黄帝问于少师曰。人之卒然忧恚而言无音者。何道之塞。何气出行。使音不彰。愿闻其方。
音声者。五音之声。嘹亮而有高下者也。语言者。分别清浊字面。发言而有语句也。在肺主声。
心主言。肝主语。然由足少阴肾气之所发。又曰五者音也。音主长夏。是音声之道。本于五脏之气
全备。而后能音声响亮。语
句清明。故善治者。审其有音声而语言不清者。当责之心肝。能语言而无音声者。当责之脾肺。不能
语言而无音声者。此肾气之逆也。夫忧则伤肺。肺伤则无声矣。恚怒伤肝。肝伤则语言不清矣。
徐振公曰。土数五而主宫音。宫乃君主之音。五音之主也。仇汝霖曰。此篇亦承前数章而言。盖忧
恐忿怒。伤五脏之形。则病五脏而成积。如伤五脏之气。则无音声矣。倪仲玉曰。忧恐忿怒伤气。气
伤脏。乃病脏。是因气而病五脏之形。或伤五脏之气。
少师答曰。咽喉者。水谷之道也。喉咙者。气之所以上下者也。会厌者。音声之户也。口唇者。
音声之扇也。舌者。音声之机也。悬雍垂者。音声之关也。颃颡者。分气之所泄也。横骨者。神气所
使。主发舌者也。故人之鼻洞涕出不收者。颃颡不开。分气失也。是故厌小而疾薄。则发气疾。其开阖利。
其出气易。其厌大而浓。则开阖难。其气出迟。故重言也。人卒然无音者。寒热客于厌。则厌不能发。
发不能下。至其开阖不致。故无音。（厌上声）
胃之上脘为咽喉。主进水谷。在喉咙之后。肺之上管为喉咙。主气之呼吸出入。在咽喉之前。会厌
者。在喉咙之上。乃喉咽交会之处。凡人饮食。则会厌掩其喉咙。而后可入于咽。此喉咙之上管。故
为音声之户。谓声气之从此而外出也。脾开窍于口唇。口开阖而后语句清明。故为音声之扇。心开窍
于舌。足少阴之脉。上挟舌本。舌动而后能发言。故为音声之机。悬雍者。喉间之上 。有如悬雍之下
垂者。声从此而出。故为音声之关。肝脉循喉咙。入颃颡。颃颡者。 之上窍。口鼻之气。及涕唾从此
相通。故为分气之所泄。谓气之从此而分出于口鼻者也。横骨者。在舌本内。心藏神而开窍于舌。骨节
之交。神气之所游行出入。故为神气之所使。主发
舌者也。盖言横骨若弩。舌之发机。神气之所使也。人之鼻洞涕出不收者。因颃颡不开。分气失也。
盖以申明颃颡乃 之上窍。口鼻之气。及涕唾之从此而相通者也。会厌者。为开为阖。主声气之出入。
是以薄小则发声疾。浓大则开阖难。其气出迟。故重言也。重言者。口吃而期期也。寒气者。足少阴
寒水之气也。盖少阴之脉。上系于舌。络于横骨。终于会厌。其正气上行。而后音声乃发。如寒气客于
厌。则厌不能发。谓不能开也。发不能下。谓不能阖也。是以至其开阖不致。而无音声矣。
黄帝曰。刺之奈何。岐伯曰。足之少阴。上系于舌。络于横骨。终于会厌。两泻其血脉。浊气乃
辟。会厌之脉。上络任脉。取之天突。其厌乃发也。
足少阴主先天之生气。留于膻中。上出于肺。以司呼吸者。后天水谷所生之宗气也。是以呼出
心与肺。吸入下通于肝肾。呼吸定息。上下之相通也。故寒气客之。则正气不通。而会厌失其开阖
之机矣。浊气者。寒水之浊气。辟、除也。两泻其血脉者。谓脉道有两歧。一通气于舌本。一通精液
于廉泉玉英。盖足少阴主藏先天之精气。而上通于空窍者也。
Huangdi asked Shaoshi: "When a person suddenly loses their voice due to sudden worry and resentment, which pathway is blocked? Which qi mechanism malfunctions, causing the voice not to emerge? I wish to hear the explanation."
The term 'yin' (tone/sound) refers to the sounds of the five tones, clear and resonant with variations in pitch. The term 'yan' (speech) refers to distinguishing clear and turbid phonetic elements, forming sentences upon utterance. The Lung governs sound production, the Heart governs speech, and the Liver governs verbal expression. However, these functions are all initiated by the qi of the Foot-Shaoyin Kidney meridian. It is also said that the five organs correspond to the five tones, with the Gong tone governing late summer. Therefore, the principle of sound and speech is rooted in the completeness of the qi of the five zang organs; only then can the voice be resonant and the speech clear. Thus, a skilled practitioner, when encountering a patient who has sound but unclear speech, should investigate the Heart and Liver; for a patient who can speak but lacks sound, they should investigate the Spleen and Lung; for a patient who cannot speak nor produce sound, this indicates rebellion of Kidney qi. Worry injures the Lung, and Lung injury results in loss of sound; anger injures the Liver, and Liver injury results in unclear speech.
Xu Zhen Gong stated: "Earth corresponds to the number five and governs the Gong tone. Gong is the tone of the sovereign and the master of the five tones." Qiu Rulin stated: "This chapter continues from the previous ones. Generally, worry, fear, anger, and resentment injure the physical forms of the five zang organs, leading to accumulations within them; if they injure the qi of the five zang organs, it results in loss of voice." Ni Zhong Yu stated: "Worry, fear, and anger first injure qi; qi injury then injures the zang, resulting in zang disease. This is injuring the physical form of the five zang organs via qi. Alternatively, one may injure only the qi of the five zang organs."
Shaoshi replied: "The pharynx (Yanhou) is the pathway for water and food. The larynx (Houtong) is where qi ascends and descends. The epiglottis (Huiyan) is the gate of sound. The lips are the fan of sound. The tongue is the mechanism of sound. The uvula (Xuan Yong Chui) is the lock of sound. The nasopharynx (Hangsang) is the outlet for distributing qi. The transverse bone (Heng Gu) is directed by shen qi and primarily controls the movement of the tongue. Therefore, if a person suffers from nasal discharge and dripping tears that cannot be controlled, it is because the nasopharynx is not open, leading to a failure in qi distribution. Consequently, if the epiglottis is small and thin, qi emission is rapid, its opening and closing are smooth, and air exits easily. If the epiglottis is large and thick, opening and closing are difficult, air exit is slow, resulting in stammering (Zhong Yan). When a person suddenly loses their voice, it is because cold-heat pathogens lodge in the epiglottis, preventing it from opening or closing properly, leading to dysfunction in opening and closing, hence no voice. ('Yan' here is pronounced as a falling tone, referring to the epiglottis)."
"The upper part of the Stomach's upper jiao is called the pharynx, receiving water and food, located behind the larynx. The upper tube of the Lung is called the larynx, governing the inhalation and exhalation of qi, located in front of the pharynx. The epiglottis is located above the larynx, at the junction of the throat and pharynx. When eating or drinking, the epiglottis covers the larynx so that food can enter the pharynx. As the upper tube of the larynx, it is called the gate of sound, meaning sound qi emerges from here. The Spleen opens into the lips; the opening and closing of the lips allow for clear speech, thus it is called the fan of sound. The Heart opens into the tongue; the Foot-Shaoyin meridian ascends alongside the root of the tongue. Movement of the tongue enables speech, thus it is called the mechanism of sound. The uvula is the hanging structure above the throat; sound emerges from here, thus it is called the lock of sound. The Liver meridian circulates through the larynx and enters the nasopharynx. The nasopharynx is an upper orifice where qi from the mouth and nose, as well as mucus and saliva, communicate. Thus, it is called the outlet for distributing qi, meaning qi distributes from here to the mouth and nose. The transverse bone is located inside the root of the tongue. The Heart stores shen and opens into the tongue; this is the junction of bone joints, where shen qi travels in and out. Thus, it is called what shen qi directs, primarily activating the tongue. One can say the transverse bone is like a crossbow trigger, and the tongue's activation mechanism is directed by shen qi. Nasal discharge and uncontrollable tearing occur because the nasopharynx is not open, leading to failure in qi distribution. This clarifies that the nasopharynx is an upper orifice where qi from the mouth and nose, as well as mucus and saliva, communicate. The opening and closing of the epiglottis govern the entry and exit of sound qi. Therefore, if thin and small, sound emission is fast; if thick and large, opening and closing are difficult, air exit is slow, resulting in stammering. Stammering refers to stuttering. Cold pathogen refers to the cold-water qi of the Foot-Shaoyin. The Shaoyin meridian ascends to tie with the tongue, connects to the transverse bone, and terminates at the epiglottis. Its healthy qi ascends, allowing sound to emerge. If cold pathogen lodges in the epiglottis, the epiglottis cannot open (cannot open), and after opening, cannot close (cannot close). Thus, opening and closing fail, resulting in loss of voice."
Huangdi asked: "How should acupuncture be performed?" Qibo answered: "The Foot-Shaoyin meridian ascends to tie with the tongue, connects to the transverse bone, and terminates at the epiglottis. Drain the blood vessels in two locations to expel turbid qi. The vessel of the epiglottis connects upward to the Ren Mai. Select Tian Tu (CV22); then the epiglottis will function."
"The Foot-Shaoyin governs the vital qi of congenital origin, which remains in the Danzhong (Conception Vessel area), emerges upward into the Lung, and governs respiration. This is the Zong Qi (Gathering Qi) generated from postnatal food and drink. Exhalation is governed by the Heart and Lung; inhalation connects downward to the Liver and Kidney. Between breaths, there is communication between upper and lower. Therefore, when cold pathogen lodges here, healthy qi does not flow, and the epiglottis loses its mechanism of opening and closing. Turbid qi refers to the turbid qi of cold water; 'Bi' means to remove. Draining the blood vessels in two places refers to the fact that the meridian has two branches: one connecting to the root of the tongue, and one connecting to Lianquan (CV23) and Yuying. The Foot-Shaoyin stores congenital essence and qi, ascending to connect with the orifices."