【口噤不语之症】面色多赤，身体壮热，牙关紧闭，昏冒不知，口干唇焦，二便赤涩
，此外感不语之症也。
【口噤不语之因】内有积热，外中风邪，经络不通，发热自盛，热极生痰，上熏心肺
，神识昏迷，则不语之症作矣。
【口噤不语之脉】右脉滑数，肠胃有热。左关浮大，表邪未解。右脉滑实，痰凝气滞
。左脉浮紧，寒邪闭结。左脉沉数，心肝有热。
【口噤不语之治】表未解者，防风通圣散减白术；表解里热者，清心丸、凉膈散、转
；宜下者，三化汤下之；有痰，涤痰汤；寒邪闭结者，温中散；心肝有热，龙胆泻肝汤；若
初起痰食凝结上焦，先用吐法极妙。
防风通圣散 见前。
清心丸 治热痰迷心窍。
黄连 麦冬 黄芩 龙脑 薄荷 胆星
凉膈散 治热壅口噤。
山栀 连翘 薄荷 黄芩 甘草 大黄 桔梗 芒硝
转舌膏 治舌音不清，语言不出。
连翘 石菖蒲 山栀 黄芩 桔梗 防风 犀角 玄明粉 甘草 柿霜 酒大黄
三化汤 见前
涤痰汤 治痰迷心窍。
南星 半夏 枳实 石菖蒲 竹茹 橘红 甘草 白茯神
温中散
浓朴 广皮 半夏 甘草 炮姜
龙胆泻肝汤 见舌音不清。
【口噤不语之症】或发热，或不发热，喉中痰声，语言不出，手足或冷或热，大便或
秘或溏，此内伤不语之症也。
【口噤不语之因】或一时感气，填塞胸臆；或食气不化，痰饮胶凝；或形寒饮冷，抑
遏心胸，阻其心窍；或恼怒伤肝，木火刑金，肺声不出，内伤口噤之症作矣。
【口噤不语之脉】右关沉滑，气食相凝。或见滑数，内有热结。左关弦大，肝胆有邪
。左寸钩洪，心经有热。脉见迟弦，苦寒抑遏。
【口噤不语之治】右脉沉滑，导气枳壳散；右关滑数，栀连二陈汤；左关弦数，龙胆
汤；左寸钩洪，导赤各半汤，若寒抑遏，大顺饮。此症实邪者多，不足者少。宜用导痰消滞
汤、胆星汤，开豁痰涎，利其诸窍。
枳壳散 治胸前热结。
枳壳 桔梗 黄芩
栀连二陈汤 即二陈汤加栀连。
龙胆泻肝汤 见舌音不清条。
导赤各半汤
黄芩 黄连 犀角 麦冬 滑石 山栀 知母 人参 灯心 白茯神
大顺饮 治口噤不语，脉沉而迟。
草豆蔻 炮姜 熟附子 广皮 白茯苓 炙甘草 熟半夏
导痰消滞汤
南星 半夏 枳实 橘红 浓朴 石菖蒲 竹沥 生姜 胆星汤 陈胆星 广橘红 苏
子石菖蒲 嫩钩藤
按∶不语之症，皆是邪结上焦，初起服导痰消滞汤，片时用探吐法最好。
[Symptoms of Jaw Lock and Inability to Speak] The complexion is often red, the body has high fever, the jaw is tightly closed, consciousness is clouded and unawareness prevails, the mouth and lips are dry and scorched, and urination and defecation are dark and painful. This is the symptom of inability to speak caused by external contraction.
[Etiology of Jaw Lock and Inability to Speak] There is accumulated heat inside, while wind-pathogens are contracted externally, leading to obstruction of the meridians and collaterals. Fever intensifies spontaneously; extreme heat generates phlegm, which steams upward to disturb the Heart and Lungs. Consciousness becomes confused, resulting in the manifestation of jaw lock and inability to speak.
[Pulse Diagnosis of Jaw Lock and Inability to Speak] The right pulse is slippery and rapid (Hua Shu), indicating heat in the intestines and stomach. The left Guan position pulse is floating and large (Fu Da), indicating that exterior pathogens have not yet resolved. The right pulse is slippery and excess (Hua Shi), suggesting phlegm coagulation and Qi stagnation. The left pulse is floating and tight (Fu Jin), indicating closure by cold pathogens. The left pulse is deep and rapid (Chen Shu), indicating heat in the Heart and Liver.
[Treatment of Jaw Lock and Inability to Speak] For those with unresolved exterior syndrome, use Fangfeng Tongsheng San (Wind-Proof Universal Release Powder) minus Baizhu (Atractylodis Macrocephalae Rhizoma). For those with resolved exterior but interior heat, use Qingxin Wan (Heart-Clearing Pill), Liangge San (Cool the Diaphragm Powder), or Zhanshe Gao (Tongue-Turning Paste). For cases suitable for purgation, use Sanhua Tang (Three Transformations Decoction) to purge. For cases with phlegm, use Ditan Tang (Phlegm-Expelling Decoction). For cases of closure by cold pathogens, use Wenzhong San (Warm the Middle Powder). For heat in the Heart and Liver, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction). If phlegm and food initially congeal in the Upper Jiao, inducing vomiting is extremely effective.
Fangfeng Tongsheng San: See previous section.
Qingxin Wan: Treats heat-phlegm confusing the Heart orifices.
Herbs: Huanglian (Coptidis Rhizoma), Maidong (Ophiopogonis Radix), Huangqin (Scutellariae Radix), Longnao (Borneolum Syntheticum), Bohe (Menthae Haplocalycis Herba), Danning (Arisaematis Cum Bile).
Liangge San: Treats jaw lock due to heat congestion.
Herbs: Shanzhi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Dahuang (Rhei Radix et Rhizoma), Jiegeng (Platycodonis Radix), Mangxiao (Natrii Sulfas).
Zhanshe Gao: Treats unclear tongue sounds and inability to speak.
Herbs: Lianqiao (Forsythiae Fructus), Shichangpu (Acori Tatarinowii Rhizoma), Shanzhi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Jiegeng (Platycodonis Radix), Fangfeng (Saposhnikoviae Radix), Xijiao (Rhinocerotis Cornu), Xuanmingfen (Natrii Sulfas Exsiccatus), Gancao (Glycyrrhizae Radix et Rhizoma), Shishuang (Diospyros Fruit Frost), Jiudahuang (Rhei Radix et Rhizoma processed with wine).
Sanhua Tang: See previous section.
Ditan Tang: Treats phlegm confusing the Heart orifices.
Herbs: Nanxing (Arisaematis Cum Bile), Banxia (Pinelliae Rhizoma), Zhishi (Aurantii Fructus Immaturus), Shichangpu (Acori Tatarinowii Rhizoma), Zhuru (Bambusae Caulis in Taenia), Juhong (Citri Reticulatae Pericarpium Rubrum), Gancao (Glycyrrhizae Radix et Rhizoma), Bai Fushen (Poria cum Radix Pini).
Wenzhong San
Herbs: Nongpo (Magnoliae Officinalis Cortex), Guangpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Paojiang (Zingiberis Rhizoma Praeparatum).
Longdan Xiegan Tang: See "Unclear Tongue Sounds" section.
[Symptoms of Jaw Lock and Inability to Speak] Some present with fever, others without; there is rattling sound of phlegm in the throat, inability to speak, hands and feet may be cold or hot, and stool may be constipated or loose. This is the symptom of inability to speak caused by internal injury.
[Etiology of Jaw Lock and Inability to Speak] It may be due to a sudden qi rebellion filling the chest and diaphragm; or due to undigested food qi causing phlegm-fluids to congeal; or due to cold exposure and cold drinks suppressing the heart and chest, blocking the Heart orifices; or due to anger injuring the Liver, where Wood fire insults Metal, preventing the Lung from producing voice, thus manifesting as jaw lock from internal injury.
[Pulse Diagnosis of Jaw Lock and Inability to Speak] The right Guan pulse is deep and slippery (Chen Hua), indicating conglomeration of qi and food. Or it may appear slippery and rapid (Hua Shu), indicating interior heat knot. The left Guan pulse is wiry and large (Xian Da), indicating pathogen in the Liver and Gallbladder. The left Cun pulse is hook-like and surging (Gou Hong), indicating heat in the Heart channel. A slow and wiry (Chi Xian) pulse indicates suppression by bitter-cold substances.
[Treatment of Jaw Lock and Inability to Speak] For right pulse deep and slippery, use Daoqi Zhike San (Qi-Guiding Aurantium Powder). For right Guan pulse slippery and rapid, use Zhi Lian Erchen Tang (Gardenia and Coptis Two-Chen Decoction). For left Guan pulse wiry and rapid, use Longdan Tang (Gentian Decoction). For left Cun pulse hook-like and surging, use Daochi Geban Tang (Half-and-Half Guiding Fire Decoction). If suppressed by cold, use Dashun Yin (Great Harmony Drink). This condition mostly involves excess pathogens and rarely deficiency. It is appropriate to use Daotan Xiaozhi Tang (Phlegm-Expelling and Stasis-Resolving Decoction) and Danxing Tang (Gall-Nut Decoction) to open up phlegm-secretions and benefit the various orifices.
Zhike San: Treats heat knot in the chest.
Herbs: Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix), Huangqin (Scutellariae Radix).
Zhi Lian Erchen Tang: Is Erchen Tang plus Zhizi (Gardeniae Fructus) and Huanglian (Coptidis Rhizoma).
Longdan Xiegan Tang: See "Unclear Tongue Sounds" section.
Daochi Geban Tang
Herbs: Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Xijiao (Rhinocerotis Cornu), Maidong (Ophiopogonis Radix), Huashi (Talcum), Shanzhi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), Renshen (Ginseng Radix), Dengxin (Junci Medullia), Bai Fushen (Poria cum Radix Pini).
Dashun Yin: Treats jaw lock and inability to speak with deep and slow pulse.
Herbs: Caodoukou (Amomi Fructus Rotundus), Paojiang (Zingiberis Rhizoma Praeparatum), Shu Fuzi (Aconiti Lateralis Radix Praeparata), Guangpi (Citri Reticulatae Pericarpium), Bai Fuling (Poria), Zhi Gancao (Glycyrrhizae Radix et Rhizoma Praeparata), Shu Banxia (Pinelliae Rhizoma Praeparatum).
Daotan Xiaozhi Tang
Herbs: Nanxing (Arisaematis Cum Bile), Banxia (Pinelliae Rhizoma), Zhishi (Aurantii Fructus Immaturus), Juhong (Citri Reticulatae Pericarpium Rubrum), Nongpo (Magnoliae Officinalis Cortex), Shichangpu (Acori Tatarinowii Rhizoma), Zhuli (Bambusae Succus).
Danxing Tang
Herbs: Chen Danxing (Arisaematis Cum Bile aged), Guang Juhong (Citri Reticulatae Pericarpium Rubrum), Suzi (Perillae Fructus), Shichangpu (Acori Tatarinowii Rhizoma), Nen Gouteng (Uncariae Ramulus cum Uncis).
Note: Inability to speak is always due to pathogen knotting in the Upper Jiao. Initially, taking Daotan Xiaozhi Tang followed immediately by inducing vomiting is best.