五脏有五声，心声为言，若儿稍长，应语而语迟，由在胎时，母卒惊怖，内动
儿脏，邪乘于心，心气不和，舌本无力，故语迟也。
〔钱〕菖蒲丸 治小儿心气不足，五六岁不能言。
石菖蒲（三钱） 人参（切去芦，焙，半两） 丹参（二钱） 天门冬 麦门冬（去
心，焙。各一两） 赤石脂（三钱）
《直指》有当归、川芎、朱砂。
上，同为细末，炼蜜、丸如绿豆大，或麻子大。温水下五七丸至一二十丸，不
计时候，日三四服。久服取效。又有病后肾虚不语者，宜兼服钱氏地黄丸。海藏
云∶地黄丸足少阴也，与菖蒲丸上下通经。
〔张〕菖蒲丹 治数岁不能语。
菖蒲（一寸九节者） 远志（去心） 桂心（各一两） 人参（去芦） 黄连（去须）
酸枣仁（各半两）
上为细末，炼蜜和，如芡实大。每服一粒至二粒，煎生姜汤化下，不拘时候。
《圣惠》治舌本无力，语迟。芍药散
赤芍药（一两） 黄 （七钱半） 犀角（镑） 槟榔 甘草（炙微赤。各半两）
上为末。每服一钱，水一小盏，煎至五分，去滓，量儿不计时分加减，温服。
〔钱〕病吐泻及大病后，虽有声而不能言，又能咽药，此非失音，为肾怯不能上
接于阳故也，当补肾地黄丸主之。失音，乃猝病耳。口噤不止，则失音，声迟亦同。
鸡头丸 治小儿诸病后不能语。
雄鸡头（一个，炙） 鸣蝉（三个，炙） 大黄（取实处，湿纸裹，煨熟） 甘草（锉、
炙。各一两） 黄 （切，焙） 川芎 远志（去心） 麦门冬（去心） 当归（去芦，焙。
各七钱半） 人参（去芦） 木通（各半两）
上，同为细末，炼蜜、丸小豆大。平旦用米饮下五丸，空心，日三四，儿大者
加之。久服取效。鸡、蝉二物，宜求死者用之，不可旋杀，孙真人所谓∶杀生求
生，去生更远。不可不知也。
《明堂》治五六岁儿不语者，灸心俞三壮。庄氏，灸两足踝各三壮。
The Five Zang organs correspond to five vocalizations; the heart governs speech. If a child, upon reaching an appropriate age for speaking, exhibits delayed speech development, it is because during the fetal period, the mother experienced sudden fright or terror, causing internal disturbance of the fetus's Zang organs. Pathogenic factors invade the heart, leading to disharmony of Heart Qi and weakness at the root of the tongue, thus resulting in delayed speech.
[Qian Yi] Shichangpu Wan (Acorus Pill): Treats pediatric deficiency of Heart Qi, where a child aged five or six cannot speak.
Ingredients: Shi Chang Pu (Rhizoma Acori Tatarinowii) (3 qian), Ren Shen (Radix Ginseng) (trimmed of rhizome, dried, 0.5 liang), Dan Shen (Radix Salviae Miltiorrhizae) (2 qian), Tian Men Dong (Herba Asparagi) and Mai Men Dong (Tuber Ophiopogonis) (decored of heart, dried, each 1 liang), Chi Shi Zhi (Lapis Kaolinis) (3 qian).
*Zhizhi Fang* includes Dang Gui (Radix Angelicae Sinensis), Chuan Xiong (Rhizoma Chuanxiong), and Zhu Sha (Cinnabaris).
Grind all ingredients into fine powder. Mix with refined honey to form pills the size of mung beans or sesame seeds. Administer 5–7 pills, up to 10–20 pills, with warm water, at any time. Take three to four times daily. Long-term administration yields results. For cases of mutism due to Kidney deficiency following illness, Qian Shi Di Huang Wan (Kidney-Nourishing Rehmannia Pill) should be taken concurrently. Zhang Yuansu (Haizang) stated that Di Huang Wan tonifies the Foot-Shaoyin (Kidney) meridian, working in conjunction with Shichangpu Wan to unblock the upper and lower meridians.
[Zhang Yuansu] Shichangpu Dan (Acorus Pill): Treats inability to speak after several years of age.
Ingredients: Shi Chang Pu (Rhizoma Acori Tatarinowii) (one cun, nine joints), Yuan Zhi (Radix Polygalae) (decored of heart), Gui Xin (Cortex Cinnamomi), Ren Shen (Radix Ginseng) (trimmed of rhizome), Huang Lian (Rhizoma Coptidis) (trimmed of roots), Suan Zao Ren (Semen Ziziphi Spinosae) (each 0.5 liang).
Grind into fine powder. Mix with refined honey to form pills the size of a Chinese quince seed. Take one to two pills per dose, dissolved in decoction of fresh ginger, at any time.
*Shenghui Fang* treats weak tongue root and delayed speech with Shaoyao San (Peony Powder):
Ingredients: Chi Shao Yao (Radix Paeoniae Rubra) (1 liang), Huang Qi (Radix Astragali) (0.75 liang), Xi Jiao (Cornu Rhinocerotis) (sliced), Bing Lang (Arecae Semen), Gan Cao (Radix Glycyrrhizae) (stir-fried until slightly red, each 0.5 liang).
Grind into powder. Take 1 qian per dose with one small cup of water, decocted to half a cup. Strain and administer warm, adjusting dosage according to the child’s condition, without strict timing restrictions.
[Qian Yi] After vomiting, diarrhea, or severe illness, if the child has voice but cannot speak, yet can swallow medicine, this is not aphonia (loss of voice). It is caused by Kidney deficiency failing to connect upward with Yang Qi. It should be treated primarily with Bu Shen Di Huang Wan (Kidney-Tonifying Rehmannia Pill). Aphonia results from acute illness. Persistent trismus (lockjaw) leads to aphonia; delayed speech is similar in nature.
Jitou Wan (Chicken Head Pill): Treats post-illness mutism in children.
Ingredients: Xiong Ji Tou (Caput Galli Masculini) (one, roasted), Ming Chan (Periostracum Cicadae) (three, roasted), Da Huang (Radix et Rhizoma Rhei) (solid part, wrapped in wet paper, baked until cooked), Gan Cao (Radix Glycyrrhizae) (chopped, stir-fried, each 1 liang), Huang Qi (Radix Astragali) (sliced, dried), Chuan Xiong (Rhizoma Chuanxiong), Yuan Zhi (Radix Polygalae) (decored of heart), Mai Men Dong (Tuber Ophiopogonis) (decored of heart), Dang Gui (Radix Angelicae Sinensis) (trimmed of rhizome, dried, each 0.75 liang), Ren Shen (Radix Ginseng) (trimmed of rhizome), Mu Tong (Caulis Akebiae) (each 0.5 liang).
Grind all into fine powder. Mix with refined honey to form pills the size of adzuki beans. In the morning, take five pills with rice water on an empty stomach. Take three to four times daily; increase dosage for older children. Long-term administration yields results. For chicken and cicada, use naturally deceased specimens; do not kill them freshly. As Sun Simiao said, "Killing life to seek life moves further away from life." This must be known.
*Mingtang* treats mutism in five-to-six-year-old children by moxibustion on Xin Shu (BL-15), three moxa cones. Zhuang’s method advises moxibustion on both ankles, three cones each.