〔薛〕经云∶舌者音声之机也,喉者音声之关也,小儿卒然无音者,乃寒气客于会
厌,则厌不能发,发不能下,致其门阖不制,故无音也。若咽喉音声如故,而舌不
能转运言语,则为舌喑,此乃风冷之邪,客于脾之络,或中于舌下廉泉穴所致也,
盖舌乃心之苗,心发声为言,风邪阻塞经络,故舌不能转运也。若舌本不能转运言
语,而喉中声嘶者,则为喉喑,此亦为风冷所客,使气道不通,故声不得发,而喉
无音也。然或风痰阻塞,或因心经气虚,或因脾之脉络受风,或因风痰滞于脾之络,
或因脾气不足,或胃中清气不升,皆足以致喑。大抵此证亦有禀父肾气不足、不能
言者,有乳母五志之火遗儿熏闭清道、不能言者,或儿病津液耗损、会厌干涸、不
能言者,或肾气不充、虚火上炎伤肺、不能言者,有惊风中风不能言者,若遗热与
津液耗者,用七味白术散。清气不升者,用补中益气汤。禀肾不足与虚火伤肺者,
用六味地黄丸。若仰首咳嗽,肢体羸瘦,目白睛多,或兼解颅,呵欠切牙等证,悉
属肾虚,非地黄丸,不能救也。
〔薛〕经云∶舌者音声之机也,喉者音声之关也,小儿卒然无音者,乃寒气客于会
厌,则厌不能发,发不能下,致其门阖不制,故无音也。若咽喉音声如故,而舌不
能转运言语,则为舌喑,此乃风冷之邪,客于脾之络,或中于舌下廉泉穴所致也,
盖舌乃心之苗,心发声为言,风邪阻塞经络,故舌不能转运也。若舌本不能转运言
语,而喉中声嘶者,则为喉喑,此亦为风冷所客,使气道不通,故声不得发,而喉
无音也。然或风痰阻塞,或因心经气虚,或因脾之脉络受风,或因风痰滞于脾之络,
或因脾气不足,或胃中清气不升,皆足以致喑。大抵此证亦有禀父肾气不足、不能
言者,有乳母五志之火遗儿熏闭清道、不能言者,或儿病津液耗损、会厌干涸、不
能言者,或肾气不充、虚火上炎伤肺、不能言者,有惊风中风不能言者,若遗热与
津液耗者,用七味白术散。清气不升者,用补中益气汤。禀肾不足与虚火伤肺者,
用六味地黄丸。若仰首咳嗽,肢体羸瘦,目白睛多,或兼解颅,呵欠切牙等证,悉
属肾虚,非地黄丸,不能救也。
[Xue Ji] The *Classic of Internal Medicine* states: "The tongue is the mechanism of voice, and the throat is the gate of sound." When a child suddenly loses their voice, it is because cold pathogenic qi has invaded the epiglottis (Huìyàn), causing the epiglottis to fail in its opening and closing functions. It cannot rise or descend, leading to a loss of control over the closure and opening of the glottis, thus resulting in aphonia. If the voice from the throat remains normal, but the tongue cannot move flexibly to articulate speech, this is termed "Ling Yin" (Tongue Aphonia). This is caused by wind-cold pathogenic factors invading the collaterals of the Spleen, or striking the Lianquan acupoint beneath the tongue. Since the tongue is the sprout of the Heart, and the Heart produces sound for speech, wind pathogenic factors blocking the meridians cause the tongue to lose its flexibility. If the root of the tongue cannot move flexibly for speech, while the voice in the throat is hoarse, this is termed "Hou Yin" (Throat Aphonia). This is also caused by wind-cold invasion obstructing the airway, preventing sound emission, resulting in a hoarse or absent voice from the throat. However, aphonia may also result from obstruction by wind-phlegm, deficiency of Qi in the Heart meridian, wind invasion of the Spleen's collaterals, stagnation of wind-phlegm in the Spleen's collaterals, insufficiency of Spleen Qi, or failure of clear Yang to ascend from the Stomach. Generally speaking, cases of aphonia may also stem from congenital insufficiency of Kidney Qi inherited from the father; or from the mother's emotional fire being transmitted to the infant, steaming and closing the clear pathways; or from the infant's illness depleting body fluids, causing dryness of the epiglottis; or from insufficient Kidney Qi with deficient fire flaming upward damaging the Lung; or from convulsive wind or stroke. For cases involving residual heat and fluid depletion, use Qiwu Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). For cases where clear Yang fails to ascend, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For cases of congenital Kidney deficiency and deficient fire damaging the Lung, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If symptoms include coughing with the head tilted back, emaciation of the limbs, prominent sclerae (excessive white of the eye), or accompanied by Jiechu (delayed closure of fontanelles), yawning, and teeth grinding, all these belong to Kidney deficiency. Without the use of Dihuang Wan (Rehmannia Pill), recovery is impossible.
[Xue Ji] The *Classic of Internal Medicine* states: "The tongue is the mechanism of voice, and the throat is the gate of sound." When a child suddenly loses their voice, it is because cold pathogenic qi has invaded the epiglottis (Huìyàn), causing the epiglottis to fail in its opening and closing functions. It cannot rise or descend, leading to a loss of control over the closure and opening of the glottis, thus resulting in aphonia. If the voice from the throat remains normal, but the tongue cannot move flexibly to articulate speech, this is termed "Ling Yin" (Tongue Aphonia). This is caused by wind-cold pathogenic factors invading the collaterals of the Spleen, or striking the Lianquan acupoint beneath the tongue. Since the tongue is the sprout of the Heart, and the Heart produces sound for speech, wind pathogenic factors blocking the meridians cause the tongue to lose its flexibility. If the root of the tongue cannot move flexibly for speech, while the voice in the throat is hoarse, this is termed "Hou Yin" (Throat Aphonia). This is also caused by wind-cold invasion obstructing the airway, preventing sound emission, resulting in a hoarse or absent voice from the throat. However, aphonia may also result from obstruction by wind-phlegm, deficiency of Qi in the Heart meridian, wind invasion of the Spleen's collaterals, stagnation of wind-phlegm in the Spleen's collaterals, insufficiency of Spleen Qi, or failure of clear Yang to ascend from the Stomach. Generally speaking, cases of aphonia may also stem from congenital insufficiency of Kidney Qi inherited from the father; or from the mother's emotional fire being transmitted to the infant, steaming and closing the clear pathways; or from the infant's illness depleting body fluids, causing dryness of the epiglottis; or from insufficient Kidney Qi with deficient fire flaming upward damaging the Lung; or from convulsive wind or stroke. For cases involving residual heat and fluid depletion, use Qiwu Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). For cases where clear Yang fails to ascend, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For cases of congenital Kidney deficiency and deficient fire damaging the Lung, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If symptoms include coughing with the head tilted back, emaciation of the limbs, prominent sclerae (excessive white of the eye), or accompanied by Jiechu (delayed closure of fontanelles), yawning, and teeth grinding, all these belong to Kidney deficiency. Without the use of Dihuang Wan (Rehmannia Pill), recovery is impossible.