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The voice is intimately related to the lung. Lung qì powers the vocal chords. Sufficiency of lung qì is reflected in a full clear voice; lung qì vacuity is reflected in a low faint voice. Contraction of external wind-cold causing congestion of lung qì is reflected a hoarse voice. This is called replete metal failing to sound. Internal damage pulmonary consumption with great damage to lung qì and hoarse voice is called broken metal failing to sound.

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