经云∶妇人重生九月而喑者，胞之络脉绝也，无治，当十月复。谓人之受孕，一月肝经养胎，二月
胆经养胎，三月心经养胎，四月小肠经养胎，五月脾经养胎，六月胃经养胎，七月肺经养胎，
八月大肠经养胎，九月肾经养胎，十月膀胱经养胎。先阴经而后阳经，始于木终于水，以五行之相生言也。
然以理推之，十二经之脉昼夜流行无间，无日、无时而不共养胎气也，必无分经养胎
之理。今曰九月而喑，时至九月，儿体已长，胞宫之络脉系于肾经者，阻绝不通，故间有之。盖肾经
之脉上系舌本，脉道阻绝，则不能言，故十月分娩后而能言，不必加治，治之当补心肾。喑谓
有言而无声，故经曰不能言，不能非绝然不语之谓。凡音出于喉咙，发于舌本，因胎气肥大，阻肾上行
之经。肾脉入肺，循喉咙，系舌本。喉者，肺之部，肺主声音。其人窃窃私语，心虽有言，而人不能听，故
曰喑。肺肾子母之脏，故云不必治。若大全解作不语，则为心病，以心主发声也，与子喑了不相干，若张子
和有降心火之说，马玄台有补心肾之言。如果肾之脉络绝，则其病不治，岂有产后自复之理乎。
故经云∶胞之络脉绝。此绝字当作阻字解也。
孕妇痰涎壅盛，忽然僵仆，或时发搐，不省人事，是血虚而阴火炎上，鼓动其痰，左脉微数，右脉滑
大者，名曰子痫，宜四物养血，酒芩清热，二陈化痰理气。故《机要》云∶风木为热，热
甚则风动，宜静胜其燥，是养血也。治法仍以安胎为主，勿过用中风之药。盖多由血虚则生热，热盛则生
风，皆内起之风火，养血而风火自灭也。若心肝风热，用钩藤汤；肝脾血虚，加味逍遥
散；肝脾郁怒，加味归脾汤；气逆痰滞，紫苏饮；脾郁痰滞，二陈加竹沥、姜汁。
《黄帝内经》记载：孕妇怀孕到第九个月时出现失音症状，是因为胞宫的络脉阻滞不通所致，无需治疗，等到第十个月分娩后自然会恢复。这指的是人受孕之后，第一个月由肝经滋养胎儿，第二个月由胆经滋养，第三个月由心经滋养，第四个月由小肠经滋养，第五个月由脾经滋养，第六个月由胃经滋养，第七个月由肺经滋养，第八个月由大肠经滋养，第九个月由肾经滋养，第十个月由膀胱经滋养。这是先讲阴经后讲阳经，从木行开始到水行结束，是按照五行相生的顺序来说的。
然而从医理上推断，十二经脉的气血昼夜循环流动没有间断，每一天、每一个时辰都在共同滋养胎气，必定没有单独某条经脉专门滋养胎儿的道理。现在说怀孕九个月会失音，是因为到了第九个月，胎儿身体已经长大，连接在肾经上的胞宫络脉受到阻碍而不通畅，所以偶尔会出现这种情况。大概因为肾经的脉络上行联系于舌根，如果脉道受阻，就会导致不能说话，所以在第十个月分娩后就能正常说话，不需要特别治疗；如果要治疗，应当补益心和肾。“喑”是指有声音但发不出来（或声音嘶哑），所以经文说“不能言”，这里的“不能”并不是指完全不能说话的昏迷状态。
凡是声音都出于喉咙，发源于舌根，因为胎体肥大，阻断了肾脏向上运行的经脉。肾脉进入肺部，沿着喉咙，联系于舌根。喉咙是肺所主的部位，肺主管声音。患者只能小声耳语，心里虽然想说话，但别人听不清楚，所以称为“喑”。肺和肾是子母关系的脏腑，所以说不用治疗。如果把“喑”解释为不说话（不语），那就是心病了，因为心主发声，这与子喑完全不相关。张子和曾提出降心火的说法，马玄台则主张补益心肾。如果真的像经文所说肾之脉络断绝，那这种病就无法治愈了，怎么会有产后自然恢复的道理呢？所以经文说“胞之络脉绝”，这个“绝”字应当解释为“阻”的意思。
如果孕妇痰涎壅盛，突然昏倒僵仆，或者时而发生抽搐，不省人事，这是由于血虚导致阴火上炎，鼓动痰湿上涌，诊见左脉微数，右脉滑大，这种情况名叫“子痫”（妊娠痫证）。适宜用四物汤养血，酒制黄芩清热，二陈汤化痰理气。所以《兰室秘藏》中说：风木化为热邪，热极生风，宜用静药来胜其燥，这就是养血的意思。治疗方法仍以安胎为主，不要过度使用治疗中风的药物。大多是因为血虚产生内热，热盛而生内风，这些都是体内产生的风火，通过养血使风火自然熄灭。如果是心肝风热，使用钩藤汤；肝脾血虚，使用加味逍遥散；肝脾郁怒，使用加味归脾汤；气逆痰滞，使用紫苏饮；脾郁痰滞，使用二陈汤加竹沥、姜汁。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: If a pregnant woman becomes aphonic at the ninth month of gestation, it is due to the obstruction of the collateral vessels of the uterus. No treatment is required; speech will recover naturally after delivery in the tenth month. This refers to the traditional view that after conception, the Liver Meridian nourishes the fetus in the first month, the Gallbladder Meridian in the second, the Heart Meridian in the third, the Small Intestine Meridian in the fourth, the Spleen Meridian in the fifth, the Stomach Meridian in the sixth, the Lung Meridian in the seventh, the Large Intestine Meridian in the eighth, the Kidney Meridian in the ninth, and the Bladder Meridian in the tenth. This sequence prioritizes Yin meridians over Yang meridians, starting with Wood and ending with Water, illustrating the principle of mutual generation among the Five Elements.
However, from a theoretical perspective, the Qi and Blood of the Twelve Primary Meridians circulate continuously day and night without interruption, nourishing the fetal Qi at all times. Therefore, there is no rationale for each meridian exclusively nourishing the fetus at specific stages. The statement that aphonia occurs in the ninth month arises because by this time, the fetus has grown significantly, causing the collateral vessels connecting the uterus to the Kidney Meridian to become obstructed. Consequently, aphonia may occasionally occur. Since the Kidney Meridian ascends to connect with the root of the tongue, obstruction of this pathway leads to an inability to speak. Thus, speech recovers after delivery in the tenth month, and specific treatment is unnecessary. If treatment were applied, it should focus on tonifying the Heart and Kidney. "Aphonia" (Yin) here refers to having the capacity for voice but being unable to produce clear sound or speaking with a hoarse/whispering quality. Hence, the text says "unable to speak," which does not imply a complete loss of consciousness or muteness.
Voice originates from the throat and is articulated at the root of the tongue. Due to the enlarged fetus, the upward flow of the Kidney Meridian is blocked. The Kidney Meridian enters the Lungs, follows the throat, and connects to the root of the tongue. The throat is the domain of the Lungs, and the Lungs govern voice. Patients may whisper quietly; although they wish to speak, others cannot hear them clearly, hence the term "aphonia." The Lungs and Kidneys are mother-son organs in the Zang-Fu relationship, justifying the assertion that no treatment is needed. Interpreting "aphonia" as muteness would attribute the condition to Heart pathology, as the Heart governs vocalization, which is entirely unrelated to gestational aphonia. Zhang Hezi proposed descending Heart Fire, while Ma Xuantai advocated tonifying the Heart and Kidney. If the renal collaterals were truly severed, the condition would be incurable, contradicting the notion of spontaneous recovery postpartum. Therefore, the phrase "obstruction of the uterine collaterals" implies that the character "jue" (severance) should be interpreted as "zu" (obstruction).
If a pregnant woman suffers from excessive phlegm-saliva accumulation, suddenly collapses into rigidity, experiences intermittent convulsions, and loses consciousness, this is termed "Zixian" (Eclampsia of Pregnancy). It results from Blood deficiency leading to the flaming up of Deficient Fire, which agitates Phlegm upwards. The pulse is typically slightly rapid on the left and slippery and large on the right. Treatment should employ Siwu Tang (Four Substances Decoction) to nourish Blood, Jiuhuangqin (Wine-fried Scutellariae Radix) to clear Heat, and Erchen Tang (Two Aged Ingredients Decoction) to resolve Phlegm and regulate Qi. As stated in *Jiyao* (Essentials of Mechanisms): "Wind-Wood transforms into Heat; when Heat is extreme, Wind moves." One should use calming agents to overcome dryness, which corresponds to nourishing Blood. The therapeutic principle remains primarily to calm the fetus, avoiding excessive use of medicines for treating Stroke. This condition usually arises from Blood deficiency generating internal Heat, and Heat excess generating internal Wind. These are internally generated Wind and Fire, which extinguish themselves through Blood nourishment. For Heart and Liver Wind-Heat, Gouteng Tang (Uncaria Decoction) is indicated; for Liver and Spleen Blood deficiency, Jiawei Xiaoyao San (Modified Free Wanderer Powder) is used; for Liver and Spleen Depression and Anger, Jiaweigui Pi Tang (Modified Return the Spleen Decoction) is prescribed; for rebellious Qi and Phlegm stagnation, Zisu Yin (Perilla Infusion) is employed; and for Spleen depression with Phlegm stagnation, Erchen Tang plus Zhuli (Bambusae Caulis in Taenia) and Jiangzhi (Zingiberis Rhizoma Recens Juice) is administered.