经义
女子二七而天癸至，任脉通，太冲脉盛，月事以时下，故有子。○七七任脉虚，太冲脉衰少，天癸竭，
地道不通，故形坏而无子也。○丈夫二八肾气盛，天癸至，精气溢泻，阴阳和，故能有子。○八八则五脏皆衰，
筋骨懈堕，天癸尽矣，故发鬓白，身体重，行步不正，而无子耳。帝曰∶有其年已老，而有子者，何也？岐伯曰∶
此其天寿过度，气脉常通，而肾气有余也。（《素问》）
总论
种子之道有四∶一曰择地。地者，母血是也。二曰养种。种者，父精是也。三曰乘时。时者，精血交感
之会合是也。四曰投虚。虚者，去旧生新之初是也。（王宇泰）
人生子嗣，虽曰天命，岂尽非人事哉！有男不能生子者，有女不能生子者。男不能生子者有六病，女不
能生子者有十病。六病维何？一精寒，二气衰，三精少，四痰多，五相火盛，六气郁。精寒者，虽射入子宫，
女子胎胞不纳，故随受而随堕矣。气衰者，则不能久战，男精已泄，女精未交，何能生物？精少者，虽能射入，
而精衰薄，故随入而随出矣。痰多者，湿多也。湿多则精不纯。相火盛者，过于久战，女精已过，男精未施，
及男精施，而女兴已寝。气郁者，肝气抑塞，则怀抱忧愁，何能种玉蓝田、毓麟兰室？故精寒者温其火，气衰
者补其气，痰多者消其痰，火盛者补其水，精少者益其精，气郁者舒其气，则男子无子者可以有子，不可徒补
其相火也。十病维何？一胎胞冷，二脾胃寒，三带脉急，四肝气郁，五痰气盛，六相火旺，七肾水衰，八督任病，
九膀胱气化不行，十气血虚而不能摄。胎胞之脉，所以受物者也。暖则生物，冷则杀物，纵男精射入，安能茹
之而不吐乎？脾胃虚寒者，则带脉必然无力，精即射入，胎胞安能胜任乎？带脉宜弛不宜急，带脉急者，由于
腰脐之不利也。腰脐不利，则胎胞无力，安能载物乎？肝气郁者，则心境不舒，何能为欢于床？第痰气盛者，
妇必肥，身肥则下体胖，子宫缩入，难以受精。相火旺者，则过于焚烧，焦干之地，苦草木之难生。肾水衰者，
则子宫燥涸，禾苗无雨露之滋，终成萎黄之叹。任、督之间，则倘有疝瘕之疾，则精不能施，因外有所障也。
膀胱与胎胞相近，倘气化不行，则水湿之气必渗入胎胞，而不能受孕矣。女子怀胎，必气血足而后能养。气虚
则阳衰，血虚则阴衰，气血双虚，则胎胞下坠，不能升举，小产所不能免矣。故胎胞冷者温之，脾胃寒者暖之，
带脉急者缓之，肝气郁者开之，痰气盛者消之，相火旺者平之，肾水衰者补之，任、督病者除之，膀胱气化不
行者助其气化，气血虚而不能摄胎者益其气血，则女之无子者亦可以有子，不可徒治其胎胞也。（陈士铎）
天地生物，必有 之时；万物化生，必有乐育之候。猫犬至微将受娠也，其雌必狂呼而奔跳，以 乐
育之气，触之不能自止耳！凡妇人经行，必有一日 之候，于一时之间，气蒸而热，昏而闷，有欲交接不可
忍之状，此的候也。逆而取之则成丹，顺而施之则成胎矣。○聚精之道∶一曰寡欲，二曰节劳，三曰息怒，四
曰戒酒，五曰慎味。肾为精之府，凡男女交接，必扰其肾，肾动则精随之而流，外虽不泄，精已离宫，未能坚
忍者，必有真精数点，随阳痿而溢出，此其验也，故贵乎寡欲。精成于血，不独房室之交损吾之精，凡日用损
血之事，皆当深戒∶如目劳于视，则血以视耗；耳劳于听，则血以听耗；心劳于思，则血以思耗。随事节之，
则血得其养矣，故贵乎节劳。主闭藏者肾也，司疏泄者肝也，二脏皆有相火，其系上属于心。心，君火也。怒
则伤肝而相火动，动则疏泄用事，闭藏不得其职，虽不交合，而精亦暗流潜耗矣，故贵乎息怒。人身之血，各
归其舍则常凝。酒能动血，凡人饮酒则面赤，是扰其血也。血气既衰之人，数月无房事，精始浓而可用。使一
夜大醉，精随薄矣，故宜戒酒。《经》云∶精不足，补以味。浓浓之味，不能生精，惟恬淡者能补精耳。万物
皆有真味，不论腥素，淡煮得法，自有一段冲和恬淡之气，益人肠胃。《洪范》论味曰∶稼穑作甘。世惟五谷
得味之正，最能养精。如煮粥饭中，有浓汁滚作一团者，此米之精液所聚，最能生精，故宜慎味。（袁了凡）
妇人无子者，冲任脉中伏热也。其原由于真阴不足，阴不足则阳胜而生内热矣。内热则营血枯，故不孕。
益阴除热，则血旺易孕矣。○肥盛妇人，不能受孕者，以其身中脂膜满溢，湿痰闭塞子宫，而至经事不行，可
用导痰汤治之。瘦怯妇人，不能受孕者，以其子宫无血，精气不聚故也，可用四物汤养阴血之药。（朱丹溪）
地之气本重，然得天气以包举之，则生机不息。若重阴冱寒之区，天日之光不显，则物生实罕。人之体中，
肌肉丰盛，乃血之荣旺，极为美事。但血旺易至气衰，久而弥觉其偏也。夫气与血，两相维附，何以偏衰、偏
旺耶？盖气为主则血流，血为主则气反不流，非真气之衰也，气不流有似乎衰耳。故一切补气之药，皆不可用，
而耗气之药，反有可施。缘气得补则愈锢，不若耗之，以助其流动之势，久之血仍归其统握中耳。湖阳公主，
体肥难产，御医进瘦胎方，而产得顺利。盖肥满之躯，胎处其中，全无空隙，以故伤胎之药，止能耗其外之血
肉，而不能耗其内之真元。此用药之妙也。（喻嘉言）
女子血海虚寒而不孕者，虽宜用暖药，亦有阴虚火旺不能摄受精血者，又不可纯用辛温矣。（缪仲淳）
种子之方，本无定轨，因人而施，各有所宜。故凡寒者宜温，热者宜凉，滑者宜涩，虚者宜补，去其所偏，
则阴阳和而生
化着矣。今人不知此理，但知传方，岂宜于彼者，亦宜于此耶？即或偶中，而不论宜否，遍传其神，竟相制服，
岂知张冠李戴乎？（张景岳）
脉候
人身气血，各有虚、实、寒、热之异，惟察脉可知。脉不宜太过而数，数则为热。不宜不及而迟，迟则为
寒。不宜太有力而实，实者正气虚而火邪乘之，所以实也。不宜太无力而虚，虚者气血虚也。又有女子，气多
血少，寒热不调，月水违期，皆当诊脉，以活法治之。务使夫妇之脉和平，交合有期，自能生子。（陈楚良）
选案
建平王，妃姬等皆丽，而无子。择良家未笄女子入御，又无子。问曰∶求男有道乎？澄对曰∶合男女，必
当其年。男虽十六而精通，必三十而娶；女虽十四而天癸至，必二十而嫁。皆欲阴阳完实而后交合，则交而孕，
孕而育，育而为子，坚壮强寿。今未笄之女，天癸始至，已近男色，阴气早泄，未完而伤，未实而动，是以交
而不孕，孕而不育，育而子脆不寿。此王之所以无子也。然妇人有所产皆女者，有所产皆男者，大王诚能访求
多男妇人，有男之道也。王曰∶善。未再期，生六男。（《褚氏遗书》）
[Classic Theory]
When a girl reaches fourteen years of age (two sevens), Tian Gui (substances that promote reproductive maturity) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes abundant. Her menstruation occurs regularly, thus enabling her to conceive. ○ When a woman reaches forty-nine years of age (seven sevens), the Qi and Blood of the Ren Mai become deficient, the Qi and Blood of the Tai Chong Mai decline, and Tian Gui is exhausted. Menstruation ceases, her physical form deteriorates, and she can no longer bear children. ○ When a man reaches sixteen years of age (two eights), his Kidney Qi becomes vigorous, Tian Gui arrives, essence overflows and is emitted. Through the harmonious interaction of Yin and Yang, he is able to procreate. ○ When a man reaches sixty-four years of age (eight eights), the Qi and Blood of all five Zang organs decline. His sinews and bones become lax and weak, Tian Gui is depleted, his hair and beard turn white, his body feels heavy, his gait is unsteady, and he can no longer father children. The Yellow Emperor asked: Some people are old but still capable of having children; why is this? Qibo replied: This is because their natural lifespan exceeds the norm, their Qi and meridians remain unobstructed, and they have surplus Kidney Qi. (From *Su Wen*)
[General Discussion]
There are four principles for conception: First, select suitable "land." Land refers to the mother's blood. Second, nourish the "seed." Seed refers to the father's sperm. Third, seize the proper "time." Time refers to the moment of synergistic union between sperm and blood. Fourth, act during the "void." Void refers to the initial stage of discarding the old and generating the new. (Wang Yutai)
The birth of offspring is said to be determined by Heaven's Mandate, yet it is not entirely devoid of human effort. There are men who cannot father children, and women who cannot bear them. There are six pathological conditions causing male infertility, and ten causing female infertility. What are the six for men? 1. Cold sperm; 2. Deficient Qi; 3. Scant sperm; 4. Excessive phlegm; 5. Hyperactive Ministerial Fire; 6. Qi stagnation. In cases of cold sperm, although ejaculation occurs into the uterus, the uterine cavity rejects it, leading to immediate miscarriage upon conception. In cases of deficient Qi, prolonged intercourse is impossible; if the male ejaculates before the female's essence has engaged, conception cannot occur. In cases of scant sperm, although ejaculation occurs, the sperm is thin and weak, flowing out immediately upon entry. Excessive phlegm indicates excessive dampness, which renders sperm impure. Hyperactive Ministerial Fire often results from overly prolonged intercourse; if the female has already reached climax and the male has not yet ejaculated, or if the male ejaculates when the female's arousal has subsided, conception fails. Qi stagnation involves liver Qi depression and obstruction, leading to sorrowful moods, making it difficult to achieve conception ("planting jade in Lantian" or "nurturing a unicorn in the Orchid Chamber"). Therefore, cold sperm requires warming the Mingmen Fire; deficient Qi requires tonifying Qi; excessive phlegm requires resolving phlegm; hyperactive fire requires nourishing Yin to subdue fire; scant sperm requires benefiting essence; and Qi stagnation requires soothing the Liver and regulating Qi. By doing so, infertile men may conceive; one must not merely tonify Ministerial Fire.
What are the ten for women? 1. Cold uterus; 2. Cold Spleen and Stomach; 3. Tense Dai Mai (Girdle Vessel); 4. Liver Qi stagnation; 5. Excessive Phlegm-Qi; 6. Hyperactive Ministerial Fire; 7. Deficient Kidney Water; 8. Disease of the Du Mai (Governor Vessel) and Ren Mai; 9. Impaired Bladder Qi transformation; 10. Deficient Qi and Blood failing to secure the fetus. The Dai Mai is responsible for receiving and holding. Warmth fosters life, while cold destroys it; even if sperm enters, how can the uterus retain it? If the Spleen and Stomach are deficient and cold, the Dai Mai lacks strength, and the uterus cannot sustain the pregnancy. The Dai Mai should be relaxed, not tense; tension arises from obstruction in the waist and umbilical region. Obstruction there leads to uterine weakness, unable to carry the fetus. Liver Qi stagnation causes mental discomfort, hindering sexual harmony. Women with excessive Phlegm-Qi tend to be obese; lower body obesity may cause the uterus to retract, making fertilization difficult. Hyperactive Ministerial Fire is like excessive burning; just as plants struggle to grow in scorched earth, conception is hindered. Deficient Kidney Water leads to a dry, barren uterus, akin to crops without rain, resulting in withering. Diseases in the Du and Ren Mai, such as hernias or masses, obstruct sperm deposition. Since the Bladder is adjacent to the uterus, impaired Qi transformation allows dampness to infiltrate the uterus, preventing conception. Pregnancy requires sufficient Qi and Blood to nourish the fetus. Qi deficiency leads to Yang decline; Blood deficiency leads to Yin decline. Dual deficiency causes uterine prolapse and inability to lift, risking spontaneous abortion. Thus, cold uterus requires warming; cold Spleen/Stomach requires warming; tense Dai Mai requires relaxing; Liver stagnation requires opening; excessive Phlegm-Qi requires resolving; hyperactive fire requires calming; deficient Kidney Water requires tonifying; Du/Ren diseases require removal; impaired Bladder Qi requires assisting transformation; and deficient Qi/Blood requires tonification. By these means, infertile women may conceive; one must not treat only the uterus. (Chen Shiduo)
Heaven and Earth generate all things at specific times; the transformation of myriad beings requires periods of joyful nurturing. Even lowly animals like cats and dogs, when about to conceive, exhibit frantic behavior—crying and jumping—driven by the irresistible influence of nurturing Qi. For women during menstruation, there is a specific fertile window within a two-hour period, characterized by steaming heat, dizziness, and an irresistible urge for intercourse. This is the precise fertile sign. Acting against this leads to alchemical cultivation; acting with it leads to conception.
Methods to conserve Essence: 1. Reduce desires; 2. Restrain labor; 3. Calm anger; 4. Abstain from alcohol; 5. Be cautious with flavors. The Kidney is the residence of Essence. Intercourse disturbs the Kidney; if the Kidney moves, Essence flows. Even if external emission does not occur, Essence leaves its palace. Failure to maintain erection often indicates leakage of true Essence, proving the need for reducing desires. Essence is formed from Blood. Not only intercourse damages Essence; daily activities that consume Blood must also be avoided. Visual strain consumes Blood; auditory strain consumes Blood; mental overthinking consumes Blood. Moderation preserves Blood, hence the importance of restraining labor. The Kidney governs storage; the Liver governs dispersion. Both contain Ministerial Fire connected to the Heart (Monarch Fire). Anger injures the Liver, stirring Ministerial Fire, causing dispersion to dominate and storage to fail. Even without intercourse, Essence may leak secretly, hence the importance of calming anger. Blood coagulates when returning to its residence. Alcohol agitates Blood (evidenced by facial redness). After months of abstinence, sperm becomes thick and usable; a night of drunkenness thins it, hence the need to abstain from alcohol. The Classics state: "Deficiency of Essence is treated with flavor." Rich flavors do not generate Essence; only bland flavors nourish it. All things have true flavors; whether meat or vegetable, properly boiled blandly, they possess a harmonious, tranquil Qi beneficial to the intestines and stomach. The *Hong Fan* states: "Grains provide the correct flavor." Only grains possess the true flavor that best nourishes Essence. The thick liquid in porridge is the concentrated essence of rice, best for generating Essence, hence caution with diet is advised. (Yuan Liaofan)
Infertility in women is often due to latent Heat in the Chong and Ren Mai, originating from insufficiency of True Yin. Yin deficiency leads to Yang excess and internal Heat. Internal Heat dries up Ying Blood, causing infertility. Nourishing Yin and clearing Heat promotes Blood abundance and facilitates conception. ○ Obese women who cannot conceive often have excessive fat and phlegm obstructing the uterus, leading to amenorrhea; *Daotan Tang* (Phlegm-Resolving Decoction) is indicated. Emaciated women who cannot conceive lack Blood in the uterus and fail to gather Essence; *Siwu Tang* (Four Substances Decoction) and other Yin-nourishing Blood-tonifying herbs are indicated. (Zhu Danxi)
Earth Qi is inherently heavy, but when enveloped by Heaven Qi, vitality remains unceasing. In regions of extreme cold where sunlight is scarce, biological generation is rare. In humans, abundant muscle indicates vigorous Blood, which is excellent. However, excessive Blood can lead to Qi deficiency over time, creating imbalance. Qi and Blood support each other; why do they become imbalanced? Generally, when Qi dominates, Blood flows; when Blood dominates, Qi stagnates. This is not true Qi deficiency, but apparent deficiency due to stagnation. Therefore, Qi-tonifying herbs should be avoided; Qi-draining herbs may be used. Tonifying Qi causes further stagnation; draining it aids flow, allowing Blood to eventually return to its control. Princess Huyang was obese and had difficult labor. The imperial physician prescribed a "Thin Fetus Formula," resulting in smooth delivery. In an obese body, the fetus occupies space tightly. Herbs that "injure the fetus" only drain external flesh and blood, not the internal True Yuan. This illustrates the subtlety of herbal application. (Yu Jiayan)
Women with empty-cold in the Sea of Blood who are infertile may use warming herbs, but those with Yin deficiency and hyperactive Fire who cannot retain fertilized blood should not use purely acrid-warm herbs. (Miao Zhongchun)
Formulas for conception have no fixed standard; they must be tailored to the individual. Cold patterns require warming; Heat patterns require cooling; Slippery patterns require astringing; Deficient patterns require tonifying. Removing bias restores Yin-Yang harmony and generation. Modern practitioners ignore this, blindly copying formulas. What suits one may not suit another. Even if effective occasionally, indiscriminate transmission is like wearing Zhang's hat on Li's head. (Zhang Jingyue)
[Pulse Diagnosis]
Qi and Blood vary in deficiency, excess, cold, and heat, discernible only through pulse diagnosis. A pulse should not be rapid (Shu), indicating Heat; nor slow (Chi), indicating Cold. It should not be excessively forceful (Shi/Excess), which indicates false excess due to Evil Fire attacking deficient Righteous Qi; nor excessively weak (Xu/Deficiency), indicating actual Qi and Blood deficiency. Women with abundant Qi and deficient Blood, irregular temperature regulation, or delayed menstruation require pulse diagnosis and flexible treatment. Ensuring both partners have harmonious pulses and timed intercourse naturally leads to conception. (Chen Chuliang)
[Selected Case]
The Prince of Jianping’s consorts were beautiful but childless. He selected young, unmarried girls from good families, yet still no heirs. He asked: Is there a method to obtain a son? Cheng Deng replied: Union of man and woman must be at the appropriate age. Although a man may master ejaculation at sixteen, he should marry at thirty; although a woman’s Tian Gui arrives at fourteen, she should marry at twenty. Only after Yin and Yang are complete and solid should intercourse occur, ensuring conception, gestation, and healthy, long-lived offspring. Currently, marrying girls before puberty, when Tian Gui has just arrived, leads to premature loss of Yin energy, injury before completion, and movement before solidity. Thus, intercourse fails to conceive, gestation fails to nurture, and offspring are frail and short-lived. This explains the Prince’s lack of heirs. However, some women bear only daughters, others only sons. If the Great King seeks women known for bearing many sons, that is the way. The Prince agreed. Within a year, he fathered six boys. (*Chu Shi Yi Shu*)