【歌】子喑言低不出声，少阴络壅不能鸣，清心降火调心肾，分娩经通语自清。
【论】《内经》黄帝问曰∶人有重身，九月而喑何也。岐伯对曰∶胞之络脉绝也。帝曰∶何以言之。岐伯曰∶
胞络者，系于肾少阴之脉，贯肾系舌本，故不能言。曰∶治之奈何。曰∶无治也，当十月复。马玄台曰∶舌云
九月肾经养胎，故喑似拘泥，但九月之时，儿体已长胞络，宫之络脉系于肾者，阻绝不通，故间有之。盖肾之脉
下贯于肾，上系舌本，脉道阻绝，则不能言，至
分娩后能言也。博陵医之神者曰∶郝翁有一妊娠，喑嘿不能言，郝曰∶儿大经壅，故不能言，儿生经通，自能言
矣。萧赓六曰∶内经大奇论以胞精不足善言为死，不言为生，此可验，九月而喑，非胞精之不足，故当十月而复也。
【歌】十二经中嗽不同，火痰湿热寒风，七情六气分虚实，活法随机可变通。
【论】肺主乎气，外合皮毛，形寒饮冷伤肺则咳嗽也。有涎曰嗽，无痰曰咳。五脏六腑俱受气于肺，各以其
时感之而成病也。秋则肺受之，冬则肾受之，春则肝受之，夏则脾受之，诸脏不已，冬传其腑。妊娠嗽者，名曰
子嗽。实者参苏饮以散之，虚者天门冬汤以补之。若久嗽不已。恐伤胎气也。
薛立斋曰∶咳嗽，秋间风邪伤肺，金沸草汤。夏间火邪克金，平肺散。冬间寒邪伤肺，人参败毒散。春间风
邪伤肺，参苏饮。然肺属辛金生于已土，久嗽不已，多因脾虚不能生肺气，腠理不密，外感风邪。或因肺虚不能
生水，致阴火上炎，治当补土生金，滋肾安胎为要也。
【方】
参苏饮
紫苏 陈皮 桔梗 前胡 枳壳 茯苓 甘草 葛根
加知母、砂仁。
天门冬汤
天冬 紫菀 知母 桑皮 北味 桔梗 一加阿胶
百合散
百合 紫菀 麦冬 桔梗 桑皮 甘草 竹茹
水煎服，加蜜三匙。
【歌诀】妊娠期间声音低微甚至不出声，称为子喑。这是因为少阴肾经的络脉阻滞，导致无法发声。治疗应清心降火，调理心肾关系，待分娩后经络通畅，言语自然清晰。
【论述】《黄帝内经》中黄帝问道：人有怀孕在身，到了第九个月出现失音（不能说话）的情况，这是为什么呢？岐伯回答说：这是因为胞宫的络脉气血暂时阻隔不通所致。黄帝问：为什么这样说？岐伯说：胞宫的络脉连接于肾，属于足少阴肾经，这条经脉贯穿肾脏并联系到舌根，所以当络脉阻滞时，就会导致不能说话。黄帝问：该如何治疗？岐伯说：不需要特殊治疗，等到第十个月分娩后自然会恢复。马玄台解释说：虽然常说九月是肾经养胎之时，但认为失音完全拘泥于此说法并不确切。只是在第九个月时，胎儿身体长大，胞宫的络脉系于肾脏的部分受到压迫而阻绝不通，所以偶尔会出现这种情况。因为肾经下行贯入肾脏，上行联系舌根，脉道受阻则不能言说，直到分娩后脉道恢复才能说话。博陵被称为神医的人曾说：郝翁有一位孕妇，沉默不语不能说话，郝翁说：这是因为胎儿大了导致经络壅滞，所以不能说话，等孩子生下来经络通畅了，自然就能说话了。萧赓六说：《内经·大奇论》中提到，如果胞精不足，反而能说话的是死证，不能说话的是活证，这可以验证。第九个月失音，并不是胞精不足，所以等到第十个月分娩后就会恢复。
【歌诀】十二经脉中的咳嗽表现各不相同，病因包括火、痰、湿热、风、寒，需根据七情和六气来区分虚实，治疗方法要灵活变通。
【论述】肺主司气，外合皮毛，形体受寒或饮食生冷损伤肺部，就会导致咳嗽。有痰涎的叫作嗽，无痰的叫作咳。五脏六腑的气都依赖于肺，各自在相应的季节感受邪气而发病。秋季肺易受邪，冬季肾易受邪，春季肝易受邪，夏季脾易受邪，如果各脏病变不愈，冬季会传变至其相合的腑。妊娠期间的咳嗽，称为子嗽。实证用参苏饮来发散解表，虚证用天门冬汤来滋补。如果久咳不止，恐怕会损伤胎气。
薛立斋说：咳嗽，如果是秋季因风邪伤肺，可用金沸草散；夏季因火邪克伐肺金，可用平肺散；冬季因寒邪伤肺，可用人参败毒散；春季因风邪伤肺，可用参苏饮。然而，肺属辛金，生于己土（脾胃），久咳不愈，多是因为脾虚不能生养肺气，导致腠理不紧密，容易外感风邪。或者因为肺虚不能生肾水，导致阴火上炎，治疗应当以补脾土以生肺金，滋补肾水以安胎为主要原则。
[Verse] During pregnancy, a low voice or inability to speak is termed "Zi Yin" (Fetal Aphonia). This occurs due to the obstruction of the collaterals of the Shaoyin (Kidney) meridian, preventing vocalization. Treatment should focus on clearing Heart fire and descending heat, regulating the relationship between the Heart and Kidney. After delivery, when the meridians become unobstructed, speech will naturally clear.
[Discussion] In the *Huangdi Neijing* (Yellow Emperor's Inner Canon), the Yellow Emperor asked: Why does a pregnant woman lose her voice in the ninth month? Qibo replied: This is because the collateral vessels of the uterus are temporarily obstructed. The Emperor asked: Why is this so? Qibo said: The collateral vessels of the uterus connect to the Kidney and belong to the Foot-Shaoyin Kidney Meridian. This meridian passes through the Kidney and connects to the root of the tongue. Therefore, when the collaterals are obstructed, speech is impaired. The Emperor asked: How should it be treated? Qibo said: No specific treatment is needed; it will recover by the tenth month. Ma Xuantai explained: Although it is often stated that the ninth month is when the Kidney meridian nourishes the fetus, attributing aphonia solely to this is somewhat rigid. However, at nine months, as the fetus grows, the uterine collaterals connecting to the Kidney may be compressed and obstructed, occasionally causing this condition. Since the Kidney meridian descends into the Kidney and ascends to connect with the root of the tongue, obstruction prevents speech until delivery restores the flow. A physician from Boling, known for his divine skill, said: Mr. Hao had a pregnant patient who was mute. Mr. Hao said: This is due to congestion of the meridions caused by the large fetus; once the child is born and the meridians unblock, speech will return. Xiao Gengliu stated: The *Da Qi Lun* chapter of the *Neijing* mentions that if Uterine Essence is insufficient, being able to speak indicates death, while inability to speak indicates life. This validates that aphonia in the ninth month is not due to insufficiency of Uterine Essence, hence recovery occurs by the tenth month.
[Verse] Coughs manifest differently across the twelve meridians. Etiologies include Fire, Phlegm, Damp-Heat, Wind, and Cold. Differentiation must be made between Excess and Deficiency based on the Seven Emotions and Six Climatic Factors. Therapeutic methods must be flexible and adaptable.
[Discussion] The Lung governs Qi and corresponds externally to the skin and hair. Exposure to cold or consumption of cold drinks damages the Lung, resulting in cough. Cough with phlegm/saliva is called "Sou"; cough without phlegm is called "Ke". The Qi of the Zang and Fu organs relies on the Lung. Each organ may contract disease when exposed to pathogenic factors during its corresponding season: Autumn affects the Lung, Winter affects the Kidney, Spring affects the Liver, and Summer affects the Spleen. If diseases in these organs persist, they may transmit to their associated Fu organs in Winter. Cough during pregnancy is termed "Zi Sou" (Fetal Cough). For Excess patterns, use Shen Su Yin (Ginseng and Perilla Decoction) to disperse; for Deficiency patterns, use Tian Men Dong Tang (Asparagus Root Decoction) to tonify. Prolonged coughing may injure fetal Qi.
Xue Lizhai stated: For coughs, if caused by Wind-Evil damaging the Lung in Autumn, use Jin Fei Cao San (Boiling Water Grass Powder); if caused by Fire-Evil overcoming Metal in Summer, use Ping Fei San (Lung-Calming Powder); if caused by Cold-Evil damaging the Lung in Winter, use Ren Shen Bai Du San (Ginseng and Detoxification Powder); if caused by Wind-Evil damaging the Lung in Spring, use Shen Su Yin. However, the Lung belongs to Xin-Metal and is born from Ji-Earth (Spleen/Stomach). Prolonged cough often results from Spleen Deficiency failing to generate Lung Qi, leading to loose interstices and susceptibility to external Wind. Alternatively, Lung Deficiency may fail to generate Kidney Water, causing Ministerial Fire to flare upward. Treatment should prioritize tonifying Earth to generate Metal and nourishing the Kidney to calm the Fetus.
[Prescriptions]
Shen Su Yin (Ginseng and Perilla Decoction)
Perillae Folium (Zisu), Citri Reticulatae Pericarpium (Chenpi), Platycodonis Radix (Jiegeng), Peucedani Radix (Qianhu), Aurantii Fructus Immaturus (Zhike), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao).
Add Anemarrhenae Rhizoma (Zhimu) and Amomi Fructus Rotundus (Sharen).
Tian Men Dong Tang (Asparagus Root Decoction)
Asparagi Radix (Tiandong), Asteris Radix (Ziwan), Anemarrhenae Rhizoma (Zhimu), Morus Cortex (Sangbai Pi), Schisandrae Fructus (Beiwei).
Add additional Epimedii Folium (Yinyanghuo - *Note: Text says 'One plus Ejiao', likely meaning add 1 qian of Donkey-hide Gelatin*) -> Correction: Add Ejiao (Donkey-hide Gelatin) 1 qian.
Baihe San (Lily Bulb Powder)
Lilii Bulbus (Baihe), Asteris Radix (Ziwan), Ophiopogonis Radix (Maidong), Platycodonis Radix (Jiegeng), Morus Cortex (Sangbai Pi), Glycyrrhizae Radix et Rhizoma (Gancao), Bambusae Folium (Zhuru).
Decoct in water, add three spoons of honey.