【舌音不清之症】身热口燥，面色多红，二便赤涩，神智昏沉，语言不便，此外感舌
【舌音不清之因】心经热甚，则舌纵而语塞；风中厥阴，则舌卷而难言；阳明邪盛，
则舌根强硬；或风寒外束，顽痰壅于胞络，则心窍不开。此外感舌音不清之因也。
【舌音不清之脉】脉多洪数。心经热者，左寸洪数。肝胆热者，左关弦数。风中厥阴
，左关弦紧。阳明热盛，右脉洪数。
【舌音不清之治】心热者，导赤各半汤；肝热者，龙胆泻肝汤、小柴胡汤；肝中风寒
，补肝散；阳明胃热，干葛清胃汤；大便秘结，有下症者，四顺饮。
导赤各半汤 见遗尿条。
龙胆泻肝汤
龙胆草 知母 川连 人参 麦冬 天门冬 山栀 黄芩 甘草 柴胡
补肝散 见口眼 斜。
干葛清胃汤 见口眼 斜。
四顺饮
当归 大黄 白芍药 枳壳
【舌音不清之症】二便不赤，气爽神清，但觉舌不能转，此肾虚舌音不清之虚症也。
神识昏沉，语言不利，便闭口渴，此积热舌音不清之实症也。
【舌音不清之因】盖肾脉挟舌本，肾经水亏，不能上循喉咙，则失润而喑；或因刺足
少阴
脉，重虚出血而喑；或因刺足太阴舌下中脉，出血不止而喑，此虚症之因也。或脾胃热，则
舌根硬而音不清，或心肝热甚，则舌卷而音不清。此实证之因也。
【舌音不清之脉】两尺细数，肾水枯涸。刺血阴亏，左脉空虚。脾胃积热，右关洪滑
【舌音不清之治】肾虚，三才丹；刺血重虚，当归补血汤；脾胃积热，转舌膏；心经
有火，导赤各半汤；肝经有火，龙胆泻肝汤。
三才封髓丹
天门冬 熟地黄 人参
当归补血汤
黄 当归
转舌膏 见口噤不语。
导赤各半汤 见内伤不语。
龙胆泻肝汤 见前。
口角流涎而舌音不清，胃热也，清胃汤、栀连平胃散。口渴引饮，而舌音不清，干葛石
膏汤。咳逆喘息而舌音不清，肺热也，栀连泻白散加枳桔，或凉膈散、清燥汤。肺遗热于大
肠，大便闭结而舌音不清，枳桔四顺饮。上焦有痰火，舌根或硬或麻者，栀连二陈汤。上有
痰火，下见大便阻滞者，指迷丸，多冲竹沥，以顺大肠。心遗热于小肠，小便赤涩而舌音不
清者，导赤各半汤，大凡舌音不清，皆系上焦之热，故转舌膏为通治之方。
【舌音不清的症状】身体发热，口舌干燥，面色多呈红色，大小便色赤且排泄涩滞不畅，神志昏沉，言语不便，这是外感引起的舌音不清。
【舌音不清的原因】心经热邪炽盛，则舌体纵缓而语言阻塞；风邪侵袭厥阴经，则舌体卷缩而难以言语；阳明经邪气亢盛，则舌根强硬；或者风寒束缚于体表，顽痰壅塞于心包络（胞络），导致心窍闭塞不通。这就是外感引起舌音不清的原因。
【舌音不清的脉象】脉象多表现为洪大且数。心经有热者，左寸脉洪数；肝胆有热者，左关脉弦数；风邪中于厥阴经，左关脉弦紧；阳明热盛，右脉洪数。
【舌音不清的治疗】心热者，使用导赤各半汤；肝热者，使用龙胆泻肝汤、小柴胡汤；肝受风寒者，使用补肝散；阳明胃热者，使用干葛清胃汤；大便秘结，有可下之证候者，使用四顺饮。
导赤各半汤 见遗尿条。
龙胆泻肝汤
龙胆草 知母 川连 人参 麦冬 天门冬 山栀 黄芩 甘草 柴胡
补肝散 见口眼歪斜。
干葛清胃汤 见口眼歪斜。
四顺饮
当归 大黄 白芍药 枳壳
【舌音不清的症状】大小便不赤红，气息顺畅，神志清醒，只感觉舌头不能转动，这是肾虚引起的舌音不清的虚证。
神志昏沉，言语不利，大便闭结口渴，这是积热引起的舌音不清的实证。
【舌音不清的原因】肾脉挟持舌本，肾经阴水亏虚，不能上行滋润喉咙，则失于润泽而声音嘶哑；或者因为针刺足少阴肾经穴位，造成重虚并出血而导致失音；或者因为针刺足太阴脾经舌下中脉，出血不止而导致失音，这是虚证的原因。如果脾胃有热，则舌根僵硬而声音不清；或者心肝热邪炽盛，则舌体卷缩而声音不清。这是实证的原因。
【舌音不清的脉象】两尺脉细数，为肾水枯涸。因刺血导致阴液亏损，左脉空虚。脾胃积热，右关脉洪滑。
【舌音不清的治疗】肾虚者，使用三才丹；因刺血导致重虚者，使用当归补血汤；脾胃积热者，使用转舌膏；心经有火者，使用导赤各半汤；肝经有火者，使用龙胆泻肝汤。
三才封髓丹
天门冬 熟地黄 人参
当归补血汤
黄芪 当归
转舌膏 见口噤不语。
导赤各半汤 见内伤不语。
龙胆泻肝汤 见前文。
口角流涎且舌音不清，是胃热所致，用清胃汤、栀连平胃散。口渴引饮且舌音不清，用干葛石膏汤。咳嗽气逆喘息且舌音不清，是肺热所致，用栀连泻白散加枳壳、桔梗，或凉膈散、清燥汤。肺将热邪传于大肠，大便闭结且舌音不清，用枳桔四顺饮。上焦有痰火，舌根或僵硬或麻木者，用栀连二陈汤。上有痰火，下见大便阻滞者，用指迷丸，多冲入竹沥，以通利大肠。心将热邪传于小肠，小便赤涩且舌音不清者，用导赤各半汤。大凡舌音不清，都属于上焦的热证，所以转舌膏是通用的方剂。
[Symptoms of Unclear Speech Due to Tongue Dysfunction] The body is feverish, the mouth and tongue are dry, the facial complexion is often red, urine and stool are dark and difficult to pass smoothly, consciousness is clouded, and speech is obstructed. These are symptoms of unclear speech due to external contraction (Wai Gan).
[Etiology of Unclear Speech Due to Tongue Dysfunction] When heat in the Heart Meridian is severe, the tongue becomes flaccid and speech is blocked; when wind strikes the Jueyin Meridian, the tongue curls and speaking is difficult; when pathogenic factors are abundant in the Yangming Meridian, the root of the tongue becomes stiff; or if wind-cold binds the exterior and phlegm-stagnation obstructs the Pericardium Collateral (Bao Luo), causing the Heart orifice to be closed, these are the causes of unclear speech due to external contraction.
[Pulse Signs of Unclear Speech Due to Tongue Dysfunction] The pulse is mostly surging (Hong) and rapid (Shu). In cases of Heat in the Heart Meridian, the left Cun position is surging and rapid. In cases of Heat in the Liver and Gallbladder, the left Guan position is wiry (Xian) and rapid. When wind strikes the Jueyin Meridian, the left Guan position is wiry and tight. In cases of Exuberant Heat in Yangming, the right pulse is surging and rapid.
[Treatment of Unclear Speech Due to Tongue Dysfunction] For Heart Heat, use Daochi Geban Tang (Half-Combined Decoction for Guiding Out Redness); for Liver Heat, use Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) or Xiaochaihu Tang (Minor Bupleurum Decoction); for Wind-Cold affecting the Liver, use Buchgan San (Liver-Nourishing Powder); for Yangming Stomach Heat, use Gange Qingwei Tang (Pueraria Decoction to Clear the Stomach); for constipation with signs indicating the need for purgation, use Sishun Yin (Four-Obedience Drink).
Daochi Geban Tang See under "Enuresis".
Longdan Xiegan Tang
Longdan Cao (Radix Gentianae) Zhimu (Rhizoma Anemarrhenae) Chuan Lian (Radix Coptidis) Renshen (Radix Ginseng) Maidong (Tuber Ophiopogonis) Tianmendong (Tuber Asparagi) Shanzhi (Fructus Gardeniae) Huangqin (Radix Scutellariae) Gancao (Radix Glycyrrhizae) Chaihu (Radix Bupleuri)
Buchgan San See under "Facial Paralysis".
Gange Qingwei Tang See under "Facial Paralysis".
Sishun Yin
Danggui (Radix Angelicae Sinensis) Dahuang (Radix et Rhizoma Rhei) Baishaoyao (Radix Paeoniae Alba) Zhiqiao (Fructus Aurantii)
[Symptoms of Unclear Speech Due to Tongue Dysfunction] Urine and stool are not dark, breath is smooth, and consciousness is clear, but there is a sensation that the tongue cannot move. This is a deficiency syndrome of unclear speech due to Kidney Deficiency.
Clouded consciousness, impaired speech, constipation, and thirst indicate an excess syndrome of unclear speech due to accumulated heat.
[Etiology of Unclear Speech Due to Tongue Dysfunction] The Kidney meridian attaches to the root of the tongue. If Kidney Water (Yin) is deficient and cannot ascend to moisten the throat, loss of moisture leads to aphonia. Alternatively, aphonia may result from puncturing the Foot-Shaoyin meridian, causing severe deficiency and bleeding; or from puncturing the middle vessel under the tongue of the Foot-Taiyin meridian, leading to unceasing bleeding. These are the causes of the deficiency syndrome. If there is Heat in the Spleen and Stomach, the root of the tongue becomes stiff and speech is unclear; or if Heat in the Heart and Liver is severe, the tongue curls and speech is unclear. These are the causes of the excess syndrome.
[Pulse Signs of Unclear Speech Due to Tongue Dysfunction] The two Chi positions are fine and rapid, indicating exhaustion of Kidney Water. After bloodletting causing Yin deficiency, the left pulse is empty. In cases of Accumulated Heat in the Spleen and Stomach, the right Guan position is surging and slippery.
[Treatment of Unclear Speech Due to Tongue Dysfunction] For Kidney Deficiency, use Santang Dan (Three Capabilities Pill); for severe deficiency after bloodletting, use Danggui Buxue Tang (Angelica Tonifying Blood Decoction); for Accumulated Heat in the Spleen and Stomach, use Zhanshe Gao (Tongue-Turning Paste); for Fire in the Heart Meridian, use Daochi Geban Tang; for Fire in the Liver Meridian, use Longdan Xiegan Tang.
Santang Fengsui Dan
Tianmendong (Tuber Asparagi) Shudihuang (Prepared Radix Rehmanniae) Renshen (Radix Ginseng)
Danggui Buxue Tang
Huangqi (Radix Astragali) Danggui (Radix Angelicae Sinensis)
Zhanshe Gao See under "Locked Jaw and Aphonia".
Daochi Geban Tang See under "Internal Injury Aphonia".
Longdan Xiegan Tang See above.
Saliva flowing from the corners of the mouth with unclear speech indicates Stomach Heat; use Qingwei Tang (Stomach-Clearing Decoction) or Zhilian Pingwei San (Coptis and Gardenia Stabilize the Middle Powder). Thirst with desire to drink and unclear speech indicates use of Gange Shigao Tang (Pueraria and Gypsum Decoction). Cough, counterflow qi, and wheezing with unclear speech indicate Lung Heat; use Zhilian Xiebai San (Coptis and Gardenia Drains White Powder) plus Zhike (Pericarpium Aurantii) and Jiegeng (Radix Platycodi), or Liangge San (Cool the Chest Powder) or Qingzao Tang (Clear Dryness Decoction). If Lung transmits heat to the Large Intestine, causing constipation and unclear speech, use Zhijie Sishun Yin (Zhiqiao and Jiegeng Four-Obedience Drink). If there is Phlegm-Fire in the Upper Jiao, with the tongue root being either stiff or numb, use Zhilian Erchen Tang (Coptis and Gardenia Two-Chen Decoction). If there is Phlegm-Fire above and bowel obstruction below, use Zhimi Wan (Eliminate Mystery Pill), mixed with much Zhuli (Bamboo Sap), to smooth the Large Intestine. If Heart transmits heat to the Small Intestine, causing dark, scanty urine and unclear speech, use Daochi Geban Tang. Generally, unclear speech is related to Heat in the Upper Jiao; therefore, Zhanshe Gao is a universal formula for treatment.