《圣惠》论∶夫喉咙者,气之所以上下也。喉厌者,声之门户也。舌者,声之机。口者,声之扇也。风寒
客于喉厌之间,故卒然无音。皆由风邪所伤,故致失音不语也。其小儿伤寒失音者,风寒邪气之所伤也。
茅生生小儿伤寒,失音、语不得方。
金毛狗脊 甘草(各等分)
上为末。每服一钱,用黄蜡一块,指头大,水六分同煎四分服。
《集验方》治小儿伤寒,失音不语。
桂(指面大)
上含桂,渐渐声音如旧。
《王氏手集》治大人、小儿感风寒失音。三拗汤
麻黄(不去根节) 甘草(不炙) 杏仁(不去皮尖)
上三物等分。每服三指撮,水一大盏,煎至七分,去滓。时时温温呷。
《石壁经》三十六种内伤寒变疽候歌∶
先前五日脸红鲜,(《凤髓经》第一句云∶已前七日唇脸青。)一见生人怕又惊。(四十候此两句云∶伤寒变疽七日前,
两睑唇青怕语言。)蓦睹胸前如痣子,(《凤髓经》云∶蓦然胸前赤痣色。)渐同梅李一般形。血光齿上时闻臭,指甲无红
色似银。食者可医无苦病,不识言风道热惊。用药表脾凉上膈,心凉疽伏始安宁。
《凤髓经》歌括一同,两句小异。外有注云∶宜与二圣散表出。(方见伤寒变疹子门中。)
四十候伤寒变疽歌一同。后云∶此候指甲白,牙上有血为证,表发只用参苓散,凉心经用南星丸。(方见伤寒变
疹门中。)不退用解表散(方见慢惊风门),去毒,托里散亦可。(方见伤寒变疹门中。)
四十八候治嗽化痰参苓散
人参 麻黄 甘草(炙) 款冬花(各一分) 半夏(小者如鱼眼大,汤浸十二次) 葶苈(各半钱) 马兜苓(三
个)
上末。每服半钱,用桑白皮汤下。
《太平圣惠方》论述道:喉咙,是气上下通行的通道。喉厌(咽喉部的软骨结构),是声音发出的门户。舌头,是发声的机关。口唇,是发声的扇叶。风寒邪气客居于喉厌之间,所以突然失音。这都是因为风邪侵袭,导致失音不能说话。小儿患伤寒而失音的,也是被风寒邪气所伤。
茅生生治疗小儿伤寒失音、不能言语的方子:
金毛狗脊、甘草(各等分)
以上药物研为细末。每次服用一钱,用一块指头大小的黄蜡,加六分水,同煎至四分水时服用。
《集验方》治疗小儿伤寒,失音不能说话。
桂枝(大小如硬币面)
含服桂枝,声音渐渐恢复如初。
《王氏手集》治疗大人、小儿感受风寒而失音。三拗汤
麻黄(不去根和节)、甘草(不炙烤)、杏仁(不去皮和尖)
以上三味药等分。每次取三指撮的药量,加大盏水,煎至七分,去渣。时时温温地呷服。
《石壁经》中关于三十六种内伤寒变疽候的歌诀:
先前五日脸红鲜亮,(《凤髓经》第一句说:此前七日嘴唇和脸色发青。)一见生人就害怕又受惊。(四十候歌诀这两句说:伤寒变疽七日前,两眼睑和嘴唇发青,怕说话。)突然看见胸前像黑痣一样,(《凤髓经》说:忽然胸前出现赤色黑痣样斑点。)渐渐变成像梅子和李子一样的形状。血光在牙齿上时常闻到臭味,指甲没有红色,颜色像银一样白。能进食的人可以医治,没有痛苦之病;不认识的人说是风热惊恐所致。用药发散脾经之邪,清凉上膈,心火清凉则疽毒潜伏而安宁。
《凤髓经》的歌诀内容相同,只有两句略有差异。另外有注释说:宜配合二圣散发散出来。(方剂见伤寒变疹子门中。)
四十候伤寒变疽歌诀内容相同。后面又说:此候指甲白,牙上有血作为证候,发散表邪只用参苓散,清心经用南星丸。(方剂见伤寒变疹门中。)不退者用解表散(方剂见慢惊风门),去毒,托里散也可以。(方剂见伤寒变疹门中。)
四十八候治疗咳嗽化痰的参苓散
人参、麻黄、甘草(炙)、款冬花(各一分)、半夏(小的如鱼眼大,用汤浸泡十二次)、葶苈(各半钱)、马兜铃(三个)
以上研为细末。每次服用半钱,用桑白皮汤送下。
The *Taiping Shenghui Fang* discusses: The throat (houlong) is the passage through which Qi ascends and descends. The laryngeal cartilage (houyan) is the gatehouse of voice. The tongue (she) is the mechanism of sound production. The mouth/lips (kou) are the fan of sound emission. When Wind-Cold pathogenic factors lodge between the laryngeal cartilages, sudden loss of voice occurs. This is all due to injury by Wind pathogenic factors, resulting in aphonia and inability to speak. In children suffering from Shanghan (Cold Damage syndrome) with aphonia, it is also caused by injury from Wind-Cold pathogenic factors.
Mao Shengsheng treated a case of pediatric Shanghan with aphonia and inability to speak with the following prescription:
*Polypodium vulgare* rhizome with golden hairs (Jinmao Gouji), Licorice root (Gancao) (equal parts).
Grind the above into powder. Take one qian per dose, decoct together with a piece of yellow beeswax (the size of a finger tip) and six fen of water until four fen remains, then administer.
The *Jiyan Fang* treats pediatric Shanghan with aphonia and inability to speak.
Cinnamon twig (Gui) (size of a coin face).
Hold the cinnamon twig in the mouth; gradually the voice returns to normal.
The *Wangshi Shouji* treats adults and children with aphonia due to contraction of Wind-Cold. San'ao Tang (Three Unrestrained Decoction):
Ephedrae Herba (Mahuang, 麻黄) (roots and nodes not removed), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (not roasted), Armeniacae Semen Amarum (Xingren, 杏仁) (skin and tips not removed).
Take equal parts of these three herbs. For each dose, take an amount held by three fingers, add one large cup of water, decoct until seven-tenths remain, remove the dregs. Sip warm frequently.
The song verse from the *Shibi Jing* regarding the thirty-six types of internal Shanghan transforming into carbuncles:
For five days prior, the face appears bright red, (The first line of the *Fengsui Jing* states: Seven days prior, lips and face appear cyanotic.) Upon seeing strangers, fear and alarm arise. (These two lines in the forty-hospitality verse state: Seven days before Shanghan transforms into carbuncles, both eyelids and lips are cyanotic, fearing speech.) Suddenly, spots like moles appear on the chest, (The *Fengsui Jing* states: Suddenly, crimson mole-like coloration appears on the chest.) Gradually taking shape like plums or cherries. Blood light emits a foul odor from the teeth; nails lack redness, appearing white as silver. Those who can eat are curable, free from painful illness; those unaware attribute it to Wind-Heat fright. Medications should disperse the Spleen exterior and cool the upper diaphragm; when Heart heat is cooled, the carbuncle lies dormant and peace is restored.
The verse from the *Fengsui Jing* is identical, with only minor differences in two lines. An additional note states: It is suitable to use Ersheng San to disperse outward. (Prescription found in the section on Shanghan transforming into rashes.)
The verse for the forty-hospitality Shanghan transforming into carbuncles is identical. It further states: This condition presents with white nails and blood on the teeth as signs. To disperse the exterior, only Shenling San should be used; to cool the Heart channel, Nanxing Wan should be used. (Prescriptions found in the section on Shanghan transforming into rashes.) If symptoms do not recede, Jiebiao San should be used (found in the section on Slow Convulsion Wind); to eliminate toxins, Tuoli San is also acceptable. (Found in the section on Shanghan transforming into rashes.)
Shenling San (Ginseng and Poria Powder) for treating cough and resolving phlegm in the forty-eight hospitality conditions:
Ginseng Radix (Renshen), Ephedrae Herba (Mahuang, 麻黄), Roasted Licorice Root (Zhi Gancao), Flos Distanthermae (Kuandonghua) (each one fen), Pinelliae Rhizoma (Banxia) (small ones the size of fish eyes, soaked in boiling water twelve times), Lepidii Fructus (Tingli) (each half qian), Aristolochiae Fructus (Madouling) (three fruits).
Grind into powder. Take half a qian per dose, administered with decoction of Morus Alba Cortex (Sangbaipi).