Discussion on Cough

The Yellow Emperor asked: The lungs can cause a person to cough—why is this? Qi Bo replied: All five zang-organs and six fu-organs can cause a person to cough; it is not only the lungs that do so. The Yellow Emperor said: I wish to hear the specific details of this. Qi Bo said: The skin and body hair are the external association of the lungs. When the skin and body hair are first invaded by pathogenic qi, this qi will follow the associative relationship and affect the lungs. If cold food and drink enter the stomach, the cold qi will travel upward along the lung meridian to reach the lungs, causing the lungs to become cold. In this way, external pathogens and internal cold combine, the pathogenic qi thereby becomes lodged in the lungs, and a lung cough develops. The five zang-organs each contract disease during their own dominant season. If it is not the corresponding season, the pathogenic qi will be transmitted from other organs. The human body and the natural world are interconnected; therefore, when the five zang-organs each encounter cold pathogens during their own dominant season, disease arises. In mild cases, it manifests as coughing; in severe cases, it manifests as diarrhea or pain. In autumn, the lungs are the first to be affected by pathogenic qi; in spring, the liver is first; in summer, the heart is first; in the long summer season, the spleen is first; in winter, the kidneys are first. The Yellow Emperor said: What are the different manifestations of these coughs? Qi Bo said: In a lung cough, there is panting and audible sound during coughing; in severe cases, there is hemoptysis. In a heart cough, there is pain in the heart during coughing, and the throat feels as if something is obstructing it, causing discomfort; in severe cases, there is throat swelling and laryngeal obstruction. In a liver cough, there is pain in both sides below the ribs during coughing; in severe cases, the person cannot turn around, and turning causes fullness below both ribs. In a spleen cough, there is dull pain below the right rib during coughing, which radiates to the shoulder and back; in severe cases, the person cannot move, and movement aggravates the cough. In a kidney cough, there is pain that mutually involves the lower back and back during coughing; in severe cases, there is expectoration of frothy sputum.

The Yellow Emperor said: What about the coughs of the six fu-organs? From where do they contract pathogenic qi? Qi Bo said: When the cough of the five zang-organs persists for a long time, it will transfer to the six fu-organs. When a spleen cough does not stop, the stomach will become diseased. The symptoms of a stomach cough are vomiting during coughing; in severe cases, roundworms are vomited. When a liver cough does not stop, the gallbladder will become diseased. The symptoms of a gallbladder cough are vomiting of bile during coughing. When a lung cough does not stop, the large intestine will become diseased. The symptoms of a large intestine cough are fecal incontinence during coughing. When a heart cough does not stop, the small intestine will become diseased. The symptoms of a small intestine cough are flatulence during coughing, and the cough and flatulence occur simultaneously. When a kidney cough does not stop, the bladder will become diseased. The symptoms of a bladder cough are urinary incontinence during coughing. When coughing persists for a long time without stopping, the triple burner will become diseased. The symptoms of a triple burner cough are abdominal fullness during coughing, with no desire to eat or drink. These coughs all accumulate in the stomach, relate to the lungs, and cause a person to have increased nasal discharge and phlegm, facial edema, and counterflow of qi.

The Yellow Emperor said: How should these be treated? Qi Bo said: In treating coughs of the five zang-organs, one should needle their (back) shu-points. In treating coughs of the six fu-organs, one should needle their (lower abdominal) he-points. If there is edema, one should needle the (relevant) jing-points for treatment. The Yellow Emperor said: Excellent.