Disease and Condition Overview
Aphasia is characterized by sudden loss of voice as the primary symptom. In Chinese medicine, it is believed that because of lung and kidney yin deficiency, the throat has lost its nourishment. Or it is caused by wind heat, qi obstruction causing difficulty in uttering the sound.

Clinically, the symptom of aphasia can be categorized into aphasia caused by damage to the brain, usually seen in stroke patients or those with neurological damages; aphasia caused by acute inflammation of the throat, or lastly, aphasia caused by hysteria, especially after an emotional trauma, mostly seen in adults and female menopausal patients.

Pair-point Treatment Combinations

(1) Shanzhong (RN 17), Neiguan (PC6) (Fig 46)
Shanzhong (RN17) is front-mu point of the pericardium. Neiguan (PC6) is luo-connectmg point of the pericardium channel. This pair point combination, work in synergy, soothes the chest harmonize, harmonizes qi to resolve obstruction, tranquilizes and calms the mind to strengthen will, lowers qi resolving phlegm unobstructs orifice. Appropriate for functional aphasia.

Needling techniques:
1. Shanzhong (RN17) towards inferior oblique insertion 0.5-1 cun, or Hegu needling technique, reducing method.
2. Neiguan (PC6) perpendicular insertion 1 cun.

(2) Lianquan (RN23), Zhongchong (PC9) (Fig 67)
Lianquan (RN23): on the neck, on the anterior midline, in the depression above the superior border of the thyroid bone.
Zhongchong (PC9): at the center of the tip of the middle finger.
Lianquan (RN23) is located inferior to the tongue. Its function is to replenish the fluid, benefit orifice, reduce swelling and stop pain. Zhongchong (PC9) unobstructs heart collaterals, clearing heart fire. This pair point combination, one superior and one inferior, clears heat, resolves poison, reduces swelling, stops pain, clear heart and restores voice. Appropriate for sudden aphasia caused by wind heat obstruction.

Needling techniques:
1. Lianquan (RN23) towards the root of the tongue, needle 0.5 cun.
2. Zhongchong (PC9) perpendicular insertion 0.1 cun, or use three-edged needle to prick a few drops blood.

(3) Tianding (LI17), Jianshi (PC5) (Fig 68)
Tianding (LI17): on the lateral side of the neck, at the posterior border of the stemocleidomastoid muscle beside the laryngeal protuberance, midway between a line connecting Futu (LI18) and Quepen (ST12).
Jianshi (PC5): on the palmer side of the forearm, on the line connecting Daling (PC7) and Quze (PC3), 3 cun superior to the wrist crease, between the tendons of m. palmaris longus and m. flexor carpi radialis.
Tianding (LI17) clears lung, benefits throat, reduce swelling and stops pain. Jianshi (PC5) soothes the chest harmonizes and regulates qi, expels phlegm and disperses stagnation. This pair point combination, one superior, one inferior, clears throat to restore voice, suitable for treating aphasias caused by blockage of phlegm and stagnation at the collaterals.

Needling techniques:
1. Tianding (LI17) perpendicular insertion 0.5 cun.
2. Jianshi (PC5) perpendicular insertion 1 cun.

Commentaries
Acupuncture treatment is effective for all types of aphasia.
The most common aphasia is the sequelae of stroke. The effectiveness of treatment varies. One can alternate between Lianquan (RN23), Zhongchong (PC9) pair-point combination and Tianding (LI17), Jianshi (PC5) pair-point combination. As for aphasia caused by chronic inflammation, select Lianquan (RN23), Zhongchong (PC9) pair-point combination to achieve notable results. Aphasia caused by emotional issues, is considered functional and temporary. Select Shanzhong (RN 17), Neiguan (PC6) pair-point combination to sooth the chest harmonize and regulate qi can immediately restore voice.