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Yin (aphonia) refers to the inability to produce sound when speaking, which is also known as "yin". The throat is the passage through which qi ascends and descends; the epiglottis is the gateway for voice production. If qi flows freely, speech can be produced normally. *Waitai Mi Yao* states: When liver wind strikes, the mouth cannot speak; when spleen wind strikes, sound cannot emerge, or there may be impairment of hand and foot movement. It further states: The spleen meridian runs along the throat and connects to the root of the tongue; the divergent meridian of the heart ties to the root of the tongue. Now, if the heart and spleen organs are invaded by wind pathogen, the tongue becomes stiff and speech is impaired. Liu Hejian stated: Internal depletion leading to jue (reversal cold/impairment) refers to a deficiency and weakness of the kidney meridian, where its qi fails to reach below the tongue due to jue reversal, resulting in aphonia (tongue stiffness preventing speech) and leg paralysis (inability to use the feet). This condition is named "Yin Fei" in the classics and is treated with Dihuang Yinzi (Rehmannia Decoction). Comparatively, those with yin (loss of voice) retain normal language content but cannot produce sound, indicating a deficiency of the zang organs. Those with a stiff tongue unable to speak may attempt to talk but with slurred and unclear articulation, caused by phlegm-dampness and wind pathogen. Those who do not speak at all have no language output; this is either due to clouded spirit and unconsciousness, or due to zang qi jue reversal failing to reach below the tongue. These conditions must be differentiated and treated separately.

Hejian Dihuang Yinzi (Rehmannia Decoction of Liu Hejian)
Shu Dihuang (Prepared Rehmannia Root), Bajitian (Morinda Officinalis Root, heart removed), Shihu (Dendrobium Stem), Shanzhuyu (Cornus Fruit), Congrong (Cistanche Stem, soaked in wine, baked), Fuzi (Aconite Lateral Root, processed), Wuweizi (Schisandra Fruit), Rougui (Cinnamon Bark), Maidong (Ophiopogon Tuber), Baifuling (Poria with Hostwood), Shichangpu (Acorus Rhizome), Yuanzhi (Polygala Root, heart removed). All ingredients in equal proportions.
Grind the above herbs into powder. Take 3 qian per dose, decoct with 1.5 cups of water, 5 slices of fresh ginger, one jujube, and seven leaves of bohe (Mint) until reduced to 0.8 cup. Take at any time.

Ditan Tang (Phlegm-Expelling Decoction)
Qingxin San (Clear Heart Powder) (Both formulas are described in the preceding section on "Expelling Phlegm-Dampness".)

*Baojian* Fushen San (Poria Spirit Powder from Baojian)
Fushen Xin (Poria Spirit with Hostwood, 1 liang, stir-fried), Bohe (Mint, 2 liang, baked), Xie Shao (Scorpion Tail, detoxified, 5 qian).
Grind the above herbs into powder. Take 1–2 qian per dose, mixed with warm wine. This is a formula treating aphonia caused by wind pathogen combined with phlegm.

The Foot-Yangming Stomach Meridian follows the Jiache point; the Hand-Taiyang Small Intestine Meridian follows the neck up to the cheek. When both meridians are affected by wind-cold, the sinews and bones pull the cheek, causing deviation of the mouth and eyes (facial paralysis). The eyes cannot move properly.
*Waitai Mi Yao* treats stroke with facial pulling, deviation of the mouth and eyes, tightness of the jaw, and immobility of the tongue with the following formula:
Duhuo (Angelica Pubescens Root, 3 liang), Zhuli (Bamboo Sap), Sheng Dihuang Zhi (Fresh Rehmannia Juice, each 1 sheng).
Decoct these three ingredients together, obtain 1 sheng of liquid, and take it in one dose. Recovery will follow.
Another prescription:
Muli (Oyster Shell, calcined), Fanshi (Alum, burnt), Fuzi (Aconite Lateral Root, processed and peeled), Zaohuangtu (Yellow Earth from the Hearth, 1 liang).
Grind each ingredient into powder in equal proportions. Mix with the blood of the comb of a three-year-old rooster and apply to the affected area. Wash off once normal appearance returns. *Qianjin Yi Fang* states: Apply to the left side if the right is deviated, and to the right side if the left is deviated. Alternatively, use eel blood mixed with a small amount of Shexiang (Musk) for application.

Dai Yuanli stated: There are cases of sudden deviation of the mouth and eyes without apparent cause where treatments for stroke are ineffective. This is likely due to bone deficiency allowing wind pathogen to invade internally. One should seek the cause from this perspective and not treat it routinely as ordinary stroke.
Another prescription:
Remove the shell of Bimazi (Castor Seed) and pound it into a paste. Apply to the left side if the right is deviated, and to the right side if the left is deviated. Alternatively, use eel blood mixed with a small amount of Shexiang (Musk) for application.