夫失声之证非一，有痰壅、邪郁、肺痿、毒风、寒热、狐惑，舌强不语，肾虚喑痱，治
法各从其类也。惟痰火声嘶，则与诸证大异，何也？以水涸火炎，熏燥肺窍，金为火烁而损
，由是而声嘎声嘶见焉。治法非苦寒降火，温燥消痰可复，惟益水清金则善矣。
愚谓言者，心之声，声者，肺之韵。肺体清虚，以气鼓之，迫之则鸣，犹钟磬之悬架
，其内空虚，击之则鸣，内有污浊壅窒，击之则声哑而不明也。若自邪郁痰壅，肺痿狐惑等
因，则其声哑嘎，惟去其痰邪等病，即犹去钟磬之泥土浊垢，击之自鸣，复何哑乎？若夫水
亏火炎，金伤声碎者，则犹钟磬击损，欲其如故，须复铸之，所以痰火声嘶，其得全愈者鲜
矣。即施益水清金之法，尤恐不迨，若更以苦寒妄治，虚虚之祸，岂不旋踵而至哉！
桔梗（除肺热，利咽喉。） 沙参（补肺气，泻肺热，益肺肾。） 麦门冬（清金益肾，利
咽喉，复声音。） 知母（滋水清金。） 木通（清心，通窍，利声音。） 人参（除肺热，利声
音。） 石菖蒲（通心窍，发声音。） 诃黎勒（治久咳失音，又同木通服，尤验。） 人乳
竹沥 姜汁 童便（四味相合，顿温服，并治久咳失音。） 柿（润喉声。） 槐花（炒，嚼，
去风热失音者。）
The syndrome of aphonia (loss of voice) is not singular; there are cases of phlegm obstruction, pathogen stagnation, lung flaccidity (Fei Wei), toxic wind, cold-heat complex, and Huhuo disease causing a stiff tongue and inability to speak, as well as Kidney deficiency leading to Yinfei (aphonia accompanied by lower limb weakness). The treatment methods should follow their respective categories. However, hoarseness caused by Phlegm-Fire differs significantly from other syndromes. Why? Because when Kidney Water is depleted and Fire blazes upward, it scorches and dries the Lung orifices. Metal (Lung) is smelted and damaged by Fire, resulting in hoarse and raspy voices. Treatment cannot be restored merely by using bitter-cold herbs to descend Fire and warm-dry herbs to resolve Phlegm; only by nourishing Water and clearing Metal can one achieve success.
I propose that speech is the voice of the Heart, and sound is the resonance of the Lung. The Lung body is pure and empty; it resonates when driven by Qi. When pressured, it sounds, much like bells and chimes suspended: their interiors are hollow, so striking them produces sound. If the interior is obstructed by filth and turbidity, striking them yields a muffled and unclear sound. In cases where hoarseness arises from pathogen stagnation, phlegm obstruction, lung flaccidity, or Huhuo disease, removing these pathogens and phlegm is akin to cleaning the mud and dirt off the bells and chimes; upon striking, they will naturally resonate, and how could they remain hoarse? Conversely, when Water deficiency leads to Fire blazing and Metal injury causing fragmented voice, it is like a bell or chime that has been physically damaged. To restore it to its original state, it must be recast. Therefore, few patients with hoarseness due to Phlegm-Fire achieve complete recovery. Even when employing the method of nourishing Water and clearing Metal, one may fear it is too late; if one further treats recklessly with bitter-cold herbs, causing deficiency to exacerbate deficiency, will not disaster strike immediately?
Jiegeng (Platycodonis Radix): Clears Lung Heat, benefits the throat.
Shashen (Glehniae Radix): Tonifies Lung Qi, drains Lung Heat, benefits Lung and Kidney.
Maimendong (Ophiopogonis Radix): Clears Metal and benefits Kidney, benefits the throat, restores voice.
Zhimu (Anemarrhenae Rhizoma): Nourishes Water and clears Metal.
Mutong (Akebiae Caulis): Clears Heart, opens orifices, benefits voice.
Renshen (Ginseng Radix et Rhizoma): Clears Lung Heat, benefits voice.
Shichangpu (Acori Tatarinowii Rhizoma): Opens Heart orifices, promotes voice.
Helile (Terminaliae Chebulae Fructus): Treats chronic cough and aphonia; especially effective when taken together with Mutong.
Renru (Human Milk), Zhuli (Bamboo Sap), Jiangzhi (Zingiberis Recens Juice), Tongbian (Infant Urine): These four combined, taken warm at once, also treat chronic cough and aphonia.
Shi (Diospyros Kaki Fruit): Moistens throat and benefits voice.
Huaihua (Sophorae Flos): Stir-fried and chewed; removes Wind-Heat causing aphonia.