论曰伤寒后失音不语者,由风寒客于会厌,会厌为音声之户,邪气伤之。故猝然无音。
又肺主声而通于气,人之五脏,有五声,皆禀气而通之,若邪客于肺,则气道不调,亦令人
语无音声,治法当随其轻重以方治之。
治伤寒后外邪客于肺,卒失音。五味子汤方
五味子 桂(去粗皮各一两半) 杏仁(汤浸去皮尖双仁炒一两) 甘草(炙锉半两)
上四味,粗捣筛,每服五钱匕,水一盏半,生姜三片,煎至一盏去滓,不计时候温服。
治伤寒后忽暴嗽失音,语不出,杏仁煎方
杏仁(汤浸去尖皮双仁研二两) 木通(锉) 贝母(去心) 紫菀(去苗土) 五味
子桑根白皮(切) 百合(各一两) 生姜汁(半两) 沙糖(四两) 蜜(四两)
上一十味,除杏仁姜汁糖蜜外,细锉,用水五盏,煎至三盏,去滓下杏仁膏姜汁糖蜜等
相和,微火再煎如稀饧。以净器盛,每服半匙,水一盏煎开,温服不计时候。
治伤寒失音不语。豆竹汤方
黑豆(淘洗半升) 青竹(如算子四十九茎各长四寸)
上二味,用水五大盏同煮,以豆熟为度,去滓分温三服。
治伤寒卒失音,牙关紧急。麻仁饮方
大麻仁(半升) 羚羊角屑(二两)
上二味,粗捣筛,每服五钱匕,酒水各一盏,共煎至一盏,去滓温服日再服。
治伤寒失音不知人,口眼不正舌强。羚羊角散方
羚羊角屑(一两) 麻黄(去根节) 石膏(各半两) 防风(去叉) 麦门冬(去心
焙) 黄芩(去黑心) 干葛(锉) 升麻(各三两)
上八味,粗捣筛,每服五钱匕,水一盏半,煎至一盏,去滓食后温服,日三。
治伤寒失音不能语,口噤。防己汤方
防己(锉) 桂(去粗皮) 麻黄(去根节) 葛根(锉各一两) 甘草(炙) 防风
(去叉) 芍药(各半两)
上七味,粗捣筛,每服五钱匕,水一盏半,生姜三片,同煎至一盏去滓,空心温服,日
再服。
治伤寒失音不语,神志昏冒。升麻饮方
升麻(一两) 桂(去粗皮三分) 木通(锉二两) 防风(去叉一两半)
上四味,粗捣筛,每服五钱匕,水一盏半,煎至一盏,去滓下竹沥半合,搅令匀,空心
温服。
治伤寒失音不语。二沥汤方
竹沥 梨汁 荆沥(各二合) 陈酱汁(半合)
上四味,搅令匀,以绵滤过,分温四服,空心日晚各一服。
治伤寒邪气伤肺,失音不语,桂心汤方
桂(去粗皮二两) 菖蒲(一两去须)
上二味,粗捣筛,每服三钱匕,用水一盏,煎至七分去滓,不计时候温服,衣覆取汗,
未退再服。
治伤寒后肺中风冷,失音不语。芥子酒熨方
白芥子(五合研碎)
上一味,用酒煮令半熟,带热包裹,熨项颈周遭,冷则易之。
论述说:伤寒之后出现失音、不能说话的症状,是因为风寒邪气侵袭会厌。会厌是声音发出的门户,邪气损伤了它,所以突然失去声音。
另外,肺主管声音并与气相通,人的五脏对应五种声音,都依赖气的通畅而发出。如果邪气客居于肺,导致气道不调畅,也会使人说话没有声音。治疗应当根据病情的轻重,采用相应的方剂进行治疗。
治疗伤寒后外邪客居于肺,突然失音的方剂:五味子汤。
药材:五味子、桂枝(去除粗皮,各一两半)、杏仁(热水浸泡,去皮尖,双仁者炒制,一两)、甘草(炙烤后切碎,半两)。
以上四味药,粗捣筛碎,每次服用五钱匕,加水一盏半,生姜三片,煎煮至一盏量,去渣滓,不分时候温服。
治疗伤寒后忽然突发咳嗽导致失音,说不出话的方剂:杏仁煎。
药材:杏仁(热水浸泡,去尖皮,双仁者研碎,二两)、木通(切碎)、贝母(去心)、紫菀(去苗土)、五味子、桑根白皮(切片)、百合(各一两)、生姜汁(半两)、沙糖(四两)、蜂蜜(四两)。
以上十味药,除了杏仁、姜汁、糖、蜜之外,其余细切,用水五盏,煎煮至三盏,去渣滓,加入杏仁膏、姜汁、糖、蜜等混合,用微火再次煎煮至像稀糖浆一样的稠度。用干净的容器盛装,每次服用半匙,加水一盏煮沸,不分时候温服。
治疗伤寒失音、不能说话的方剂:豆竹汤。
药材:黑豆(淘洗半升)、青竹(如算筹般四十九茎,每茎长四寸)。
以上两味药,用水五大盏同煮,以豆子煮熟为标准,去渣滓,分三次温服。
治疗伤寒突然失音,牙关紧闭的方剂:麻仁饮。
药材:大麻仁(半升)、羚羊角屑(二两)。
以上两味药,粗捣筛碎,每次服用五钱匕,加酒和水各一盏,共同煎煮至一盏量,去渣滓温服,每日两次。
治疗伤寒失音、神志昏迷不知人,口眼歪斜、舌体强硬的方剂:羚羊角散。
药材:羚羊角屑(一两)、麻黄(去根节)、石膏(各半两)、防风(去叉)、麦门冬(去心焙干)、黄芩(去黑心)、干葛(切碎)、升麻(各三两)。
以上八味药,粗捣筛碎,每次服用五钱匕,加水一盏半,煎煮至一盏量,去渣滓,饭后温服,每日三次。
治疗伤寒失音、不能说话,口噤不开的方剂:防己汤。
药材:防己(切碎)、桂枝(去粗皮)、麻黄(去根节)、葛根(切碎,各一两)、甘草(炙烤)、防风(去叉)、芍药(各半两)。
以上七味药,粗捣筛碎,每次服用五钱匕,加水一盏半,生姜三片,共同煎煮至一盏量,去渣滓,空腹温服,每日两次。
治疗伤寒失音、不能说话,神志昏蒙的方剂:升麻饮。
药材:升麻(一两)、桂枝(去粗皮三分)、木通(切碎二两)、防风(去叉一两半)。
以上四味药,粗捣筛碎,每次服用五钱匕,加水一盏半,煎煮至一盏量,去渣滓,加入竹沥半合,搅拌均匀,空腹温服。
治疗伤寒失音、不能说话的方剂:二沥汤。
药材:竹沥、梨汁、荆沥(各二合)、陈酱汁(半合)。
以上四味药,搅拌均匀,用绵布过滤,分四次温服,空腹和晚间各服一次。
治疗伤寒邪气伤肺,失音、不能说话的方剂:桂心汤。
药材:桂枝(去粗皮二两)、石菖蒲(一两,去须)。
以上两味药,粗捣筛碎,每次服用三钱匕,用水一盏,煎煮至七分,去渣滓,不分时候温服,覆盖衣被取汗,若症状未退再服。
治疗伤寒后肺受风冷,失音、不能说话的方剂:芥子酒熨法。
药材:白芥子(五合,研碎)。
以上一味药,用酒煮至半熟,趁热包裹,熨烫项颈周围,变冷则更换。
It is discussed that loss of voice and inability to speak after Shanghan (Cold Damage) are caused by wind-cold pathogens invading the epiglottis. The epiglottis serves as the gate for sound production; when injured by pathogenic factors, sudden aphonia occurs.
Furthermore, the Lung governs sound and connects with Qi. The five Zang organs correspond to five vocalizations, all relying on the free flow of Qi. If pathogens lodge in the Lung, causing disharmony of the Qi mechanism, it also leads to speech without voice. Treatment should be administered according to the severity of the condition using appropriate formulas.
Formula: Wuweizi Tang (Schisandra Decoction) for treating sudden aphonia due to external pathogens lodging in the Lung after Shanghan.
Ingredients: Fructus Schisandrae Chinensis (Wuweizi), Ramulus Cinnamomi (Guizhi, peeled, 1.5 liang each), Semen Armeniacae Amarum (Xingren, soaked in hot water, skin and tip removed, roasted, double-kernel, 1 liang), Radix Glycyrrhizae Preparata (Gancao, roasted and cut, 0.5 liang).
The above four herbs are coarsely crushed and sifted. Take 5 qianbi per dose, add 1.5 zhan of water and 3 slices of Rhizoma Zingiberis Recens (Shengjiang), decoct until 1 zhan remains, strain, and take warm at any time.
Formula: Xingren Jian (Apricot Kernel Electuary) for treating sudden aphonia and inability to speak accompanied by violent cough after Shanghan.
Ingredients: Semen Armeniacae Amarum (Xingren, soaked, tip and skin removed, double-kernel pounded, 2 liang), Caulis Akebiae (Mutong, cut), Bulbus Fritillariae Thunbergii (Beimu, heart removed), Herba Asteris Tatarici (Ziwan, roots and soil removed), Fructus Schisandrae Chinensis (Wuweizi), Cortex Morus Radicis (Sangbaipí, sliced), Bulbus Lilii (Baihe, 1 liang each), Expressio Zingiberis Recens (Shengjiangzhi, 0.5 liang), Saccharum (Shatang, 4 liang), Mel (Fengmi, 4 liang).
Of the above ten ingredients, except for Xingren, Jiangzhi, Shatang, and Fengmi, finely cut the rest. Add 5 zhan of water, decoct until 3 zhan remain, strain, then add the paste of Xingren, Jiangzhi, Shatang, and Fengmi. Simmer over low heat until the consistency resembles thin syrup. Store in a clean vessel. Take half a spoon per dose, boil with 1 zhan of water, and take warm at any time.
Formula: Douzhu Tang (Black Bean and Bamboo Decoction) for treating aphonia and inability to speak after Shanghan.
Ingredients: Faba Seed Preparata (Heidou, washed, 0.5 sheng), Virgo Bambusae Caulis (Qingzhu, 49 stalks like counting rods, each 4 cun long).
Decoct the above two ingredients together in 5 zhan of large water until the beans are cooked. Strain and divide into three warm doses.
Formula: Maren Yin (Hemp Seed Drink) for treating sudden aphonia and trismus after Shanghan.
Ingredients: Semen Cannabis Sativae (Damaoren, 0.5 sheng), Cornu Saigae Tataricae (Lingyangjiao xie, 2 liang).
Coarsely crush and sift the above two ingredients. Take 5 qianbi per dose, add 1 zhan of wine and 1 zhan of water, decoct together until 1 zhan remains, strain, and take warm. Administer twice daily.
Formula: Lingyangjiao San (Saiga Antelope Horn Powder) for treating aphonia, unconsciousness, facial paralysis (deviation of mouth and eyes), and stiff tongue after Shanghan.
Ingredients: Cornu Saigae Tataricae (Lingyangjiao xie, 1 liang), Caulis Ephedrae (Mahuang, root and joints removed), Radix Pseudoginsengis? No, Gypsum Fibrosum (Shigao, 0.5 liang each), Radix Saposhnikoviae (Fangfeng, fork removed), Radix Ophiopogonis (Maimendong, heart removed and dried), Radix Scutellariae (Huangqin, black heart removed), Radix Puerariae Lobatae (Gegen, cut), Rhizoma Cimicifugae (Shengma, 3 liang each).
Coarsely crush and sift the above eight ingredients. Take 5 qianbi per dose, add 1.5 zhan of water, decoct until 1 zhan remains, strain, and take warm after meals. Three times daily.
Formula: Fangji Tang (Stephania Tetrandra Decoction) for treating aphonia, inability to speak, and trismus after Shanghan.
Ingredients: Radix Stephaniae Tetrandrae (Fangji, cut), Ramulus Cinnamomi (Guizhi, peeled), Caulis Ephedrae (Mahuang, root and joints removed), Radix Puerariae Lobatae (Gegen, cut, 1 liang each), Radix Glycyrrhizae Preparata (Gancao, roasted), Radix Saposhnikoviae (Fangfeng, fork removed), Radix Paeoniae Alba (Shaoyao, 0.5 liang each).
Coarsely crush and sift the above seven ingredients. Take 5 qianbi per dose, add 1.5 zhan of water and 3 slices of Rhizoma Zingiberis Recens (Shengjiang), decoct together until 1 zhan remains, strain, and take warm on an empty stomach. Twice daily.
Formula: Shengma Yin (Cimicifuga Drink) for treating aphonia, inability to speak, and mental confusion after Shanghan.
Ingredients: Rhizoma Cimicifugae (Shengma, 1 liang), Ramulus Cinnamomi (Guizhi, peeled, 3 fen), Caulis Akebiae (Mutong, cut, 2 liang), Radix Saposhnikoviae (Fangfeng, fork removed, 1.5 liang).
Coarsely crush and sift the above four ingredients. Take 5 qianbi per dose, add 1.5 zhan of water, decoct until 1 zhan remains, strain, add 0.5 he of Expressio Bambusae (Zhuli), mix well, and take warm on an empty stomach.
Formula: Erli Tang (Two Juices Decoction) for treating aphonia and inability to speak after Shanghan.
Ingredients: Expressio Bambusae (Zhuli), Expressio Pyri Sinensis (Lizhi), Expressio Viticis Trifoliae (Jingli, 2 he each), Expressio Fermenti Sojae Veteris (Chenjiangzhi, 0.5 he).
Mix the above four ingredients thoroughly, filter through cotton cloth, and divide into four warm doses. Take one dose on an empty stomach and one dose in the evening.
Formula: Guixin Tang (Cinnamon Heart Decoction) for treating lung injury by pathogenic factors leading to aphonia and inability to speak after Shanghan.
Ingredients: Ramulus Cinnamomi (Guizhi, peeled, 2 liang), Rhizoma Acori Tatarinowii (Changpu, 1 liang, whiskers removed).
Coarsely crush and sift the above two ingredients. Take 3 qianbi per dose, add 1 zhan of water, decoct until 0.7 zhan remains, strain, and take warm at any time. Cover with clothing to induce sweating. If symptoms do not subside, administer again.
Method: Jiezi Jiuyun (White Mustard Seed Wine Compress) for treating lung invasion by wind-cold after Shanghan, resulting in aphonia and inability to speak.
Ingredients: Semen Sinapis Albae (Baijiezi, 5 he, ground).
Cook the above single ingredient in wine until half-cooked. Wrap while hot and apply as a compress around the neck and nape. Replace when it cools down.