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The principles of voice are subtle and difficult to comprehend. Therefore, diagnosing disease through listening is termed "Shen" (divine/profound diagnostic skill).

The Liver corresponds to Wood; in the Five Tones it corresponds to Jue (Jiao), in the Five Sounds it corresponds to Hu (calling out), and in its pathological changes it manifests as grasping or convulsions. The Heart corresponds to Fire; in the Five Tones it corresponds to Zhi, in the Five Sounds it corresponds to Xiao (laughter), and in its pathological changes it manifests as You (worry/sorrow). The Spleen corresponds to Earth; in the Five Tones it corresponds to Gong, in the Five Sounds it corresponds to Ge (singing), and in its pathological changes it manifests as Yue (hiccup). The Lung corresponds to Metal; in the Five Tones it corresponds to Shang, in the Five Sounds it corresponds to Ku (crying), and in its pathological changes it manifests as Ke (cough). The Kidney corresponds to Water; in the Five Tones it corresponds to Yu, in the Five Sounds it corresponds to Shen (groaning), and in its pathological changes it manifests as Li (shivering/trembling).

These points have been detailed in the previous volume under the section "Correspondences of the Five Zang Organs." If one can base their inquiry on the Five Tones (Gong, Jue, Zhi, Shang, Yu) and the Five Sounds (Hu, Xiao, Ge, Ku, Shen) to investigate the pathogenic factors of the Five Qi, then more than half of the understanding will be achieved. Western medicine diagnoses diseases even to the extent of tasting urine, which is quite crude; this is merely because they fail to analyze voice and complexion, thus resorting to such inferior methods.

When dampness is excessive within, causing fullness in the viscera and excess Qi that injures the spirit of fear, the voice sounds as if coming from a closed room; this indicates dampness in the Middle Jiao. When speech is faint and one can only speak intermittently throughout the day, this indicates depletion of Qi. When speech lacks discernment of good and evil and shows no distinction between relatives and strangers, this indicates chaos of the Shen (Spirit).

The meaning of the classics is very clear: it is precisely through listening to the voice that one knows the state of the Shen and Qi.

If a patient speaks silently but likes to shout suddenly, the disease is in the joints and bones. If the voice is hoarse and not resonant, the disease is in the heart and diaphragm. If the voice is fine and long ("jiu jiu"), the disease is in the head.

These sentences are from the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet). "Silent," meaning unwilling to speak, belongs to the Three Yin meridians. "Likes to shout suddenly" belongs to the Jueyin Liver meridian. Disease entering the Three Yin meridians involves the Jueyin, which governs the sinews and bones; thus, the disease is known to be in the Lower Jiao. Voice that is not unobstructed or resonant indicates that the Great Qi in the chest fails to circulate freely, with difficult entry and exit; thus, the disease is known to be in the Middle Jiao, specifically the chest and diaphragm.

"Jiu jiu," referring to a fine and long sound, originates from the Yin aspect of the Lower Jiao, travels along the Foot-Taiyang Bladder Meridian, and reaches the vertex of the head; thus, the disease is known to be in the head.

Note: Voice and Qi root in the Kidneys, ascend to the chest and diaphragm, emerge from the lung passages, reach the nose, move through the tongue, and are articulated by the lips. It may be that Qi deficiency leads to faint voice, or that stagnation of Qi mechanisms leads to stuttering speech, or that obstruction in the diaphragm hinders Qi flow, or that nasal impediments cause abnormal voice. These are scattered across various texts; attentive practitioners should grasp them intuitively, as they cannot be fully exhausted by pen and paper.