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[Symptoms of Unclear Speech Due to Tongue Dysfunction] The body is feverish, the mouth and tongue are dry, the facial complexion is often red, urine and stool are dark and difficult to pass smoothly, consciousness is clouded, and speech is obstructed. These are symptoms of unclear speech due to external contraction (Wai Gan).

[Etiology of Unclear Speech Due to Tongue Dysfunction] When heat in the Heart Meridian is severe, the tongue becomes flaccid and speech is blocked; when wind strikes the Jueyin Meridian, the tongue curls and speaking is difficult; when pathogenic factors are abundant in the Yangming Meridian, the root of the tongue becomes stiff; or if wind-cold binds the exterior and phlegm-stagnation obstructs the Pericardium Collateral (Bao Luo), causing the Heart orifice to be closed, these are the causes of unclear speech due to external contraction.

[Pulse Signs of Unclear Speech Due to Tongue Dysfunction] The pulse is mostly surging (Hong) and rapid (Shu). In cases of Heat in the Heart Meridian, the left Cun position is surging and rapid. In cases of Heat in the Liver and Gallbladder, the left Guan position is wiry (Xian) and rapid. When wind strikes the Jueyin Meridian, the left Guan position is wiry and tight. In cases of Exuberant Heat in Yangming, the right pulse is surging and rapid.

[Treatment of Unclear Speech Due to Tongue Dysfunction] For Heart Heat, use Daochi Geban Tang (Half-Combined Decoction for Guiding Out Redness); for Liver Heat, use Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) or Xiaochaihu Tang (Minor Bupleurum Decoction); for Wind-Cold affecting the Liver, use Buchgan San (Liver-Nourishing Powder); for Yangming Stomach Heat, use Gange Qingwei Tang (Pueraria Decoction to Clear the Stomach); for constipation with signs indicating the need for purgation, use Sishun Yin (Four-Obedience Drink).
Daochi Geban Tang See under "Enuresis".
Longdan Xiegan Tang
Longdan Cao (Radix Gentianae) Zhimu (Rhizoma Anemarrhenae) Chuan Lian (Radix Coptidis) Renshen (Radix Ginseng) Maidong (Tuber Ophiopogonis) Tianmendong (Tuber Asparagi) Shanzhi (Fructus Gardeniae) Huangqin (Radix Scutellariae) Gancao (Radix Glycyrrhizae) Chaihu (Radix Bupleuri)
Buchgan San See under "Facial Paralysis".
Gange Qingwei Tang See under "Facial Paralysis".
Sishun Yin
Danggui (Radix Angelicae Sinensis) Dahuang (Radix et Rhizoma Rhei) Baishaoyao (Radix Paeoniae Alba) Zhiqiao (Fructus Aurantii)

[Symptoms of Unclear Speech Due to Tongue Dysfunction] Urine and stool are not dark, breath is smooth, and consciousness is clear, but there is a sensation that the tongue cannot move. This is a deficiency syndrome of unclear speech due to Kidney Deficiency.
Clouded consciousness, impaired speech, constipation, and thirst indicate an excess syndrome of unclear speech due to accumulated heat.

[Etiology of Unclear Speech Due to Tongue Dysfunction] The Kidney meridian attaches to the root of the tongue. If Kidney Water (Yin) is deficient and cannot ascend to moisten the throat, loss of moisture leads to aphonia. Alternatively, aphonia may result from puncturing the Foot-Shaoyin meridian, causing severe deficiency and bleeding; or from puncturing the middle vessel under the tongue of the Foot-Taiyin meridian, leading to unceasing bleeding. These are the causes of the deficiency syndrome. If there is Heat in the Spleen and Stomach, the root of the tongue becomes stiff and speech is unclear; or if Heat in the Heart and Liver is severe, the tongue curls and speech is unclear. These are the causes of the excess syndrome.

[Pulse Signs of Unclear Speech Due to Tongue Dysfunction] The two Chi positions are fine and rapid, indicating exhaustion of Kidney Water. After bloodletting causing Yin deficiency, the left pulse is empty. In cases of Accumulated Heat in the Spleen and Stomach, the right Guan position is surging and slippery.

[Treatment of Unclear Speech Due to Tongue Dysfunction] For Kidney Deficiency, use Santang Dan (Three Capabilities Pill); for severe deficiency after bloodletting, use Danggui Buxue Tang (Angelica Tonifying Blood Decoction); for Accumulated Heat in the Spleen and Stomach, use Zhanshe Gao (Tongue-Turning Paste); for Fire in the Heart Meridian, use Daochi Geban Tang; for Fire in the Liver Meridian, use Longdan Xiegan Tang.
Santang Fengsui Dan
Tianmendong (Tuber Asparagi) Shudihuang (Prepared Radix Rehmanniae) Renshen (Radix Ginseng)
Danggui Buxue Tang
Huangqi (Radix Astragali) Danggui (Radix Angelicae Sinensis)
Zhanshe Gao See under "Locked Jaw and Aphonia".
Daochi Geban Tang See under "Internal Injury Aphonia".
Longdan Xiegan Tang See above.
Saliva flowing from the corners of the mouth with unclear speech indicates Stomach Heat; use Qingwei Tang (Stomach-Clearing Decoction) or Zhilian Pingwei San (Coptis and Gardenia Stabilize the Middle Powder). Thirst with desire to drink and unclear speech indicates use of Gange Shigao Tang (Pueraria and Gypsum Decoction). Cough, counterflow qi, and wheezing with unclear speech indicate Lung Heat; use Zhilian Xiebai San (Coptis and Gardenia Drains White Powder) plus Zhike (Pericarpium Aurantii) and Jiegeng (Radix Platycodi), or Liangge San (Cool the Chest Powder) or Qingzao Tang (Clear Dryness Decoction). If Lung transmits heat to the Large Intestine, causing constipation and unclear speech, use Zhijie Sishun Yin (Zhiqiao and Jiegeng Four-Obedience Drink). If there is Phlegm-Fire in the Upper Jiao, with the tongue root being either stiff or numb, use Zhilian Erchen Tang (Coptis and Gardenia Two-Chen Decoction). If there is Phlegm-Fire above and bowel obstruction below, use Zhimi Wan (Eliminate Mystery Pill), mixed with much Zhuli (Bamboo Sap), to smooth the Large Intestine. If Heart transmits heat to the Small Intestine, causing dark, scanty urine and unclear speech, use Daochi Geban Tang. Generally, unclear speech is related to Heat in the Upper Jiao; therefore, Zhanshe Gao is a universal formula for treatment.