黄帝问曰∶肺之令人咳,何也?岐伯对曰∶五脏六腑皆令人咳,非独肺也。帝曰∶
愿闻其状。曰∶皮毛者,肺之合也。皮毛先受邪气,邪气以从其合也。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。五脏各以其时受病,非
其时各传以与之(时谓王月)。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。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。帝曰∶何以异之?曰∶肺咳之状,咳而
喘息有音,甚则唾血;心咳之状,咳则心痛,喉
仲介介如梗状,甚则咽肿喉痹;肝咳之状,咳则两胁下痛,甚则不可以转,转则两 下满
;脾咳之状,咳则右 下痛,阴阴引肩背,甚则不可以动,动则咳剧;肾咳之状,咳则腰
背相引而痛,甚则咳涎。
帝曰∶六腑之咳奈何?安所受病?曰∶五脏之久咳,乃移于六腑。脾咳不已,则胃受之,
胃咳之状,咳而呕,呕甚则长虫出;肝咳不已,则胆受之,胆咳之状,咳呕胆汁;肺咳不已
,则大肠受之,大肠咳状,咳而遗矢;心咳不已,则小肠受之,小肠咳状,咳而失气,气与
咳俱失;肾咳不已,则膀胱受之,膀胱咳状,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。此皆聚于胃,关于肺,使人多涕唾,而面浮肿气逆也。帝曰∶治之
奈何?岐伯曰∶治脏者治其俞;治腑者治其合;浮肿者治其经。
黄帝问道:肺脏使人咳嗽,是什么原因呢?岐伯回答说:五脏六腑都能使人咳嗽,不仅仅是肺脏。黄帝说:我想听听它的症状表现。岐伯说:皮毛是肺的外合。皮毛先受到邪气侵袭,邪气便顺着经络内传于肺。如果寒冷的饮食进入胃中,会沿着肺脉上行至肺,导致肺寒;肺寒则外感之邪与内伤之寒相互结合,邪气因此客居于肺,这就形成了肺咳。五脏分别在各自所主的季节受病,如果不是其主令的季节,其他脏腑也会通过传变而受到影响(“时”指旺月)。人与天地相应,所以五脏各自主导相应的时节。感受寒邪就会生病,轻微的表现为咳嗽,严重的则为泄泻或疼痛。逢秋季则肺先受邪,逢春季则肝先受之,逢夏季则心先受之,逢长夏(至阴)则脾先受之,逢冬季则肾先受之。黄帝说:如何区分它们呢?岐伯说:肺咳的症状,咳嗽伴有喘息且有声音,严重的会咳出血液;心咳的症状,咳嗽时心痛,喉咙里感觉像有东西梗塞一样,严重的会出现咽喉肿痛、喉痹;肝咳的症状,咳嗽时两侧胁下疼痛,严重时身体不能转动,一转动两侧胁下就胀满;脾咳的症状,咳嗽时右胁下疼痛,隐隐作痛牵引肩背,严重时不能活动,一动则咳嗽加剧;肾咳的症状,咳嗽时腰背相互牵引而痛,严重时咳出涎沫。
黄帝说:六腑的咳嗽怎么样?是从哪里受病的?岐伯说:五脏久咳不愈,就会转移影响到六腑。脾咳不止,就会传到胃,胃咳的症状,咳嗽伴随呕吐,呕吐严重时会吐出蛔虫;肝咳不止,就会传到胆,胆咳的症状,咳嗽并呕吐胆汁;肺咳不止,就会传到大肠,大肠咳的症状,咳嗽时大小便失禁;心咳不止,就会传到小肠,小肠咳的症状,咳嗽时放屁,气体随咳嗽一起排出;肾咳不止,就会传到膀胱,膀胱咳的症状,咳嗽时遗尿;久咳不止,就会传到三焦,三焦咳的症状,咳嗽伴腹部胀满,不想饮食。这些咳嗽都是病邪聚集在胃,关联于肺,使人多涕唾,并且面部浮肿、气逆上冲。黄帝说:如何治疗呢?岐伯说:治疗脏病取用俞穴;治疗腑病取用合穴;伴有浮肿的取用经穴。
The Yellow Emperor asked, "Why does the Lung organ cause coughing?" Qibo replied, "All five Zang organs and six Fu organs can cause coughing; it is not exclusive to the Lung." The Emperor said, "I wish to hear about their manifestations." Qibo said, "The skin and hair are the exterior correspondence of the Lung. When the skin and hair are first invaded by pathogenic factors, these pathogens follow the meridians to transmit internally to the Lung. If cold food and drink enter the Stomach, they travel up along the Lung meridian to the Lung, causing Cold in the Lung. When the Lung is Cold, external pathogens and internal Cold combine, allowing pathogens to lodge there, resulting in a Lung Cough. Each of the five Zang organs becomes diseased during its respective ruling season; if it is not that season, transmission occurs from other organs (the 'season' refers to the month when the organ is prosperous). Humans correspond with Heaven and Earth, so each Zang organ governs a specific period. Contracting Cold leads to disease; mild cases manifest as coughing, while severe cases result in diarrhea or pain. In Autumn, the Lung is first affected by pathogens; in Spring, the Liver; in Summer, the Heart; in Late Summer (Extreme Yin), the Spleen; and in Winter, the Kidney." The Emperor asked, "How can they be distinguished?" Qibo said, "In a Lung Cough, symptoms include coughing with wheezing and audible sounds, and in severe cases, expectoration of blood. In a Heart Cough, symptoms include heart pain upon coughing, a sensation of obstruction in the throat like a foreign body, and in severe cases, sore throat and Bi syndrome of the throat. In a Liver Cough, symptoms include pain under both hypochondria upon coughing, inability to turn the body in severe cases, and fullness under both sides when turning. In a Spleen Cough, symptoms include pain under the right hypochondrium, dull pain radiating to the shoulder and back, inability to move in severe cases, and aggravated coughing upon movement. In a Kidney Cough, symptoms include mutual pulling pain between the waist and back upon coughing, and expectoration of saliva in severe cases."
The Emperor asked, "What about coughs of the six Fu organs? From where do they contract the disease?" Qibo said, "Prolonged coughing of the five Zang organs transfers to the six Fu organs. If Spleen Cough persists, it affects the Stomach; Stomach Cough presents with coughing and vomiting, and in severe cases, expulsion of roundworms. If Liver Cough persists, it affects the Gallbladder; Gallbladder Cough presents with coughing and vomiting of bile. If Lung Cough persists, it affects the Large Intestine; Large Intestine Cough presents with coughing and involuntary defecation. If Heart Cough persists, it affects the Small Intestine; Small Intestine Cough presents with coughing and passage of flatus, with gas escaping simultaneously with the cough. If Kidney Cough persists, it affects the Bladder; Bladder Cough presents with coughing and urinary incontinence. If prolonged coughing persists, it affects the Sanjiao (Triple Burner); Sanjiao Cough presents with coughing accompanied by abdominal fullness and loss of appetite for food and drink. All these conditions involve pathogenic accumulation in the Stomach and involvement of the Lung, causing excessive phlegm and saliva, facial edema, and rebellious Qi." The Emperor asked, "How should they be treated?" Qibo said, "To treat Zang disorders, select Shu (Stream) points; to treat Fu disorders, select He (Sea) points; for edema, select Jing (River) points."