程鸣谦云∶褚澄氏言男女交合，阴血先至，阳精后冲而男形成，阳精先入，阴血后
参而女形成，信斯言也。人有精先泄而生男，精后泄而生女者，独何欤？东垣曰∶经水才
断一二日，血海始净，感者成男，四五日，血脉已旺，感者成女，至于六七日后，则虽交
感亦不成胎，信斯言也。人有经始断，交合生女，经久断交合生男者，亦有四五日以前
交合无孕，八九日以后交合有孕者独何欤？俞子本撰《广嗣要略》，着方立图，谓实阳能入
虚阴，实阴不能受阳，即东垣之故见也。又谓微阳不能射阴，弱阴不能摄阳，信斯言也。
世有 羸之夫，怯弱之妇，屡屡受胎，虽欲止之而不能止者，亦有血气方刚，精力过人，
顾乃艰于育嗣而莫之救者，独何欤？朱丹溪论治，专以妇人经水为主，然富贵之家，侍
外家已多，其中宁无月水当期者乎？有已经前
夫频频生育，而娶此以图其易者，顾亦不能得胎，更遣与他人，转盼生男矣，岂不能受
孕于此，而能受孕于彼乎？愚以为父母之生子，如天地之生物。易曰∶坤道其顺乎，承
天而时行。夫知地之生物，不过顺承乎天。则知母之生子，亦不过顺承乎父而已。知母之
顺承乎父，则种子者果以妇人为主乎？以男子为主乎？然所谓主于男子者，不拘老少强
弱，康宁病患，精易泄难泄，只以交感之时，百脉齐到为善耳。交感而百脉齐到，虽老弱
病患易泄，亦可以成胎。交感而百脉参差，虽少强，虽康宁，虽难泄，亦难以成胎矣。妇
人所构之血，固由于百脉合聚，较之男子之精，不能无轻重之分也。孔子赞干元资始曰
大，赞坤元资生曰至，得无意乎？若男妇之辨，又不以精血先后为拘，不以经尽几日为
拘，不以夜半前后交感为拘，不以父强母弱母强父弱为拘，只以精血各由百脉齐到者别
胜负耳！是故精之百脉齐到，有以胜乎血则成男矣。血之百脉齐到，有以胜乎精则成女
矣。至有既孕而小产者，有产而不育，有育而不寿者，有寿而黄 无疆者，则亦精血之
坚脆，分为修短耳。世人不察，其精血之坚脆，已定于禀受之初。乃以小产专责之母，以
不育专付之儿，以寿天专诿之数，不亦谬乎？
程鸣谦说：褚澄认为，男女交合时，如果阴血先到达，阳精随后进入，则形成男胎；如果阳精先进入，阴血随后参合，则形成女胎。相信这种说法的话，为什么有的人精液先泄出而生男孩，精液后泄出而生女孩呢？李东垣说：月经刚结束的一两天，血海刚刚干净，此时受孕会生男孩；到了第四五天，血脉已经旺盛，此时受孕会生女孩；至于第六七天以后，即使进行交感也不能成胎。相信这种说法的话，为什么有的人月经刚结束就交合生了女孩，月经结束后很久才交合生了男孩呢？也有的人在月经结束四五天前交合没有怀孕，而在八九天后交合却怀孕了，这又是为什么呢？俞子本撰写《广嗣要略》，制定方剂并绘制图表，认为“实阳能入虚阴，实阴不能受阳”，这不过是李东垣的旧见罢了。他又说“微阳不能射阴，弱阴不能摄阳”，相信这种说法的话，世上为何有身体瘦弱的丈夫和怯懦虚弱的妻子，屡屡能够受孕，虽然想要停止却无法停止的情况呢？也有的人血气正盛、精力过人，反而难以生育后代且无人能救，这又是为什么呢？朱丹溪论述治疗，专门以妇女的月经为主，然而富贵人家，侍奉外室（妾）已经很多了，其中难道没有按时来月经的吗？有人娶了曾经与前夫频繁生育的女子，以为这样容易怀孕，结果却不能得子；再让她改嫁给别人，转眼就生了男孩，难道是她不能在此处受孕，却能在彼处受孕吗？
我认为父母生子，就像天地化生万物。《易经》说：“地道柔顺，承天时而运行。”既然知道大地化生万物，不过是顺应承接天道，那么就知道母亲生子，也不过是顺应承接父亲罢了。既然知道母亲是顺应承接父亲，那么孕育种子究竟是以妇人为主，还是以男子为主呢？然而所谓以男子为主，并不拘泥于年龄老少、体质强弱、健康或患病、精液易泄或难泄，只以在交感之时，“百脉齐到”为最佳状态。交感时若百脉齐到，即使是年老体弱、患病易泄之人，也可以成胎；交感时若百脉参差不齐，即使是年轻强壮、健康、精液难泄之人，也难以成胎。女子所汇聚之血，固然也是由于百脉聚合而成，但相较于男子的精液，不能说没有轻重之分。孔子赞美乾元资始称为“大”，赞美坤元资生称为“至”，这其中难道没有深意吗？
至于男女之别，又不以精血先后为拘束，不以月经结束几天为拘束，不以半夜前后交感为拘束，不以父强母弱或母强父弱为拘束，只以精血是否各自由百脉齐到来决定胜负！因此，如果精液的百脉齐到有胜过血液的百脉齐到，就形成男胎；如果血液的百脉齐到有胜过精液的百脉齐到，就形成女胎。至于有怀孕后小产的，有生产后无法养育的，有养育后寿命不长的，有长寿但无后代的，这也是因为精血的坚固或脆弱，决定了寿命的长短。世人不明察，不知道他们的精血坚固或脆弱，已经在禀受之初就定下了。却将小产专门归咎于母亲，将无法养育专门推给儿子，将寿夭专门推诿给命运，这不也是荒谬的吗？
Cheng Mingqian stated: Chu Cheng claimed that during sexual intercourse, if the yin blood arrives first and the yang essence follows to enter, a male fetus is formed; if the yang essence enters first and the yin blood subsequently joins, a female fetus is formed. If one believes this statement, why do some people who ejaculate semen first give birth to sons, while those who ejaculate later give birth to daughters? Li Dongyuan said: One or two days after menstruation ceases, the Blood Sea (Xue Hai) has just cleared; conception at this time results in a male. By the fourth or fifth day, the blood vessels are already vigorous; conception at this time results in a female. After the sixth or seventh day, even if sexual intercourse occurs, pregnancy cannot be achieved. If one believes this statement, why do some women conceive daughters immediately after menstruation ends, but conceive sons only after a long period post-menstruation? Why is it that some fail to conceive when having intercourse before the fourth or fifth day after menstruation ends, yet succeed when doing so after the eighth or ninth day? Yu Ziben wrote *Guang Si Yao Lue* (Essentials for Prolonging Offspring), prescribing formulas and drawing diagrams, asserting that "solid yang can enter hollow yin, but solid yin cannot receive yang," which is merely an old view of Li Dongyuan. He further stated that "weak yang cannot shoot into yin, and weak yin cannot grasp yang." If one believes this, why are there frail husbands and timid, weak wives who frequently conceive, unable to stop despite wanting to? Conversely, why are there individuals with robust qi and blood and superior vitality who struggle to produce offspring and cannot be saved? Zhu Danxi's discussion on treatment focuses primarily on women's menstruation. However, among wealthy families with many concubines, are there not those whose menstrual periods are regular? Some marry women who have frequently borne children by previous husbands, thinking it will be easy to conceive, yet they fail to get pregnant. When these women are remarried to others, they quickly bear sons. Is it possible that they cannot conceive here but can conceive elsewhere?
I believe that parents giving birth to children is like heaven and earth generating all things. The *Yi Jing* (Book of Changes) states: "The way of Earth is its docility, receiving from Heaven and acting according to the seasons." Since we know that Earth generates all things by simply following and receiving from Heaven, we should understand that mothers giving birth to children also simply follow and receive from fathers. Knowing that mothers follow and receive from fathers, does the process of conceiving depend primarily on the woman or the man? However, regarding the primacy of the man, it does not matter whether he is young or old, strong or weak, healthy or sickly, prone to premature ejaculation or able to retain semen. The key is whether, at the moment of sexual intercourse, the "hundred pulses arrive together" (Bai Mai Qi Dao). If the hundred pulses arrive together during intercourse, even an old, weak, sickly person prone to ejaculation can achieve conception. If the hundred pulses are disordered during intercourse, even a young, strong, healthy person capable of retaining semen will find it difficult to conceive. The blood gathered by the woman is indeed due to the convergence of the hundred pulses, yet compared to the man's essence, there must be a distinction in weight and importance. Confucius praised the Qian Yuan (Heavenly Origin) for initiating creation as "Great," and praised the Kun Yuan (Earthly Origin) for nourishing life as "Ultimate." Does this not imply something profound?
Regarding the differentiation between male and female fetuses, it is not determined by the sequence of essence and blood arrival, nor by how many days after menstruation cessation, nor by whether intercourse occurs before or after midnight, nor by whether the father is stronger than the mother or vice versa. It is solely determined by whether the essence and blood respectively arrive together via the hundred pulses, which decides the outcome. Therefore, if the arrival of the hundred pulses in the essence surpasses that of the blood, a male is formed. If the arrival of the hundred pulses in the blood surpasses that of the essence, a female is formed. As for those who suffer miscarriage after conception, those who give birth but cannot raise the child, those who raise the child but have a short lifespan, or those who live long but have no descendants, these outcomes are also determined by the firmness or fragility of the essence and blood, which dictates longevity. People of the world fail to observe that the firmness or fragility of their essence and blood was established at the very beginning of their endowment. Yet, they blame the mother exclusively for miscarriage, attribute the failure to raise the child to the son, and dismiss longevity or early death to fate. Is this not absurd?