(《灵枢·忧恚无言篇》全)
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。(恚,慧、畏二音,恨怒
也。)少师答曰∶咽喉者,水谷之道也。喉咙者,气之所以上下者也。(人有二喉,一软一硬。软者居后,是谓咽喉,乃
水谷之道,通于六腑者也。硬者居前,是谓喉咙,为宗气出入之道,所以行呼吸,通于五脏者也。其在太阴阳明论,则
单以软者为咽,硬者为喉,故曰喉主天气,咽主地气。硬,硬同。)会厌者,音声之户也。(会厌者,喉间之薄膜也,周
围会合,上连悬雍,咽喉食息之道得以不乱者,赖其遮厌,故谓之会厌。能开能阖,声由以出,故谓之户。)口唇者,音
声之扇也。(唇启则声扬,故谓之扇。)舌者,音声之机也。(舌动则音生,故谓之机。)悬雍垂者,音声之关也。(悬雍垂
者,悬而下垂,俗谓之小舌,当气道之冲,为喉间要会,故谓之关。)颃颡者,分气之所泄也。(颃,颈也。颃颡,即颈
中之喉颡,当咽喉之上,悬雍之后,张口可见者也。颡前有窍,息通于鼻,故为分气之所泄。颃,何朗切,又去声。颡,
思朗切。)横骨者,神气所使,主发舌者也。(横骨,即喉上之软骨也。下连心肺,故为神气所使。上连舌本,故主举发
舌机。)故人之鼻洞涕出不收者,颃颡不开,分气失也。(鼻洞者,涕液流泄于鼻也。颃颡之窍不开则清气不行,清气不
行则浊液聚而下出,由于分气之失职也。)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。(疾,速也。重言,言语蹇涩之谓。)人卒然无音者,寒气客于厌,则厌不能发,发不能下,至其
开阖不致,故无音。(不致,不能也。寒气客于会厌,则气道不利,既不能发扬而高,又不能低抑而下,开阖俱有不便,
故卒然失音。)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。(两
泻者,两足俱刺也。足少阴之血脉,当是所注之 穴,即太溪也。然人有虚劳失音者,观此节之义,则亦无非属乎肾经;
但其所致有渐,与此卒然者不同,其治当分补泻耳。辟,开也。)会厌之脉,上络任脉,取之天突,其厌乃发也。(天突
为阴维任脉之会,取之能治暴喑。)
《灵枢·忧恚无言篇》(全篇)
黄帝向少师问道:人突然因忧愁愤怒而失音,是什么经络阻塞了?什么气机运行失常,导致声音不能发出?我想了解其中的道理。(“恚”字读作慧或畏,意为怨恨愤怒。)
少师回答说:咽喉,是饮食水谷通行的道路。喉咙,是气机上下运行的通道。(人体有两个喉部结构,一个软一个硬。软的在后,称为咽喉,是水谷进入六腑的通道;硬的在前,称为喉咙,是宗气出入的通道,主管呼吸,与五脏相通。在《太阴阳明论》中,仅将软的部分称为咽,硬的部分称为喉,所以说喉主天气,咽主地气。“硬”通“哽”。)会厌,是声音发出的门户。(会厌是喉间的薄膜,周围会合,上连悬雍垂,依靠它的遮盖作用使咽喉进食和呼吸的通道不致混乱,所以叫会厌。它能开能闭,声音由此发出,所以叫门户。)口唇,是声音传播的扇叶。(嘴唇张开声音就扬起,所以叫扇叶。)舌,是声音产生的机关。(舌头运动声音就产生,所以叫机关。)悬雍垂,是声音发出的关卡。(悬雍垂悬挂而下,俗称小舌,位于气道冲要之处,是喉间的重要交会点,所以叫关卡。)颃颡,是清气分流排泄的地方。(颃指颈项。颃颡即颈中的喉部上方,位于咽喉之上、悬雍垂之后,张口可见。颃颡前方有孔窍,气息通达于鼻,所以是清气分流排泄之处。“颃”音何朗切,又读去声;“颡”音思朗切。)横骨,受神气的驱使,主要主管舌头的发动。(横骨即喉上方的软骨,下连心肺,所以受神气驱使;上连舌根,所以主管舌机的举发。)因此,人如果鼻孔漏气、鼻涕流出无法收敛,是因为颃颡孔窍不开,导致分气功能失职。(鼻洞指鼻涕从鼻腔流泄。颃颡的孔窍如果不打开,清气就不能正常运行,清气不行则浊液积聚而向下流出,这是由于分气功能失职造成的。)所以,如果会厌小而薄,则气机发动迅速,开阖灵活,排气容易;如果会厌大而厚,则开阖困难,气机排出迟缓,说话就会显得重浊迟钝。(“疾”意为快。重言指言语蹇涩。)人突然失音,是因为寒气侵袭会厌,导致会厌不能正常发动,发动后也不能正常闭合,致使开阖功能失调,所以没有声音。(“不致”意为不能。寒气客居会厌,导致气道不利,既不能向上发扬,也不能向下低抑,开阖都有障碍,所以突然失音。)
黄帝问:如何针刺治疗?岐伯说:足少阴肾经上行系于舌,联络横骨,终于会厌。针刺两侧血脉,使浊气得以消散。(“两泻”指双足同时针刺。足少阴的血脉,应当是所注的穴位,即太溪穴。然而人有因虚劳而失音的,参照此节的含义,也都归属于肾经;但其发病是逐渐形成的,与此处突然发作的情况不同,治疗时应当区分补法和泻法。“辟”意为开散。)会厌的脉络,向上联络任脉,取天突穴针刺,会厌的功能就能恢复。(天突穴是阴维脉和任脉的交会穴,针刺此穴能治疗暴发性失音。)
The Ling Shu · Chapter on Sudden Loss of Speech Due to Grief and Anger (Complete)
Huangdi asked Shaoshi: When a person suddenly loses their voice due to grief and anger, which meridians are blocked? Which qi mechanisms malfunction, causing the voice to fail to emerge? I wish to hear the explanation. ("Hui" is pronounced as "hui" or "wei", meaning resentment and anger.)
Shaoshi replied: The pharynx (throat for swallowing) is the pathway for food and drink. The larynx (windpipe for breathing) is the channel through which qi moves up and down. (Humans have two throat structures, one soft and one hard. The soft part is located posteriorly, called the pharynx, which serves as the passage for food and drink connecting to the six fu organs. The hard part is located anteriorly, called the larynx, which is the pathway for Zong Qi (Gathering Qi) to enter and exit, governing respiration and connecting to the five zang organs. In the *Taiyin Yangming Treatise*, only the soft part is referred to as Yan (pharynx) and the hard part as Hou (larynx), hence it is said that the larynx governs Heavenly Qi and the pharynx governs Earthly Qi. "Ying" is synonymous with "Geng".) The epiglottis is the gatehouse of sound production. (The epiglottis is a membrane in the larynx that joins around the periphery and connects superiorly to the uvula. It prevents confusion between the pathways of eating/breathing by covering them, thus named Epiglottis. It can open and close, allowing sound to emerge, thus named Gatehouse.) The lips are the fan blades of sound transmission. (When the lips open, the voice projects, thus named Fan Blades.) The tongue is the mechanism of sound generation. (When the tongue moves, sound is produced, thus named Mechanism.) The uvula is the checkpoint of sound emission. (The uvula hangs down, commonly known as the little tongue. It is situated at the critical point of the airway and serves as an important convergence point in the larynx, thus named Checkpoint.) The nasopharynx (Hangsang) is the place where clear qi diverges and exits. ("Hang" refers to the neck. Hangsang refers to the upper part of the throat in the neck, located above the pharynx/larynx and behind the uvula, visible when opening the mouth. There are apertures anterior to the Hangsang, through which breath communicates with the nose, making it the site for the divergence and exit of clear qi. "Hang" is pronounced He-lang qie, also read as departing tone; "Sang" is pronounced Si-lang qie.) The hyoid bone (Henggu) is driven by Shen Qi (Spirit Qi) and primarily governs the movement of the tongue. (The hyoid bone is the cartilage above the larynx. It connects inferiorly to the heart and lungs, thus being driven by Shen Qi; it connects superiorly to the root of the tongue, thus governing the activation of the tongue mechanism.) Therefore, if a person has nasal leakage and uncontrolled dripping of mucus, it is because the nasopharyngeal aperture is not open, leading to a failure of the diverging qi function. (Nasal leakage refers to mucus flowing out from the nose. If the nasopharyngeal aperture does not open, clear qi cannot circulate normally. If clear qi does not circulate, turbid fluids accumulate and flow downward, resulting from the dysfunction of the diverging qi.) Consequently, if the epiglottis is small and thin, qi activation is rapid, opening and closing are flexible, and air expulsion is easy. If the epiglottis is large and thick, opening and closing are difficult, qi expulsion is slow, resulting in heavy and slurred speech. ("Ji" means fast. "Zhongyan" refers to slurred or hesitant speech.) When a person suddenly loses their voice, it is because cold pathogenic factors invade the epiglottis, preventing it from activating properly. Even if it activates, it fails to close, causing dysfunction in opening and closing, thus resulting in aphonia. ("Bu zhi" means unable to. When cold pathogens lodge in the epiglottis, the airway becomes obstructed. It neither ascends nor descends properly, and both opening and closing are impaired, leading to sudden loss of voice.)
Huangdi asked: How should acupuncture be applied? Qibo answered: The Foot-Shaoyin Kidney Meridian ascends to tie to the tongue, links to the hyoid bone, and terminates at the epigllottis. By reducing the blood vessels on both sides, turbid qi will dissipate. ("Liang xie" refers to needling both feet simultaneously. The blood vessel of the Foot-Shaoyin meridian corresponds to the Jing-River point, which is Taixi (KI3). However, for patients with aphonia caused by deficiency and exhaustion, referring to the meaning of this section, it still belongs to the Kidney Meridian; but since its onset is gradual, unlike the sudden case here, treatment must distinguish between tonification and reduction methods. "Pi" means to open and disperse.) The vessels of the epiglottis connect superiorly to the Ren Mai (Conception Vessel). Needling Tiantu (CV22) allows the epiglottis to function properly. (Tiantu is the meeting point of the Yin Wei Mai and Ren Mai. Needling this point treats sudden aphonia.)