夫失声之证非一，有痰壅、邪郁、肺痿、毒风、寒热、狐惑，舌强不语，肾虚喑痱，治
法各从其类也。惟痰火声嘶，则与诸证大异，何也？以水涸火炎，熏燥肺窍，金为火烁而损
，由是而声嘎声嘶见焉。治法非苦寒降火，温燥消痰可复，惟益水清金则善矣。
愚谓言者，心之声，声者，肺之韵。肺体清虚，以气鼓之，迫之则鸣，犹钟磬之悬架
，其内空虚，击之则鸣，内有污浊壅窒，击之则声哑而不明也。若自邪郁痰壅，肺痿狐惑等
因，则其声哑嘎，惟去其痰邪等病，即犹去钟磬之泥土浊垢，击之自鸣，复何哑乎？若夫水
亏火炎，金伤声碎者，则犹钟磬击损，欲其如故，须复铸之，所以痰火声嘶，其得全愈者鲜
矣。即施益水清金之法，尤恐不迨，若更以苦寒妄治，虚虚之祸，岂不旋踵而至哉！
桔梗（除肺热，利咽喉。） 沙参（补肺气，泻肺热，益肺肾。） 麦门冬（清金益肾，利
咽喉，复声音。） 知母（滋水清金。） 木通（清心，通窍，利声音。） 人参（除肺热，利声
音。） 石菖蒲（通心窍，发声音。） 诃黎勒（治久咳失音，又同木通服，尤验。） 人乳
竹沥 姜汁 童便（四味相合，顿温服，并治久咳失音。） 柿（润喉声。） 槐花（炒，嚼，
去风热失音者。）
失音（声音嘶哑或不能发声）的证候不止一种，有痰浊壅盛、邪气郁结、肺痿、毒风、寒热错杂、狐惑病导致舌体僵硬不能言语，以及肾虚引起的喑痱（下肢萎软无力伴失音），治疗方法应当根据各自的病机类别进行。唯独痰火导致的声嘶，与其他证候大不相同，为什么呢？这是因为肾水枯竭而心火炎上，熏蒸灼燥肺窍，肺金被火邪烁伤而受损，因此出现声音嘎涩、嘶哑的症状。治疗这种病症，非用苦寒药物降火、温燥药物化痰就能恢复的，只有采用滋补肾水、清肃肺金的方法才是良策。
我认为，言语是心的外现，声音是肺的韵律。肺体清虚，依靠气的鼓动，受到逼迫就会鸣响，就像悬挂的钟磬一样，内部空虚，敲击就会发出声响；如果内部有污浊之物壅塞阻滞，敲击时声音就会哑涩而不清晰。如果是由于邪气郁结、痰浊壅盛、肺痿、狐惑等原因导致的声哑，只要去除痰邪等病因，就如同清除钟磬上的泥土污垢，敲击自然能鸣响，哪里还会哑呢？至于因肾水亏虚、心火炎上、肺金受伤导致声音破碎的情况，则如同钟磬被击损，想要恢复原状，必须重新铸造。所以痰火导致的声嘶，能够完全痊愈的人很少了。即使施用滋水清金的方法，还担心来不及见效，如果再错误地使用苦寒药物治疗，造成虚上加虚的祸患，岂不是立刻就会发生吗！
桔梗（清除肺热，利咽喉。） 沙参（补肺气，泻肺热，益肺肾。） 麦门冬（清肺金益肾水，利咽喉，恢复声音。） 知母（滋肾水清肺金。） 木通（清心火，通窍道，利声音。） 人参（清除肺热，利声音。） 石菖蒲（通心窍，发声音。） 诃黎勒（治疗久咳失音，又与木通同服，尤其有效。） 人乳、竹沥、姜汁、童便（这四味药相合，顿温服用，并治久咳失音。） 柿（润喉利声。） 槐花（炒后嚼服，去除风热导致的失音者。）
The syndrome of aphonia (loss of voice) is not singular; there are cases of phlegm obstruction, pathogen stagnation, lung flaccidity (Fei Wei), toxic wind, cold-heat complex, and Huhuo disease causing a stiff tongue and inability to speak, as well as Kidney deficiency leading to Yinfei (aphonia accompanied by lower limb weakness). The treatment methods should follow their respective categories. However, hoarseness caused by Phlegm-Fire differs significantly from other syndromes. Why? Because when Kidney Water is depleted and Fire blazes upward, it scorches and dries the Lung orifices. Metal (Lung) is smelted and damaged by Fire, resulting in hoarse and raspy voices. Treatment cannot be restored merely by using bitter-cold herbs to descend Fire and warm-dry herbs to resolve Phlegm; only by nourishing Water and clearing Metal can one achieve success.
I propose that speech is the voice of the Heart, and sound is the resonance of the Lung. The Lung body is pure and empty; it resonates when driven by Qi. When pressured, it sounds, much like bells and chimes suspended: their interiors are hollow, so striking them produces sound. If the interior is obstructed by filth and turbidity, striking them yields a muffled and unclear sound. In cases where hoarseness arises from pathogen stagnation, phlegm obstruction, lung flaccidity, or Huhuo disease, removing these pathogens and phlegm is akin to cleaning the mud and dirt off the bells and chimes; upon striking, they will naturally resonate, and how could they remain hoarse? Conversely, when Water deficiency leads to Fire blazing and Metal injury causing fragmented voice, it is like a bell or chime that has been physically damaged. To restore it to its original state, it must be recast. Therefore, few patients with hoarseness due to Phlegm-Fire achieve complete recovery. Even when employing the method of nourishing Water and clearing Metal, one may fear it is too late; if one further treats recklessly with bitter-cold herbs, causing deficiency to exacerbate deficiency, will not disaster strike immediately?
Jiegeng (Platycodonis Radix): Clears Lung Heat, benefits the throat.
Shashen (Glehniae Radix): Tonifies Lung Qi, drains Lung Heat, benefits Lung and Kidney.
Maimendong (Ophiopogonis Radix): Clears Metal and benefits Kidney, benefits the throat, restores voice.
Zhimu (Anemarrhenae Rhizoma): Nourishes Water and clears Metal.
Mutong (Akebiae Caulis): Clears Heart, opens orifices, benefits voice.
Renshen (Ginseng Radix et Rhizoma): Clears Lung Heat, benefits voice.
Shichangpu (Acori Tatarinowii Rhizoma): Opens Heart orifices, promotes voice.
Helile (Terminaliae Chebulae Fructus): Treats chronic cough and aphonia; especially effective when taken together with Mutong.
Renru (Human Milk), Zhuli (Bamboo Sap), Jiangzhi (Zingiberis Recens Juice), Tongbian (Infant Urine): These four combined, taken warm at once, also treat chronic cough and aphonia.
Shi (Diospyros Kaki Fruit): Moistens throat and benefits voice.
Huaihua (Sophorae Flos): Stir-fried and chewed; removes Wind-Heat causing aphonia.