人有口渴之极，快饮凉水，忽然喑哑，不能出声，人以为心火亢热也，谁知肺气之闭
乎。夫肺主气，气通则声音响亮，气塞则声音喑哑。盖肺属金，金实则不鸣
耳。但肺金最恶心火，火来刑金，宜为金之所畏，金不敢出声，理也。何得水而反闭耶？不
知水来克火，则火必为水所克，金虽幸水之克火，犹恐火之刑金，肺气随水气而下降，金沉于
水底，何能自鸣耶？此种喑哑，乃水抑肺气而不升，非肺气之自败。治法宣扬肺气，分消其
水湿，不治喑哑，而喑哑自鸣矣。方用发声汤∶
枇杷叶（五片） 贝母（二钱） 茯苓（五钱） 百部（一钱） 苏叶（一钱） 麦冬（
三钱） 甘草（一钱） 玄参（五钱） 桑白皮（三钱）水煎服。一剂声少出，再剂声大
出矣，三剂全愈。
此方宣通肺气，则肺气自扬。分消水势则火气自降。火降水消，金无所畏，肺亦何所顾
忌而不鸣哉。
此症亦可用冬茯苏贝汤∶
苏叶（三钱） 麦冬（二两） 贝母（三钱） 茯苓（五钱）水煎服。二剂而声出。
人有劳损弱怯，喘嗽不宁，渐渐喑哑，气息低沉，人以为肺气之绝也，谁知是肾水之涸
乎。夫肺为肾之母，本生肾者也。肺母自病，何能乳子？肾又不足，日来取资于肺，则子
贫而母益贫矣。子母两贫，伶仃苦弱，气息奄奄，所谓金破不鸣也。世医谓金破必须补土，
然而脾胃虽能生金，而补土之药多属阳药，用阳药以补土，
则阳旺而阴愈消，反有损于肺矣。治法必须大补肾子之水，子富而母自不贫。况肺气夜归于
肾子之宫，将息安宁，劳瘁之肺，忽变为逸乐之肺，而又有津液以供肺母之用，则肺金顿生，
自必气息从容，重施其清肃之令矣。方用助音汤∶
熟地（一两） 麦冬（一两） 北五味子（一钱） 甘草（一钱） 苏子（一钱） 天
门冬（二钱） 贝母（三分） 款冬花（五分） 沙参（五钱） 地骨皮（三钱）水煎服。
二剂而喘少平，四剂而嗽少止，连服二十剂声出矣。再服二月，断不喑哑也。二月后，前方
加人参五分，山药一两，茯苓二钱，再服半年，可变痨怯为平人矣。
此方补肾之中，意仍注于补肺，然补肺之中，仍是补肾，所以能收已败之功，克奏将坏之
绩也。
此症亦可用留线汤治之。
熟地（五钱） 款冬花（一钱） 山茱萸（二钱） 麦冬（五钱） 地骨皮（五钱）
贝母 苏子（各一钱） 山药 芡实（各三钱） 百部（三分）
水煎服。
人有口渴之甚，舌上无津，两唇开裂，喉中干燥，遂至失音，人以为肺火之旺也，谁知
心火太旺乎。夫肺属金，最畏者心火之克肺也，金气已衰，心中之火过于
大旺，未免刑金太甚， 炼销烁，金无清肃之气，惟有焚化之形，欲求其音声之疏越，何可
得耶？治法必须泻心火之有余，滋肺金之不足，则火易息，而肺可安矣。虽然又不可徒泻
心火也，盖心之所以有余者，实因肾水之不足耳。水衰不能制火，火得遂其炎上之性，倘不
补水而徒泻其火，则火无水制，服寒凉之药反增其助火之焰，所谓因激而成其横也。方用∶
黄连（三钱） 麦冬（五钱） 玄参（五钱） 生地（五钱） 桔梗（三钱） 甘草（二
钱） 天花粉（二钱）水煎服。一剂声出，二剂声响，不必三剂。
方名鸣金汤。泻火而补肾存其中，全不见补肾，仍是救肺之药。盖肺肾为子母，救肺正
所以生肾水也，肾水生而心火降矣。
此症用加味元冬汤亦可治。
元参（一两） 丹参（三钱） 麦冬（一两） 北五味子（一钱）水煎服。十剂全愈。
有人极度口渴，快速饮用凉水后，突然失音嘶哑，无法发声。人们认为是心火亢盛炽热所致，殊不知是肺气闭阻的缘故。肺主司气机，气机通畅则声音洪亮，气机阻滞则声音嘶哑。肺在五行中属金，金体实塞便不能鸣响。然而肺金最厌恶心火，火来克制金，这本是金所畏惧的，金因恐惧而不敢出声，这是常理。为何遇到水反而导致闭塞呢？不知道水能克火，火必然被水所制，虽然金庆幸水能克制火，但仍担心火会刑克金，肺气随着水气的下行而下降，如同金沉入水底，怎么能自己发出声音呢？这种失音，是由于水抑制了肺气使其不能上升，并非肺气自身的败坏。治疗应当宣发肺气，分消体内的水湿，不直接治疗失音，而失音自然痊愈。方用发声汤：枇杷叶（五片）、贝母（二钱）、茯苓（五钱）、百部（一钱）、苏叶（一钱）、麦冬（三钱）、甘草（一钱）、玄参（五钱）、桑白皮（三钱），水煎服。服用一剂声音稍出，两剂声音大出，三剂完全痊愈。
此方能宣通肺气，则肺气自然上扬；分消水势，则火气自然下降。火降水消，金无所畏惧，肺又有什么顾忌而不发出声音呢？
此症也可使用冬茯苏贝汤：苏叶（三钱）、麦冬（二两）、贝母（三钱）、茯苓（五钱），水煎服。两剂后声音即可发出。
有人因劳损导致身体虚弱怯懦，气喘咳嗽不得安宁，逐渐出现失音嘶哑，气息低沉。人们认为是肺气衰竭，殊不知是肾水枯竭所致。肺为肾之母，本是生养肾的。如果肺母自身患病，怎能滋养子脏？肾又不足，每日向肺索取资助，则是子贫而母更贫。子母两虚，伶仃苦弱，气息奄奄，这就是所谓的“金破不鸣”。世俗医生认为金破必须补土（脾胃），然而脾胃虽能生金，但补土的药材多属阳药，使用阳药来补土，则阳气旺盛而阴液更加消减，反而损害肺脏。治疗方法必须大补肾中之水，子脏富足了，母脏自然不再贫穷。况且肺气夜间归于肾宫，得以休养安宁，劳损疲惫的肺，忽然变为安逸快乐的肺，又有津液供给肺母使用，那么肺金顿时生机恢复，自然气息从容，重新施行其清肃的职能。方用助音汤：熟地黄（一两）、麦冬（一两）、北五味子（一钱）、甘草（一钱）、苏子（一钱）、天门冬（二钱）、贝母（三分）、款冬花（五分）、沙参（五钱）、地骨皮（三钱），水煎服。两剂后喘息稍平，四剂后咳嗽稍止，连续服用二十剂声音即可发出。再服用两个月，绝不会再次失音。两个月后，前方加入人参五分、山药一两、茯苓二钱，再服用半年，可将痨病虚弱之体转变为健康常人。
此方在补肾之中，用意仍在于补肺，然而在补肺之中，仍是重在补肾，所以能收回复已败坏之功，完成将坏未坏之绩。
此症也可使用留线汤治疗：熟地黄（五钱）、款冬花（一钱）、山茱萸（二钱）、麦冬（五钱）、地骨皮（五钱）、贝母、苏子（各一钱）、山药、芡实（各三钱）、百部（三分），水煎服。
有人口渴非常严重，舌上无津液，双唇开裂，喉中干燥，以至于失音。人们认为是肺火旺盛，殊不知是心火太旺所致。肺属金，最畏惧的是心火对肺金的克制。肺金之气已经衰弱，心中之火过于旺盛，难免刑克肺金太过，煎熬销烁，肺金失去清肃之气，只剩下焚化的形态，想要寻求其声音的清越疏朗，怎么可能得到呢？治疗方法必须泻去心火的有余，滋补水肺金的不足，则火容易熄灭，而肺可安宁。虽然如此，又不能单纯地泻心火。因为心之所以有余，实在是因为肾水不足。水衰不能制约火，火得以顺从其炎上的本性，如果不补水而只泻火，则火无水制约，服用寒凉药物反而增加助火的焰势，这就是所谓因激怒而导致其暴横。方用：黄连（三钱）、麦冬（五钱）、玄参（五钱）、生地黄（五钱）、桔梗（三钱）、甘草（二钱）、天花粉（二钱），水煎服。一剂声音发出，两剂声音响亮，不必等到第三剂。
此方名为鸣金汤。泻火的同时补肾之意蕴含其中，全方不见明显的补肾药，实则仍是救肺的药物。因为肺肾互为子母，救肺正是为了滋生肾水，肾水生则心火降。
A person with extreme thirst drinks cold water rapidly and suddenly loses their voice, becoming hoarse and unable to speak. People attribute this to hyperactivity of Heart Fire (Xin Huo, excessive heat in the Heart), but little do they know it is due to the closure of Lung Qi (Fei Qi, the vital energy of the Lung). The Lung governs Qi; when Qi flows freely, the voice is resonant; when Qi is obstructed, the voice becomes hoarse. In Five Element theory, the Lung belongs to Metal (Jin, 金). When Metal is solid and obstructed, it cannot resonate. However, Lung Metal most dislikes Heart Fire; if Fire attacks Metal, it is indeed what Metal fears, and Metal refrains from sounding out of caution, which is logical. Why does encountering Water cause such closure? It is unknown that Water controls Fire, so Fire must be subdued by Water. Although Metal is relieved that Water subdues Fire, it still fears Fire attacking Metal. Lung Qi descends along with the descending force of Water, sinking like metal to the bottom of a pool; how can it sound on its own? This type of aphonia is caused by Water suppressing Lung Qi and preventing it from ascending, not by the failure of Lung Qi itself. The treatment method should be to promote the diffusion of Lung Qi and dissipate dampness-water, without directly treating aphonia, yet the voice will naturally return. Use Shengyin Tang (Voice-Generating Decoction): Loquat Leaf (Loquat Folium, 5 slices), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus, 2 qian), Poria (Poria, 5 qian), Stemona Root (Stemonae Radix, 1 qian), Perilla Leaf (Perillae Folium, 1 qian), Ophiopogon Tuber (Ophiopogonis Radix, 3 qian), Licorice Root (Glycyrrhizae Radix et Rhizoma, 1 qian), Scrophularia Root (Scrophulariae Radix, 5 qian), Mulberry Root Bark (Mori Cortex, 3 qian). Decoct in water and take orally. After one dose, the voice slightly returns; after two doses, the voice increases significantly; after three doses, full recovery occurs.
This formula promotes the free flow of Lung Qi, causing Lung Qi to rise naturally. By dissipating the Water pathogen, Fire Qi descends naturally. With Fire extinguished and Water dissipated, Metal has nothing to fear, and why would the Lung hesitate to produce sound?
This condition can also be treated with Dongfu Subei Tang (Winter-Poria-Perilla-Fritillaria Decoction): Perilla Leaf (Perillae Folium, 3 qian), Ophiopogon Tuber (Ophiopogonis Radix, 2 liang), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus, 3 qian), Poria (Poria, 5 qian). Decoct in water and take orally. Voice returns after two doses.
A person suffering from exhaustion and weakness experiences restless wheezing and coughing, gradually leading to aphonia and hoarseness, with low-pitched breath. People assume this is the exhaustion of Lung Qi, but little do they know it is due to the depletion of Kidney Water (Shen Shui, Yin fluids of the Kidney). The Lung is the mother of the Kidney and generates it. If the Mother organ (Lung) is diseased, how can it nourish the Child (Kidney)? Since the Kidney is deficient and daily draws resources from the Lung, the Child becomes poor and the Mother even poorer. With both Mother and Child depleted, weak and desolate, with faint breath, this is known as "Broken Metal Cannot Sound" (Jin Po Bu Ming). Empirical physicians claim that broken Metal must be supplemented by Earth (Spleen/Stomach). Although Spleen and Stomach can generate Metal, most Earth-supplementing herbs are Yang-tonifying. Using Yang herbs to tonify Earth leads to excess Yang and further consumption of Yin, which damages the Lung instead. The treatment must strongly tonify Kidney Water. Once the Child is abundant, the Mother will naturally not be poor. Moreover, Lung Qi returns to the Kidney palace at night for rest and peace. The exhausted Lung suddenly transforms into a relaxed Lung, supplied with body fluids for the Lung Mother's use. Thus, Lung Metal instantly regenerates, breathing becomes leisurely, and its clearing and descending function is restored. Use Zhuyin Tang (Sound-Assisting Decoction): Prepared Rehmannia Root (Rehmanniae Radix Praeparata, 1 liang), Ophiopogon Tuber (Ophiopogonis Radix, 1 liang), Schisandra Berry (Schisandrae Chinensis Fructus, 1 qian), Licorice Root (Glycyrrhizae Radix et Rhizoma, 1 qian), Perilla Seed (Perillae Fructus, 1 qian), Asparagus Tuber (Asparagi Radix, 2 qian), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus, 3 fen), Winter Flower Bud (Adenophorae Radix, 5 fen)* [Note: Adenophorae Radix is often used for Kua Dong Hua in some contexts or strictly Adenophora, here likely referring to Adenophorae Radix or similar tonic], Glehnia Root (Glehniae Radix, 5 qian), Wolfberry Bark (Lycii Cortex, 3 qian). Decoct in water and take orally. After two doses, wheezing subsides slightly; after four doses, cough stops slightly; after continuous administration of twenty doses, voice returns. Continue taking for two months to ensure no recurrence of aphonia. After two months, add Ginseng Root (Ginseng Radix, 5 fen), Chinese Yam Rhizome (Dioscoreae Rhizoma, 1 liang), and Poria (Poria, 2 qian) to the previous formula, and continue taking for half a year to transform consumptive weakness into normal health.
This formula focuses on tonifying the Lung while tonifying the Kidney, and tonifying the Kidney while tonifying the Lung, thereby restoring failed functions and achieving results in critical conditions.
This condition can also be treated with Liuxian Tang (Thread-Retaining Decoction): Prepared Rehmannia Root (Rehmanniae Radix Praeparata, 5 qian), Winter Flower Bud (Adenophorae Radix, 1 qian), Cornus Fruit (Corni Fructus, 2 qian), Ophiopogon Tuber (Ophiopogonis Radix, 5 qian), Wolfberry Bark (Lycii Cortex, 5 qian), Fritillaria Bulb (Fritillariae Cirrhosae Bulbus, 1 qian), Perilla Seed (Perillae Fructus, 1 qian), Chinese Yam Rhizome (Dioscoreae Rhizoma, 3 qian), Euryale Seed (Euryales Semen, 3 qian), Stemona Root (Stemonae Radix, 3 fen). Decoct in water and take orally.
A person with severe thirst, dry tongue lacking fluids, cracked lips, and dry throat eventually loses their voice. People attribute this to exuberant Lung Fire, but little do they know it is due to excessive Heart Fire. The Lung belongs to Metal, which most fears being controlled by Heart Fire. Lung Qi is already weakened, and Heart Fire is excessively strong, inevitably over-attacking Metal, scorching and melting it. Deprived of its clearing and descending nature, Metal assumes only a burnt form. How can one expect clear and resonant voice under these circumstances? The treatment must reduce the excess of Heart Fire and nourish the deficiency of Lung Metal, allowing Fire to subside and Lung to settle. However, one cannot merely drain Heart Fire. The reason Heart Fire is excessive is actually due to the insufficiency of Kidney Water. Weak Water fails to control Fire, allowing Fire to follow its flaming-upward nature. If Water is not replenished and only Fire is drained, Fire will lack control, and administering cold-cooling herbs may反而 increase the flame, described as provoking aggression through stimulation. Use the following formula: Coptis Rhizome (Coptidis Rhizoma, 3 qian), Ophiopogon Tuber (Ophiopogonis Radix, 5 qian), Scrophularia Root (Scrophulariae Radix, 5 qian), Raw Rehmannia Root (Rehmanniae Radix, 5 qian), Platycodon Root (Platycodi Radix, 3 qian), Licorice Root (Glycyrrhizae Radix et Rhizoma, 2 qian), Trichosanthes Root (Trichosanthis Radix, 2 qian). Decoct in water and take orally. Voice returns after one dose, becomes loud after two doses; a third dose is unnecessary.
This formula is named Mingjin Tang (Metal-Sounding Decoction). It drains Fire while containing the intent to tonify the Kidney, though no obvious Kidney-tonifying herbs are seen; it remains a Lung-saving formula. Since Lung and Kidney are mother and child, saving the Lung generates Kidney Water; once Kidney Water is generated, Heart Fire descends.
This condition can also be treated with Jiawei Yuandong Tang (Modified Yuan-Dong Decoction): Scrophularia Root (Scrophulariae Radix, 1 liang), Salvia Root (Salviae Miltiorrhizae Radix, 3 qian), Ophiopogon Tuber (Ophiopogonis Radix, 1 liang), Schisandra Berry (Schisandrae Chinensis Fructus, 1 qian). Decoct in water and take orally. Full recovery after ten doses.