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Zhu Danxi stated: In women who have been infertile for a long time, there is latent heat within the Chong and Ren meridians (two primary meridians regulating reproductive functions). Infertility stems from blood deficiency; blood deficiency generates heat, the root of which must lie in the insufficiency of True Yin (the fundamental yin fluids of the body). When True Yin is insufficient, Yang becomes excessive, leading to internal heat. Internal heat causes Ying Blood (nutritive blood circulating within the vessels) to wither, thus preventing conception. By nourishing Yin and eliminating heat, blood volume increases, making pregnancy easier. The *Mai Jue* states: "When blood is abundant, conception is easy; when Qi is abundant, conception is difficult." This refers to this principle.

Miao Zhongchun said: For women whose infertility is due to deficiency-cold in the Sea of Blood (referring to the uterus and the blood it stores), it is indeed appropriate to use warming medicines. However, some cases of female infertility are caused by Yin deficiency with hyperactive fire, where the body cannot retain fertilized essence and blood; in such cases, one must not solely employ acrid-warm herbs.

Zhu Danxi stated: Human fetal development begins with the bestowal of Yang Essence, which is retained by Yin Blood. The essence forms the fetus, and the blood forms the uterine sac, thereby establishing pregnancy. Currently, women without children mostly suffer from insufficient blood that fails to retain essence. Although blood deficiency arises from various causes, those wishing to conceive must replenish their essence and blood until no deficiency remains, so that conception can occur. If one indiscriminately uses formulas like Qingu Wan (Cinnamon Pill), it will scorch and damage the Zang-Fu organs, causing blood and Qi to boil, bringing disaster swiftly. He also stated: Thin and weak women often have irritable temperaments and excess fire, resulting in irregular menstruation and an inability to conceive. This is because the uterus is dry and lacks blood, failing to retain fertilized essence and blood. One should tonify Kidney Water and nourish Yin, preferably using Dabu Wujia Wan (Great Five Tonification Pill) or Zengsun Sancai Wan (Modified Three Capabilities Pill) with modifications, focusing primarily on nourishing blood. Li Dongyuan's Liuwei Wan (Six-Ingredient Pill) is used to tonify Yin and blood deficiency in women causing infertility; taking it can restore fertility.

Zhu Danxi stated: The causes of infertility often originate in women. Physicians fail to investigate the specific origin of the cause, yet perusing ancient prescriptions, they only find Qingu Wan, employing warm-hot herbs. People willingly endure the disaster of being scorched without repentance. Why? Some say: Spring warmth is mild, allowing all things to grow; Winter cold is biting, causing all things to wither. Without warm-hot herbs like Qingu Wan, how can the uterus be warmed to form a fetus? I reply: When a woman's constitution is harmonious, she joyfully bears children. Harmony ensures balanced Qi and Blood; equilibrium prevents conflict between Yin and Yang. Now, taking this medicine, menstrual blood inevitably turns purple-black and gradually diminishes. Initially, appetite may increase, but over time, bitterness and dryness in the mouth appear, leading to imbalance of Yin and Yang and disharmony of Qi and Blood. Diseases then arise in swarms, precisely because Qingu Wan depletes True Yin. Beware of this.

Commentary: Qingu Wan is designed for women with uterine deficiency-cold and accumulated cold causing infertility. If taken by those with blood deficiency and hyperactive fire, or True Yin insufficiency unable to retain essence, it will instead consume Yin and Blood and aggravate dryness-heat pathogenic factors.

Shen Zhai commented: The above six sections discuss female infertility, covering deficiency-cold, latent heat, Kidney deficiency, and blood deficiency, categorizing them as diseases of insufficiency.