Formulas · Text · Donguibogam 東醫寶鑑

Speech

Eoneo

한글 언어 · Pinyin Yan Yu

The lung makes the sound and the heart makes the words — delirium and its quieter twin, and the nine noises a body makes without meaning to

言語

The chapter after Voice, and it divides the subject cleanly: the Voice chapter was about the sound, and this one is about what the sound carries. The lung governs sound, but the sound becomes speech only when it enters the heart — so disordered speech is a heart disease, and the chapter opens on 譫語, delirious speech, with Dongwon's test for telling it from raving: the delirious patient talks with the eyes shut about the ordinary things of his life, the raving one talks with the eyes open about things that were never there. Its opposite is 鄭聲, the repeating voice — the same words over and over, faint and broken, after a great illness, which is not an excess but an emptiness. Then muteness from phlegm and from lost blood, with two of Danxi's cases worked out in full. The middle of the chapter is its oddest and best part: nine involuntary sounds, each assigned to an organ and explained — shouting to the liver, laughing to the heart, singing to the spleen, weeping to the lung, groaning to the kidney, and then yawning, sneezing, belching and sighing, with the Lingshu's mechanism for each. There is a case of a woman who had laughed without stopping for half a year, and what Zhang Zihe did about it. The chapter ends on rules for talking: not while eating, not while walking, not lying down, and as little as possible.

4.1 The Lung Governs Sound and Makes Speech 肺主聲爲言

4.1.1

Source원문

難經曰, 肺主聲. 入肝爲呼, 入心爲言, 入脾爲歌, 入腎爲呻, 自入爲哭.

Translation영역

The Nanjing says: the lung governs sound. Entering the liver it becomes shouting; entering the heart, speech; entering the spleen, singing; entering the kidney, groaning; entering itself, weeping.

Clinical note임상 주석

One sound taking five forms according to the organ it enters, and speech is the heart's. The five are the subject of 4.8 to 4.12, one section each, and the scheme is what holds this chapter together.

Nangyeong 難經

4.1.2

Source원문

又曰, 肺邪入心爲譫言妄語.

Translation영역

It also says: where the lung's evil enters the heart, there is delirious and raving speech.

Nangyeong 難經

4.2 Delirious and Raving Speech 言語譫妄

4.2.1

Source원문

自言曰言, 答人曰語. 《得效》

Translation영역

To speak of oneself is 言; to answer another is 語.

Deukhyo 得效

4.2.2

Source원문

內經註曰, 譫, 亂語也.

Translation영역

The commentary on the Neijing says: 譫 is disordered speech.

Naegyeong-ju 內經註

4.2.3

Source원문

譫者, 妄也. 或自言平生常事, 或開目言人所未見事, 或獨語, 或睡中呢喃, 或呻吟不已, 甚則狂言罵詈, 俱謂之譫語. 皆因胃熱乘心故也詳見寒門.

Translation영역

譫 means raving. Sometimes the patient speaks of the ordinary affairs of his life; sometimes with the eyes open he speaks of things no one has seen; sometimes he talks to himself; sometimes he murmurs in his sleep; sometimes he groans without cease; and at the worst he speaks wildly and curses. All of these are called delirious speech, and all come of stomach heat riding the heart treated in detail in the Cold Damage chapter.

Clinical note임상 주석

胃熱乘心 — stomach heat riding the heart. The tradition's mechanism for delirium, and it points at the yang brightness fever of the Cold Damage chapter: a high fever with a loaded bowel, which is exactly the setting delirium arises in.

Donguibogam · Eoneo

4.2.4

Source원문

問曰, 邪入陽明爲譫言妄語, 此果陽明乎. 答曰, 傷寒始自皮毛入, 是從肺中來. 肺主聲, 入于心則爲言也. 又曰, 合目自言, 言所日用常見常行之事, 卽譫語也. 大開目與人語, 語所未嘗見之事, 卽爲狂言也. 《東垣》

Translation영역

It is asked: evil entering the yang brightness makes delirious and raving speech — is it truly the yang brightness? The answer: cold damage enters first by the skin and hair, and so comes from within the lung. The lung governs sound, and entering the heart it becomes speech. It is also said: with the eyes shut, speaking of oneself, speaking of the daily and familiar things one sees and does — that is delirious speech. With the eyes wide open, speaking with people, speaking of things never seen — that is raving speech.

Clinical note임상 주석

The chapter's sharpest distinction and a usable one. Eyes shut and talking about ordinary life is delirium — the feverish patient rehearsing his day. Eyes open and talking to people about what is not there is psychosis. Dongwon separates the two by watching the eyes.

Dongwon 東垣

4.2.5

Source원문

譫語者, 口出無倫, 邪氣勝也. 《回春》

Translation영역

In delirious speech what comes out of the mouth has no order — the evil qi prevails.

Hoechun 回春

4.2.6

Source원문

衣被不斂, 言語善惡不避親疎者, 此神明之亂也, 乃狂疾也. 《內經》

Translation영역

Where the clothes and bedding are not kept together, and the speech, good or ill, does not spare kin or stranger — this is the spirit-brightness disordered, and it is mania.

Clinical note임상 주석

不避親疎 — sparing neither kin nor stranger. The Suwen's sign for mania, and it is a behavioural one: the loss of the sense of who one is speaking to.

Naegyeong 內經

4.2.7

Source원문

悲泣呻吟, 言語譫妄, 此乃邪祟也. 《綱目》

Translation영역

Weeping and groaning with delirious and raving speech — this is an evil haunting.

Gangmok 綱目

4.3 Muteness with Inability to Speak 瘖不得語

4.3.1

Source원문

內經曰, 邪入於陰搏則爲瘖. 有舌瘖ㆍ喉瘖之異詳見聲音.

Translation영역

The Neijing says: where evil enters the yin and strikes, there is muteness. There is the difference between tongue muteness and throat muteness treated in detail in the Voice chapter.

Naegyeong 內經

4.3.2

Source원문

不得語非止一端. 有舌强不語, 神昏不語, 口噤不語, 舌縱語澁, 舌麻語澁. 其間治痰ㆍ治風ㆍ安神ㆍ養氣血, 各從活法治之. 《醫鑑》

Translation영역

Inability to speak is not of one kind only. There is a stiff tongue that will not speak; a clouded spirit that will not speak; a clenched mouth that will not speak; a slack tongue with laboured speech; a numb tongue with laboured speech. Among these, treating phlegm, treating wind, quieting the spirit and nourishing qi and blood — each is treated by the living method as the case requires.

Clinical note임상 주석

Five kinds of speechlessness with four treatments between them, and 活法, the living method, is the Bogam's standing phrase for fitting the treatment to the case rather than the name. The five are distinguishable at the bedside: a stiff tongue, a clouded mind, a locked jaw, a lolling tongue and a numb one.

Uigam 醫鑑

4.3.3

Source원문

有氣血虛損者, 有腎虛及老人忽言不出者, 宜於十全大補湯方見虛勞去桂, 加菖蒲ㆍ遠志. 《入門》

Translation영역

There are those whose qi and blood are vacuous and detrimented, and there are kidney vacuity and old people whose speech suddenly will not come out; for these, Perfect Major Supplementation Decoction formula in the Vacuity Taxation chapter with the cinnamon removed and acorus and polygala added is appropriate.

Immun 入門

4.4 Phlegm Blocking and Blood Lost Also Make Muteness 痰塞亡血亦爲瘖

4.4.1

Source원문

足少陰之脈挾舌本, 足太陰之脈連舌本, 手少陰之別脈繫舌本. 故此三脈虛, 則痰涎乘虛閉塞其脈道, 而舌不能轉運言語也. 若此三脈亡血, 則舌無血榮養而瘖. 內經曰, 刺足少陰脈, 重虛出血, 爲舌難以言. 又云, 刺舌下中脈太過, 血出不止爲瘖, 治當補血. 又此三脈風熱中之, 則舌脈弛縱而瘖. 風寒客之, 則舌脈縮急而瘖. 隨證治之. 《丹溪》

Translation영역

The foot lesser yin channel flanks the root of the tongue, the foot greater yin channel connects with the root of the tongue, and the divergent channel of the hand lesser yin ties to the root of the tongue. So where these three channels are vacuous, phlegm and drool take advantage of the vacuity to block their course, and the tongue cannot turn and move for speech. If these three channels lose blood, the tongue has no blood to nourish it and there is muteness. The Neijing says: needling the foot lesser yin channel where it is doubly vacuous and drawing blood makes the tongue hard to speak with. It also says: needling under the tongue and striking the vessel too deeply, so that the blood does not stop, makes muteness — and the treatment should supplement the blood. Again, where wind heat strikes these three channels the tongue's vessels slacken and there is muteness; where wind cold lodges in them the tongue's vessels shrink and tighten and there is muteness. Treat according to the pattern.

Clinical note임상 주석

Three channels to the root of the tongue — kidney, spleen and heart — and four ways they fail: blocked by phlegm, starved of blood, slackened by heat, tightened by cold. Danxi builds the whole differential from one anatomical fact, and the warning about needling under the tongue too deeply is a real complication.

Danggye 丹溪

4.4.2

Source원문

痰塞不語, 宜導痰湯方見痰門加菖蒲ㆍ竹茹ㆍ人參, 或芩連. 亡血不語, 宜四物湯方見血門加人參ㆍ白朮ㆍ陳皮ㆍ甘草ㆍ菖蒲ㆍ遠志. 《入門》

Translation영역

For muteness from phlegm blocking, Guide Out Phlegm Decoction formula in the Phlegm chapter with acorus, bamboo shavings and ginseng added, or with scutellaria and coptis. For muteness from lost blood, Four Substances Decoction formula in the Blood chapter with ginseng, white atractylodes, tangerine peel, licorice, acorus and polygala added.

Immun 入門

4.4.3

Source원문

一男子因傷寒發熱, 忽神昏而瘖, 作體虛有痰治之. 以人參三錢, 黃芪ㆍ白朮ㆍ當歸ㆍ陳皮各一錢, 煎湯入竹瀝ㆍ薑汁飮之. 十三日始能言一字, 半月舌轉運能言語, 熱除而愈此痰塞也.

Translation영역

A man took cold damage with fever, and suddenly his spirit clouded and he went mute. It was treated as a vacuous body with phlegm: ginseng 3 don, astragalus, white atractylodes, angelica and tangerine peel 1 don each, decocted, with bamboo sap and ginger juice added and drunk. On the thirteenth day he could say a single word; in half a month the tongue turned and moved and he could speak; the heat was removed and he was healed this was phlegm blocking.

Clinical note임상 주석

Thirteen days to one word and half a month to sentences. The case is worth the space it takes: Danxi treating a post-febrile aphasia by supplementing rather than attacking, and counting the recovery in days.

Danggye 丹溪

4.4.4

Source원문

一男子嗜酒, 多吐血後, 舌不能語, 但渴飮水, 脈略數. 與當歸ㆍ芍藥ㆍ川芎ㆍ地黃各一錢, 白朮ㆍ人參各二錢, 陳皮一錢半, 甘草五分, 水煎, 入竹瀝ㆍ童便ㆍ薑汁服之. 至二十餘貼能言此亡血瘖也. 《丹溪》

Translation영역

A man fond of wine, after vomiting much blood, could not speak with his tongue; he was only thirsty and drank water, and his pulse was slightly rapid. He was given angelica, peony, chuanxiong and rehmannia 1 don each, white atractylodes and ginseng 2 don each, tangerine peel 1 don 5 pun, licorice 5 pun, decocted in water with bamboo sap, child's urine and ginger juice added. By something over twenty packets he could speak this was muteness from lost blood.

Clinical note임상 주석

The matching case for the other half of the section: a heavy drinker who bled, went mute, and was treated with Samul-tang and ginseng for twenty days. The two cases together are the Bogam's way of teaching a distinction — the same symptom, two causes, two formulas, both written out.

Danggye 丹溪

4.5 The Pulse 脉法

4.5.1

Source원문

寸口脈微而澁. 微則衛氣不足, 澁則榮氣無餘. 衛不足, 其息短, 其形燥. 血不足, 其形逆. 榮衛俱虛, 言語謬誤. 《脈經》

Translation영역

The inch-opening pulse is faint and rough. Faint means the defence qi is insufficient; rough means the construction qi has nothing to spare. Where the defence is insufficient the breath is short and the form is dry; where the blood is insufficient the form is contrary. Where construction and defence are both vacuous, the speech goes wrong.

Maekgyeong 脉經

4.5.2

Source원문

心脈搏堅而長, 當病舌卷不能言. 《內經》

Translation영역

Where the heart's pulse beats firm and long, there should be disease with the tongue curled and unable to speak.

Naegyeong 內經

4.5.3

Source원문

心脈澁甚爲瘖. 又曰, 手少陰之別脈, 名曰通里, 別而上行, 入於心中, 繫舌本. 虛則不能言. 《靈樞》

Translation영역

Where the heart's pulse is very rough there is muteness. It is also said: the divergent channel of the hand lesser yin is named Tongni; it diverges and runs upward, enters into the heart and ties to the root of the tongue. Where it is vacuous one cannot speak.

Clinical note임상 주석

Tongni (通里, HT5) — the heart channel's connecting point, and the Lingshu traces it to the root of the tongue. It is the point 4.24.2 needles for speechlessness, and the anatomical claim behind 4.1's rule that speech belongs to the heart.

Yeongchu 靈樞

4.6 The Repeating Voice 鄭聲

4.6.1

Source원문

鄭者, 重也. 言語重復不已, 聲音糢糊, 有如鄭衛不正之音也詳見寒門. 《入門》

Translation영역

鄭 means repeated. The speech repeats over and over without cease and the voice is blurred, like the irregular music of Zheng and Wei treated in detail in the Cold Damage chapter.

Clinical note임상 주석

Named for the music of the states of Zheng and Wei, which the Confucians called licentious and irregular — a voice that has lost its measure. The Immun's gloss on 鄭 as 重, repeated, is the clinical one.

Immun 入門

4.6.2

Source원문

鄭聲者, 語不接續, 精氣脫也. 《回春》

Translation영역

In the repeating voice the speech does not join up — the essential qi has deserted.

Hoechun 回春

4.6.3

Source원문

鄭聲者, 聲戰無力, 不相接續, 造字出于喉中, 卽鄭聲也. 皆大病後有之. 《東垣》

Translation영역

In the repeating voice the sound trembles and is without strength, does not join up, and the words are made from within the throat — this is the repeating voice. It is found after a great illness.

Clinical note임상 주석

Delirium's quiet twin. 譫語 at 4.2 was too much speech from too much heat; 鄭聲 is too little from too little qi, and the Cold Damage tradition insists on the difference because one is purged and the other supplemented. 聲戰無力 — a trembling voice without strength — is what exhaustion sounds like.

Dongwon 東垣

4.7 Faint Speech 言微

4.7.1

Source원문

內經曰, 言而微, 終日乃復言者, 奪氣也.

Translation영역

The Neijing says: where the speech is faint and one only repeats it after a whole day, the qi has been robbed.

Naegyeong 內經

4.7.2

Source원문

靈樞曰, 膻中爲氣之海. 不足則少氣力, 不多言.

Translation영역

The Lingshu says: the centre of the chest is the sea of qi; where it is insufficient there is little strength and little speech.

Yeongchu 靈樞

4.7.3

Source원문

易老曰, 眞氣虛弱, 脈微懶語, 宜人參黃芪湯及益氣丸方幷見氣門.

Translation영역

Yi Lao says: where the true qi is vacuous and weak, the pulse faint and speech reluctant, Ginseng and Astragalus Decoction and Boost the Qi Pill both formulas in the Qi chapter are appropriate.

Yeokro 易老

4.8 Shouting 呼

4.8.1

Source원문

內經曰, 肝在聲爲呼.

Translation영역

The Neijing says: the liver in sounds is shouting.

Naegyeong 內經

4.8.2

Source원문

爪甲靑, 惡罵不休, 爲膽絶. 夫呼罵者, 怒之聲. 狂病不在此例. 《千金方》

Translation영역

Where the nails are green and foul cursing does not stop, the gallbladder is expiring. Shouting and cursing are the sound of anger; mania is not in this case.

Clinical note임상 주석

The Liver chapter's 2.11 gave green as the liver's dying colour, and the Cheongeum adds the sound. 狂病不在此例 — mania is a different thing — is the caution that keeps the sign usable.

Cheongeum 千金

4.8.3

Source원문

手足甲靑, 呼罵多, 筋絶, 九日定難過. 《脈訣》

Translation영역

Where the nails of hands and feet are green and there is much shouting and cursing, the sinews are expiring, and nine days will surely be hard to pass.

Maekgyeol 脉訣

4.9 Laughing 笑

4.9.1

Source원문

靈樞曰, 心氣虛則悲, 實則笑不休.

Translation영역

The Lingshu says: where the heart qi is vacuous there is grief; where it is replete, laughter without cease.

Yeongchu 靈樞

4.9.2

Source원문

內經曰, 心藏神. 神有餘則笑不休, 神不足則悲.

Translation영역

The Neijing says: the heart stores the spirit. Where the spirit is in surplus there is laughter without cease; where it is insufficient, grief.

Naegyeong 內經

4.9.3

Source원문

難經曰, 心外證, 面赤, 口乾, 善笑.

Translation영역

The Nanjing says: the heart's outer signs are a red face, a dry mouth and readiness to laugh.

Nangyeong 難經

4.9.4

Source원문

內經曰, 心在聲爲笑. 又曰, 喜與笑皆屬心火.

Translation영역

The Neijing says: the heart in sounds is laughter. It also says: joy and laughter both belong to the heart's fire.

Naegyeong 內經

4.9.5

Source원문

皇甫士安曰, 心實則笑, 笑則喜.

Translation영역

Huangfu Shi'an says: where the heart is replete there is laughter, and laughing there is joy.

Hwangbo Sian (皇甫士安)

4.9.6

Source원문

河間曰, 喜爲心火之志也. 喜極而笑者, 猶燔灼太甚而鳴笑之象也. 故病笑者, 心火之盛也.

Translation영역

Hejian says: joy is the mind of the heart's fire. That one laughs at the height of joy is like a fire burning too fiercely and crackling — the image of laughter. So one whose disease is laughing has an exuberance of heart fire.

Clinical note임상 주석

Liu Wansu's image: the crackle of a fire burning too hot is what laughter is. It reads as a metaphor and is meant as a mechanism — fire makes a sound when it is excessive, and so does a heart.

Hagan 河間

4.9.7

Source원문

一婦人病喜笑不已, 已半年, 衆治無效. 戴人曰, 此易治也. 滄鹽成塊者二兩餘, 火煆令赤, 放冷硏細, 河水一大椀同煎, 溫服三次, 以釵股探喉, 吐出熱痰四五升. 次服黃連解毒湯, 不數日而笑定. 內經曰, 神有餘則笑不休. 神者, 心火是也. 火得風而焰, 故笑之象也. 五行之中, 惟火有笑. 嘗治一老人笑不休, 口流涎, 以黃連解毒湯方見寒門加半夏ㆍ竹葉ㆍ竹瀝ㆍ薑汁服之, 笑止矣. 《子和》

Translation영역

A woman was ill with laughing without cease, already for half a year, and many treatments had no effect. Zhang Zihe said: this is easy to treat. He took over 2 nyang of sea salt in lumps, calcined it in fire until red, let it cool and ground it fine, boiled it in a large bowl of river water, and gave it warm three times; then he probed her throat with a hairpin, and she vomited four or five seung of hot phlegm. Next she took Coptis Resolve Toxin Decoction, and in a few days the laughing settled. The Neijing says: where the spirit is in surplus there is laughter without cease. The spirit is the heart's fire. Fire meets wind and flares, and so it is the image of laughter; among the five phases only fire laughs. He once treated an old man who laughed without cease and drooled from the mouth, with Coptis Resolve Toxin Decoction formula in the Cold Damage chapter and pinellia, bamboo leaf, bamboo sap and ginger juice added, and the laughing stopped.

Clinical note임상 주석

Half a year of uncontrollable laughing, treated by emesis and then cooling — Zhang Zihe's method throughout. 以釵股探喉, probing the throat with a hairpin, is the mechanical part he is known for. Pathological laughter is a real presentation, and the second case, with drooling in an old man, sounds like pseudobulbar affect.

Jahwa 子和

4.10 Singing 歌

4.10.1

Source원문

內經曰, 脾在聲爲歌.

Translation영역

The Neijing says: the spleen in sounds is singing.

Naegyeong 內經

4.10.2

Source원문

靈樞曰, 足陽明之脈病甚, 則欲上高而歌.

Translation영역

The Lingshu says: where the foot yang brightness channel's disease is severe, one wants to climb somewhere high and sing.

Clinical note임상 주석

欲上高而歌 — wanting to climb up high and sing. The Lingshu's description of yang brightness mania, and it is one of the most exact clinical images in the classics: the manic patient who climbs and sings, and in the same passage throws off his clothes.

Yeongchu 靈樞

4.10.3

Source원문

癲狂邪祟之病, 皆或歌或哭. 《綱目》

Translation영역

In the diseases of withdrawal, mania and evil haunting, there is either singing or weeping.

Gangmok 綱目

4.10.4

Source원문

脾好音樂, 是其性也. 《延壽》

Translation영역

The spleen likes music; this is its nature.

Yeonsuseo 延壽書

4.11 Weeping 哭

4.11.1

Source원문

內經曰, 肺在聲爲哭. 哭者, 肺之本聲也.

Translation영역

The Neijing says: the lung in sounds is weeping. Weeping is the lung's own sound.

Naegyeong 內經

4.11.2

Source원문

難經曰, 肺外證, 面白, 善嚔, 悲愁不樂, 欲哭.

Translation영역

The Nanjing says: the lung's outer signs are a white face, much sneezing, grief and sorrow without pleasure, and a wish to weep.

Nangyeong 難經

4.11.3

Source원문

婦人藏燥, 悲傷欲哭, 詳見婦人門.

Translation영역

In women, visceral agitation with grief and a wish to weep is treated in detail in the Women chapter.

Clinical note임상 주석

藏燥 — visceral agitation, Zhongjing's condition of a woman who weeps without cause and behaves as though possessed, treated with wheat, licorice and jujube. The Women chapter has it.

Donguibogam · Eoneo

4.12 Groaning 呻

4.12.1

Source원문

內經曰, 腎在聲爲呻.

Translation영역

The Neijing says: the kidney in sounds is groaning.

Naegyeong 內經

4.12.2

Source원문

脈訣曰, 呻吟者, 困重形於外也.

Translation영역

The Pulse Verses say: groaning is exhaustion and heaviness showing outwardly.

Maekgyeol 脉訣

4.12.3

Source원문

腎病好呻吟. 呻吟者, 痛聲也. 《入門》

Translation영역

In kidney disease there is much groaning. Groaning is the sound of pain.

Immun 入門

4.13 Yawning 欠

4.13.1

Source원문

內經曰, 腎爲欠.

Translation영역

The Neijing says: the kidney makes yawning.

Naegyeong 內經

4.13.2

Source원문

難經曰, 腎病, 面黑, 善恐, 數欠.

Translation영역

The Nanjing says: in kidney disease the face is black, there is readiness to fear, and frequent yawning.

Nangyeong 難經

4.13.3

Source원문

黃帝問曰, 人之欠者, 何氣使然. 岐伯對曰, 衛氣晝行于陽, 夜行于陰. 陰者主夜, 夜則臥. 陽者主上, 陰者主下. 故陰氣積于下, 陽氣未盡, 陽引而上, 陰引而下, 陰陽相引, 故數欠. 又曰, 足陽明之脈病, 善伸數欠. 《靈樞》

Translation영역

The Yellow Emperor asked: when a person yawns, what qi makes it so? Qi Bo answered: the defence qi travels in the yang by day and in the yin by night. The yin governs the night, and at night one lies down. The yang governs what is above and the yin what is below; so the yin qi accumulates below while the yang qi is not yet spent, and the yang pulls upward while the yin pulls downward — yin and yang pulling against each other, and so there is frequent yawning. It is also said: where the foot yang brightness channel is diseased, there is much stretching and frequent yawning.

Clinical note임상 주석

Yawning as the moment when the day's qi and the night's are pulling in opposite directions — which is when people actually yawn, at the turn between waking and sleeping. The Lingshu has no better account of anything.

Yeongchu 靈樞

4.13.4

Source원문

瘧之始作也, 善伸數欠. 又曰, 二陽胃也一陰心包發病, 善噫善欠. 註云, 氣鬱於胃, 故欠生焉. 《內經》

Translation영역

When malaria first breaks out there is much stretching and frequent yawning. It is also said: where the second yang the stomach and the first yin the pericardium break out in disease, there is much belching and yawning. The commentary says: the qi is depressed in the stomach, and so yawning arises.

Naegyeong 內經

4.13.5

Source원문

氣乏故欠, 伸引之. 《入門》

Translation영역

Yawning comes because the qi is short, and stretching draws it out.

Immun 入門

4.14 Sneezing 嚔

4.14.1

Source원문

黃帝曰, 人之嚔者, 何氣使然. 岐伯曰, 太陽之氣一云陽氣和利而滿於心, 出於鼻, 故爲嚔. 《靈樞》

Translation영역

The Yellow Emperor said: when a person sneezes, what qi makes it so? Qi Bo said: the greater yang's qi one version says the yang qi being harmonious and free, it fills the heart and issues from the nose, and so there is a sneeze.

Yeongchu 靈樞

4.14.2

Source원문

難經曰, 肺外證, 面白, 善嚔.

Translation영역

The Nanjing says: the lung's outer signs are a white face and much sneezing.

Nangyeong 難經

4.14.3

Source원문

嚔者, 鼻中因痒而氣噴作于聲也. 鼻爲肺竅, 痒爲火化, 是火乘金爲病也. 《河間》

Translation영역

A sneeze is the nose itching and the qi bursting out with a sound. The nose is the lung's orifice and itching is the transformation of fire — this is fire riding metal and making disease.

Hagan 河間

4.14.4

Source원문

腠理不密, 噴嚔不已. 《綱目》

Translation영역

Where the interstices are not tight, sneezing does not stop.

Gangmok 綱目

4.14.5

Source원문

欠爲氣乏, 嚔爲氣通. 《綱目》

Translation영역

Yawning is qi short; sneezing is qi through.

Clinical note임상 주석

Eight graphs that sum up two sections. A yawn is the body short of qi and a sneeze is the body clearing it, and the pairing is the chapter's neatest piece of thinking.

Gangmok 綱目

4.15 Belching 噫

4.15.1

Source원문

與噯氣同, 吐出飽氣也. 詳見內傷.

Translation영역

The same as eructation — bringing up the qi of fullness. Treated in detail in the Internal Damage chapter.

Donguibogam · Eoneo

4.16 Sighing 太息

4.16.1

Source원문

黃帝問曰, 人之太息者, 何氣使然. 岐伯對曰, 人憂愁則心系急, 心系急則氣道約, 約則不利, 故太息以出之. 《靈樞》

Translation영역

The Yellow Emperor asked: when a person sighs, what qi makes it so? Qi Bo answered: when a person grieves, the heart's cord tightens; when the heart's cord tightens the airway is constricted; constricted, it does not pass freely — and so one sighs to let it out.

Clinical note임상 주석

Grief tightens the chest, the tight chest restricts the breath, and the sigh is what releases it. The Lingshu's account of sighing is a physiology of sadness, and it is close to what is now said about the sigh's role in resetting the breath.

Yeongchu 靈樞

4.16.2

Source원문

膽病者, 善太息. 又曰, 足少陽之脈病, 口苦, 善太息. 《靈樞》

Translation영역

In gallbladder disease there is much sighing. It is also said: where the foot lesser yang channel is diseased, the mouth is bitter and there is much sighing.

Clinical note임상 주석

The Gallbladder chapter's 7.6.1 opened on the same pair — sighing and a bitter mouth — and the two chapters agree. A patient who sighs and tastes bitterness is a lesser yang case.

Yeongchu 靈樞

4.17 Speechlessness After a Great Fright 大驚不語

4.17.1

Source원문

大驚入心, 則敗血頑痰塡塞心竅, 故瘖不能言. 宜密陀僧散ㆍ遠志丸ㆍ茯神散. 《直指》

Translation영역

Where a great fright enters the heart, spoiled blood and stubborn phlegm fill and block the heart's orifice, and so there is muteness and inability to speak. Litharge Powder, Polygala Pill and Poria with Pine Root Powder are appropriate.

Clinical note임상 주석

塡塞心竅 — filling and blocking the heart's orifice. The Heart chapter's 3.1.3 made the number of the heart's openings the measure of understanding; here a shock is said to stop them up, and the treatment is to open them again. All three formulas are registered.

Jikji 直指

4.18 Speechlessness in Wind-Stroke 中風不語

4.18.1

Source원문

詳見風門.

Translation영역

Treated in detail in the Wind chapter.

Donguibogam · Eoneo

4.19 Laboured Speech All Belongs to Wind 語澁皆屬風

4.19.1

Source원문

宜考風門.

Translation영역

Consult the Wind chapter.

Donguibogam · Eoneo

4.20 Women Speechless Before and After Childbirth 婦人産前不語産後不語

4.20.1

Source원문

幷見婦人.

Translation영역

Both are in the Women chapter.

Donguibogam · Eoneo

4.21 Children Late in Speaking 小兒語遲

4.21.1

Source원문

詳見小兒.

Translation영역

Treated in detail in the Children chapter.

Donguibogam · Eoneo

4.22 Rules for Speaking 言語法

4.22.1

Source원문

少言語, 養內氣. 《七禁文》

Translation영역

Speak little, and nourish the inner qi.

Clinical note임상 주석

The first of the Body chapter's seven prohibitions at 1.21.1, repeated here as the first rule of speech. The chapter on speech begins its practical advice by advising against it.

Taeeulchilgeummun 太乙眞人七禁文

4.22.2

Source원문

語過多, 成咳嗽, 或失音. 《脈訣》

Translation영역

Too much speech makes cough, or loss of voice.

Maekgyeol 脉訣

4.22.3

Source원문

凡言語誦讀, 常想聲在氣海中臍下穴名. 每日初入後, 勿言誦讀, 寧待平朝也. 《得效》

Translation영역

In speaking and reciting, always imagine the sound to be in the sea of qi the name of a point below the navel. After nightfall each day, do not speak or recite; better to wait for the morning.

Clinical note임상 주석

想聲在氣海中 — imagine the voice sitting below the navel. It is the oldest advice in singing and public speaking, arrived at as a Daoist practice: the voice supported from the lower field rather than pushed from the throat.

Deukhyo 得效

4.22.4

Source원문

食上不得語. 語而食者, 常患胸背痛. 古人食不語, 寢不言, 以此故也. 《得效》

Translation영역

One must not speak while eating; one who talks and eats will often suffer pain in chest and back. That the ancients did not talk while eating and did not speak while lying down was for this reason.

Deukhyo 得效

4.22.5

Source원문

臥勿大語, 損人氣力. 亦不用寢臥多言笑. 寢不得言語者, 言五藏如鍾磬然, 不懸則不可發聲也. 《得效》

Translation영역

Do not speak loudly lying down; it damages a person's strength. Nor should one talk and laugh much while lying. That one may not speak lying down is because the five viscera are like a bell or a chime: if they are not hung, they cannot be made to sound.

Clinical note임상 주석

五藏如鍾磬, 不懸則不可發聲 — the viscera are like a bell, and a bell that is not hung will not ring. The image is the chapter's best, and the observation behind it is true enough: the voice is weaker lying down.

Deukhyo 得效

4.22.6

Source원문

行不得語. 若欲語, 須住脚乃得語. 行語則令人失氣. 《得效》

Translation영역

One must not speak while walking. If one wishes to speak, one must stop the feet and then speak; speaking while walking makes a person lose qi.

Deukhyo 得效

4.22.7

Source원문

東垣省言箴詳見身形.

Translation영역

Dongwon's Admonition on Sparing Speech treated in detail in the Body chapter.

Clinical note임상 주석

The Body chapter's 1.25.5, where Dongwon ends by saying that since he is no sage, he will at least talk less. The chapter on speech closes its rules with it.

Donguibogam · Eoneo

4.23 Untreatable Signs 不治證

4.23.1

Source원문

病人循衣縫譫語者, 不可治. 《華佗》

Translation영역

A patient who picks along the seams of his clothes and speaks deliriously is not to be treated.

Clinical note임상 주석

循衣縫 — running the fingers along the seams of the clothing. Carphologia, the plucking at bedclothes of the terminally delirious, and the tradition had it as a sign four hundred years before it was named in European medicine.

Hwata 華佗

4.23.2

Source원문

病人陰陽俱絶, 掣衣撮空, 妄言者死. 《華佗》

Translation영역

A patient whose yin and yang are both cut off, who pulls at his clothes and grasps at the air and raves — death.

Hwata 華佗

4.23.3

Source원문

病人妄語錯亂, 及不能語者, 不治. 熱病及狂者, 不在此例. 《醫鑑》

Translation영역

A patient whose speech is raving and disordered, and one who cannot speak, are not to be treated. Heat disease and mania are not in this case.

Clinical note임상 주석

The exception saves the section from being fatalistic: delirium in a fever and speech in mania are treatable, and it is only the raving of an exhausted body that is not.

Uigam 醫鑑

4.24 Acupuncture and Moxibustion 鍼灸法

4.24.1

Source원문

瘖不能言, 取合谷ㆍ涌泉ㆍ陽交ㆍ通谷ㆍ天鼎ㆍ期門ㆍ支溝. 《甲乙經》

Translation영역

For muteness with inability to speak, take Hapgok (合谷, LI4), Yongcheon (涌泉, KI1), Yanggyo (陽交, GB35), Tonggok (通谷, BL66), Cheonjeong (天鼎, LI17), Gimun (期門, LR14) and Jigu (支溝, TE6).

Gabeulgyeong 甲乙經

4.24.2

Source원문

足太陰之脈病, 舌本强不能言. 又手少陰之別脈, 名曰通里, 虛則不能言, 取此穴. 《靈樞》

Translation영역

Where the foot greater yin channel is diseased, the root of the tongue is stiff and one cannot speak. And the divergent channel of the hand lesser yin is named Tongni; where it is vacuous one cannot speak — take this point.

Yeongchu 靈樞

4.24.3

Source원문

舌緩不能言, 取瘂門. 舌下腫難言, 取廉泉. 《資生》

Translation영역

Where the tongue is slack and one cannot speak, take Amun (瘂門, GV15); where there is swelling under the tongue and speech is difficult, take Yeomcheon (廉泉, CV23).

Clinical note임상 주석

瘂門, the mute's gate — the point at the base of the skull named for exactly this use, and Yeomcheon under the chin for a swollen tongue. The chapter ends on the two points whose names are their indications.

Jasaenggyeong 資生經

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 2, Speech chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.