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A person with extreme thirst drinks cold water rapidly and suddenly loses their voice, becoming hoarse and unable to speak. People attribute this to hyperactivity of Heart Fire (Xin Huo, excessive heat in the Heart), but little do they know it is due to the closure of Lung Qi (Fei Qi, the vital energy of the Lung). The Lung governs Qi; when Qi flows freely, the voice is resonant; when Qi is obstructed, the voice becomes hoarse. In Five Element theory, the Lung belongs to Metal (Jin, 金). When Metal is solid and obstructed, it cannot resonate. However, Lung Metal most dislikes Heart Fire; if Fire attacks Metal, it is indeed what Metal fears, and Metal refrains from sounding out of caution, which is logical. Why does encountering Water cause such closure? It is unknown that Water controls Fire, so Fire must be subdued by Water. Although Metal is relieved that Water subdues Fire, it still fears Fire attacking Metal. Lung Qi descends along with the descending force of Water, sinking like metal to the bottom of a pool; how can it sound on its own? This type of aphonia is caused by Water suppressing Lung Qi and preventing it from ascending, not by the failure of Lung Qi itself. The treatment method should be to promote the diffusion of Lung Qi and dissipate dampness-water, without directly treating aphonia, yet the voice will naturally return. Use Shengyin Tang (Voice-Generating Decoction): Loquat Leaf (Loquat Folium, 5 slices), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus, 2 qian), Poria (Poria, 5 qian), Stemona Root (Stemonae Radix, 1 qian), Perilla Leaf (Perillae Folium, 1 qian), Ophiopogon Tuber (Ophiopogonis Radix, 3 qian), Licorice Root (Glycyrrhizae Radix et Rhizoma, 1 qian), Scrophularia Root (Scrophulariae Radix, 5 qian), Mulberry Root Bark (Mori Cortex, 3 qian). Decoct in water and take orally. After one dose, the voice slightly returns; after two doses, the voice increases significantly; after three doses, full recovery occurs.

This formula promotes the free flow of Lung Qi, causing Lung Qi to rise naturally. By dissipating the Water pathogen, Fire Qi descends naturally. With Fire extinguished and Water dissipated, Metal has nothing to fear, and why would the Lung hesitate to produce sound?

This condition can also be treated with Dongfu Subei Tang (Winter-Poria-Perilla-Fritillaria Decoction): Perilla Leaf (Perillae Folium, 3 qian), Ophiopogon Tuber (Ophiopogonis Radix, 2 liang), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus, 3 qian), Poria (Poria, 5 qian). Decoct in water and take orally. Voice returns after two doses.

A person suffering from exhaustion and weakness experiences restless wheezing and coughing, gradually leading to aphonia and hoarseness, with low-pitched breath. People assume this is the exhaustion of Lung Qi, but little do they know it is due to the depletion of Kidney Water (Shen Shui, Yin fluids of the Kidney). The Lung is the mother of the Kidney and generates it. If the Mother organ (Lung) is diseased, how can it nourish the Child (Kidney)? Since the Kidney is deficient and daily draws resources from the Lung, the Child becomes poor and the Mother even poorer. With both Mother and Child depleted, weak and desolate, with faint breath, this is known as "Broken Metal Cannot Sound" (Jin Po Bu Ming). Empirical physicians claim that broken Metal must be supplemented by Earth (Spleen/Stomach). Although Spleen and Stomach can generate Metal, most Earth-supplementing herbs are Yang-tonifying. Using Yang herbs to tonify Earth leads to excess Yang and further consumption of Yin, which damages the Lung instead. The treatment must strongly tonify Kidney Water. Once the Child is abundant, the Mother will naturally not be poor. Moreover, Lung Qi returns to the Kidney palace at night for rest and peace. The exhausted Lung suddenly transforms into a relaxed Lung, supplied with body fluids for the Lung Mother's use. Thus, Lung Metal instantly regenerates, breathing becomes leisurely, and its clearing and descending function is restored. Use Zhuyin Tang (Sound-Assisting Decoction): Prepared Rehmannia Root (Rehmanniae Radix Praeparata, 1 liang), Ophiopogon Tuber (Ophiopogonis Radix, 1 liang), Schisandra Berry (Schisandrae Chinensis Fructus, 1 qian), Licorice Root (Glycyrrhizae Radix et Rhizoma, 1 qian), Perilla Seed (Perillae Fructus, 1 qian), Asparagus Tuber (Asparagi Radix, 2 qian), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus, 3 fen), Winter Flower Bud (Adenophorae Radix, 5 fen)* [Note: Adenophorae Radix is often used for Kua Dong Hua in some contexts or strictly Adenophora, here likely referring to Adenophorae Radix or similar tonic], Glehnia Root (Glehniae Radix, 5 qian), Wolfberry Bark (Lycii Cortex, 3 qian). Decoct in water and take orally. After two doses, wheezing subsides slightly; after four doses, cough stops slightly; after continuous administration of twenty doses, voice returns. Continue taking for two months to ensure no recurrence of aphonia. After two months, add Ginseng Root (Ginseng Radix, 5 fen), Chinese Yam Rhizome (Dioscoreae Rhizoma, 1 liang), and Poria (Poria, 2 qian) to the previous formula, and continue taking for half a year to transform consumptive weakness into normal health.

This formula focuses on tonifying the Lung while tonifying the Kidney, and tonifying the Kidney while tonifying the Lung, thereby restoring failed functions and achieving results in critical conditions.

This condition can also be treated with Liuxian Tang (Thread-Retaining Decoction): Prepared Rehmannia Root (Rehmanniae Radix Praeparata, 5 qian), Winter Flower Bud (Adenophorae Radix, 1 qian), Cornus Fruit (Corni Fructus, 2 qian), Ophiopogon Tuber (Ophiopogonis Radix, 5 qian), Wolfberry Bark (Lycii Cortex, 5 qian), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus, 1 qian), Perilla Seed (Perillae Fructus, 1 qian), Chinese Yam Rhizome (Dioscoreae Rhizoma, 3 qian), Euryale Seed (Euryales Semen, 3 qian), Stemona Root (Stemonae Radix, 3 fen). Decoct in water and take orally.

A person with severe thirst, dry tongue lacking fluids, cracked lips, and dry throat eventually loses their voice. People attribute this to exuberant Lung Fire, but little do they know it is due to excessive Heart Fire. The Lung belongs to Metal, which most fears being controlled by Heart Fire. Lung Qi is already weakened, and Heart Fire is excessively strong, inevitably over-attacking Metal, scorching and melting it. Deprived of its clearing and descending nature, Metal assumes only a burnt form. How can one expect clear and resonant voice under these circumstances? The treatment must reduce the excess of Heart Fire and nourish the deficiency of Lung Metal, allowing Fire to subside and Lung to settle. However, one cannot merely drain Heart Fire. The reason Heart Fire is excessive is actually due to the insufficiency of Kidney Water. Weak Water fails to control Fire, allowing Fire to follow its flaming-upward nature. If Water is not replenished and only Fire is drained, Fire will lack control, and administering cold-cooling herbs may反而 increase the flame, described as provoking aggression through stimulation. Use the following formula: Coptis Rhizome (Coptidis Rhizoma, 3 qian), Ophiopogon Tuber (Ophiopogonis Radix, 5 qian), Scrophularia Root (Scrophulariae Radix, 5 qian), Raw Rehmannia Root (Rehmanniae Radix, 5 qian), Platycodon Root (Platycodi Radix, 3 qian), Licorice Root (Glycyrrhizae Radix et Rhizoma, 2 qian), Trichosanthes Root (Trichosanthis Radix, 2 qian). Decoct in water and take orally. Voice returns after one dose, becomes loud after two doses; a third dose is unnecessary.

This formula is named Mingjin Tang (Metal-Sounding Decoction). It drains Fire while containing the intent to tonify the Kidney, though no obvious Kidney-tonifying herbs are seen; it remains a Lung-saving formula. Since Lung and Kidney are mother and child, saving the Lung generates Kidney Water; once Kidney Water is generated, Heart Fire descends.

This condition can also be treated with Jiawei Yuandong Tang (Modified Yuan-Dong Decoction): Scrophularia Root (Scrophulariae Radix, 1 liang), Salvia Root (Salviae Miltiorrhizae Radix, 3 qian), Ophiopogon Tuber (Ophiopogonis Radix, 1 liang), Schisandra Berry (Schisandrae Chinensis Fructus, 1 qian). Decoct in water and take orally. Full recovery after ten doses.