stiffness of the tongue and speech impairment are the cardinal symptoms of this pattern of internal obstruction due to severe phlegm in which the smooth movement of the fluids has ceased, and the fluids accumulate and form phlegm. stiffness of the tongue and speech impairment are due to excessive accumulation of phlegm which spreads throughout the body, or phlegm moving upward under the influence of internal wind.

this is a variation of er chen tang (two-cured decoction), which is the basic formula for drying dampness and transforming phlegm. it is most commonly used in treating impaired speech following wind-stroke due to phlegm veiling the orifices of the heart, and thus the tongue. based on the actions of its constituent ingredients, its use has been expanded to include wheezing with copious sputum and focal distention and fullness in the chest due to obstruction of the qi in the chest by phlegm.