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Student asked: "Why is it that women cannot conceive?"

The reply was: "Women's inability to conceive is always due to irregular menstruation. The reason for irregular menstruation lies in internal injury from the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright), external invasion by the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), or an imbalance where Qi and Blood are excessively strong, leading to Yin and Yang mutually overcoming each other.

The method of seeking offspring lies within regulating menstruation, as detailed in previous discussions. If menstruation has been regulated and the body suffers from no other diseases, yet still remains infertile, there are two possibilities. First, the body may be excessively obese, with fat filling the uterus preventing sperm reception; a formula named Qigong Wan (Palace-Opening Pill) proposed by predecessors is quite effective. Xiuyuan (Chen Nianzu's pseudonym) detested gynecological texts that listed numerous formulas merely to confuse people; essentially, these were often Erchen Tang (Two-Cured Decoction) added with Cangzhu (Atractylodis Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Liushenqu (Six Divine Fermented Mass), and Xiangfu (Cyperi Rhizoma), etc., which might as well be stated directly. Second, the body may be excessively emaciated, with the uterus lacking blood so that essence cannot gather; Jingyue (Zhang Jingyue) had Yulin Zhu (Kidney-Nourishing Pearl) which is extremely effective, but this too is basically Bazhen Tang (Eight-Treasure Decoction) added with Tusizi (Cuscutae Semen), Lurongshuang (Deer Antler Frost), Chuanjiao (Sichuan Pepper), and Duzhong (Eucommiae Cortex), four ingredients, seemingly unnecessary to establish as a separate name. In cases where only daughters are born but no sons, it is because the man's Du Meridian (Governing Vessel) is insufficient, and Yang cannot overcome Yin; let the man take Lu Rong (Deer Antler) four pieces, Renshen (Ginseng Radix et Rhizoma) one jin, Yuanzhi (Polygalae Radix) four liang, Tusizi half a jin, made into pills with pure wine. This captures the essence in one sentence, whereas other books are verbose and inappropriate.

[Appendix Formulas]
Qigong Wan (Palace-Opening Pill). Contemporary Formula.
Banxia (Prepared Pinellia Rhizome), Cangzhu (Atractylodis Rhizoma), Xiangfu (Cyperi Rhizoma) [each 4 liang, soaked in child's urine and stir-fried], Liushenqu (Fermented Mass of Medicinal Leaven) [stir-fried], Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium) [each 2 liang, stir-fried with salt water], Chuanxiong (Ligustici Chuanxiong Rhizome) [3 liang].
Made into pills with steamed wheat cake, taken with wine, 3 qian per dose. (Note: Cangzhu is written as Baizhu (Atractylodis Macrocephalae Rhizoma) in another version.)

Yulin Zhu (Kidney-Nourishing Pearl). Contemporary Formula.
Lujiaoshuang (Deer Horn Frost), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma), Fuling (Poria) [each 2 liang], Chuanjiao (Sichuan Pepper) [1 liang], Renshen (Ginseng Radix et Rhizoma) [2 liang], Danggui (Angelicae Sinensis Radix) [4 liang], Duzhong (Eucommiae Cortex), Gancao (Licorice Root) [each 1 liang], Tusizi (Cuscutae Semen), Dihuang (Rehmanniae Radix Praeparata) [each 4 liang].
Grind into powder, make pills with refined honey, size of Sophora seeds, swallow with rice soup or unadulterated wine.

The student further asked: "Can a woman's infertility or ease of conception be predicted through pulse diagnosis?"

The reply was: "Chen Chuliang said: 'Human Qi and Blood vary in deficiency, excess, cold, and heat; only by observing the pulse can one know this. To speak of medicine alone without the pulse is absurd.' The pulse should not be too rapid; rapidity indicates Heat. It should not be too slow; slowness indicates Cold. It should not be too forceful and full; a Full condition often masks underlying Righteous Qi deficiency, with Fire Evil invading to create a false excess. The treatment method should be to disperse stagnation and eliminate the Evil; only after the Evil is gone can the Righteous Qi be tonified. It should not be too weak and deficient; Deficiency implies Qi and Blood insufficiency; the treatment method should be to tonify Qi and Blood. Furthermore, for women with excessive Qi and scant Blood, irregular cold and heat, and delayed menstruation, pulse diagnosis is essential, and flexible methods should be applied. It is crucial that both husband and wife have harmonious and forceful pulses, intercourse occurs at appropriate times, and medications are not used recklessly, so that offspring can be conceived."

The student then asked: "Dongyuan (Li Gao) stated: 'If intercourse occurs three days before the end of menstruation, a male is conceived because Essence surpasses Blood; if three days after, a female is conceived because Blood surpasses Essence. After seven days, the uterus closes, and even with intercourse, pregnancy does not occur.' Chu Shi (Chu Cheng) said: 'If Blood arrives first and wraps Essence, a male is born; if Essence arrives first and wraps Blood, a female is born.' The Daoist Canon states: 'After menstruation cleanses, intercourse on the 1st, 3rd, and 5th days yields males; on the 2nd, 4th, and 6th days yields females.' Sacred Scriptures state: 'Movement to the left driven by Qi, aided by Yang, produces a male; movement to the right driven by Qi, aided by Yin, produces a female.' Cheng Mingqian said: 'If Essence's hundred vessels arrive simultaneously and surpass Blood, a male is born; if Blood's hundred vessels arrive simultaneously and surpass Essence, a female is born.' These are all one-sided statements, insufficient to discuss the Way of Heaven and Earth, Yin and Yang. Laozi said: 'Heaven follows the Dao, the Dao follows Nature; simply follow it.' Although Heaven's mandate listens to nature, human effort must not be neglected. May I ask if there is indeed a method for seeking heirs?"

The reply was: "Yuan Liaofan said: 'Heaven and Earth produce life, necessarily having moments of interaction; all things transform and generate, necessarily having periods of joyful nourishment. Even humble animals like cats and dogs, when about to conceive, the female will cry wildly and jump around, touched by the Qi of joyful nourishment unable to restrain herself. This is the natural rhythm, the true mechanism of transformation and generation.' Whenever a woman menstruates once a month, there is certainly one day of the conception window, within one shichen (two-hour period), where Qi steams and generates heat, feeling dizzy and stifled, with an unbearable desire for intercourse. This is the precise window. Reversing this to take leads to forming elixirs (Daoist term, metaphorically implying non-standard conception or cultivation); following it to apply leads to forming a fetus."

The student asked again: "Gynecological discussions on seeking offspring are complex and confusing. Which school's theory should be followed for the most appropriate and unchangeable method?"

The reply was: "In the Song Dynasty, Luo Longji wrote *Neijing Shiyi* (Supplement to the Inner Canon), supplemented by Ming Dynasty scholars, containing one treatise on seed-seeking and three formulas, outstanding and extraordinary. The treatise states: 'Male and female intertwining essence leads to the transformation and generation of all things; thus, partial Yin does not generate, and partial Yang does not grow; this is logically inevitable.' However, if marital intercourse does not occur at the appropriate time, it is also considered partial Yin or partial Yang. Blaming childlessness on Heaven's Mandate in such cases is rigid! Occasionally, people use drugs to nourish Essence and Blood, waiting for menstruation to conceive, mostly using harsh tonics seeking accidental success. Often, seeking heirs fails while harm follows, deeply regrettable! Fortunately, I studied under a master and received secret teachings passed down over centuries: First, Select the Land; Second, Nurture the Seed; Third, Ride the Time; Fourth, Enter the Void. 'Land' refers to the mother's Blood; 'Seed' refers to the father's Essence; 'Time' refers to the moment of Essence and Blood interaction; 'Void' refers to the beginning of discarding the old and generating the new. I heard my teacher say: 'When the mother does not conceive, it is due to Excess Qi and Deficient Blood.' Deficiency arises from Cold Injury and Seven Emotions, causing Qi stagnation and Blood stasis, Disharmony of Ying and Wei, resulting in irregular menstrual flow volume, termed 'Yin losing its way,' how can it receive? When the father does not seed, it is due to Qi Deficiency and Weak Essence. Weakness stems from excessive sexual desire damaging the Five Zang Organs; although organs store Essence, it is stored in the Kidneys. Once Kidney Essence is weak, like an archer with weak strength whose arrow misses the target, it is termed 'Yang losing its way,' how can it seed? Therefore, fertile land does not sprout barren seeds, nor do large seeds grow in barren soil; the principles of regulating menstruation and nourishing Essence must be studied. If Essence and Blood are truly abundant, one must wait for the right time to act, entering during the void. For example, record the time of menstruation onset, count thirty shichen; then filth is washed away, new Blood begins to sprout—this is the Void. Enter during this time. If worried that emotional doors remain closed and Yin and Yang repel each other, there are special acupuncture techniques inserted internally to stimulate desire. Thus, the uterus opens, emotions harmonize, True Yuan intertwines like fish in water; even those previously infertile will conceive! This method has been tested repeatedly with success, hitting the mark every time, surely not false words! Once pregnant, to predict gender, place the father's birth year trigram below, the mother's birth year trigram above, and the conception month in the center; if encountering Qian, Kan, Gen, Zhen (Yang images), a male is born; if encountering Xun, Li, Kun, Dui (Yin images), a female is born; prediction is possible. Alas! Those initially childless are not victims of Heaven, but humans destroying their own nature. Those who later have children are not favored by Heaven, but human determination can overcome Heaven."