《宝鉴》灸幼宫，三壮，又灸中指甲后一分。《万全方》灸小儿夜啼，上灯啼，鸡鸣
止者。灸中指甲后一分，中冲穴一壮，炷如小麦大。
〔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。
巢氏云，喉咙者，气之道路，喉厌者，声音之门户，有暴寒气客于喉厌，
得寒即不能发声，故卒然失音也，不能语者，语声不出，非牙关噤也。
*Ba Jian* (Precious Mirror) records: Moxibustion at Yougong (Infant Palace) acupoint, three moxa cones; additionally, moxibustion at one fen posterior to the middle fingernail. *Wan Quan Fang* (Ten Thousand Complete Formulas) records treatment for infant night crying (unexplained nocturnal crying): if the crying starts when lamps are lit and stops at cockcrow, moxibustion at Zhongchong (Zhongchong, Pericardium 9), located one fen posterior to the middle fingernail, one moxa cone, with a cone size resembling a wheat grain.
[Xue Ji] The classics state: The tongue is the mechanism of voice; the throat is the gate of voice. Sudden loss of voice in infants is caused by cold pathogen lodging in the epiglottis, causing the epiglottis to fail to open and close properly, leading to uncontrolled closure of the glottis, thus resulting in aphonia. If the throat sounds remain normal but the tongue cannot move to articulate speech, this is termed "tongue aphonia" (She Yin). This is caused by wind-cold pathogen lodging in the collaterals of the Spleen, or invading the Lianquan (Lianquan, Ren 23) acupoint below the tongue. Since the tongue is the sprout of the Heart, and the Heart produces speech, wind pathogen blocking the meridians causes the tongue to be unable to move flexibly. If the root of the tongue cannot move to articulate speech, while the throat sounds hoarse, this is termed "throat aphonia" (Hou Yin). This is also caused by wind-cold pathogen lodging, obstructing the airway, so that sound cannot emerge, resulting in a voiceless throat. However, some cases are due to wind-phlegm obstruction, some due to Qi deficiency of the Heart Meridian, some due to wind affecting the collaterals of the Spleen, some due to wind-phlegm stagnating in the collaterals of the Spleen, some due to insufficiency of Spleen Qi, and some due to failure of clear Qi to ascend from the Stomach; all these can lead to aphonia. Generally, this condition may also involve congenital insufficiency of Kidney Qi inherited from the father, preventing speech; or fire from the Five Emotions of the wet nurse lingering on the infant, steaming and closing the clear pathways, preventing speech; or fluid consumption due to infant illness, drying up the epiglottis, preventing speech; or insufficient Kidney Qi with deficient fire flaming upward damaging the Lung, preventing speech; or aphonia due to convulsive wind or stroke. For cases with residual heat and fluid consumption, use Qiwu Baizhu San (Seven-Ingredient White Atractylodes Macrocephala Powder). For cases with failure of clear Qi to ascend, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For cases of congenital Kidney insufficiency and deficient fire damaging the Lung, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If symptoms include coughing with head tilted back, emaciation of limbs, prominent whites of the eyes, or accompanied by delayed fontanelle closure (Jie Lu), yawning, and teeth grinding, all belong to Kidney deficiency; without Dihuang Wan, there is no cure.
Chao Yuanfang stated: The throat is the pathway for Qi; the epiglottis is the portal for sound. If sudden cold pathogen lodges in the throat and epiglottis, upon encountering cold, it cannot produce sound, thus resulting in sudden aphonia. Inability to speak refers to the inability to vocalize, not trismus (lockjaw).