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。（肺主气而位居尊高。受百脉之朝会。是咳
虽肺证。而五脏六腑之邪。皆能上归于肺而为咳。）帝曰。愿闻其状。岐伯曰。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。（此首论咳属肺脏之本病
也。肺为阴。主秋金清肃之气。是以形寒饮冷则伤肺。皮毛者。肺之合。天之寒邪。始伤皮毛。皮毛受邪。则邪气从其
合而内伤肺矣。手太阴之脉起于中焦。还循胃口。寒饮入胃。则冷冻饮料之邪。从肺脉而上至于肺矣。外内之邪合并。因而
客之。则为肺咳矣。）五脏各以其时受病。非其时。各传以与之。（次论五脏之邪上归于肺。而亦为咳也。乘春则肝先受
邪。乘夏则心先受邪。乘秋则肺先受邪。是五脏各以所主之时而受病。如非其秋时。则五脏之邪。各传与之肺而为咳也。）
人与天地相参。故五脏各以治时。感于寒则受病。微则为咳。甚则为泄为痛。（人与天地参也。五脏之气。与四时五行之
气相合。故五脏各以所主治之时而感于寒则受病。微则上乘于肺而为咳。甚则上行极而下为泄痛矣。）乘秋则肺先受邪。
乘春则肝先受邪。乘夏则心先受之。乘至阴则脾先受之。乘冬则肾先受之。（此申明五脏各以其时受病也。曰先受之者。
谓次即传及于肺而为咳也。咳乃肺之本病。故先言肺先受邪。）帝曰。何以异之。（言何以明其五脏之不同也。）岐伯曰。
肺咳之状。咳而喘息有音。甚则唾血（状、形状也。肺司呼吸。故咳则喘息有音。肺主气。甚则随气上逆而唾血也。）心
咳之状。咳则心痛。喉仲介介如梗状。甚则咽肿喉痹。（脏腑病形篇曰。心脉大甚为喉 。盖喉乃肺之窍。心火淫金。故
喉仲介然如梗状。手少阴心脉起于心中。出属心系。上挟咽。故咽喉皆肿痛也。）肝咳之状。咳则两胁下痛。甚则不可以
转。转则两 下满。（肝脉布腰肋。上注肺。故咳则两胁下痛。不可转者。不可以俯仰也。胁下谓之 。盖肝邪上乘于肺
则为咳。甚则下逆于经而不可以转。转则 下满也。）脾咳之状。咳则右胁下痛。阴阳引肩背。甚则不可以动。动则咳剧。
（脾脏居右。故咳则右胁下痛。脾气上通于肺。肺之俞在肩背。故阴阴引于肩背也。不可以动者。不能动摇也。经脉篇
曰。肝是动则病腰痛不可以俯仰。脾病则身体皆重。不能动摇。盖微则上乘于肺而为咳。甚则病及于本经。）肾咳之状。
咳则肩背相引而痛。甚则咳涎。（肾脉贯膈。入肺中。故咳则肺俞相引而痛。肺肾皆积水也。故甚则咳涎。）帝曰。六腑
之咳奈何。安所受病。岐伯曰。五脏之久咳。乃移于六腑。（奈何者。何状也。安所受病者。病从安生也。盖五脏之气。
与天地四时五行之气相参合。故各以时受病。而六腑之病。又从脏气而转移。）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。脾病移于胃。则胃气反逆。故呕。呕甚则谷气消。谷消则虫上入胃。故甚则长虫出。长虫、
蛔虫也。张兆璜曰。胃之精气。上输于脾。脾病传胃。故胃气反逆而为呕。）肝咳不已。则胆受之。胆咳之状。咳呕胆
汁。（胆汁。苦汁也。邪在胆则逆在胃。胆液泄则口苦。胃气逆则呕苦。故曰呕胆汁也。）肺咳不已。则大肠受之。大肠
咳状。咳而遗失。（大肠者。肺之府。为传道之官。是以上逆则咳。下逆则遗。失当作矢。廉颇传曰。坐顷三遗矢。）心
咳不已。则小肠受之。小肠咳状。咳而失气。气与咳俱失。（失气、后气也。夫厥气上逆则咳。下逆则为失为遗。气与咳
俱失者。厥逆从上下散也。张兆璜曰。阴阳气厥。则为寒热相移。邪气上逆则为咳。下逆则为失为遗。寒热之气。客
于形身则为痛。当知百病皆生于气也。）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。（肾合膀胱。膀胱者。津液之府。水道出焉。故咳而遗溺。灵枢经曰。少阳属肾。肾上连肺。
故将两脏。三焦者。中渎之府也。水道出焉。属膀胱。是孤腑也。是六腑之所与合者。是以肾咳不已。膀胱受之。久咳
不已。三焦受之。是肾为两脏。而合于六腑者也。三焦为中渎之府。故腹满。咳则上焦不能主纳。故不欲食饮也。）此
皆聚于胃。关于肺。使人多涕唾而面浮肿。气逆也。（此言膀胱三焦之咳。皆邪聚于胃。而上关于肺故也。夫三焦为决渎
之府。膀胱者。津液之所藏。关门不利。则聚水而从其类矣。水聚于胃。则上关于肺而为咳。咳则肺举。肺举则液上溢。
故使人涕唾。水气上乘。故面浮肿而气厥也。）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。（咳在五脏。当治其俞。五脏之俞。皆在于背。欲知背俞。先度其两乳间。以草度其背。是谓五脏之俞。灸刺之
度也。合治内腑。故咳在六腑者。取之于合。胃合于三里。大肠合入于巨虚上廉。小肠合入于巨虚下廉。三焦合入于委
阳。膀胱合入于委中央。胆合入于阳陵泉。浮肿者。取肺胃之经脉以治之。）
黄帝问道：肺脏为什么会使人咳嗽？岐伯回答说：五脏六腑的病变都能导致咳嗽，并不仅仅是肺脏本身的问题。（肺主司气，且位置居于人体上部高位，接受全身血脉的朝会。因此，虽然咳嗽表现为肺部的证候，但五脏六腑的邪气，都能向上汇聚于肺从而引发咳嗽。）黄帝说：我想听听咳嗽的具体症状表现。岐伯说：皮毛是肺的外合部位。皮毛首先受到外邪侵袭，邪气便顺着这种内外联系内传于肺。如果寒冷的饮食进入胃中，寒气会沿着肺脉上行至肺，导致肺寒。肺受寒后，体表的寒邪与体内的寒饮相互结合，邪气停留其中，就会形成肺咳。（这里首先论述属于肺脏本源的咳嗽病机。肺属阴，主掌秋季金气清肃的特性。因此，形体受寒或饮用冷食都会损伤肺脏。皮毛是肺之外合，天之寒邪首先伤害皮毛；皮毛受邪，邪气便通过其相合的关系内伤肺脏。手太阴肺经起于中焦，回绕经过胃口。寒饮入胃，冷冻饮料的邪气便顺着肺脉上行到达肺部。体表与体内的邪气合并，进而客居于此，就形成了肺咳。）五脏分别在各自所主的季节感受病邪，如果不是该季节，其他脏腑的病邪也会传变给肺。（其次论述五脏的邪气上归于肺，也能引起咳嗽。如果在春季，肝先受邪；在夏季，心先受邪；在秋季，肺先受邪。这是五脏分别在其所主的时令感受病邪。假如不是秋季，其他脏腑的邪气便会各自传变给肺而引发咳嗽。）人与天地自然相应相通，所以五脏在各自当令的时节，若感受寒邪就会生病。病情轻微则表现为咳嗽，病情严重则表现为泄泻或疼痛。（人与自然相参合。五脏之气与四季五行的气相融合，所以五脏在各自主治的时令感受寒邪就会发病。病势轻微则上乘于肺而表现为咳嗽；病势严重则上行至极点转而向下，表现为泄泻和疼痛。）在秋季，肺先受邪；在春季，肝先受邪；在夏季，心先受邪；在长夏（至阴之时），脾先受邪；在冬季，肾先受邪。（这里进一步阐明五脏各自在其所主的时令感受病邪。所谓“先受邪”，是指随即传变给肺而导致咳嗽。咳嗽本是肺脏的疾病，所以先提及肺先受邪。）黄帝问：如何区分这些不同脏腑引起的咳嗽呢？（意思是怎样明确辨别五脏咳嗽的不同之处。）岐伯说：肺咳的症状，是咳嗽伴有喘息且有声音，严重时则会咳出血液（状，指形状特征。肺主管呼吸，所以咳嗽时会有喘息声。肺主气，严重时气机上逆，随气上溢而咳血。）心咳的症状，是咳嗽时伴有心痛，喉咙中有异物感，像有东西梗塞一样，严重时咽喉肿痛、喉痹（《脏腑病形篇》说：心脉盛大甚则导致喉部疾病。因为喉是肺之窍，心火亢盛克制肺金，所以喉咙中有异物梗塞感。手少阴心经起于心中，出来归属于心系，向上夹着咽喉，所以咽喉都会肿痛。）肝咳的症状，是咳嗽时两侧胁肋下疼痛，严重时身体不能转动，一转动两侧胁肋下就胀满（肝经布散于腰肋，上行注入肺中，所以咳嗽时两胁下疼痛。不能转动，是因为无法进行俯仰动作。胁下称为“胁”。肝邪上乘于肺导致咳嗽，严重时邪气下逆于经脉导致不能转动，转动时胁下感到胀满。）脾咳的症状，是咳嗽时右侧胁肋下疼痛，疼痛牵引肩背，严重时身体不能活动，一动则咳嗽加剧（脾脏位于右侧，所以咳嗽时右胁下疼痛。脾气上通于肺，肺的俞穴在肩背部，所以疼痛隐隐牵引至肩背。不能活动，是指身体无法摇动。《经脉篇》说：肝经发生变动就会病腰痛，不能俯仰；脾病则身体沉重，不能摇动。大概是因为病轻则上乘于肺而为咳，病重则波及本经。）肾咳的症状，是咳嗽时肩背互相牵引而疼痛，严重时则咳出涎沫（肾脉贯穿膈肌，进入肺中，所以咳嗽时肺俞部位互相牵引而痛。肺和肾都容易积聚水液，所以严重时咳出涎沫。）黄帝问：六腑的咳嗽又是怎样的？是从哪里受病的？岐伯说：五脏的久咳不愈，就会转移影响到六腑。（奈何，是问什么样子。安所受病，是问病从哪里产生。五脏之气与天地四时五行之气相参合，所以各自在时令中受病，而六腑的病，又是从脏气转移而来的。）脾咳不止，就会传给胃，形成胃咳。胃咳的症状，是咳嗽并呕吐，呕吐严重时蛔虫会被吐出（脾与胃相表里，脾病传及于胃，导致胃气反而上逆，所以呕吐。呕吐严重时谷气消耗殆尽，谷消则寄生虫向上进入胃，所以严重时吐出蛔虫。长虫，即蛔虫。张兆璜说：胃的精气上输于脾，脾病传胃，所以胃气反而上逆而发生呕吐。）肝咳不止，就会传给胆，形成胆咳。胆咳的症状，是咳嗽并呕吐胆汁（胆汁，是苦味的汁液。邪气在胆则气逆在胃，胆液外泄则口苦，胃气上逆则呕吐苦水，所以说呕吐胆汁。）肺咳不止，就会传给大肠，形成大肠咳。大肠咳的症状，是咳嗽并大便失禁（大肠是肺的府邸，作为传导之官，所以气上逆则咳嗽，气下逆则遗矢。“失”通“矢”，即粪便。《廉颇蔺相如列传》中说：坐了一会儿，拉了三次屎。）心咳不止，就会传给小肠，形成小肠咳。小肠咳的症状，是咳嗽并放屁，排气与咳嗽同时发生（失气，即放屁。厥逆之气上逆则咳嗽，下逆则导致失禁或遗矢。气与咳嗽同时发生，说明厥逆之气上下散乱。张兆璜说：阴阳之气厥逆，就会导致寒热相互移易，邪气上逆则为咳，下逆则为失为遗。寒热之气客居形体身躯则导致疼痛。应当知道百病皆生于气。）肾咳不止，就会传给膀胱，形成膀胱咳。膀胱咳的症状，是咳嗽并小便失禁。久咳不愈，就会传给三焦，形成三焦咳。三焦咳的症状，是咳嗽并腹部胀满，不想饮食（肾与膀胱相表里，膀胱是津液的府邸，水道由此而出。《灵枢经》说：少阳经隶属于肾，肾向上连接肺，所以将两脏联系起来。三焦是中渎之府，水道由此而出，隶属于膀胱，是孤独的腑。这是与六腑相配合的。所以肾咳不止，膀胱受病；久咳不止，三焦受病。这是因为肾关联两脏，并与六腑相合。三焦作为中渎之府，所以出现腹满。咳嗽导致上焦不能主司纳受，所以不想饮食。）这些咳嗽都是邪气聚集在胃，并关联于肺，使人多流涕唾、面部浮肿，这是由于气机上逆所致。（这里说明膀胱和三焦的咳嗽，都是邪气聚集在胃，而上连于肺的缘故。三焦是决渎之官，膀胱是津液储藏之所，如果关门不利，就会聚水而从同类相聚。水聚于胃，则上连于肺而引发咳嗽。咳嗽时肺气上举，肺气上举则津液上溢，所以使人涕唾增多。水气上乘，所以面部浮肿且气机厥逆。）黄帝问：治疗的方法是怎样的？岐伯说：治疗五脏的咳嗽，要针刺五脏的俞穴；治疗六腑的咳嗽，要针刺六腑的合穴；伴有浮肿的，要治疗其经脉。（咳嗽在五脏，应当治疗其俞穴。五脏的俞穴都在背部。要知道背俞的位置，先测量两乳之间的距离，用草量度背部，这就是五脏俞穴的位置，也是灸刺的尺度。合穴治疗内脏疾病，所以咳嗽在六腑者，取用合穴。胃经合穴在足三里，大肠经合穴在上巨虚，小肠经合穴在下巨虚，三焦经合穴在委阳，膀胱经合穴在委中，胆经合穴在阳陵泉。浮肿者，取肺经和胃经的经脉进行治疗。）
Huangdi asked, "Why does the Lung organ cause coughing?" Qibo replied, "The pathologies of all five Zang organs and six Fu organs can lead to coughing; it is not exclusive to the Lung." (The Lung governs Qi and resides in a high position, receiving the convergence of all meridians. Thus, although coughing manifests as a Lung syndrome, pathogens from the five Zang and six Fu organs can all ascend and converge upon the Lung to induce coughing.) Huangdi said, "I wish to hear about its manifestations." Qibo said, "The skin and hair are the exterior correspondence of the Lung. The skin and hair are first invaded by pathogens, and the pathogens then enter the Lung through 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 and lodge within, resulting in Lung cough." (This section first discusses the primary pathology of cough belonging to the Lung organ. The Lung belongs to Yin and governs the clear and descending Qi of Autumn Metal. Therefore, exposure to cold or consumption of cold drinks injures the Lung. The skin and hair are the exterior of the Lung; heavenly cold pathogens first injure the skin and hair. Once injured, the pathogens enter the Lung through their correspondence. The Hand-Taiyin Lung Meridian originates in the middle Jiao and circles around the stomach opening. Cold drinks entering the Stomach allow the pathogenic cold to travel up the Lung meridian to the Lung. The combination of external and internal pathogens lodges there, resulting in Lung cough.) Each of the five Zang organs receives disease in its respective season; if it is not that season, pathogens from other organs transmit to the Lung. (This section discusses how pathogens from the five Zang organs ascend to the Lung, also causing coughing. In Spring, the Liver is first invaded; in Summer, the Heart is first invaded; in Autumn, the Lung is first invaded. This means each Zang organ receives disease in its governing season. If it is not Autumn, pathogens from other Zang organs transmit to the Lung to cause coughing.) Humans correspond with Heaven and Earth; thus, when the five Zang organs are affected by cold during their respective governing seasons, they become diseased. Mild cases manifest as coughing, while severe cases manifest as diarrhea or pain. (Humans correspond with nature. The Qi of the five Zang organs integrates with the Qi of the four seasons and five elements. Thus, when the Zang organs encounter cold during their governing times, they become diseased. Mildly, the pathogen ascends to the Lung causing coughing; severely, it ascends to the extreme and then descends, causing diarrhea and pain.) In Autumn, the Lung is first invaded; in Spring, the Liver is first invaded; in Summer, the Heart is first invaded; in the time of Supreme Yin (Late Summer), the Spleen is first invaded; in Winter, the Kidney is first invaded. (This clarifies that each of the five Zang organs receives disease in its respective season. 'First invaded' means it subsequently transmits to the Lung to cause coughing. Since coughing is the primary disease of the Lung, the Lung's invasion is mentioned first.) Huangdi asked, "How can one distinguish them?" (Meaning: How to differentiate the distinct characteristics of coughing caused by different Zang organs?) Qibo said, "The manifestation of Lung cough is coughing with wheezing and audible sounds; in severe cases, blood may be expectorated. (Manifestation refers to the physical signs. The Lung governs respiration, so coughing is accompanied by wheezing sounds. The Lung governs Qi; in severe cases, Qi rebels upward, bringing blood with it.) The manifestation of Heart cough is coughing accompanied by heart pain, a sensation of obstruction in the throat as if something were stuck, and in severe cases, sore throat and throat bi-syndrome. (The 'Zang-Fu Organ Manifestations Chapter' states that an excessively large Heart pulse leads to throat diseases. The throat is the orifice of the Lung; excessive Heart Fire insults Lung Metal, causing a sensation of obstruction. The Hand-Shaoyin Heart Meridian originates in the heart, connects to the heart system, and ascends along the throat, causing swelling and pain in both.) The manifestation of Liver cough is coughing accompanied by pain in the hypochondrium; in severe cases, the body cannot turn, and turning causes fullness in the hypochondrium. (The Liver meridian spreads over the waist and ribs and ascends to inject into the Lung, causing hypochondriac pain during coughing. Inability to turn refers to inability to bend or extend. The hypochondrium is called 'he'. Liver pathogens ascending to the Lung cause coughing; severely, pathogens rebel downward in the meridians, preventing turning and causing fullness.) The manifestation of Spleen cough is coughing accompanied by pain in the right hypochondrium, radiating to the shoulder and back; in severe cases, movement aggravates the cough. (The Spleen is located on the right, causing right hypochondriac pain during coughing. Spleen Qi connects upward to the Lung, and the Shu points of the Lung are on the shoulder and back, causing radiating pain. Inability to move refers to immobility. The 'Meridians Chapter' states that Liver meridian disorders cause lower back pain and inability to bend/extend; Spleen disease causes heaviness and immobility. Mildly, pathogens ascend to the Lung causing coughing; severely, the disease affects the primary meridian.) The manifestation of Kidney cough is coughing accompanied by pulling pain between the shoulder and back; in severe cases, saliva is coughed up. (The Kidney meridian passes through the diaphragm and enters the Lung, causing pulling pain in the Lung Shu area during coughing. Both Lung and Kidney are prone to water accumulation, leading to expectoration of saliva in severe cases.) Huangdi asked, "What about coughing of the six Fu organs? Where do these diseases originate?" Qibo said, "Prolonged coughing of the five Zang organs transfers to the six Fu organs. ('Naihe' asks for the appearance; 'An suo shou bing' asks for the origin. The Qi of the five Zang organs corresponds with Heaven, Earth, seasons, and elements, receiving disease in their seasons. The diseases of the Fu organs arise from the transmission of Zang Qi.) If Spleen cough persists, it transfers to the Stomach, resulting in Stomach cough. The manifestation of Stomach cough is coughing with vomiting; in severe cases, roundworms may be expelled. (The Spleen and Stomach are interior-exterior pairs. Spleen disease transferring to the Stomach causes rebellious Stomach Qi, leading to vomiting. Severe vomiting depletes grain Qi; once depleted, parasites move upward into the Stomach, expelling roundworms. Zhang Zhaohuang stated: Stomach essence transports upward to the Spleen; Spleen disease transmitting to the Stomach causes rebellious Qi and vomiting.) If Liver cough persists, it transfers to the Gallbladder, resulting in Gallbladder cough. The manifestation of Gallbladder cough is coughing with vomiting of bile. (Bile is a bitter fluid. Pathogens in the Gallbladder cause rebellion in the Stomach; leakage of bile causes bitter taste, and rebellious Stomach Qi causes vomiting of bitter fluid.) If Lung cough persists, it transfers to the Large Intestine, resulting in Large Intestine cough. The manifestation of Large Intestine cough is coughing with fecal incontinence. (The Large Intestine is the mansion of the Lung and serves as the official of transmission; upward rebellion causes coughing, downward rebellion causes incontinence. 'Shi' is a variant for 'shi' (feces).) If Heart cough persists, it transfers to the Small Intestine, resulting in Small Intestine cough. The manifestation of Small Intestine cough is coughing with flatus, where gas expulsion occurs simultaneously with coughing. (Flatus refers to passing wind. Rebellious Qi ascending causes coughing; descending causes incontinence. Simultaneous occurrence indicates dispersal of rebellious Qi both up and down. Zhang Zhaohuang stated: Rebellion of Yin-Yang Qi causes shifting of cold and heat; ascending pathogens cause coughing, descending pathogens cause incontinence. One must know that all diseases arise from Qi.) If Kidney cough persists, it transfers to the Bladder, resulting in Bladder cough. The manifestation of Bladder cough is coughing with urinary incontinence. If prolonged coughing persists, it transfers to the Sanjiao (Triple Burner), resulting in Sanjiao cough. The manifestation of Sanjiao cough is coughing with abdominal fullness and loss of appetite. (The Kidney and Bladder are interior-exterior pairs; the Bladder is the mansion of fluids and the pathway of waterways. The 'Ling Shu' states: Shaoyang is affiliated with the Kidney, which connects upward to the Lung, linking two organs. The Sanjiao is the mansion of water channels, affiliated with the Bladder, and is the solitary Fu organ. Thus, persistent Kidney cough affects the Bladder; prolonged coughing affects the Sanjiao. The Sanjiao, as the mansion of water channels, causes abdominal fullness. Coughing prevents the Upper Jiao from accepting, leading to lack of appetite.) All these coughs gather in the Stomach and relate to the Lung, causing excessive phlegm and drool, facial edema, and rebellious Qi. (This explains that Bladder and Sanjiao coughs involve pathogens gathering in the Stomach and relating upward to the Lung. The Sanjiao is the official of water drainage, and the Bladder stores fluids. If the gate fails to regulate, water accumulates. Water accumulating in the Stomach relates upward to the Lung, causing coughing. Coughing lifts Lung Qi, causing fluids to overflow, leading to phlegm and drool. Water qi assaulting upward causes facial edema and Qi rebellion.) Huangdi asked, "How should they be treated?" Qibo said, "For coughing of the Zang organs, treat their Shu points; for coughing of the Fu organs, treat their He-sea points; for edema, treat their meridians. (Coughing in the Zang organs should be treated at their Shu points, which are located on the back. To locate them, measure the distance between the nipples and use grass to measure the back. For Fu organ coughing, use He-sea points: Stomach He-sea is Zusanli (ST36); Large Intestine He-sea is Shangjuxu (ST37); Small Intestine He-sea is Xiajuxu (ST39); Sanjiao He-sea is Weiyang (BL39); Bladder He-sea is Weizhong (BL40); Gallbladder He-sea is Yanglingquan (GB34). For edema, treat the meridians of the Lung and Stomach.)"