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A woman with a frail and thin physique has been unable to conceive for a long time. After intercourse, she falls ill and stays in bed all day. People attribute this to Qi deficiency, but little do they know it is due to Blood deficiency. Blood is stored in the Liver, and Essence is contained within the Kidneys. If Liver Qi fails to flow freely, Essence cannot be discharged. Once Essence is discharged, Liver Qi becomes even more deficient. Since the Kidney is the mother of the Liver, when the "mother" (Kidney) depletes Essence, it cannot nourish its "child" (Liver Wood), leading to Liver dryness and lack of Yin fluid. Consequently, deficient fire stirs internally to scorch Essence, further weakening the Kidneys. Moreover, thin individuals tend to have internal heat; combined with the loss of Essence, Yin water decreases while fire flares up. With insufficient water to control fire, the lower back and Kidneys become empty, causing fatigue and a desire to lie down. Such women are prone to generating internal fire, yet this fire originates from Liver Wood and is termed "Thunder Fire" rather than true fire. Without intercourse, nothing happens; with intercourse, Essence easily leaks out. This results in Yin deficiency with hyperactive fire, making conception impossible. Even if conception occasionally occurs, the excessive fire may dry up the male's Essence, causing the embryo to dissipate immediately after implantation. The treatment method must focus on greatly tonifying Kidney Yin water and soothing Liver Wood. When Water is abundant, Blood also becomes abundant; when Blood is abundant, fire subsides. Use Yang Yin Zhong Yu Tang: Shu Di Huang (Prepared Rehmannia Root, 5 qian), Bai Shao (White Peony Root, 5 qian), Dang Gui (Angelica Sinensis, 5 qian), Fu Ling (Poria, 2 qian), Shan Zhu Yu (Cornus Fruit, 5 qian), Gan Ju Hua (Chrysanthemum Flower, 1 qian), Dan Pi (Moutan Cortex, 2 qian), Shan Yao (Dioscorea Rhizome, 3 qian), Du Zhong (Eucommia Bark, 2 qian), Niu Xi (Achyranthes Root, 1 qian). Decoct in water and take orally. Conception can occur after one month of use; after three months, the body becomes robust, ensuring fertility. This formula not only tonifies Blood but primarily fills Essence. When Essence is full, the uterus easily receives sperm; when Blood is sufficient, the uterus easily accommodates the fetus. These are the principles of conception. However, many people indulge in desires while few practice moderation. One must observe sexual abstinence for two months while taking this medicine to ensure pregnancy; otherwise, only general health will improve, and one should not blame the medicine for being ineffective. Wu Mei Dan is also effective for this condition. Shu Di Huang (1 liang), Dang Gui, Shan Zhu Yu, Mai Dong (Ophiopogon Tuber), Shan Yao (each 5 qian). Decoct in water and take orally. Conception can occur after ten doses.

Another woman has reduced appetite, feels bloated and fatigued after eating, and desires sleep constantly. After intercourse, she groans incessantly. People attribute this to Spleen and Stomach Qi deficiency, but it is actually due to Kidney Qi insufficiency. Qi should ascend and rise, not sink and fall. When Qi ascends to the Upper Jiao, the Spleen and Stomach digest food easily; when Qi sinks to the Lower Jiao, Spleen and Stomach transportation is difficult. Without nourishment from food and drink, spirit naturally becomes fatigued. However, Spleen and Stomach Qi is generated within the two Kidneys. Without Kidney Yin water, Stomach Qi cannot ascend; without Kidney Yang fire, Spleen Qi cannot transform. Therefore, it is urgent to tonify the Water and Fire of the Kidneys. Yet, if one only tonifies the Kidneys without using herbs that tonify the Spleen and Stomach, the Water and Fire of the Kidneys cannot be lifted to the highest Yang level. Use Jian Ti Tang: Ren Shen (Ginseng Root, 5 qian), Bai Zhu (Atractylodes Macrocephala Rhizome, 1 liang), Shu Di Huang (1 liang), Shan Zhu Yu (3 qian), Huang Qi (Astragalus Root, 5 qian), Gou Qi Zi (Goji Berry, 2 qian), Chai Hu (Bupleurum Root, 5 fen), Ba Ji Tian (Morinda Root, 1 liang). Decoct in water and take orally. After one month, Kidney Qi becomes strong; after another month, conception is highly likely. This formula contains more Qi-tonifying herbs than Essence-tonifying ones, seemingly focusing on the Spleen and Stomach. However, a healthy Spleen and Stomach generates Essence easily; thus, tonifying the Spleen and Stomach is essentially tonifying the Kidneys. Once the Spleen and Stomach are strong and supplemented with Essence-tonifying herbs, Yin Qi grows, and Yang Qi rises easily. There is no need for specific lifting actions as Qi naturally ascends to the Upper Jiao, especially since the formula already contains lifting herbs. Yang Qi does not sink, resembling the spring warmth of the earth, bringing vitality everywhere, so why would conception fail? Wang Shen Tang is also very effective for this condition. Shu Di Huang (1 liang), Shan Zhu Yu, Ba Ji Tian (each 4 qian), Bai Zhu, Ren Shen (each 5 qian), Fu Ling (3 qian), Sha Ren (Amomum Fruit, 2 grains). Decoct in water and take orally. Conception can occur naturally after one month.

A woman has cold lower extremities that require external heat to warm up. During intercourse, there is absolutely no sense of warmth in the vagina. People attribute this to weak congenital constitution, but it is actually due to a cold Uterus (Bao Gong). In icy lands, plants do not grow; in deep, yin-heavy abysses, fish and dragons do not thrive. How can a cold Uterus conceive? Even if it temporarily accepts the seed, it will eventually reject it. The Uterus is located between the Heart and Kidneys, connected above to the Heart and below to the Kidneys. Coldness of the Uterus indicates weak Heart Fire and declining Kidney Fire. Therefore, treating the Uterus requires tonifying the Fire of both the Heart and Kidneys. Use Wen Bao San: Ren Shen (3 qian), Bai Zhu (1 liang), Ba Ji Tian (1 liang), Po Gu Zhi (Cibotium Rhizome, 2 qian), Du Zhong (3 qian), Tu Si Zi (Dodder Seed, 3 qian), Qian Shi (Euryale Seed, 3 qian), Shan Yao (3 qian), Rou Gui (Cinnamon Bark, 2 qian), Fu Zi (Aconite Root, 3 fen). Decoct in water and take orally. After one month of continuous use, the Uterus becomes warm. This formula tonifies the Heart by tonifying the Kidney and warms the Kidney by warming the Heart. When Heart and Kidney Qi are strong, their Fire generates naturally, dispersing Uterine cold. Originally, coldness caused rejection; now that it is warm, acceptance is guaranteed. If prepared as pills and taken morning and evening, it enhances sperm retention, preventing childlessness. Chun Wen Tang is also excellent for this condition. Ren Shen, Ba Ji Tian, Bai Zhu, Du Zhong (each 5 qian), Po Gu Zhi (3 qian), Rou Gui (1 qian), Tu Si Zi (5 qian). Decoct in water and take orally. After ten doses, warmth returns, facilitating conception.

A woman is naturally calm and eats little; overeating causes nausea and diarrhea, along with chest and abdominal distension. People think it is weak congenital constitution, but it is actually Spleen and Stomach deficiency-cold. Spleen and Stomach deficiency-cold stems from Heart and Kidney deficiency-cold. Stomach Earth is not born without Heart Fire, and Spleen Earth is not transformed without Kidney Fire. When Heart and Kidney Fire decline, the Spleen and Stomach lose their transformative power, failing to convert food into essence. Without this essence, fluids cannot nourish the Uterus, making it impossible for the Uterus to maintain warmth for fetal development. Even if conception occurs, the Dai Mai (Penis Belt Vessel) lacks strength, leading to miscarriage. Thus, treatment must urgently warm and tonify the Spleen and Stomach. Since the Spleen’s mother is the Ming Men (Gate of Life) of the Kidney, and the Stomach’s mother is the Xin Bao (Pericardium) of the Heart, warming the Spleen and Stomach requires warming these two levels of Fire. When the mother is strong and hot, the child is not weak or cold. Use Wen Tu Yu Lin Tang: Ba Ji Tian (1 liang), Fu Pen Zi (Raspberry Fruit, 1 liang), Bai Zhu (5 qian), Ren Shen (3 qian), Shen Qu (Medicated Leaven, 1 qian), Shan Yao (5 qian). Decoct in water and take orally. After one month, fertility is achieved. The herbs used warm both Ming Men and Xin Bao Fire. Strong fire prevents Spleen and Stomach cold, increasing appetite and digestion. As Qi and Blood strengthen and Dai Mai gains force, conception succeeds. Pei Tu San is also effective. Rou Gui (1 qian), Fu Ling (3 qian), She Chuang Zi (Cnidium Fruit, 2 qian), Rou Dou Kou (Nutmeg, 1 piece), Bei Wu Wei Zi (Schisandra Berry, 1 qian), Chen Pi (Tangerine Peel, 5 fen), Shen Qu (1 qian), Ren Shen, Bai Zhu (each 5 qian), Rou Cong Rong (Cistanche Stem, 3 qian). Decoct in water and take orally.

A woman feels tightness and discomfort in the lower abdomen, making conception difficult. This is due to tension in the Dai Mai caused by obstruction in the waist and umbilical region. Obstruction here stems from Spleen and Stomach deficiency. Weak Spleen and Stomach closes Qi in the waist and umbilicus, causing Dai Mai spasm and pulling on the Uterus. Although sperm enters the Uterus, the Uterus lacks the strength to carry the fetus, risking miscarriage. If sexual activity is not moderated, abortion is likely. Treatment must unblock Qi in the waist and umbilicus while greatly tonifying the Spleen and Kidneys to relax the Dai Mai. Use Kuan Dai Tang: Bai Zhu (1 liang), Ba Ji Tian (5 qian), Bu Gu Zhi (Psoralea Fruit, 1 qian), Rou Cong Rong (3 qian), Ren Shen (3 qian), Mai Dong (3 qian), Wu Wei Zi (Schisandra Berry, 3 fen), Du Zhong (3 qian), Lian Rou (Lotus Seed, 20 pieces, keep the plumule), Shu Di Huang (5 qian), Dang Gui (2 qian), Bai Shao (3 qian). Decoct in water and take orally. After four doses, abdominal tightness resolves; after one month, conception is assured. This formula tonifies both Spleen and Kidney and benefits waist Qi, relaxing the Dai Mai. Some may question the use of sour astringents like Wu Wei Zi and Bai Shao, fearing they increase Dai Mai tension. However, Dai Mai tension arises from Qi and Blood deficiency. Blood deficiency causes contraction; Qi deficiency causes spasms. Bai Shao soothes the Liver, preventing it from attacking the Spleen; Wu Wei Zi generates Kidney Yin, benefiting the Dai Mai. They appear contradictory but work synergistically. Kuan Dai Tang is also effective. Bai Zhu (2 liang), Du Zhong (1 liang), Gan Cao (Licorice Root, 2 qian). Decoct in water and take orally. After four doses, urgency disappears.

A woman with a depressive temperament cannot conceive due to Liver Qi stagnation. A pulse indicating pregnancy must be slippery and smooth in the Heart position, relaxed and harmonious in the Liver position, and vigorous in the Kidney position. If all three positions are stagnant, conception is impossible. Even if Heart and Kidney pulses are normal, a stagnant Liver pulse rules out pregnancy. Unfree Liver Qi attacks Spleen Earth, blocking Qi in the waist and umbilicus, preventing flow through the Ren Mai (Conception Vessel) and Dai Mai. With Dai Mai blocked, the Uterus mouth remains closed, rejecting sperm. Treatment must open the Uterus by resolving stagnation. Use Kai Yu Zhong Zi Tang: Xiang Fu (Cyperus Rhizome, 3 qian), Bai Shao (1 liang), Dang Gui (5 qian), Dan Pi (3 qian), Chen Pi (5 fen), Bai Zhu (5 qian), Fu Ling (3 qian), Tian Hua Fen (Trichosanthes Root, 1 qian). Decoct in water and take orally. After one month, stagnation clears, joy fills the abdomen, and conception occurs quickly. This formula resolves Liver stagnation and relieves Spleen distress. With free waist Qi, Ren Mai and Dai Mai open spontaneously, and the Uterus opens without forced intervention. Yu Jin Shu He San is also effective. Bai Shao (1 liang), Dang Gui (5 qian), Yu Jin (Curcuma Radix), Xiang Fu, Shen Qu (each 1 qian), Zhi Ke (Aurantii Fructus, 3 fen), Bai Zhu (3 qian), Chuan Xiong (Ligusticum Rhizome, 2 qian). Decoct in water and take orally. Resolving stagnation facilitates conception.

An obese woman with excessive phlegm cannot conceive due to dampness abundance. Dampness entering from below usually refers to external pathogens, but in women, it is an internal Spleen Earth pathology. Due to weak Qi and excess flesh, she appears robust but is internally deficient, unable to move fluids. Dampness stagnates in the intestines and stomach, transforming into saliva instead of essence. Obesity implies fatty tissue filling the abdomen, obstructing the Uterus and hindering fertilization. Excess dampness flows in and out. Treatment must drain water and resolve phlegm. However, without urgently tonifying Spleen Earth, Yang Qi remains weak, damp-phlegm persists, and the patient suffers. Use Bu Zhong Yi Qi Tang modified: Ren Shen (3 qian), Dang Gui (3 qian), Huang Qi (3 qian), Bai Zhu (1 liang), Chen Pi (5 fen), Gan Cao (1 qian), Chai Hu (1 qian), Ban Xia (Pinellia Tuber, 3 qian), Sheng Ma (Cimicifuga Rhizome, 4 fen), Fu Ling (5 qian). Decoct in water and take orally. After eight doses, phlegm and Qi stagnation clear; after ten more doses, water metabolism improves, exposing the Uterus for easier fertilization. This formula lifts Spleen Qi upward, aiding downward drainage of dampness, and assists Stomach Qi to transform phlegm. It avoids damaging muscles with harsh draining herbs. Strong Yang Qi captures sperm; dispersed dampness allows conception. Dun Nong San is also good. Bai Zhu (1 liang), Ban Xia, Ren Shen (each 2 qian), Yi Zhi Ren (Alpinia Oxyphylla Fruit, 1 qian), Fu Ling (5 qian), Sha Ren (2 grains). Decoct in water and take orally. After ten doses, phlegm clears, facilitating conception.

A woman with dry mouth, bone-steaming night fever, burning sensation throughout the body, coughing with frothy sputum, cannot conceive. People attribute this to Yin deficiency with fire movement, but it is actually heat within the Bone Marrow. Cold yin lands do not produce life; dry, hot fields cannot yield crops. What is the connection between Bone Marrow and the Uterus causing infertility? The Uterus is an organ outside the Five Zang, neither purely Yin nor Yang, hence not classified among them. It connects above to the Xin Bao (Pericardium) and below to the Ming Men. Connection to Xin Bao links to the Heart; connection to Ming Men links to the Kidney. Yin contains Yang, and Yang contains Yin, allowing transformation for male or female offspring. Balance of Yin and Yang is essential; otherwise, conception fails. Bone Marrow is transformed by the Kidney. Heat in Bone Marrow means Heat in the Kidney, which heats the Uterus. Without Bone Marrow nourishment, how can an infant form? Empty bones with only fire cannot create a fetus. Treatment must clear heat from the bones. Since bone heat stems from Yin deficiency, tonifying Kidney Yin removes bone heat, protecting the Uterus from drying. Use Qing Gu Tang: Di Gu Pi (Lycium Bark, 1 liang), Dan Pi (5 qian), Sha Shen (Glehnia Root, 5 qian), Mai Dong (5 qian), Xuan Shen (Scrophularia Root, 5 qian), Bei Wu Wei Zi (Schisandra Berry, 5 fen), Jin Cha Shi Hu (Dendrobium Stem, 2 qian), Bai Zhu (3 qian). Decoct in water and take orally. After one month, bone heat resolves; after two more months, conception occurs. This formula tonifies Kidney Essence and cools Bone Marrow, indirectly cooling the Uterus. While Yin-deficient individuals often conceive easily, excessive marrow heat dries the seed, hindering development. Adjusting the Kidney reduces excess fire and supplements insufficient water, aiding conception. Jie Fen San is also effective. Di Gu Pi (1 liang), Dan Pi, Sha Shen (each 5 qian), Bai Jie Zi (White Mustard Seed, 3 qian), Shan Yao (1 liang). Decoct in water and take orally. After one month, bone-steaming fever recedes, offering hope for children.

A woman with sore back, chest oppression, abdominal masses, constant sleepiness, and failed attempts at conception is often thought to have Kidney deficiency, but it is actually a blockage in the Ren Mai and Du Mai. The Ren Mai runs anteriorly, and the Du Mai runs posteriorly, both traversing via the Dai Mai. Deficiency in Ren and Du Mai causes the Dai Mai to sag front and back. Even if sperm is received, miscarriage is common. Additionally, hernias or masses between Ren and Du Mai obstruct the Uterus, preventing sperm entry. Treatment must remove masses and tonify Ren and Du Mai to provide support. With no external obstruction and internal capacity, conception is possible. Use Sheng Dai Tang: Bai Zhu (1 liang), Ren Shen (3 qian), Sha Shen (5 qian), Rou Gui (1 qian), Bi Qi Fen (Water Chestnut Powder, 3 qian), Bie Jia (Turtle Shell, stir-fried, 3 qian), Shen Qu (2 qian), Fu Ling (3 qian), Ban Xia (1 qian). Decoct in water and take orally. After one month, Ren and Du Qi strengthens; after another month, masses disappear. This formula benefits waist Qi and lifts Ren and Du Qi. Rising Qi makes masses hard to sustain. Rou Gui dispels cold, Bi Qi removes accumulation, Bie Jia breaks hardness, and Fu Ling drains dampness. Form transforms into non-form through ascending Qi, preventing post-conception loss. Ren Du Liang Zi Tang is also usable. Bai Zhu (1 liang), Ren Shen (5 qian), Rou Gui (1 qian), Fu Ling (3 qian), Bai Guo (Ginkgo Nut, 10 pieces), Hei Dou (Black Soybean, a large handful), Du Zhong (5 qian), Ba Ji Tian (5 qian). Decoct in water and take orally. After ten doses, Ren and Du Qi strengthens, enabling sperm retention and conception.

A woman with difficult urination, abdominal distension, and puffy legs cannot conceive because Bladder Qi fails to transform. The Bladder is near the Uterus; water-dampness flows to the Bladder. However, the Bladder cannot self-transform without Kidney Qi communication to excrete water via the genital opening. Without Kidney Qi, Qi transformation fails, and dampness seeps into the Uterus, creating a swampy field where life cannot grow. Treatment must drain dampness from the Uterus. But without strong Kidney Qi, Uterine water cannot transform. Thus, treat Kidney Fire to reach the Bladder. Use Hua Shui Zhong Yu Dan: Ren Shen (3 qian), Bai Zhu (1 liang), Ba Ji Tian (1 liang), Rou Gui (2 qian), Tu Si Zi (5 qian), Fu Ling (5 qian), Che Qian Zi (Plantago Seed, 2 qian), Qian Shi (5 qian). Decoct in water and take orally. After two doses, Bladder Qi transforms; after four doses, difficulty resolves; after ten more doses, distension vanishes. Two months of use strengthens Kidney Qi, facilitating conception. This formula benefits Bladder water by tonifying Kidney Qi. Although Kidney tonics are often moistening, this formula tonifies Kidney Fire, not Water. Tonifying Fire avoids dryness; draining water avoids harsh purging. Thus, Bladder Qi transforms, Uterus is not overly wet, and conception succeeds. Shen Zhu Jia Gui Tang is also effective. Fu Ling (1 liang), Bai Zhu (1 liang), Rou Gui (1 qian), Ren Shen (5 qian). Decoct in water and take orally. After ten doses, Bladder flows freely, distension ceases, and pregnancy is possible.