人知肺之令人咳，不知五脏六腑，皆令人咳，非独肺也。夫皮毛者，肺之合也；皮毛先受邪气，
邪气以从其合也。
（邪气，风寒也。皮毛先受之，则入于肺，所以从其合也。）其寒饮食入胃，从肺脉上至于肺，则肺寒，
肺寒则外内合邪，因而客之，则为肺咳。（肺脉起于中焦，循胃口，上膈属肺，故胃中饮食之寒从肺脉
上于肺也。所谓形寒寒饮则伤肺者，此之谓也。）五脏各以其时受病，非其时各传以与之。（如肝当受
病于春，以其时也。然有非木令之时而肝亦病者，正以肺先受邪而能传以与之也，凡诸脏腑之非时受邪者，其义
皆然。所以五脏六腑虽皆有咳，然无不由于肺者。）人与天地相参，故五脏各以治时感于寒则受病，微则为
咳，甚者为泄为痛。（治时，治令之时也，上文言外内合邪，此即其症。邪微者浅而在表，故为咳；
甚者深而入里，故为泄为痛。）乘秋则肺先受邪，乘春则肝先受之，乘夏则心先受之，乘至阴则脾先受之，乘
冬则肾先受之。（此即治时受病也，故当其时者，必先受也。）何以异之？（此下辨五脏之咳不同也。）
肺咳之状，咳而喘息有音，甚则唾血。（肺主气而司呼吸，故喘息有音唾血者，随咳而出，其病在肺，与呕
血者不同。）心咳之状，咳则心痛，喉仲介介如梗状，甚则咽肿喉痹。（心肺起于心中，出属心系，上挟于咽，
故病喉中梗介，咽肿喉痹也。介介如有所梗，妨碍之意。）肝咳之状，咳则两胁下痛，甚则不可以转，转
则两 下满。（肝脉布胁肋，故病如是， ，腋下胁也。）脾咳之状，咳则右 下痛，阴阴引肩背，甚则不可
以动，动则咳剧。（脾脉上膈挟咽，其支者复从胃别上膈，故为 下痛而阴阴然痛引肩背。脾应土，其性静，
故甚者不可以动，动则增剧也，脾咳则右 下痛者，盖阴土之气应于坤，出西南也。胃之大络名曰虚里，贯
膈络肺，出于左乳下，岂非阳土之气应于艮而出东北乎？人与天地相参也。）肾咳之状，咳则腰背相引而痛，
甚则咳涎。（肾脉贯脊，系于腰背，故相引而痛。其直者入肺中，循喉咙，故甚则咳涎，盖肾为水脏，主涎
饮也。）六腑之咳，又安所受病？（此下辨六腑之咳不同也。）夫五脏之咳，久乃移于六腑。（五脏之咳久
不已，则病及于腑，皆各因其合而表里相移也。）脾咳不已，则胃受之。胃咳之状，咳而呕，呕甚则长虫出。
（脾与胃合，故脾咳不已，胃必受之。胃不能容，则气逆为呕。长虫，蛔虫也，居肠胃之中，呕甚则随
气而上出。蛔，音回。）肝咳不已，则胆受之。胆咳之状，咳呕胆汁。（胆汁，苦汁也。）肺咳不已，则大肠
受之。大肠咳状，咳而遗矢。（矢，屎也。）心咳不已，则小肠受之。小肠咳状，咳而失气，气与咳俱失。（小
肠之下，则大肠也。大肠之气，由于小肠之化，故小肠受邪而咳则下奔失气也。）肾咳不已，则膀胱受之。膀
胱咳状，咳而遗溺。（膀胱为津液之府，故邪气居之则咳而遗溺。）久咳不已，则三焦受之，三焦咳状，咳而
腹满，不欲食饮。（久咳不已，则上、中、下三焦俱病，出纳升降皆失其和，故腹满不能食饮。）此皆
聚于胃，关于肺，使人多涕唾而面浮肿气逆也。（此下总结诸咳之症而并及其治也，诸咳皆聚于胃，关于
肺者，以胃为五脏六腑之本，肺为皮毛之合，如上文所云“皮毛先受邪气”及“寒饮食入胃”者，皆肺、胃之
候也。阳明之脉起于鼻，会于面，出于口，故使人多涕唾而面浮肿，肺为脏腑之盖而主气，故令人咳而气逆。）
治脏者治其俞，治腑者治其合，浮肿者治其经。（脉之所注者为俞，所入者为合，所行者为经。诸脏腑皆
然也。咳证必由于肺，而“五脏六腑，皆令人咳”；又曰“五脏各以其时受病，非其时各传以与之”，则不
独在肺矣。盖咳有内伤、外感之分，故自肺而传及五脏者有之，自五脏而传于肺者亦有之。如风寒暑湿伤于外，
则必先中于皮毛，皮毛为肺之合，而受邪不解，此则自肺而后传于诸脏也；劳欲情志伤于内，则脏气受伤，先
由阴分而病及上焦，此则自诸脏而后传于肺也。但自表而入者，其病在阳。故必自表而出之，治法宜辛宜温，
求其属而散去外邪，则肺气清而咳自愈矣；自内而生者伤其阴也，阴虚于下则阳浮于上，水涸金枯则肺苦于
燥，肺燥则痒，痒则咳不能已，治此者宜甘以养阴，润以养肺，使水壮气复而肺则宁也。大法治表邪者药不宜静，
静则留连不解，久必变生他病，故最忌寒凉收敛之剂；治里症者药不宜动，动则虚火不宁，真阴不复，燥痒
愈增，病必日甚，故最忌辛香助阳等剂。然治表者虽宜从散，若形气病气俱虚者，又当补其中气而佐以温解之药，
若专于解散，恐肺气益弱，腠理益疏，外邪乘虚而入，病益甚也；治里者虽宜静以养阴，若命门阳虚不能纳
气，则参、姜、桂、附之类，亦所必用，否则气不化水，终无济于阴也，至若因于火者宜清，因于湿者宜利，
因痰者降其痰，因气者理其气，虽方书条目极多，病本惟风寒、劳损而已，风寒者责在阳实，劳损者责在阴
虚，此咳证之纲领。其他治标之法，亦不过随其所见之证，而兼以调之则可，原非求本之法也，至于老人之久
嗽者，元气既虚，本难全愈，多宜温养脾肺，或兼治标，但保其不致羸困则善矣；若求奇效而必欲攻之，则
非计之得也。）
人们只知道肺会导致咳嗽，却不知道五脏六腑都会导致咳嗽，并不仅仅是肺的问题。皮毛是肺的外合；皮毛先受到邪气侵袭，邪气就会顺着这种联系进入肺脏。（这里的邪气，指的是风寒。皮毛先受邪，邪气就进入肺，所以说是顺着其外合的关系而入。）如果寒冷的饮食进入胃中，会沿着肺脉上行至肺，导致肺寒，肺寒则内外邪气相合，从而客居于肺，这就形成了肺咳。（肺脉起于中焦，循行经过胃口，向上穿过膈肌归属于肺，所以胃中饮食的寒气通过肺脉上行到肺。所谓形体受寒、饮用冷食会伤肺，说的就是这种情况。）五脏在各自所主的季节容易受病，如果不是那个季节，其他脏腑也会传变给肺。（比如肝应当在春季受病，因为那是它的当令之时。然而有时并非木气主令的时候肝也生病，正是因为肺先受了邪气而传给它，所有其他脏腑在非当令时节受邪的道理都是这样。所以虽然五脏六腑都有咳嗽，但没有不是由于肺引起的。）人与天地相应，所以五脏在各自所主的时令感受寒邪就会生病，轻的就表现为咳嗽，重的就表现为泄泻或疼痛。（“治时”是指当令的时节，上文所说的内外邪气相合，这里就是指那些症状。邪气轻微则浅而在表，所以表现为咳嗽；邪气严重则深入体内，所以表现为泄泻或疼痛。）遇到秋季则肺先受邪，遇到春季则肝先受邪，遇到夏季则心先受邪，遇到长夏（至阴）则脾先受邪，遇到冬季则肾先受邪。（这就是在当令时节受病，所以在其当令之时，必然最先受邪。）如何区分它们呢？（下文辨析五脏咳嗽的不同之处。）肺咳嗽的症状，是咳嗽伴有喘息且有声，严重的会咳出血液。（肺主气而司呼吸，所以喘息有声、咳血是随着咳嗽而出，病位在肺，这与呕血不同。）心咳嗽的症状，是咳嗽时心痛，咽喉中有异物感像被梗塞一样，严重的会出现咽肿和喉痹。（心肺经脉起于心中，属于心系，上行挟持咽喉，所以病发时咽喉有梗塞感，出现咽肿喉痹。“介介”形容好像有什么东西梗塞住，有妨碍的意思。）肝咳嗽的症状，是咳嗽时两侧胁肋下疼痛，严重时身体不能转动，转动时两侧胁肋下胀满。（肝脉布散于胁肋，所以病症如此，“䏚”指腋下胁部。）脾咳嗽的症状，是咳嗽时右胁下疼痛，隐隐作痛牵引肩背，严重时不能活动，活动则咳嗽加剧。（脾脉上行穿过膈肌挟持咽喉，其分支又从胃别出上行穿过膈肌，所以引起胁下疼痛且隐隐作痛牵引肩背。脾属土，性质安静，所以严重时不能活动，活动则病情加重。脾咳导致右胁下疼痛，是因为阴土之气对应坤卦，出自西南方。胃的大络名为虚里，贯穿膈肌联络肺，出于左乳下，这难道不是阳土之气对应艮卦而出自东北方吗？这是人与天地相应的体现。）肾咳嗽的症状，是咳嗽时腰背相互牵引而痛，严重时咳出涎沫。（肾脉贯穿脊柱，系连腰背，所以相互牵引而痛。其直行者入肺中，循喉咙，所以严重时咳出涎沫，因为肾是水脏，主管涎饮。）六腑的咳嗽，又是从哪里受病的呢？（下文辨析六腑咳嗽的不同之处。）五脏的咳嗽，日久不愈就会转移到六腑。（五脏的咳嗽长久不好，就会波及到腑，都是根据其表里配合关系而相互转移的。）脾咳不止，就会传给胃。胃咳嗽的症状，是咳嗽并呕吐，呕吐严重时蛔虫会出来。（脾与胃相表里，所以脾咳不止，胃必定受病。胃不能容纳，气机上逆导致呕吐。长虫即蛔虫，居住在肠胃之中，呕吐剧烈时随气上出。蛔，读音同回。）肝咳不止，就会传给胆。胆咳嗽的症状，是咳嗽并呕吐胆汁。（胆汁是苦味的汁液。）肺咳不止，就会传给大肠。大肠咳嗽的症状，是咳嗽并大便失禁。（矢，即屎。）心咳不止，就会传给小肠。小肠咳嗽的症状，是咳嗽并放屁，排气与咳嗽同时发生。（小肠之下是大肠。大肠的气，源于小肠的消化转化，所以小肠受邪咳嗽就会导致向下奔迫排气。）肾咳不止，就会传给膀胱。膀胱咳嗽的症状，是咳嗽并遗尿。（膀胱是津液之府，所以邪气停留其中就会咳嗽并遗尿。）久咳不止，就会传给三焦。三焦咳嗽的症状，是咳嗽并腹部胀满，不想饮食。（久咳不止，上、中、下三焦都生病了，出纳升降功能都失去和谐，所以腹部胀满不能进食饮水。）这些咳嗽都是因为邪气聚集在胃，关联于肺，使人多涕唾且面部浮肿、气机上逆。（下文总结各种咳嗽的症状并涉及治疗。各种咳嗽都聚集在胃，关联于肺，是因为胃是五脏六腑的根本，肺是皮毛的外合，如上文所说“皮毛先受邪气”及“寒饮食入胃”，都是肺、胃受病的征候。阳明脉起于鼻，交会于面部，出于口，所以使人多涕唾且面部浮肿；肺为脏腑之盖而主气，所以令人咳嗽且气机上逆。）治疗脏的病要取用俞穴，治疗腑的病要取用合穴，有浮肿的要取用经穴。（脉气所注的是俞穴，所入的是合穴，所行的是经穴。所有脏腑都是这样的。咳嗽证必然与肺有关，但“五脏六腑，皆令人咳”；又说“五脏各以其时受病，非其时各传以与之”，说明不仅仅在肺。大概咳嗽有内伤和外感之分，所以有从肺传到五脏的，也有从五脏传到肺的。如风寒暑湿伤害于外，则必先中于皮毛，皮毛是肺的外合，受邪不解，这是从肺而后传到各脏；劳倦情志伤害于内，则脏气受伤，先从阴分发病波及上焦，这是从各脏而后传到肺。凡是自表而入的，病在阳分。所以必须从表发散出去，治法宜辛温，寻找病因所属而散去外邪，则肺气清肃而咳嗽自愈；自内而生的损伤了阴分，阴虚于下则阳浮于上，水涸金枯则肺感到干燥，肺燥则痒，痒则咳嗽不停，治疗这类应当用甘味药滋养阴液，用润剂养肺，使水壮气复则肺安宁。大凡治疗表邪的药物不宜静止，静止则邪气留恋不解，久了必变生他病，所以最忌寒凉收敛的药物；治疗里症的药物不宜动散，动散则虚火不安，真阴不复，燥痒更增，病必日益加重，所以最忌辛香助阳等药物。然而治疗表证虽然宜于发散，若形气和病气都虚的人，又应当补益中气并辅以温解的药物，如果专门用于解散，恐怕肺气更弱，腠理更疏，外邪乘虚而入，病更严重；治疗里证虽然宜于静养阴液，若命门阳虚不能纳气，则人参、干姜、肉桂、附子之类，也是必须使用的，否则气不能化水，终究无助于滋阴。至于因火邪的宜清热，因湿邪的宜利湿，因痰的降其痰，因气的理其气，虽然医书条目极多，病的根本只有风寒和劳损而已。风寒者责在阳实，劳损者责在阴虚，这是咳嗽证的纲领。其他治标的方法，也不过是根据所见症状兼以调理即可，原本就不是求本的方法。至于老人久咳，元气既已虚弱，本来难以痊愈，多宜温养脾肺，或兼治标，只要保证不致瘦弱困顿就可以了；如果追求奇效而一定要攻伐，那就不是妥善的办法了。）
It is known that the Lung causes cough, but it is not understood that all five Zang and six Fu organs can cause cough, not just the Lung. The skin and hair are the exterior correspondence of the Lung; when the skin and hair are first invaded by pathogenic factors, the pathogens enter following this correspondence. (The pathogenic factors refer to wind-cold. When the skin and hair are first affected, the pathogens enter the Lung, hence described as entering via its exterior correspondence.) If cold food and drink enter the Stomach, they travel up along the Lung meridian to the Lung, causing Lung cold. With Lung cold, internal and external pathogens combine, lodging in the Lung, thus forming a Lung cough. (The Lung meridian originates from the middle Jiao, follows the stomach opening, passes through the diaphragm, and connects with the Lung; therefore, the cold from dietary intake in the Stomach travels up to the Lung via the Lung meridian. This is what is meant by "external cold on the body and cold drinks injuring the Lung.") Each of the five Zang organs becomes diseased during its respective season; if it is not that season, other organs transmit the disease to it. (For example, the Liver should become diseased in Spring, as it is its ruling season. However, the Liver may also become diseased outside the Wood season precisely because the Lung was first invaded by pathogens and transmitted them to it. The principle applies similarly to all other Zang and Fu organs becoming diseased out of season. Thus, although all five Zang and six Fu organs can produce cough, none occurs without involvement of the Lung.) Humans correspond with Heaven and Earth; therefore, when each of the five Zang organs contracts cold during its ruling season, it becomes diseased. Mild cases result in cough, while severe cases result in diarrhea or pain. ("Ruling season" refers to the time when a specific Qi governs. The aforementioned combination of internal and external pathogens corresponds to these symptoms. Mild pathogens remain superficial and in the exterior, resulting in cough; severe pathogens penetrate deeply into the interior, resulting in diarrhea or pain.) In Autumn, the Lung is first invaded; in Spring, the Liver is first invaded; in Summer, the Heart is first invaded; during the late summer (extreme Yin), the Spleen is first invaded; in Winter, the Kidney is first invaded. (This refers to contracting disease during the ruling season; thus, the organ corresponding to that season is inevitably affected first.) How can they be distinguished? (The following differentiates the coughs of the five Zang organs.) The manifestation of Lung cough includes coughing with wheezing and audible sounds; in severe cases, hemoptysis occurs. (The Lung governs Qi and respiration; thus, wheezing with sounds and hemoptysis occur随 the cough, indicating the pathology resides in the Lung, differing from hematemesis.) The manifestation of Heart cough includes heart pain upon coughing, a sensation of obstruction in the throat as if something were stuck, and in severe cases, sore throat and glottal obstruction. (The Heart and Lung meridians originate from the Heart, belong to the Heart system, and ascend alongside the pharynx; thus, pathology manifests as a feeling of obstruction in the throat, sore throat, and glottal obstruction. "Jie jie" describes the sensation of being obstructed or hindered.) The manifestation of Liver cough includes pain under both hypochondria upon coughing; in severe cases, turning the body is impossible, and turning exacerbates fullness under both hypochondria. (The Liver meridian spreads over the hypochondriac region, hence such pathology. "Dai" refers to the area under the axilla and hypochondrium.) The manifestation of Spleen cough includes pain under the right hypochondrium upon coughing, dull pain radiating to the shoulder and back; in severe cases, movement is impossible, and movement aggravates the cough. (The Spleen meridian ascends through the diaphragm and flanks the pharynx; its branch diverges from the Stomach, ascends through the diaphragm, hence causing pain under the hypochondrium and dull pain radiating to the shoulder and back. The Spleen corresponds to Earth, whose nature is quiet; thus, in severe cases, movement is impossible, and movement increases severity. Spleen cough causing right hypochondriac pain is because Yin Earth Qi corresponds to Kun, emerging from the southwest. The great Luo vessel of the Stomach is named Xuli, piercing the diaphragm and connecting with the Lung, emerging below the left breast; does this not indicate that Yang Earth Qi corresponds to Gen, emerging from the northeast? This reflects the correspondence between humans and Heaven and Earth.) The manifestation of Kidney cough includes pain in the waist and back radiating to each other upon coughing; in severe cases, salivation is coughed up. (The Kidney meridian penetrates the spine and is connected to the waist and back, hence the radiating pain. Its straight branch enters the Lung, follows the throat; thus, in severe cases, saliva is coughed up, as the Kidney is the Water organ governing saliva and fluids.) From where do the coughs of the six Fu organs arise? (The following differentiates the coughs of the six Fu organs.) Coughs of the five Zang organs, if prolonged, transfer to the six Fu organs. (If Zang cough persists, the disease extends to the Fu organs, transferring via their exterior-interior relationships.) If Spleen cough persists, the Stomach is affected. The manifestation of Stomach cough includes coughing and vomiting; in severe cases, roundworms are expelled. (The Spleen and Stomach are exterior-interior paired; thus, persistent Spleen cough inevitably affects the Stomach. The Stomach cannot accommodate, leading to rebellious Qi and vomiting. Chang chong refers to roundworms, residing in the intestines and stomach; severe vomiting expels them upward with the Qi. "Hui" is pronounced like "hui".) If Liver cough persists, the Gallbladder is affected. The manifestation of Gallbladder cough includes coughing and vomiting bile. (Bile is a bitter fluid.) If Lung cough persists, the Large Intestine is affected. The manifestation of Large Intestine cough includes coughing with fecal incontinence. ("Shi" means stool.) If Heart cough persists, the Small Intestine is affected. The manifestation of Small Intestine cough includes coughing with flatus, where gas is lost simultaneously with coughing. (Below the Small Intestine lies the Large Intestine. The Qi of the Large Intestine derives from the transformation by the Small Intestine; thus, when the Small Intestine is invaded and coughs, there is downward rushing and loss of gas.) If Kidney cough persists, the Bladder is affected. The manifestation of Bladder cough includes coughing with urinary incontinence. (The Bladder is the reservoir of fluids; thus, when pathogens reside within, coughing accompanies urinary incontinence.) If chronic cough persists, the San Jiao is affected. The manifestation of San Jiao cough includes coughing with abdominal fullness and loss of appetite. (Chronic cough affects the upper, middle, and lower San Jiao; excretion, intake, ascending, and descending functions lose harmony, resulting in abdominal fullness and inability to eat or drink.) All these coughs gather at the Stomach and relate to the Lung, causing excessive nasal discharge and saliva, facial edema, and rebellious Qi. (The following summarizes the symptoms of various coughs and touches upon treatment. All coughs gather at the Stomach and relate to the Lung because the Stomach is the root of the five Zang and six Fu organs, and the Lung is the exterior correspondence of the skin and hair. As mentioned earlier, "skin and hair first invaded by pathogens" and "cold food entering the Stomach" are signs of Lung and Stomach pathology. the Yangming meridian originates at the nose, converges on the face, and emerges from the mouth, hence causing excessive discharge and facial edema; the Lung is the canopy of the organs and governs Qi, hence causing cough and rebellious Qi.) To treat Zang diseases, use Shu (Stream) points; to treat Fu diseases, use He (Sea) points; for edema, use Jing (River) points. (Where the pulse notes is the Shu point, where it enters is the He point, and where it flows is the Jing point. This applies to all Zang and Fu organs. Cough pathology must involve the Lung, yet "all five Zang and six Fu organs can cause cough"; it is also said "each Zang organ becomes diseased in its season, and others transmit to it," indicating it is not solely in the Lung. Generally, coughs are divided into internal injury and external contraction. There are cases transmitting from the Lung to the Zang organs, and from the Zang organs to the Lung. For instance, wind, cold, summer-heat, and dampness invading externally first strike the skin and hair; since the skin and hair are the Lung's exterior correspondence, unresolved pathogens transmit from the Lung to other Zang organs. Conversely, labor, desire, and emotional injuries internally damage Zang Qi, starting from the Yin aspect affecting the Upper Jiao, transmitting from other Zang organs to the Lung. Pathogens entering from the exterior affect the Yang aspect; thus, treatment should disperse from the exterior using acrid and warm methods to identify the pathogen's nature and scatter it, clearing Lung Qi and resolving cough. Pathogenesis arising internally injures the Yin; deficiency of Yin below leads to floating Yang above, drying up water and withering Metal, causing Lung dryness. Dryness causes itching, which perpetuates cough. Treatment here should use sweet flavors to nourish Yin and moistening agents to nourish the Lung, restoring water and Qi to calm the Lung. Generally, drugs treating exterior pathogens should not be static; stagnation allows pathogens to linger and transform into other diseases, so cold and astringent agents are strictly contraindicated. Drugs treating interior syndromes should not be dispersing; dispersion unsettles deficient fire, prevents restoration of true Yin, and worsens dryness and itching, aggravating the disease, so acrid and aromatic Yang-assisting agents are strictly contraindicated. However, while treating exterior syndromes requires dispersal, if both constitutional Qi and pathogenic Qi are deficient, one must tonify Middle Qi and assist with warm-diffusing herbs; exclusive dispersal may weaken Lung Qi further, loosen interstices, allow external pathogens to invade due to deficiency, and worsen the condition. While treating interior syndromes requires stillness to nourish Yin, if Mingmen Yang deficiency fails to grasp Qi, herbs like Ginseng, Ginger, Cinnamon Twig, and Aconite Root are necessary; otherwise, Qi cannot transform fluids, ultimately failing to aid Yin. For heat pathogens, clear heat; for damp pathogens, promote diuresis; for phlegm, descend phlegm; for Qi stagnation, regulate Qi. Although medical texts list many categories, the root causes are only wind-cold and exhaustion. Wind-cold is attributed to Yang excess; exhaustion is attributed to Yin deficiency. This is the guideline for cough syndromes. Other symptomatic treatments merely adjust based on observed symptoms and are not root-treating methods. For elderly patients with chronic cough, having depleted primordial Qi, complete cure is difficult; warming and nourishing the Spleen and Lung, or combining symptomatic treatment, is preferred, aiming only to prevent emaciation and debility. Seeking miraculous effects through aggressive attack is inadvisable.)