钱氏论肾怯、失音、相似，病吐泻及大病后，虽有声而不能言，又能咽药，此非
失音，为肾怯不能上接于阳故也，补肾地黄丸（肾）主之。失音乃卒病耳。
《吉氏家传》治小儿患后声不出。
酸枣仁（去壳，一钱） 白茯苓（半钱） 朱砂（二钱）
上件为末，蜜丸如豆大。每服一丸，人参汤下。
《圣惠》鸡头丸（见舌）
汉东王先生通关散 治小儿惊风并退，只是声哑不能言。
上以天南星炮，为末。每服婴孩半字或一字，三五岁半钱，八九岁一钱， 猪
胆汁调下，令孩儿吃咽入喉中，便能言语。
《集验方》治小儿惊退而哑，不能言语。
木通（锉） 防风（去芦） 川升麻 羚羊角（屑） 桂心（以上各半两） 甘草（炙，二钱半）
上件药捣为粗散。每服一钱，水一小盏，煎至五分，去滓，入竹沥少许，更煎
一两沸，不计时候，量儿大小加减服之。
《集验》又方
腊月牛胆酿天南星（不拘多少）
上研细。每服半字，薄荷汤调下，临卧服，儿大者、服一字至半钱。
《巢氏病源》小儿发痫瘥后，六七岁不能语候，风痫发之状，口眼相引，或目睛
上摇，或手足螈 ，或脊背强直，或颈项反折，屈搐如数，皆由以儿当风取凉，乳
哺失节之所为也。而痫发瘥后不能语者，是风痫因儿衣浓汗出，以儿乘风取凉太过，
为风所伤得之，其初发之状，屈指如数，然后发螈 是也。心之声为言，开窍于口，
其痫发虽止，风冷之气犹滞心之络脉，使心气不和，其声不发，故不能言也。
《千金》大补心汤 治小儿痫瘥后，风冷留滞于心络，使心气不和，语声不发。
黄芩 附子（炮，去皮脐。各一两） 甘草 茯苓 桂心（各三两） 石膏 半夏 远志肉（各四两）
生姜（六两） 大枣（二十枚） 饴糖（一斤） 干地黄 阿胶 麦门冬（各三两）
上件药 咀。每服一大撮，入前饴糖半匙许，水一盏半，煎半盏服之。
钱乙论述肾怯、失音症状相似的情况：在呕吐腹泻及大病之后，患儿虽然能发出声音但不能言语，且能够吞咽药物，这并非失音，而是因为肾气虚弱不能上承于阳气所致，治疗以补肾地黄丸（滋补肾阴的方剂）为主。失音则是突然发生的疾病。
《吉氏家传》记载治疗小儿病后声音不出。
酸枣仁（去壳，一钱） 白茯苓（半钱） 朱砂（二钱）
以上药材研为细末，用蜂蜜制成如豆粒大小的丸药。每次服用一丸，用人参汤送服。
《太平圣惠方》中的鸡头丸（见“舌”病章节）
汉东王先生通关散 治疗小儿惊风消退后，只是声音嘶哑不能言语。
将天南星炮制后研为细末。每次用量：婴儿半字或一字，三至五岁半钱，八至九岁一钱，用猪胆汁调匀送下，让患儿咽入喉中，便能恢复言语。
《集验方》治疗小儿惊风消退后变哑，不能言语。
木通（锉碎） 防风（去芦头） 川升麻 羚羊角（镑屑） 桂心（以上各半两） 甘草（炙，二钱半）
以上药材捣成粗散。每次服用一钱，加水一小盏，煎煮至五分，滤去药渣，加入少许竹沥，再煮沸一两滚，不分时候，根据患儿年龄大小调整剂量服用。
《集验方》又一方
腊月时收集牛胆，酿入天南星（数量不限）
以上药材研细。每次服用半字，用薄荷汤调匀送下，临睡前服用，年龄较大的儿童可服用一字至半钱。
《诸病源候论》记载小儿癫痫发作痊愈后，六至七岁仍不能说话的证候：风痫发作时的表现，口眼牵引歪斜，或眼球上翻摇动，或手足抽搐，或脊背强直，或颈项向后反折，屈伸抽搐次数不定，这都是因为让幼儿对着风乘凉，以及哺乳喂养不规律所导致的。而癫痫发作痊愈后不能说话的原因，是风痫因幼儿衣着厚重出汗后，乘凉太过，被风邪所伤所致。其初发时的表现，屈指计数，随后发生抽搐。心的声音表现为言语，开窍于口。癫痫发作虽已停止，但风冷之气仍滞留于心之络脉，导致心气不和，声音无法发出，因此不能言语。
《千金方》大补心汤 治疗小儿癫痫痊愈后，风冷留滞于心之络脉，导致心气不和，语声无法发出。
黄芩 附子（炮制，去皮脐。各一两） 甘草 茯苓 桂心（各三两） 石膏 半夏 远志肉（各四两）
生姜（六两） 大枣（二十枚） 饴糖（一斤） 干地黄 阿胶 麦门冬（各三两）
以上药材切碎。每次取一大撮，加入前文所述的饴糖半匙许，加水一盏半，煎煮至半盏，服用。
Qian Yi discussed the similarity between Kidney Deficiency (Shen Qie, a condition characterized by weakness of kidney essence and qi) and Aphonia (loss of voice). After vomiting, diarrhea, or severe illness, although the child may produce sounds but cannot speak, and is able to swallow medicine, this is not Aphonia. It is caused by Kidney Deficiency failing to connect with Yang Qi upwards. The treatment is governed by Bushen Dihuang Wan (Kidney-Nourishing Rehmannia Pill). Aphonia is an acute onset disease.
"Ji Shi Jia Chuan" records the treatment for children whose voices do not emerge after illness.
Suanzaoren (Ziziphi Spinosae Semen, husked, 1 qian) Baifuling (Poria, 0.5 qian) Zhusha (Cinnabar, 2 qian)
The above ingredients are ground into powder and formed into pills the size of beans using honey. Take one pill per dose, administered with Ginseng Decoction.
"Taiping Shenghui Fang" contains Jitou Wan (see "Tongue" section).
Mr. Wang from Handong's Tongguan San treats children who, after the subsidence of Infantile Convulsions (Jing Feng), have hoarseness and cannot speak.
Processed Tian Nan Xing (Arisaematis Rhizoma Preparatum) is ground into powder. Dosage: infants take half zi or one zi; children aged three to five take half qian; children aged eight to nine take one qian. Mix with Pig Bile (Su Zhi Dan Huang) and administer, allowing the child to swallow it into the throat, after which speech will return.
"Ji Yan Fang" treats children who become mute and unable to speak after the subsidence of Infantile Convulsions.
Mutong (Akebiae Caulis, sliced) Fangfeng (Saposhnikoviae Radix, de-gorged) Chuanshengma (Bupleuri Radix) Lingyangjiao (Saigae Tataricae Cornu, shaved) Guixin (Cinnamomi Cortex, each 0.5 liang) Gancao (Glycyrrhizae Radix et Rhizoma, roasted, 2.5 qian)
The above medicines are crushed into coarse powder. Take one qian per dose, add one small cup of water, decoct until reduced to 0.5 cup, filter out the dregs, add a small amount of Bamboo Sap (Zhuli), boil for one or two more boils, and administer at any time, adjusting the dose according to the child's age and size.
"Ji Yan Fang" another prescription
In the twelfth lunar month, stuff Tian Nan Xing (Arisaematis Rhizoma) into Ox Gallbladder (Niu Dan) (quantity unrestricted).
Grind the above finely. Take half zi per dose, mixed with Mint Decoction (Bohe Tang), taken before going to bed. Older children may take one zi to half qian.
"Chushi Bingyao" describes the syndrome where children aged six to seven cannot speak after the remission of Epilepsy (Xian): The manifestation of Wind-Epilepsy includes pulling of the mouth and eyes, upward rolling of the eyeballs, convulsions of the hands and feet, rigidity of the spine, or retrocollis (opisthotonos), and flexion-extension spasms occurring in numbers. These are all caused by exposing the child to wind for cooling and irregular breastfeeding/feeding habits. The reason for inability to speak after the remission of epilepsy is that due to heavy clothing causing sweating during an epileptic fit, followed by excessive exposure to wind for cooling, the body is injured by Wind Pathogen. The initial manifestation involves counting on fingers, followed by convulsions. The sound of the Heart manifests as speech, and the Heart opens into the mouth. Although the epileptic seizure has stopped, Wind-Cold Qi remains stagnant in the collaterals of the Heart, causing Disharmony of Heart Qi, preventing the voice from emerging, thus resulting in inability to speak.
"Qianjin Fang" Da Bu Xin Tang treats children after epilepsy remission, where Wind-Cold lingers in the Heart collaterals, causing Disharmony of Heart Qi and preventing vocalization.
Huangqin (Scutellariae Radix) Fuzi (Aconiti Lateralis Radix Praeparata, processed, skin and navel removed, each 1 liang) Gancao (Glycyrrhizae Radix et Rhizoma) Fuling (Poria) Guixin (Cinnamomi Cortex, each 3 liang) Shigao (Gypsum Fibrosum) Banxia (Pinelliae Rhizoma) Yuanzhi Rou (Polygalae Radix flesh, each 4 liang)
Shengjiang (Zingiberis Rhizoma Recens, 6 liang) Dazao (Jujubae Fructus, 20 pieces) Yitang (Maltose, 1 jin) Gadihuang (Rehmanniae Radix) Ejiao (Colla Corii Asini) Maidong (Ophiopogonis Radix, each 3 liang)
The above medicines are cut into pieces. Take a large handful per dose, add half a spoonful of the aforementioned Maltose, add one and a half cups of water, decoct until half a cup remains, and administer.