CHAPTER 38 Aphonia During Pregnancy
Loss of voice or hoarseness occurring towards the end of pregnancy is called zi yin, which means ‘loss of voice in pregnancy’.
Aetiology and pathology
The aetiology of this condition is always related to Yin deficiency. It occurs towards the end of the pregnancy because, due to the Yin deficiency of the Kidneys, the Uterus channel (Bao Luo), which pertains to the Kidneys, becomes ‘detached’. In fact, one of the earliest references to the Uterus channel is in connection with aphonia in pregnancy.
Chapter 47 of the Simple Questions says:
The Yellow Emperor asked: In the ninth month of pregnancy some women develop aphonia, how does this happen? Chi Po replied: It is because the Uterus Channel becomes cut off. The Yellow Emperor asked: How do you explain that? Chi Po replied: The Uterus channel is connected to the Kidneys which pertains to Lesser Yin; the Kidney channel reaches the root of the tongue, hence the woman cannot speak.1
The pathology of aphonia in pregnancy is always related to Yin deficiency of the Kidneys and possibly Lungs.
Identification of patterns and treatment
There is only one pattern and that is Kidney-Yin deficiency.
Kidney-Yin deficiency
Clinical manifestations
Aphonia or hoarseness towards the end of pregnancy, dry throat, malar flush, a feeling of heat in the evening, dizziness, tinnitus. Tongue: without coating; Red in case of Empty-Heat. Pulse: Floating-Empty.
Herbal treatment
Three Treasures remedies
This remedy is a variation of Zuo Gui Wan Restoring the Left [Kidney] Pill which nourishes Kidney-Yin and strengthens the Directing and Penetrating Vessels. The tongue presentation appropriate to this remedy is a Red body without coating.
This remedy is a variation of Sha Shen Mai Dong Tang Glehnia-Ophiopogon Decoction which nourishes Lung- and Stomach-Yin. It is used in preference to the previous remedy when there is a deficiency of Lung- and Stomach-Yin rather than Kidney-Yin.
Prognosis and prevention
This condition is easy to treat, especially with herbs. It should be cleared with a few decoctions. In such a case, it would be important for the patient to take decoctions rather than a powder or tablets as they would soothe the throat directly. Pears are also highly recommended as this fruit nourishes Yin and benefits the throat.
), People’s Health Publishing House, Beijing, p. 259. First published c. 100 BC..