上对应哭；肾脏在五音中对应羽音，在声音表现上对应呻吟。这是五音与五脏的对应关系，但如果发生疾病，情况就不一定完全如此了。只是这五音不外乎阴阳，而阴阳不外乎燥湿两种性质。春山先生区分平声和仄声的看法，确实很有道理。燥邪导致干涩，声音多属于仄声（音调高亢或短促），或者出现干呕，或者咳嗽声音不响亮，或者咳嗽时牵引疼痛，或者干咳连续不断，或者频繁叹气气短（燥邪严重则导致经络拘急痉挛，痉挛想要舒展，所以喜欢叹气）；如果燥邪化火，则多言，严重时出现胡言乱语、狂躁，声音似破似哑，听起来有干涩不利的现象。湿邪性质重浊，声音必定低平，壅塞不通畅，古人说就像从瓮中发出的声音一样，或者沉默寡言懒得说话，或者昏沉倦怠，或者多嗽多痰，或者痰在喉咙中漉漉作响，或者水饮停聚在心下部位发出声响，或者频繁打嗝（湿气阻滞不通畅，所以多打嗝），周身酸痛，沉重难以舒展；如果湿邪化火，则向上蒸腾心肺，神志模糊，喃喃自语，或者昏沉迷睡，一派都是重浊不清的现象，流露在呼吸之间。其他如说话声音壮厉，先轻后重的，是外感病；说话懒怯，先重后轻的，是内伤病。胡乱看见、胡乱说话称为谵语（神志不清时的胡言乱语），没有根据的狂叫称为狂言，属于实证。又有神气虚弱导致的谵语、虚烦似狂两种证候，应当结合脉象、症状、舌苔来综合判断，断不可误认为是实证。如果话语不连贯称为郑声（精神衰惫时的重复呓语），无人对话却自言自语称为独语，这些大多属于虚证。又有说话声音微弱，整天才说几句话的，这是夺气（正气大伤）的表现；衣服被子穿得不整齐，说话不分好坏、不顾亲疏远近的，这是神明（心神）混乱的表现，这两种都属于危重证候。又如痰液壅塞肺络，咳嗽声音不响亮，这是“金实无声”（肺气壅实所致）；劳瘵（肺结核等慢性消耗性疾病）导致的声音嘶哑，这是“金破无声”（肺气阴亏虚所致）。腹部形状充大，敲击时感觉板结坚实的，是实证；腹皮绷急，敲击时感觉空响的，是虚证。
那么燥湿、表里、虚实，难道不可以通过听声音就知道吗？而且还不止这些。声音出于肺而根于肾，那些没有回声、声音像乌鸦叫声一样的，是肺肾之气即将衰竭，金水不能相交，声音不能发自丹田，也不能返回丹田，所以声音直出而没有回音！但也有可能是痰浊闭塞肺窍造成的，又应当用辛润、清润的方法化痰开窍利窍，不可直接当作不治之症论处。至于喘促这一证候，尤其应当仔细辨认。肺是气的统帅，肾是气的根本，肺主呼气，肾主纳气，阴阳相互交合，呼吸才能调和，如果出纳升降功能失常，就会发生喘证。实喘的责任在肺，虚喘的责任在肾。实喘的患者，胸部满闷，声音粗重，气息长而有余力；虚喘的患者，呼气长吸气短，呼吸急促而不足。实喘的患者，呼气不爽利；虚喘的患者，吸气时有声音。实喘，有水邪射肺，有痰饮遏阻肺脏，有客邪（六淫之邪，皆能导致喘证）犯肺，上焦气机壅滞，治疗宜疏通利降；虚喘是因为肾不纳气，孤阳无根，治疗宜固摄收敛。虚实分途治疗，阴阳不同治法，那么通过听声音诊断疾病的道理，难道不重要吗？经典故曰：通过听声音就能知道病情的人，称为圣手。
The Five Tones: Gong (宫) belongs to Earth, Shang (商) belongs to Metal, Jue (角) belongs to Wood, Zhi (徵) belongs to Fire, and Yu (羽) belongs to Water. The Liver corresponds to Jue in the five tones and to "Hu" (shouting/calling out) in vocalizations; the Heart corresponds to Zhi in the five tones and to "Xiao" (laughter) in vocalizations; the Spleen corresponds to Gong in the five tones and to "Ge" (singing) in vocalizations; the Lung corresponds to Shang in the five tones and to "Ku" (crying/weeping) in vocalizations; the Kidney corresponds to Yu in the five tones and to "Shen" (groaning/moaning) in vocalizations. This is the correspondence between the five tones and the five Zang organs. However, in cases of disease, this may not always hold true. Nevertheless, the five tones are encompassed by Yin and Yang, and Yin and Yang are encompassed by Dryness and Dampness. Mr. Chunshan's method of distinguishing between Ping (level/flat tone) and Ze (oblique/accented tone) contains profound truth. Dryness pathogen causes dryness and astringency; voices often fall into the Ze category, manifesting as dry hiccups or retching, hoarse or suppressed cough sounds, pain radiating upon coughing, continuous dry coughing, or frequent sighing with shortness of breath (when Dryness is severe, it causes spasms and tension in the meridians; due to the desire for relief from tension, sighing is prevalent); if Dryness transforms into Fire, there is excessive talking, and in severe cases, delirium and mania occur, with voices sounding broken or hoarse, presenting an image of dryness and obstruction. Dampness pathogen is heavy and turbid; voices must be low and flat, obstructed and unventilated, as the ancients described it like sounds made from within a jar. Patients may be silent and reluctant to speak, drowsy and fatigued, have frequent coughing with much phlegm, hear rattling sounds of phlegm in the throat, hear fluid retention sounds below the heart, or experience frequent belching (due to Dampness obstruction preventing free flow, belching is common). They suffer from generalized soreness and pain, heaviness, and difficulty moving freely; if Dampness transforms into Fire, it steams upward affecting the Heart and Lung, causing mental confusion, muttering to oneself, deep coma and sleep, presenting a picture of heaviness and turbidity, evident in respiration. Other examples include: speaking loudly and vigorously, starting light and becoming heavy, indicates Exogenous Disease (Wai Gan); speaking lazily and timidly, starting heavy and becoming light, indicates Internal Injury (Nei Shang). Delirious speech (Chan Yu) involving hallucinations and nonsensical talk is Excess (Shi). There are also two conditions: delirium due to Spirit deficiency and restlessness resembling mania due to Deficiency; these must be judged by combining pulse, symptoms, and tongue coating, and must not be mistaken for Excess. Speech that cannot continue is Zheng Sheng (repetitive mumbling due to exhaustion); speaking alone without anyone present is Du Yu (soliloquy); these mostly belong to Deficiency. Speaking faintly, only speaking again after a whole day, indicates Duo Qi (loss of Qi); inability to dress properly, speaking without distinguishing good from bad or avoiding relatives from strangers, indicates disorder of the Shen Ming (Spirit/Mind); both are critical conditions. For instance, when Phlegm obstructs the Lung collaterals and cough sounds are suppressed, it is "Metal Solid, No Sound" (Jin Shi Wu Sheng), caused by Lung Qi excess; when consumption diseases (Lao Zhai) cause hoarseness, it is "Metal Broken, No Sound" (Jin Po Wu Sheng), caused by Lung Qi and Yin deficiency. An abdomen that is distended and large, feeling hard and solid upon percussion, is Excess; an abdominal wall that is tense, sounding hollow upon percussion, is Deficiency.
Thus, can Dryness/Dampness, Exterior/Interior, and Excess/Deficiency not all be known through listening? And it does not stop here. Voice originates from the Lung but is rooted in the Kidney. Voices lacking resonance, sounding like crow calls, indicate impending failure of Lung and Kidney Qi, where Metal and Water do not interact, so voice cannot originate from or return to the Dan Tian, resulting in direct sound without echo! However, this may also be caused by Phlegm blocking the Lung orifices; in such cases, one should use Pungent-Moistening and Clear-Moistening methods to resolve Phlegm and open the orifices, and should not immediately declare it incurable. Regarding the syndrome of panting and shortness of breath (Chuan Cu), careful differentiation is especially important. The Lung is the commander of Qi, and the Kidney is the root of Qi. The Lung governs exhalation, and the Kidney governs inhalation. When Yin and Yang interact harmoniously, breathing is balanced. If the functions of excretion and reception, ascending and descending become abnormal, panting occurs. Real Panting (Shi Chuan) is attributed to the Lung, while Deficient Panting (Xu Chuan) is attributed to the Kidney. In Real Panting, the chest is full, the voice is coarse, and the breath is long and sufficient. In Deficient Panting, exhalation is long and inhalation is short, with rapid and insufficient breathing. In Real Panting, exhalation is not smooth; in Deficient Panting, inhalation produces sounds. Real Panting may be caused by Water Pathogen shooting into the Lung, Phlegm-Fluid obstructing the Lung, or Guest Pathogens (Six Qi pathogens, all capable of causing panting) invading the Lung, leading to Upper Jiao Qi stagnation; treatment should focus on dispersing and draining. Deficient Panting is due to the Kidney failing to grasp Qi, with isolated Yang lacking a root; treatment should focus on consolidating and securing. Differentiating between Excess and Deficiency leads to different paths, and treating Yin and Yang differently highlights the importance of the art of listening to diagnose. Thus, the Classics state: "To know through hearing is called Sage."