妇人血风疮，因肝脾二经风热郁火血燥所致，其外症身发疙瘩，痒痛不常，搔破成疮，脓水淋漓。内症月经
无定，小便不调，夜热盗汗，恶寒憎热，倦怠懒食。宜先用加味逍遥散，或小柴胡汤合四物，多加胡麻子，后以
归脾汤，加熟地去木香。
梦与鬼交者，因血气虚衰，思想过度，神明耗损外邪乘虚而犯之，其状时笑时泣，不欲见人，如有对忤者是也。
其脉迟伏，或如乌啄，或绵绵而来，不知度数，乍大乍小，乍短乍长，总由七情亏损心血，神无所护而然，宜用安神
定志等药，正气复而神自安，外以患人两手拇指相并，用线扎紧，当合缝外，半肉半甲之间，名鬼哭穴，灼艾七壮，果
是邪崇，病者，乞求免灸自去矣。然人之五脏各有所藏，心神、肝魂、肺魂、脾意、肾精与志也。若心之血虚，则神
无所根据，肝之血虚，则魂无所附，脉之气虚，则魄无所归，脾肾二脏虚，则意与离其体，夜梦鬼邪。若有所见者
，即我之魂魄也。岂真有所谓鬼邪崇魅与之交感者哉！立斋断以七情亏损，心血神无所护而然，真得
病情之至理矣。
夫天地之大德，曰生，生之气，固流行遍满，何至于我而独斩耶！人之嗣续者，上接亘古之传，下衍无疆之脉，
顾不甚重，祖宗至令不知几千百世，一旦至我而斩，孝子慈孙，可不HT 天祝寿地，猛心自咎。了凡先生曰∶爱者，
生之本，忍则自绝其本矣。《素问》云∶道者，能却老而全角，年皆百数，能有子也。故从无绝嗣之圣贤。何人不以
好善乐道为本，再以事副之，则麟趾呈祥，宁有限哉！
妇人无子者，或经不匀，或血不足，或有疾病，或交不时，四者而已。调其经而补其血，去其病而节
其欲，无疾病而交有时，岂有不妊娠者乎。然更有二，凡肥盛妇人，禀受甚浓，恣于酒食，不
能有胎，谓之躯脂满溢，闭塞子宫，宜燥湿痰，如星、半、苍术、台芎、香附、陈皮，或导痰汤之类；若
是瘦怯性急之人，经水不调，不能成胎，谓之子宫干涩无血，不能摄受精气，宜凉血降火。
如四物加黄芩、香附，养阴补血及六味地黄丸之类。然合男女，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，然后交而孕，孕而育，育而其子，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。
天地者，形之大也。阴阳者。气之大
也。惟形与气，相资而立，未始偏废，男女媾精，万物化生，天地阴阳之形气寓焉。语
七八之数，七，少阳也。八，少阴也。相感而流通，故女子二七天癸至，男子二八而精
通，则阴阳交合而兆始也。《易》曰∶天地氤氲，万物化醇，男女媾精，万物化生。天
地之道，阴阳和而后万物育，夫妇之道，阴阳和而后男女生，苟父精母血不及而有孕
者，未之有也。是故欲求子者，必先审妇之月经调否。经者，常也。每月应期而来，按
期而止，无易常也。期有不调者，或先或后，或一月两至，或间月一至，有绝闭不
通，有频来不止，或先痛而后行者，或先行而后痛者，有黑色者，有紫色者，有淡色
者，有白带、白淫、白浊者，是皆血气不调者也。诸如此类，必按症用药而调之。及夫
男子之病，亦在所当知也。有肾虚精滑，有精冷精清，或临事不坚，坚则流而不射。坚
者，肝火强于外也。不射者，真阳弱于中也。有盗汗梦遗，有便浊淋涩，有腰惫不能转摇，有好
色以致阴虚，有劳热者，有虚寒者，或阳虚而气弱，或阴乏而精衰，是皆精气不足者
也，诸如此类，亦必按症施药而补益之。若妇之精脉既调，男之真精亦足，所谓阴阳
和，气血平，则百病不生，而有子且寿矣。然既和之以阴阳，又宜按之以方法，诀曰∶
二十时中两日半，二十八九君须算，落红满地是佳期，金水过时空霍乱，霍乱之时枉费
工，树头树底觅残红，但解花开能结子，何愁丹桂不成丛？此盖以妇人月经方止，金水
初生，此时子宫正开而虚，惟虚能受，乃受
精结胎之候，正妙合太和之时，宜以人事副之，不失造化之妙也。过此佳期，则子宫闭
而不受胎矣。然男女之别，各有要妙存焉。月经方过一日三日交合者，新血未盛，精胜
其血，感者成男，且干道成男之义也。四日六日交合者，新血渐长，血胜其精，感者成
女，且坤道成女之义也。又云∶阴血先至，阳精后冲，纵气来乘，血开裹精，精入为
骨，阳内阴外，而成坎卦之象，是则精胜其血，故阳为之主，男形所由以成也。若阳精
先入，阴血后参，横气来助，精开裹血，血入居本，阴内阳外，而成离卦之象，是则血
胜其精，故阴为主，女形所由以成也。然天地交而万物亨，阴阳和而男女育，禀阳气之
偏者成男，禀阴气之偏者成女，故曰∶干道成男，坤道成女。欲嗣之广者，必由斯而求
之，亦由斯而得也。其或不然者，特缴幸于偶然耳。虽孕多堕也，虽产多难也，虽子多病也。
凡男子体浓脉沉小，年虽幼而阳不固，是禀元气不足也，宜多服人参膏，或加
术。中年阳道痿弱，身体益肥，姬外家多而不孕，是胃中脂膜虽盛，而气内怯也，补中益
气汤，加鹿角、枸杞、制附子、锁阳、苁蓉之类，兼补相火，宜减浓味肥甘，使浊气清
而真精固也。如脾胃不和，食少倦怠，每使内后益甚。而不能成胎者，是中气弱而不能
施化也，多服补中益气汤。如黑瘦脉弦数，身体多热，肠胃燥涩，不能成胎者，是阴水
不足也，虽胎亦夭，宜六味加知柏、归身、枸杞为丸服之，务使阴阳和平，而能生子，
不必定在热药也。
夫人至晚年无嗣，医皆责之于肾，肾以主精，精旺则孕成故也。殊不知肾主相火，
心主君火，一君一相，本于天成，君宁相服，精血乃生，盖心之所藏者神，神之所附
者血，血之所患者，火也。心欲萌而火动，则血沸腾，而神元虚耗，不能下交于肾，肾
水虚寒，精因之而妄泄，所以然者，由心火一动，则相火翕然从之，相火既动，则天君
亦督扰而不宁矣。是以心肾有相须之义，善摄生者，贵有交养之方，尝观富贵之人，反
多乏嗣，盖富多纵欲而伤精，贵每劳心而损神，要之肾精妄泄，常因火迫使然，心火上
炎，亦由水乏弗制也。且人年三十以往，精气渐减，不惟饮食男女之欲，足以损败，一
与物接，则视听言动，皆足以耗神散气，而况役志劳心者，复攻之以众欲乎？是以或伤
精，或劳神，有一于此，而不知节，非所以保天和而广嗣胤也。
男女交媾，凝结成胎者，虽不离精血，犹为后天滓质之物，而一点先天之气，萌于
情欲之感者，妙合于其间，朱子所谓禀于有生之初；《悟真篇》所谓生身受气初者是也。
医之上工，治无子者，语男则主于精，语女则主于血，着论立方，男子以补肾为要，女
子以调经为先，又参以补气行气之说，察其脉络，究其盈亏，审而治之，自可孕也。然
人身气血，各有虚实寒热之异，惟察脉可知，舍脉而独言药者妄也。脉不宜大过而
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
以实也。当散郁以伐其邪，邪去而后正可补，不宜太无力而虚，虚乃气血虚也，惟当
调补其气血。又有女子气多血少，寒热不调，月水违期，皆当诊脉而以活法治之，务
使夫妇之脉和平有力，交合有期，不妄用药，乃能生子也。其种子之道有匹，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，精血交感之会是
也。四曰投虚。虚者，去旧生新之初是也。然少年生子多羸弱者，欲盛而精薄也。老年
主子多强壮者，欲少而精浓也。多欲者，子多不育，盖孕后不节，则盗泄母阴，以夺养胎之气。
严冬之后，必有阳春，是知天地之道，不收敛则不能发生，故冬寒得闭藏之令者，
则遇阳春，靡不发育，此自然之理也。令人
既昧收藏之理，纵欲竭精，以耗真气，及其无子，复云血冷，又谓精寒，燥热之剂过
投，而真阴益耗矣，安得而有子？故无子之因，不独在女，亦多由男，房劳过度，施泄
过多，精清如水，或冷如水，及思虑无穷皆难有子，盖心主神，有所思则神驰于外，致
君火伤而不能降，肾主智，有所劳则智乱于中，俾肾亏而不能升，上下不交，水火不
媾，而能生育者，未之有也。
夫五脏各有精，五脏平和，则脏藏之精华输归于肾，以资其用，盖肾为水脏，乃聚
会关司之所，故种子有百脉齐到之论，而《内经》有五脏盛乃能泻之语也。袁了凡曰∶
聚精之道，一曰寡欲，二曰节劳，三曰息怒，四日戒酒，五曰慎味。肾为精之府，凡
男女交接，必扰其肾，肾动则精血随之而流，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，则精以视耗；耳劳于听，则精以听
耗，心劳于思，则精以思耗，随事节之，则血得养而精与日俱积矣，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，闭藏其职，虽不交合，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，饮酒则面赤，手足俱红，是扰其血也，血气既衰
之人，数月无房事，精始浓而可用，一夜大醉，精随薄矣，故宜戒酒，《经》云∶精不
足，补以味。浓郁之味，不能生津，惟恬淡者，能补精耳。盖万物皆有真味，调和胜，
真味失矣。不论腥素，淡煮得法，自有一段冲和恬淡之气，益人肠胃。《洪范》论味而
曰∶稼穑作甘。世物惟五谷得味之正，若能淡食谷味，最能养精，如煮粥饮中有浓汁滚
作一团者，此米之精液所聚也。食之最能生精，故宜慎味。
天生各物，必有氤氲之时，万物化生，必有乐育之候，猫犬至微，将受娠也。其牝
者，必狂呼而奔跳，以氤氲乐育之气，触之不能自止，此天然之节候，生化之真机也。
凡妇人一月经行一度，必有一日氤氲之候，于一时辰间，气蒸而热，昏而闷，有欲交接
不可忍之状，此的候也。此时逆而取之则成丹，顺而施之则成胎矣。然男女交媾之时，
均有其精，何常有血？褚氏、东垣、丹溪，俱以精血混言，几见男女媾精，而妇人以血施也。
女子系胞于肾，及心胞络，皆阴脏也。虚则风寒乘袭子宫，则绝孕无子，非得温暖
药，则无以去风寒而资化育之妙，宜用辛温之剂，必加引经至下焦，走肾及心胞，散风
寒，暖子宫为要，更宜兼以补养气血之药。
若不兼补养，徒事辛温，则反增燥热之热，何以为化育之机耶！故血海虚寒而不孕者，
诚用暖药，但人之孕胎，阳精之施也，必阴血能摄之，精成其孕，血成其胞。若有真阴
不足，阴虚则火旺，阳胜则内热而血枯，是以不能摄受精血者，又不可纯用辛温之药
矣。《脉诀》曰∶血旺易胎，气旺难孕，故贵乎以脉消息，所以不能废诊也。至于父少
母老，生女必羸，母壮父衰，产男必弱，古人之成语。然有老者强，而少者弱，岂无变
异其间乎？但有生之初，虽阳子为正，育而充之，必阴为之主。
有妇人年三十四，梦与鬼交，及见神堂阴司，舟揖桥梁，如此一十五年，竟无妊
娠，此阳火盛于上，阴水盛于下。见鬼神者，阴之灵。神堂者，阴之所。舟揖桥梁，
水之用。两手寸脉皆沉而伏，知胸中有实痰也。三涌三泻三汗，不旬日而无梦，一月而有娠。
妇人不孕，亦有六淫七情之邪伤冲任，或宿疾淹留，传遗脏腑；或子宫虚冷；或气
旺血衰，或血中伏热∶或脾胃损，不能荣养冲任；或有积血积痰，凝滞胞络。更当审男
子形质何如？有肾虚精弱；有禀受不足，气虚血损；有嗜欲无度，阴精衰竭，各当求原
而治。又当审其男女尺脉，若有尺脉细或虚大无力，用八味丸。左尺洪大，按之无力，
用六味丸。两尺俱微细，或浮大，用十补丸。若徒用辛热燥血，不惟无益，反受其害矣。
世有妇人血气充实，饮食健旺，而生育则少，有血气不足，饮食减少，而生育偏多
者，何？盖卫府清肌，恒存辟谷，楚宫细腰，得之忍饥，月满则亏，月亏乃盈，由是
观之，弱者易育，实者难胎，此定理也。
褚氏曰∶男女之合，二情交畅，阴血先至，阳精后充，血开裹精，精入为骨，而男
形成。阳精先入，阴血后参，精开裹血，血入居本，而女形成。（此成胎以精血先后分男女也。）
《圣济经》曰∶天之德，地之气，阴阳至和，流薄一体，因气而左动则属阳，阳资
之则成男，因气而右动则属阴，阴资之则成女，《易》云∶干道成男，坤道成女，此男
女之分别也。（此成胎以左右阴阳之气动分男女也。）
《易》云∶干道成男，坤道成女，父精母血，因感交会，精之泄阳之施也。血能摄
【血风疮】
妇女患血风疮，是由于肝、脾两经的风热郁结化火，导致血液干燥所致。其外在症状表现为身上长出疙瘩，瘙痒和疼痛交替出现，抓破后形成疮疡，流脓流水。内在症状包括月经周期不规律，小便排泄不调，夜间发热并盗汗，怕冷又憎恨发热，身体疲倦乏力，食欲不振。治疗宜先用加味逍遥散，或者用小柴胡汤合四物汤，并多加胡麻子；随后使用归脾汤，加入熟地黄，去掉木香。
【梦与鬼交】
所谓“梦与鬼交”，是因为气血虚弱衰退，思虑过度，导致神明耗损，外邪乘虚而入侵犯人体。其表现是时而大笑时而哭泣，不想见人，好像与人发生冲突一样。其脉象迟缓沉伏，或像乌鸦啄食般断续，或连绵不断而不知节律，忽大忽小，忽短忽长，这都是由于七情（喜、怒、忧、思、悲、恐、惊）亏损心血，神气失去保护所致。适宜使用安神定志等药物，待正气恢复，神气自然安定。外部疗法是将患者两手拇指并拢，用线紧紧扎住，在指甲与皮肤交界处的缝隙外侧，名为“鬼哭穴”，施灸七壮。如果确实是邪祟作怪，病人会乞求停止艾灸，病就会自行去除。然而人的五脏各有其所藏：心藏神，肝藏魂，肺藏魄，脾藏意，肾藏精与志。如果心血虚，则神无所依托；肝血虚，则魂无所依附；肺气虚，则魄无所归宿；脾肾两脏虚弱，则意与志脱离形体，夜间梦见鬼怪邪气，仿佛有所看见，那其实是我自身的魂魄罢了。难道真有所谓的鬼怪邪祟与我交感吗？薛立斋将其断定为七情亏损，心血不足导致神无所护，这确实抓住了病情的根本道理。
【嗣育门绪论】
天地的伟大德行在于“生”，生生之气固然流行充满天地，为何到我这里却独自断绝呢！人类的继承延续，上接亘古以来的传承，下衍无尽的血脉，难道这不重要吗？祖宗留下的命令，不知道经过了几千几百年，一旦在我这里断绝，作为孝子慈孙，怎能不向天祝寿、向地祈年，猛烈反省并自责呢？了凡先生说：“爱”是生命的根本，忍心克制则会自绝其根本。《素问》说：“懂得养生之道的人，能抗拒衰老而保全形体，年纪都上百岁，还能生育子女。”所以从来没有断绝后代的圣贤。谁不以好善乐道为根本，再以此付诸行动，那么麒麟趾现祥瑞的景象，难道会有尽头吗！
妇女不能生育的原因，不外乎四种：或者月经不匀，或者血不足，或者有疾病，或者性交不合时宜。调理月经以补血，去除疾病以节制欲望，没有疾病且性交有时机，哪有不能怀孕的呢？然而还有两种情况：凡是肥胖的妇人，禀赋浓厚，放纵于酒食，不能受孕，这叫“躯脂满溢，闭塞子宫”，宜用燥湿化痰的方法，如半夏、陈皮、苍术、川芎、香附、陈皮等药，或者导痰汤之类；如果是瘦弱急躁的人，月经不调，不能成胎，这叫“子宫干涩无血”，不能摄受精气，宜凉血降火，如四物汤加黄芩、香附，养阴补血及六味地黄丸之类。然而男女结合，必须年龄相当。男子虽然十六岁精气通畅，但一定要三十岁才娶妻；女子虽然十四岁天癸至，但一定要二十岁才出嫁。都要等到阴阳完全充实，然后交合才能怀孕，怀孕才能养育，养育出的孩子才能坚壮长寿。现在未成年的少女，天癸刚来，就接近男色，阴气早泄，形体未成熟而受伤，元气未充实而妄动，所以交合而不能怀孕，怀孕而不能养育，养育的孩子脆弱不长寿。
天地是巨大的形体，阴阳是巨大的气。只有形与气相互依赖而立，从未偏废。男女交合精气，万物化生，天地的阴阳之形气蕴含其中。说到七八之数，七是少阳，八是少阴。二者相互感应而流通，所以女子二七（14岁）天癸至，男子二八（16岁）精气通，这是阴阳交合的开始。《易经》说：“天地氤氲，万物化醇，男女媾精，万物化生。”天地的道理，阴阳和谐而后万物孕育；夫妇的道理，阴阳和谐而后男女出生。假如父精母血不及而能有孕，是从未有过的。所以想求子的人，必须先审视妇人的月经是否调和。经，就是常道。每月按时到来，按期停止，没有改变常态。如果经期不调，或提前或推后，或一月两次，或隔月一次，有闭经不通的，有频繁来不止的，或先痛后行的，或先行后痛的，颜色有黑色的，有紫色的，有淡色的，有白带、白淫、白浊的，这些都是血气不调的表现。诸如此类，必须根据症状用药来调理。至于男子的疾病，也应当知晓。有肾虚精滑的，有精冷精清的，或临事阴茎不坚硬，坚硬了也只流出而不射精。坚硬的，是肝火强盛于外；不射精的，是真阳虚弱于内。有盗汗梦遗的，有小便浑浊淋涩的，有腰背疲惫不能转动的，有好色导致阴虚的，有劳热的，有虚寒的，或阳虚而气弱，或阴乏而精衰，这些都是精气不足的表现。诸如此类，也必须根据症状施药补益。如果妇人的经脉已经调和，男子的真精也充足，所谓阴阳和谐，气血平和，那么百病不生，而且能生子且长寿。既然已经以阴阳调和，又适宜按方法操作，诀曰：“二十天中有两天半，二十八九你要算，落红满地是好时机，金水过时空忙乱，忙乱之时枉费工，树头树底找残红，只要懂得花开能结子，何愁丹桂不成丛？”这大概是指妇人月经刚结束，金水初生，此时子宫正开放而空虚，只有空虚才能受纳，这是受精结胎的时候，正是妙合太和的时刻，适宜以人事配合，不失造化的奥妙。过了这个佳期，子宫闭合就不能受孕了。然而男女的区别，各有要妙存在。月经刚过的一日、三日交合，新血尚未旺盛，精胜过血，感者成男，符合“乾道成男”的意义。第四日、第六日交合，新血渐长，血胜过精，感者成女，符合“坤道成女”的意义。又说：阴血先到，阳精后冲，纵气来临，血打开包裹精，精进入成为骨，阳在内阴在外，形成坎卦的形象，这是精胜过血，所以阳为主，男形由此形成。如果阳精先入，阴血后参，横气来助，精打开包裹血，血进入居于本位，阴在内阳在外，形成离卦的形象，这是血胜过精，所以阴为主，女形由此形成。然而天地交合而万物亨通，阴阳和谐而男女孕育，禀受阳气偏多者成男，禀受阴气偏多者成女，所以说：乾道成男，坤道成女。想要后代广博的人，必须由此寻求，也由此得到。如果不这样，只是侥幸于偶然罢了。虽然怀孕多流产，虽然生产多艰难，虽然孩子多病。
凡是男子体格浓重，脉象沉小，年纪虽轻但阳气不固，这是禀受元气不足，宜多服人参膏，或者加白术。中年阳气痿弱，身体日益肥胖，姬妾众多但不孕，这是胃中脂膜虽盛，但内部气怯，宜用补中益气汤，加鹿角、枸杞、制附子、锁阳、肉苁蓉之类，兼补相火，宜减少浓味肥甘，使浊气清而真精固。如果脾胃不和，食少倦怠，每次房事后更加严重，而不能成胎，这是中气弱而不能施化，多服补中益气汤。如果黑瘦，脉弦数，身体多热，肠胃燥涩，不能成胎，这是阴水不足，即使怀孕也会夭折，宜用六味地黄丸加知母、黄柏、当归身、枸杞做成丸服用，务必使阴阳和平，而能生子，不一定非要用热药。
人到晚年无子，医生都责怪于肾，因为肾主精，精旺则孕成。殊不知肾主相火，心主君火，一君一相，本于天成，君火宁则相火服，精血乃生。盖心所藏的是神，神所依附的是血，血所害怕的是火。心欲萌动而火动，则血沸腾，而神元虚耗，不能下交于肾，肾水虚寒，精因此妄泄。之所以这样，是因为心火一动，相火便随之翕然发动，相火既动，则天君（心）也受干扰而不宁。所以心肾有相互依存的意义，善于养生的人，贵在有无伤交的方术。曾观察富贵之人，反而多无子嗣，大概富人多纵欲而伤精，贵人每劳心而损神。总之肾精妄泄，常因火迫使然，心火上炎，也是由于水缺乏不能制约。况且人年过三十，精气渐减，不仅饮食男女的欲望足以损害，一与物接触，视听言动，都足以耗神散气，何况役使意志劳心的人，又用各种欲望去攻击呢？所以有的伤精，有的劳神，有一于此而不知节制，就不是保养天和而广继嗣胤的方法。
男女交媾，凝结成胎，虽然离不开精血，但仍属于后天滓质之物，而一点先天之气，萌动于情欲之感中，妙合于其间，这就是朱子所说的“禀于有生之初”；《悟真篇》所说的“生身受气初”就是这种情况。高明的医生，治疗无子者，对男子主要着眼于精，对女子主要着眼于血，著论立方，男子以补肾为要，女子以调经为先，又参考补气行气的说法，察其脉络，究其盈亏，审慎治疗，自然可以怀孕。然而人身气血，各有虚实寒热之异，只有通过诊脉可知，舍弃脉象独言用药是荒谬的。脉不宜过大而数，数则为热；不宜不及而迟，迟则为寒；不宜太有力而实，实者是正气虚而火邪乘之以实，当散郁以伐其邪，邪去而后正可补；不宜太无力而虚，虚乃是气血虚，只当调补其气血。又有女子气多血少，寒热不调，月水违期，都应当诊脉而以活法治之，务必使夫妇之脉和平有力，交合有期，不妄用药，才能生子。其种子的道法有四：一曰择地。地，指母血。二曰养种。种，指父精。三曰乘时。时，指精血交感的时刻。四曰投虚。虚，指去旧生新的初始。然而少年生子多羸弱的，是因为欲望盛而精薄；老年生子多强壮的，是因为欲望少而精浓。多欲者，子多不育，因为怀孕后不节制，则盗泄母阴，以夺取养胎之气。严冬之后，必有阳春，由此可知天地的道理，不收敛则不能发生，所以冬寒得闭藏之令者，则遇阳春，无不发育，这是自然的道理。令人既不明白收藏的道理，纵欲竭精，以耗真气，等到无子，又说血冷，又说精寒，燥热之剂过投，而真阴更耗，怎么能有子呢？所以无子的原因，不仅在女，也多由男，房劳过度，施泄过多，精清如水，或冷如水，以及思虑无穷，都难有子。盖心主神，有所思则神驰于外，致君火伤而不能降；肾主智，有所劳则智乱于中，使肾亏而不能升。上下不交，水火不媾，而能生育的，是从未有过的。
五脏各有精，五脏平和，则脏腑之精华输归于肾，以资其用。盖肾为水脏，乃聚会关司之所，所以种子有“百脉齐到”的理论，而《内经》有“五脏盛乃能泻”的话。袁了凡说：聚精之道，一是寡欲，二是节劳，三是息怒，四是戒酒，五是慎味。肾为精之府，凡男女交接，必扰其肾，肾动则精血随之而流，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，这是验证，所以贵在寡欲。精成于血，不独房室之交损吾之精，凡日用损血之事，都应当深戒。如目劳于视，则精以视耗；耳劳于听，则精以听耗；心劳于思，则精以思耗。随事节之，则血得养而精与日俱积矣，所以贵在节劳。主闭藏的是肾，司疏泄的是肝。二脏皆有相火，其系上属于心。心，是君火。怒则伤肝，而相火动，动则疏泄用事，闭藏其职，虽不交合，亦暗流潜耗矣，所以贵在息怒。人身之血，各归其舍则常凝，酒能动血，饮酒则面赤，手足俱红，是扰其血也。血气既衰之人，数月无房事，精始浓而可用，一夜大醉，精随薄矣，故宜戒酒。《经》云：“精不足，补以味。”浓郁之味，不能生津，惟恬淡者，能补精耳。盖万物皆有真味，调和胜，真味失矣。不论腥素，淡煮得法，自有一段冲和恬淡之气，益人肠胃。《洪范》论味而曰：“稼穑作甘。”世物惟五谷得味之正，若能淡食谷味，最能养精，如煮粥饮中有浓汁滚作一团者，此米之精液所聚也。食之最能生精，故宜慎味。
天生各物，必有氤氲之时，万物化生，必有乐育之候，猫犬至微，将受娠也。其牝者，必狂呼而奔跳，以氤氲乐育之气，触之不能自止，此天然之节候，生化之真机也。凡妇人一月经行一度，必有一日氤氲之候，于一时辰间，气蒸而热，昏而闷，有欲交接不可忍之状，此的候也。此时逆而取之则成丹，顺而施之则成胎矣。然男女交媾之时，均有其精，何常有血？褚氏、东垣、丹溪，俱以精血混言，几见男女媾精，而妇人以血施也。女子系胞于肾，及心胞络，皆阴脏也。虚则风寒乘袭子宫，则绝孕无子，非得温暖药，则无以去风寒而资化育之妙，宜用辛温之剂，必加引经至下焦，走肾及心胞，散风寒，暖子宫为要，更宜兼以补养气血之药。若不兼补养，徒事辛温，则反增燥热之热，何以为化育之机耶！故血海虚寒而不孕者，诚用暖药，但人之孕胎，阳精之施也，必阴血能摄之，精成其孕，血成其胞。若有真阴不足，阴虚则火旺，阳胜则内热而血枯，是以不能摄受精血者，又不可纯用辛温之药矣。《脉诀》曰：“血旺易胎，气旺难孕”，故贵乎以脉消息，所以不能废诊也。至于父少母老，生女必羸，母壮父衰，产男必弱，古人之成语。然有老者强，而少者弱，岂无变异其间乎？但有生之初，虽阳子为正，育而充之，必阴为之主。
有妇人年三十四，梦与鬼交，及见神堂阴司，舟揖桥梁，如此一十五年，竟无妊娠，此阳火盛于上，阴水盛于下。见鬼神者，阴之灵。神堂者，阴之所。舟揖桥梁，水之用。两手寸脉皆沉而伏，知胸中有实痰也。三涌三泻三汗，不旬日而无梦，一月而有娠。
妇人不孕，亦有六淫七情之邪伤冲任，或宿疾淹留，传遗脏腑；或子宫虚冷；或气旺血衰，或血中伏热；或脾胃损，不能荣养冲任；或有积血积痰，凝滞胞络。更当审男子形质何如？有肾虚精弱；有禀受不足，气虚血损；有嗜欲无度，阴精衰竭，各当求原而治。又当审其男女尺脉，若有尺脉细或虚大无力，用八味丸。左尺洪大，按之无力，用六味丸。两尺俱微细，或浮大，用十补丸。若徒用辛热燥血，不惟无益，反受其害矣。
世有妇人血气充实，饮食健旺，而生育则少，有血气不足，饮食减少，而生育偏多者，何？盖卫府清肌，恒存辟谷，楚宫细腰，得之忍饥，月满则亏，月亏乃盈，由是观之，弱者易育，实者难胎，此定理也。
褚氏曰：男女之合，二情交畅，阴血先至，阳精后充，血开裹精，精入为骨，而男形成。阳精先入，阴血后参，精开裹血，血入居本，而女形成。（此成胎以精血先后分男女也。）
《圣济经》曰：天之德，地之气，阴阳至和，流薄一体，因气而左动则属阳，阳资之则成男，因气而右动则属阴，阴资之则成女，《易》云：干道成男，坤道成女，此男女之分别也。（此成胎以左右阴阳之气动分男女也。）
[Blood Wind Itch]
Women suffering from Blood Wind Itch (Xue Feng Chuang) are caused by wind-heat stagnation and fire in the Liver and Spleen meridians, leading to blood dryness. External symptoms include nodules appearing on the body, alternating itching and pain, which become sores with oozing pus and fluid when scratched. Internal symptoms include irregular menstruation, dysuria, night fever with night sweats, aversion to cold and hatred of heat, fatigue, and poor appetite. Treatment should initially use Modified Xiaoyao San (Jia Wei Xiao Yao San) or a combination of Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Si Wu Tang (Four Substances Decoction), adding more Sesame seeds (Humaizi). Subsequently, use Guipi Tang (Restore the Spleen Decoction) with Shu Dihuang (Prepared Rehmannia Root), removing Muxiang (Aucklandia Root).
[Dreams of Intercourse with Ghosts]
"Dreaming of intercourse with ghosts" occurs due to deficiency and decline of Qi and Blood, excessive thinking, consumption of Shen (Spirit), allowing external pathogens to invade when defenses are weak. The presentation includes laughing and crying intermittently, avoiding people, as if conflicting with others. The pulse is slow and deep, or intermittent like a crow pecking, or continuous without rhythm, fluctuating between large and small, short and long. This is entirely due to the Seven Emotions damaging Heart Blood, leaving the Shen unprotected. It is appropriate to use herbs that calm the Shen and stabilize the Will (An Shen Ding Zhi). When Zheng Qi (Upright Qi) recovers, the Shen naturally settles. Externally, bind the patient's two thumbs together tightly with thread. At the junction between the nail and skin on the outer side of the seam, known as the Guiku Acupoint (Ghost Cry Point), apply moxibustion for seven moxa cones. If it is indeed an evil influence, the patient will beg to stop the moxibustion, and the illness will depart. However, the Five Zang each store specific entities: the Heart stores Shen, the Liver stores Hun (Ethereal Soul), the Lungs store Po (Corporeal Soul), the Spleen stores Yi (Intellect), and the Kidneys store Jing (Essence) and Zhi (Will). If Heart Blood is deficient, Shen has no basis; if Liver Blood is deficient, Hun has no attachment; if Lung Qi is deficient, Po has no return; if the Spleen and Kidneys are deficient, Yi and Zhi detach from the body, causing dreams of ghosts at night. What is seen is merely one's own Hun and Po. Is there truly a ghost interacting? Xue Lizhai attributed this to damage from the Seven Emotions and insufficient Heart Blood failing to protect the Shen, which truly grasps the fundamental principle of the condition.
[Introduction to Procreation]
The great virtue of Heaven and Earth is "Life". The Qi of generation flows everywhere; why should it cease only for me? Human lineage connects to ancient times and extends endlessly. Is this not important? Ancestors' commands have lasted thousands of generations; if they end with me, how can filial sons not pray to Heaven and Earth and blame themselves? Mr. Liaofan said: "Love" is the root of life; restraining it cuts off the root. *Su Wen* states: "Those who follow the Dao can resist aging and preserve their form, living to hundreds of years and still having children." Thus, there are no sages without offspring. Who does not take kindness and love for the Dao as the root, and act upon it? Then auspicious signs will appear endlessly.
Women unable to conceive may have four causes: irregular menstruation, insufficient Blood, disease, or untimely intercourse. Regulate menstruation and tonify Blood, remove disease and restrain desires, ensure no disease and timely intercourse, and pregnancy will occur. However, two other conditions exist: Obese women with strong constitution who indulge in alcohol and food cannot conceive, called "abdominal fat overflowing, blocking the uterus"; treat with damp-drying and phlegm-resolving herbs like Banxia (Pinellia Rhizome), Chenpi (Tangerine Peel), Cangzhu (Atractylodes Rhizome), Chuanxiong (Sichuan Lovage Rhizome), Xiangfu (Cyperus Rhizome), or Daotan Tang (Phlegm-Dredging Decoction). Thin, irritable women with irregular menstruation cannot conceive, called "dry uterus lacking Blood", unable to capture sperm; treat with cooling Blood and descending Fire, such as Si Wu Tang plus Huangqin (Scutellaria Root) and Xiangfu, or Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia).
Men and women must be of appropriate age. Although men's Jing flows at 16, marriage should be at 30; although women's Tian Gui arrives at 14, marriage should be at 20. Only when Yin and Yang are complete and solid should intercourse occur to conceive, nurture, and produce robust, long-lived children. Young girls whose Tian Gui has just arrived but engage in sexual activity suffer premature leakage of Yin Qi, injury before maturity, and movement before solidity, leading to infertility, miscarriage, or weak offspring.
Heaven and Earth are large forms; Yin and Yang are large Qi. Form and Qi support each other. Male and female essence interaction generates all things. Regarding the numbers seven and eight: seven is Shaoyang (Lesser Yang), eight is Shaoyin (Lesser Yin). They interact and flow. Women's Tian Gui arrives at 2x7 (14); men's Jing flows at 2x8 (16). This is the beginning of Yin-Yang union. The *I Ching* says: "Heaven and Earth interact, all things become pure; male and female essence unite, all things are born." Heaven and Earth's way requires Yin-Yang harmony for generation; husband and wife's way requires Yin-Yang harmony for birth. If father's Jing and mother's Blood are insufficient, pregnancy is impossible. Therefore, seeking conception requires checking if the woman's menstruation is regulated. "Jing" means constancy: arriving on time, stopping on time. Irregularities include early/late arrival, twice a month, every other month, amenorrhea, frequent bleeding, pain before/after flow, black/purple/light colors, leukorrhea, etc. These indicate Blood-Qi disharmony and require symptom-based regulation.
Men's diseases must also be known: Kidney deficiency with seminal emission, cold/clear semen, erectile dysfunction (strong externally due to Liver Fire, non-ejaculation due to weak True Yang), night sweats/dream emission, turbid/dysuric urine, back fatigue, Yin deficiency from lust, labor heat, deficiency cold, Yang deficiency with weak Qi, or Yin lack with depleted Jing. These require symptom-based tonification. If the woman's channels are regulated and the man's Jing is sufficient, Yin-Yang harmonizes, Blood-Qi balances, diseases do not arise, and conception leads to longevity.
After harmonizing Yin-Yang, follow specific methods: "In twenty days, two and a half days are key, calculate days 28-29. Red discharge indicates the good period; after Jin-Shui passes, confusion ensues. Wasted effort then; search trees for remaining red. If you understand flowers bear fruit, why worry about osmanthus not clustering?" This refers to the time after menstruation ends, when Jin-Shui (Water/Metal phase) begins, the uterus is open and empty, ready to receive essence. This is the optimal time for conception. After this, the uterus closes.
Timing affects gender: Intercourse 1-3 days after menstruation, new Blood is not full, Jing overcomes Blood, resulting in a male (Qian Dao creates male). Days 4-6, Blood grows, Blood overcomes Jing, resulting in a female (Kun Dao creates female). If Yin Blood arrives first and Yang Jing follows, Blood wraps Jing, Jing enters as bone, Yang inside Yin outside, forming Kan Trigram (Yang dominant, male). If Yang Jing enters first and Yin Blood follows, Jing wraps Blood, Blood enters as root, Yin inside Yang outside, forming Li Trigram (Yin dominant, female). Heaven and Earth interact for prosperity; Yin-Yang harmony for birth. Those biased toward Yang Qi become male; those biased toward Yin Qi become female. To broaden lineage, seek this method. Deviation leads to miscarriage, difficult birth, or sick children.
Men with thick build and deep/small pulse, young but unstable Yang, have insufficient Yuan Qi; use Renshen Gao (Ginseng Paste) or add Baizhu (Atractylodes Macrocephala Rhizome). Middle-aged men with weak Yang, increasing obesity, many concubines but no children, have abundant stomach fat but internal Qi weakness; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Lujiao (Deer Antler Glue), Gouqi (Goji Berry), Zhifuzi (Prepared Aconite Root), Suoyang (Cynomorium Herb), and Congrong (Cistanche Stem). Supplement Minister Fire, reduce rich/greasy foods to clear turbidity and secure Jing. Spleen-Stomach disharmony with poor appetite/fatigue worsening after sex indicates weak Middle Qi; use Buzhong Yiqi Tang. Black/thin individuals with wiry/rapid pulse, heat, dry intestines, unable to conceive, have insufficient Yin Water; even if pregnant, fetus may die; use Liuwei Dihuang Wan plus Zhimu (Anemarrhena Rhizome), Huangbai (Phellodendron Bark), Danggui (Angelica Sinensis Root), and Gouqi, ensuring Yin-Yang balance, not necessarily using hot herbs.
Older adults without children are often blamed on Kidneys. Kidney governs Jing; abundant Jing leads to pregnancy. But Kidney governs Minister Fire, Heart governs Lord Fire. One Lord, one Minister, formed by Heaven. If Lord Fire is calm, Minister Fire obeys, Jing-Blood generates. Heart stores Shen, Shen attaches to Blood, Blood fears Fire. Heart desire moves Fire, boiling Blood, depleting Shen, preventing descent to Kidney. Kidney Water becomes cold, Jing leaks. Heart Fire moves, Minister Fire follows, disturbing the Heavenly Lord (Heart). Heart and Kidney depend on each other. The wealthy often lack heirs because wealth breeds lust (damaging Jing) and status breeds mental labor (damaging Shen). Jing leaks due to Fire pressure; Heart Fire rises due to lack of Water control. After age 30, Jing-Qi declines. Sensory interactions consume Shen-Qi. Unrestrained desires damage Jing/Shen. Preserving Harmony and expanding lineage requires moderation.
Conception involves Jing-Blood but relies on a spark of Pre-Heaven Qi arising from desire. High doctors treat infertility by focusing on Male Jing and Female Blood, supplementing Kidney for men, regulating menstruation for women, considering Qi tonification/movement, examining pulses, and treating based on excess/deficiency. Pulses should not be too large/rapid (Heat), too small/slow (Cold), too forceful/excess (Deficient Righteous Qi with pathogenic Fire), or too weak/deficient (Blood-Qi deficiency). Women with excess Qi/deficient Blood, temperature imbalance, and irregular menses require pulse diagnosis and flexible treatment. Couples' pulses should be peaceful and strong, intercourse timed, medication used wisely.
Seed-conceiving principles: 1. Select Land (Mother's Blood). 2. Nourish Seed (Father's Jing). 3. Ride Time (Moment of Essence-Blood interaction). 4. Enter Emptiness (Initial stage of discarding old/generating new). Youthful fathers have weak children due to high desire/thin Jing; elderly fathers have strong children due to low desire/thick Jing. Excessive desire leads to infertile offspring because post-conception unrestraint drains Mother's Yin, stealing nourishing Qi. Winter precedes Spring; Heaven's way requires storage for generation. Winter closure allows Spring development. Ignoring storage, exhausting Jing through lust, then blaming Cold Blood/Cold Jing and using hot/dry herbs consumes True Yin, preventing conception. Infertility stems from both sexes: excessive sexual activity, thin/cold semen, endless worrying. Heart governs Shen; thought scatters Shen, injuring Lord Fire. Kidney governs Wisdom; labor confuses Wisdom, injuring Kidney. Upper/Lower non-interaction, Water/Fire non-communion prevents fertility.
Five Zang each store Jing; peace among Zang sends essence to Kidney. Kidney is Water Organ, gathering point. "Hundred pulses arrive together" theory exists; *Neijing* states "Five Zang abundant then able to discharge." Yuan Liaofan: Gather Jing by: 1. Few desires, 2. Moderate labor, 3. Rest anger, 4. Quit alcohol, 5. Careful diet. Kidney is Jing mansion; intercourse disturbs Kidney, moving Jing-Blood. Even if not ejaculated, Jing leaves palace; inability to maintain erection shows true Jing leaking. Hence, few desires. Jing forms from Blood; daily activities damaging Blood (eye strain, ear strain, mental labor) consume Jing. Moderation preserves Blood and accumulates Jing. Hence, moderate labor. Kidney stores; Liver disperses. Both have Minister Fire, connected to Heart (Lord Fire). Anger injures Liver, moving Minister Fire, causing dispersion/storage failure, leaking Jing even without intercourse. Hence, rest anger. Alcohol moves Blood; face/hands redden. In weakened persons, months of abstinence thicken Jing; one night of drunkenness thins it. Hence, quit alcohol. *Classic*: "Insufficient Jing, tonify with taste." Rich tastes don't generate fluids; bland tastes tonify Jing. All things have true taste; strong flavors lose it. Light cooking preserves harmonious Qi benefiting Stomach-Intestines. *Hongfan*: "Grains make sweet." Grains have correct taste; bland grain diet nourishes Jing best. Rice porridge concentrate is grain essence; eating it generates Jing. Hence, careful diet.
All things have a "Yinyun" (misty/vital) time for generation. Cats/dogs show this before pregnancy. Women have one Yinyun day per menstrual cycle, within one shichen (2 hours): steaming heat, dizziness, unbearable urge for intercourse. This is the precise timing. Reversing it makes Elixir; following it makes Fetus. Men/Women both have Jing; where is Blood? Chu Shi, Dongyuan, Danxi confused Jing/Blood. Women's uterus connects to Kidney and Pericardium (Yin organs). Deficiency allows Wind-Cold to attack uterus, stopping pregnancy. Warm herbs are needed to dispel Wind-Cold and aid transformation, using acrid-warm agents guiding to Lower Jiao, Kidney, Pericardium, warming uterus, combined with Blood-Qi tonics. Without tonification, acrid-warm herbs increase dryness-heat, hindering transformation. For Blood Sea deficiency-cold, warm herbs are used. But pregnancy requires Yang Jing applied and Yin Blood capturing it. If True Yin is insufficient, Yin deficiency leads to Fire hyperactivity, Yang excess leads to internal heat and Blood depletion, preventing capture. Pure acrid-warm herbs are unsuitable. *Maijue*: "Abundant Blood easy to conceive; Abundant Qi hard to conceive." Pulse diagnosis is essential. Father young/Mother old -> weak daughter; Mother strong/Father weak -> weak son. Ancient sayings, but variations exist. Initially Yang seed is correct, but nurturing requires Yin dominance.
Case: 34-year-old woman, dreamed of ghost intercourse, saw spirit halls/underworld/boats/bridges for 15 years, no pregnancy. Yang Fire excess above, Yin Water excess below. Seeing ghosts/spirits/halls/boats relates to Yin/Yin location/Water usage. Both Cun pulses deep/depressed indicate Phlegm-Excess in chest. Three applications of Yongquan (Kidney 1) draining/sweating stopped dreams in less than 10 days, pregnancy in one month.
Infertility causes: Six Evils/Seven Emotions damaging Chong/Ren, chronic diseases affecting Zang-Fu, cold uterus, Qi excess/Blood deficiency, latent Heat in Blood, Spleen-Stomach damage failing to nourish Chong/Ren, accumulated Blood/Phlegm blocking Bao Luo. Examine male constitution: Kidney deficiency/weak Jing, congenital insufficiency/Qi-Blood damage, uncontrolled desires/Jing exhaustion. Treat according to origin. Check Chi pulses: Fine or void/large/weak -> Babai Wan. Left Chi large/forceless -> Liuyi Wan. Both Chi micro/fine or floating/large -> Shibai Wan. Pure acrid-hot drying herbs are harmful.
Some women with full Blood-Qi and good appetite have few children; some with deficient Blood-Qi and poor appetite have many. Why? "Wei Fu Qing Ji" (clear muscles) implies fasting; "Chu Palace Thin Waist" implies hunger. Moon wanes then waxes. Weakness is easy to nurture; Fullness is hard to conceive. This is a fixed principle.
Chu Shi: Mutual affection, Yin Blood first/Yang Jing second -> Blood wraps Jing -> Male. Yang Jing first/Yin Blood second -> Jing wraps Blood -> Female. (Gender determined by Jing/Blood order).
*Shengji Jing*: Heaven's Virtue, Earth's Qi, Yin-Yang harmony. Qi moving left is Yang -> Male. Qi moving right is Yin -> Female. *I Ching*: Qian creates Male, Kun creates Female. (Gender determined by Yin-Yang Qi movement direction).
*I Ching*: Qian creates Male, Kun creates Female. Father's Jing, Mother's Blood, interaction via sensation. Jing release is Yang application. Blood captures...