张子和曰∶有妇人年三十四，梦与鬼交，及见神堂阴司，舟楫桥梁，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。舟楫桥梁，水之用。两手寸脉皆沉而伏，知胸中有实
痰也。凡三涌、三泄、三汗，不旬日而无梦，一月而有娠。
朱丹溪曰∶妇人肥盛者，多不能孕育。以身中有脂膜闭塞子宫，致经事不行。瘦弱妇人不能孕育，以子宫无
血，精气不聚故也。肥人无子，宜先服二陈汤，四物去生地，加香附，久服之。丸更妙。
朱丹溪曰∶肥盛妇人，禀受甚浓，恣于酒食，经水不调，不能成孕。以躯脂满溢，湿痰闭塞子宫故也。宜燥
湿、去痰、行气、二陈加木香、二术、香附、芎、归，或导痰汤。
陈良甫曰∶妇人有全不产育，及二三十年断绝者，荡胞汤主之，日三服，夜一服，温覆汗，必下积血及冷赤
脓如豆汁，力弱大困者，一二服止。
何松庵曰∶有肥白妇人不能成胎者，或痰滞血海，子宫虚冷，不能摄精，尺脉沉滑而迟者，当温其子宫，
补中气，消痰为主。有瘦弱妇人不能成胎者，或内热多火，子宫血枯，不能凝精，尺脉洪数而浮者，当滋阴降
火，顺气养血为主。
慎斋按∶以上五条，序妇人不孕，有痰饮、积血、脂膜，为实邪有余之病也。
薛立斋曰∶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。又有脾胃虚损，不能荣养冲任。更当审男子形质何如。有肾虚精弱，不能融育成胎。有禀赋原弱，气
血虚损。有嗜欲无度，阴精衰惫。各当求原而治。至大要，则当审男女尺脉。若右尺脉细，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。若误用辛热燥血，不唯无益，反受其害矣。
慎斋按∶以上一条，序不孕之理，兼男女病情而论之也。
张子和说：有一位三十四岁的女性，做梦与鬼魅交合，或者看见神堂阴司、船只桥梁等景象，这种情况持续了十五年，最终未能怀孕。这是因为上焦阳火过盛，下焦阴水过盛。见到鬼神，是阴灵的表现；神堂，是阴气聚集的场所；舟楫桥梁，都是水的功用体现。诊察其两手寸脉皆沉伏，可知胸中有实痰阻滞。经过三次涌吐、三次泻下、三次发汗治疗，不到十天梦魇消失，一个月后便怀孕了。
朱丹溪说：身体肥胖丰腴的妇女，大多不能孕育。因为体内有脂膜闭塞子宫，导致月经不行。身体瘦弱的妇女不能孕育，是因为子宫无血，精气无法汇聚。肥胖妇女不孕，适宜先服用二陈汤，在四物汤中去掉生地黄，加入香附，长期服用。制成丸药效果更佳。
朱丹溪说：身体肥胖的妇女，先天禀赋浓厚，放纵于酒食，导致经水不调，不能受孕。这是因为体内脂肪满溢，湿痰闭塞子宫所致。适宜采用燥湿、祛痰、行气的方法，可用二陈汤加木香、苍术、白术、香附、川芎、当归，或者使用导痰汤。
陈良甫说：妇女有完全不能生育，或者二三十年月经断绝的，用荡胞汤主治，每日服三次，夜间服一次，服药后温覆取汗，必然排出积血及冷赤脓液如豆汁状，如果体力虚弱、病情严重困顿者，一二剂即可停止。
何松庵说：有身体肥白的女性不能受孕，或者是痰滞血海，子宫虚冷，不能摄纳精气，尺脉沉滑而迟的，应当温暖子宫，补益中气，以消除痰浊为主。有身体瘦弱的女性不能受孕，或者是内热多火，子宫血枯，不能凝结精气，尺脉洪数而浮的，应当滋阴降火，以顺气养血为主。
慎斋按语：以上五条，论述了妇人不孕，由痰饮、积血、脂膜引起的，属于实邪有余的病证。
薛立斋说：妇人不孕，也有因六淫七情之邪损伤冲任二脉的情况。或者有宿疾停留，传变遗留至脏腑，或者子宫虚冷，或者气旺血衰，或者血中伏热。又有脾胃虚损，不能滋养冲任。更应当审察男子的体质状况。有肾虚精弱，不能融合育成胎的。有先天禀赋原弱，气血虚损的。有嗜欲无度，阴精衰惫的。各自应当探究根源而治疗。至于关键要点，则应当审察男女双方的尺脉。如果右尺脉细，或虚大无力，用八味丸。左尺脉洪大，按之无力，用六味丸。两尺脉都微细，或浮大，用十补丸。如果误用辛热燥血之药，不仅无益，反而会受到伤害。
Zi Hezi said: There was a thirty-four-year-old woman who dreamed of copulating with ghosts, or seeing divine halls and underworld offices, boats, and bridges. This condition persisted for fifteen years, yet she failed to conceive. This is due to excessive Yang fire in the upper jiao and excessive Yin water in the lower jiao. Seeing ghosts and deities is a manifestation of Yin spirits; divine halls are places where Yin qi gathers; boats and bridges are functions of water. Palpation revealed that both cun positions of the two wrists were deep and hidden (chen fu), indicating the presence of excess phlegm in the chest. After three treatments of emesis (yong), purgation (xie), and diaphoresis (han), the nightmares ceased within ten days, and she conceived within one month.
Zhu Danxi said: Women who are obese often cannot conceive. This is because fatty membranes block the uterus, causing amenorrhea. Thin and weak women cannot conceive because the uterus lacks blood, preventing the gathering of essence and qi. For obese women infertile, it is appropriate to first administer Er Chen Tang (Two-Cured Decoction). In Si Wu Tang (Four-Substance Decoction), remove Sheng Di Huang (Rehmanniae Radix) and add Xiang Fu (Cyperi Rhizoma); long-term administration is recommended. Forming pills is even better.
Zhu Danxi said: Obese women, possessing strong constitutions, indulge in alcohol and food, leading to irregular menstruation and inability to conceive. This is due to fullness of adipose tissue overflowing and damp-phlegm blocking the uterus. The treatment should involve drying dampness, resolving phlegm, and moving qi. One may use Er Chen Tang (Two-Cured Decoction) added with Mu Xiang (Aucklandiae Radix), Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Xiang Fu (Cyperi Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), and Dang Gui (Angelicae Sinensis Radix), or use Dao Tan Tang (Phlegm-Guiding Decoction).
Chen Liangfu said: For women who have never given birth or whose menstruation has ceased for twenty to thirty years, Dang Bao Tang (Uterus-Sweeping Decoction) is the primary prescription. It should be taken three times daily and once at night. After taking the medicine, cover warmly to induce sweating. Accumulated blood and cold red pus resembling bean juice will inevitably be discharged. If the patient is physically weak and severely debilitated, stop after one or two doses.
He Song'an said: Some fat and fair-skinned women cannot conceive due to phlegm stagnating in the Sea of Blood (Xue Hai) and uterine deficiency-cold, which prevents the reception of sperm. If the chi position pulse is deep, slippery, and slow, the treatment should focus on warming the uterus, tonifying middle qi, and eliminating phlegm. Some thin and weak women cannot conceive due to internal heat and excessive fire, resulting in uterine blood dryness, which prevents the condensation of sperm. If the chi position pulse is surging, rapid, and floating, the treatment should focus on nourishing yin, descending fire, regulating qi, and nourishing blood.
Shen Zhai commented: The above five cases describe infertility caused by phlegm-fluids, accumulated blood, and fatty membranes, which belong to diseases of excess pathogens and surplus conditions.
Xue Lizhai said: Female infertility can also result from pathogenic factors of the Six Excesses (Liu Yin) and Seven Emotions (Qi Qing) damaging the Chong and Ren vessels. Or, old diseases linger and transmit to the zang-fu organs. Or, there is uterine deficiency-cold, or abundant qi but deficient blood, or latent heat in the blood. Additionally, spleen-stomach deficiency fails to nourish the Chong and Ren vessels. One must also examine the male partner's constitution. There are cases of kidney deficiency and weak essence unable to fuse and form the fetus; cases of innate weakness with deficient qi and blood; and cases of excessive desires leading to exhaustion of yin essence. Each case requires identifying the root cause for treatment. The key point lies in examining the chi pulses of both men and women. If the right chi pulse is fine, or deficient and large without strength, use Ba Wei Wan (Eight-Ingredient Pill). If the left chi pulse is surging and large but weak upon pressure, use Liu Wei Wan (Six-Ingredient Pill). If both chi pulses are micro and fine, or floating and large, use Shi Bu Wan (Ten-Nourishing Pill). Misusing acrid-hot and blood-drying herbs will not only be ineffective but also harmful.
Shen Zhai commented: The above case discusses the principles of infertility, analyzing the conditions of both men and women.