建平孝王妃、姬、侍皆丽无子，择良家未笄女入御，又无子。问尚书褚澄曰∶求男有道乎？澄对曰∶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。皆欲阴阳完实后交合，则交而
孕，孕而育，育而为子，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，此王之所以无子也。然妇人有所产皆女者，有所产皆男者。大王诚能
访求多男妇人，媒至宫府，有男之道也。王曰∶善。未再期生六男。夫老阳遇少阴，老阴遇少阳，亦有子之道
也。（《褚氏遗书》。）
朱丹溪曰∶肥盛妇人不能孕育者，以其身中脂膜闭塞子宫，而致经事不行，可用导痰汤之类。瘦怯妇人不
能孕育者，以子宫无血，精气不聚故也，可用四物汤养血养阴等药。余侄女形气俱实，以得子之迟，服神仙聚
宝丹，背上发痈疽，症候甚危。予诊其脉散大而涩，急以加减四物汤百余帖，补其阴血。幸其质浓，易于收救。
质之薄者，悔将何及。
龚子材治刘小亭，年四十无子，阳事痿弱，精如冰冷。求诊，两寸脉洪，两尺沉微无力，此真元衰惫，平
素斫丧过度所致。以固本健阳丹加人参、附子、枸杞、覆盆子各二两，制一料，服尽，觉下元温暖。如前又
制一料，服至半料而止，果孕生一子。后传之于刘柏亭、刘敏庵，服之俱得子。
汪石山治一妇人，形肥色淡紫，年几三十，艰于育子。脉之，两尺皆沉微，法当补血。以形言之，肥人气
虚，亦当补气。遂令多服八物汤，仍以补阴丸加参、 ，空腹吞之，三月余有孕。复为诊之，两尺如旧。以理
论之，孕不当有。昔人云∶脉难尽凭，殆此类与。
薛立斋治儒者钱思习子室，年三十余无嗣，月经淋沥无期。夫妇异处几年矣，思习欲为娶外家，以谋诸薛。
薛意此郁怒伤肝，脾虚火动，而血不归经，乃肝不能藏，脾不能摄也。当清肝火，补脾气，遂与加味归脾、逍
遥二药四剂，送至其家，仍告其姑，曰服此病自愈，而当受胎，外家可无娶也。果病愈，次年生子。
后妃不妒忌，而百斯男。独中山靖王饮酒好内，生子百十二人。世称全鹿丸为周文王所定，常服之，故生
子众多。岂中山靖王亦常服是丸者耶，何生子之多于文王也？（《张氏丽言》。）
冯楚瞻治金绍老，晨泻不已。就诊，按其脉，两寸关俱沉弱无力，两尺沉微更甚，曰∶少年得此，不惟难
愈，更恐嗣育之间，多女少男矣。适许某至，亦索诊，其脉亦然。各道连生数女而无子，令以八味去丹皮、泽
泻，加补骨脂三两，菟丝子四两，五味子二两，早晚食前各服五钱，后各生子矣。《精要》云∶久服令人肥健
多子。信然。
吴孚先治蔡孝廉，年已五旬，苦乏嗣，遍求种子方备尝，十载无一验。诊得右尺神旺，真火本自不衰，惟
左尺虚弱，乃真水干涸也。宜补阴配阳，与六味地黄丸加元武胶。越二年，果得一子。
万密斋曰∶尝见男子阴痿者，多致无子，不可不虑也。惟其求嗣之急，易为庸医之惑。或以附子、蛇床、
故纸为内补。或以蟾酥、阿芙蓉为外助。阳事未兴，内热已作，玉茎虽劲，顽木无用，以致终身无子，或有夭
殁者。吾见此辈无辜，而受医药之害，遍访诸方，无越此者，出以示人，名曰壮阳丹。熟地黄四两，巴戟去心
破故纸炒各二两，仙灵脾一两，桑螵蛸真者盐焙，阳起石 ，另研水飞，各半两。上六味合阴之数，研末炼蜜
丸如桐子大。每三十丸，空心只一服，温酒下。不可恃此自恣也，戒之。（雄按∶用石药弊滋甚矣。）
生地四两，熟地四两，天冬四两，麦冬四两，当归二两，枸杞一两，仙灵脾八两，制碎，绢袋盛，浸大
酒内，隔汤煮，从卯至酉，取出埋地下七日，夫妇日共饮五六杯。妇人经水不准者，即准而受孕。此方刻邹南
皋仁文书院《集验方》中。吴银台、徐光禄俱云往往得验，因复记而笔之。（李日章《六砚斋笔记》。雄按∶
此集灵膏方也。）
吴桥治胡翳卿。胡喜诙谐，故与桥习。胡以久不宜子，请壮阳方。桥诊曰∶公寸脉洪，尺中沉涩，火炎而
不降，水涸而不升，水火不交，是曰未济，法宜滋阴补肾，庶几相济相生。使复壮阳，则火益炎而水益涸，咳
血呕血，将不可谋，殆矣。胡大笑曰∶吾五十而善饭，不异丁年，何病？徒以阳痿滑精，愿得方药壮之。且吾
服滋阴药，如奉漏卮无益。桥曰∶技止此尔。胡后遇国人老而举子者，得壮阳方，至留都亟服之，咳而失音，
已复咳血，久之肉削，大溲浸动，则遣使逆桥，桥谢不暇。病深请告归，即召桥，叹曰∶不用公言至此矣。幸
脉不数，声不喑，骨不蒸，血不咳，独大溲日三四行尔。桥曰∶否，否，夫数者、喑者、蒸者、咳者，则阳火
未息，犹可鼓而行之。今熄矣，即炉 无及也。无何而绝。
冯楚瞻曰∶五脏之精华，轮归于肾，故经曰，五脏盛乃能泻，是五脏各有精，随所用而灌注于肾，岂止肾
所藏而已哉？然精生于血，血少精何以生？夫心主血，故曰无子责乎心，发白责乎肾。是以重嗣育者，不独补
肾，尤宜养心。不但养心，更宜调和五脏，使五脏精气常盛，而后肾家之充溢裕如也。设四脏燥槁不荣，将何
物以输归于肾，而为嗣绪之本乎？余故制养心育脾，和肝清肺，滋肾，补荣益卫，膏滋丸与八味丸兼服。一补
先天之不足，一助后天之发生，将见血气日长，螽斯衍庆，自可必也。方用嫩黄 四两，蜜水拌炒，同人参补
气以为君；当归身酒拌炒三两，养血宣血，调和荣分以为臣，酸枣仁炒熟捣碎五两，宁心益肝，兼养脾土以为
臣；熟地六两，滋水润燥，与白术同用，则白术补脾气，熟地滋脾阴，亦以为臣；于潜白术，人乳拌透晒干炒
黄四两，专补脾元以为臣；远志肉用甘草浓汁煮去辣水，二两，养心神生脾土，下济肾气，使真精藏固，用以
为佐；麦冬同老米炒燥去米三两，保护肺金，以济白术之燥，用以为佐；白芍蜜酒拌炒二两四钱，甘寒入脾，
酸敛入肝，既佐当归以和肝荣，复佐白术以养脾阴，用以为佐；杜仲酒拌炒三两，接引诸药深达至阴之所，川
续断酒拌炒三两，熟地补肾精，杜仲补肾气，续断专调理于骨节筋络之间，用以为使；川牛膝酒拌蒸三两，焙
干引诸药强壮下元，用以为使。莲子三斤，清水煮汁三十余碗，去渣入前药，煎取头二汁，去渣熬膏。以人参
二两，茯苓、茯神各三两，研细末，和前膏为丸。临卧白汤送下四钱。
沈尧封曰∶求子全赖气血充足，虚衰即无子，故薛立斋云，至要处，在审男女尺脉。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。此遵《内经》而察脉用
方，可谓善矣。然此特言其本体虚，而不受胎者也。若本体不虚，而不受胎者，必有他病。缪仲淳主风冷乘袭
子宫，朱丹溪主冲任伏热；张子和主胸中实痰；丹溪于肥盛妇人，主脂膜塞胞；陈良甫于二三十年全不产育者，
胞中必有积血，主以荡胞汤。诸贤所论不同，要皆理之所有，宜察脉辨证施治。荡胞汤在《千金》为妇人求子
第一方，孙真人郑重之。
雄按∶荡胞汤，虽有深意，其药太峻，未可轻用。
惟保胎神佑丸，善舒气郁，缓消积血，不但为保胎之良药，亦是调经易孕之仙丹。每日七丸，频服甚效。
余历用有验，因附录之。白茯苓二两，于潜术米泔浸一日，黄土炒香一两，益母草净叶去梗一两，真没药瓦上
焙干去油三钱。上为末，蜜丸桐子大，每服七丸，白滚水下。若胎动，一日可服三五次，不可多服一丸。至嘱。
【背景信息】
书名：续名医类案 作者：魏之琇 朝代：清 章节：求子 类别：医论
建平孝王的妃子、姬妾和侍从都容貌美丽却无子嗣，于是挑选未成年的良家女子入宫侍奉，依然没有子嗣。孝王向尚书褚澄请教说：“想要男孩有什么方法吗？”褚澄回答说：“男女交合必须年龄相当。男子虽然十六岁精气已通，但一定要等到三十岁才娶妻；女子虽然十四岁天癸（月经）已至，但一定要等到二十岁才出嫁。都要等到阴阳之气完全充实之后再进行交合，这样才能交合而受孕，受孕后顺利生育，生下的孩子才能坚固强壮、长寿健康。现在那些未成年的女子，天癸刚刚到来，就接近男子进行房事，导致阴气过早泄漏，身体尚未发育成熟就已受损，元气尚未充实就已妄动，因此交合而不能受孕，即使受孕也不能顺利生育，生下的孩子脆弱且不长寿，这就是大王没有子嗣的原因。然而，有些妇人生的全是女孩，有些妇人生的全是男孩。大王如果能访求那些生了很多男孩的妇人，通过媒人接到宫中，就有生出男孩的方法了。”孝王说：“好。”不到一年就生了六个男孩。所谓老阳遇到少阴，老阴遇到少阳，也是生育的方法。（出自《褚氏遗书》。）
朱丹溪说：肥胖的妇人不能孕育，是因为体内脂膜闭塞子宫，导致月经不行，可以用导痰汤之类的方剂治疗。瘦弱的妇人不能孕育，是因为子宫无血，精气不聚，可以用四物汤养血养阴等药物治疗。我的侄女形体和气机都实盛，因为得子晚，服用了神仙聚宝丹，背上发了痈疽，症状非常危险。我诊察她的脉象散大且涩，急忙用加减四物汤一百多帖，补益她的阴血。幸好她体质浓厚，容易救治。如果体质薄的，后悔就来不及了。
龚子材治疗刘小亭，四十岁没有儿子，性功能痿弱，精液像冰一样冷。请求诊治，两手寸脉洪大，两尺脉沉微无力，这是真元衰败疲惫，平时过度耗损所致。用固本健阳丹加入人参、附子、枸杞、覆盆子各二两，制成一料药，服完后，感觉下焦温暖。像之前那样又制了一料药，服到半料时停止，果然怀孕生了一个儿子。后来传给刘柏亭、刘敏庵服用，都得了儿子。
汪石山治疗一个妇人，形体肥胖，面色淡紫，将近三十岁，难以生育。诊脉，两尺脉皆沉微，按照法度应当补血。从形体来看，肥人气虚，也应当补气。于是让她多服用八物汤，同时服用补阴丸加人参、[此处原文缺字，推测为某药]，空腹吞服，三个多月后怀孕。再次为她诊脉，两尺脉依然如旧。按理说，怀孕不应该有这种脉象。古人说：脉象不能完全凭信，大概就是这样吧。
薛立斋治疗儒者钱思习的妻子，三十多岁没有后代，月经淋漓不断没有定期。夫妇分居几年了，钱思习想纳外室，来征求薛立斋的意见。薛立斋认为这是郁怒伤肝，脾虚火动，导致血不归经，是肝不能藏血，脾不能摄血。应当清肝火，补脾气，于是给予加味归脾汤、逍遥散两种药各四剂，送到他家，并告诉他的婆婆说：服用这些病自然会好，并且会受孕，不需要纳外室了。果然病好了，第二年生了儿子。
后宫妃嫔不嫉妒，所以子孙众多。唯独中山靖王饮酒好色，生了112个儿子。世人称全鹿丸是周文王制定的，经常服用，所以生子众多。难道中山靖王也常服用这个丸药吗？为什么他比周文王生的儿子还多呢？（出自《张氏丽言》。）
冯楚瞻治疗金绍老，早晨腹泻不止。就诊时，按摸他的脉象，两手寸关脉都沉弱无力，两尺脉沉微更甚，说：“少年得此脉象，不仅难愈，更恐怕在生育方面，多女少男了。”恰好许某也来求诊，脉象也是这样。各自诉说连生几个女儿而没有儿子，令他们服用八味丸去掉牡丹皮、泽泻，加入补骨脂三两，菟丝子四两，五味子二两，早晚饭前各服五钱，后来都生了儿子。《精要》说：久服使人肥壮健硕多子。确实如此。
吴孚先治疗蔡孝廉，已经五十岁，苦于没有后代，遍寻种子方剂尝试过，十年没有一个见效。诊得右尺脉神气旺盛，真火本来就不衰弱，只有左尺脉虚弱，是真水干涸了。应当补阴配阳，给予六味地黄丸加元武胶。过了两年，果然得到一个儿子。
万密斋说：曾经见到男子阳痿的，多导致无子，不可不考虑啊。正因为求子心切，容易被庸医迷惑。有的用附子、蛇床子、破故纸作为内补。有的用蟾酥、阿芙蓉作为外助。阳气还没兴起，内热已经产生，阴茎虽然坚硬，像朽木一样无用，以致终身无子，或者有夭折的。我看到这些人无辜受到医药的危害，遍访各方，没有超过这个的，拿出来给人看，名叫壮阳丹。熟地黄四两，巴戟天去心，破故纸炒各二两，仙灵脾一两，桑螵蛸真的盐焙，阳起石[此处原文缺字，推测为煅或研]，另研水飞，各半两。以上六味符合阴数，研末炼蜜丸如梧桐子大。每次三十丸，空心只服一次，温酒送下。不可依赖此药放纵自己，切记。（雄按：使用石药弊端很严重。）
生地四两，熟地四两，天冬四两，麦冬四两，当归二两，枸杞一两，仙灵脾八两，切碎，绢袋盛装，浸在大酒内，隔水煮，从卯时到酉时，取出埋在地下七天，夫妇每天共饮五六杯。妇人月经不准的，就会准并受孕。此方刻在邹南皋仁文书院《集验方》中。吴银台、徐光禄都说往往有效，因此记录下来。（李日章《六砚斋笔记》。雄按：这是集灵膏方。）
吴桥治疗胡翳卿。胡喜欢开玩笑，所以与吴桥熟悉。胡因为长久不宜子，请求壮阳方。吴桥诊脉说：“您的寸脉洪大，尺中沉涩，火炎上而不降，水枯竭而不升，水火不交，这叫未济卦，法度应当滋阴补肾，或许能相互济助相生。如果再用壮阳药，则火更炎而水更涸，咳血呕血，将无法挽救，危险了。”胡大笑说：“我五十岁还能好好吃饭，不像年轻人，有什么病？只是阳痿滑精，希望得到方药壮阳。况且我服用滋阴药，像捧着漏勺一样没效果。”吴桥说：“技术只到这里了。”胡后来遇到年纪大却能生子的国人，得到了壮阳方，到了留都赶紧服用，咳嗽失音，随后咳血，久了肌肉消瘦，大小便频繁动摇，于是派使者迎接吴桥，吴桥推辞来不及。病情深重请假回乡，随即召见吴桥，叹息说：“不听您的话到了这一步。幸好脉不数，声音不哑，骨头不蒸热，血不咳出，只有大便一天三四次罢了。”吴桥说：“不对，不对。如果脉数、声哑、骨蒸、咳血，那么阳火未息，还可以鼓动而行。现在火熄了，即使炉灰也无济于事了。”不久就去世了。
冯楚瞻说：五脏的精华，轮归于肾，所以经上说，五脏盛才能泻，是五脏各有精，随所用而灌注于肾，岂止是肾所藏而已呢？然而精生于血，血少精怎么生？心主血，所以说无子责之于心，头发白责之于肾。因此重视生育的人，不只补肾，尤其宜养心。不但养心，更宜调和五脏，使五脏精气常盛，然后肾家的充溢裕如。如果四脏干燥枯槁不荣，将用什么物质输送归于肾，作为生育的根本呢？所以我制定养心育脾，和肝清肺，滋肾，补营益卫，膏滋丸与八味丸兼服。一补先天之不足，一助后天之发生，将会看到血气日渐增长，子孙繁衍，自然可以必定。方用嫩黄芪四两，蜜水拌炒，同人参补气作为君药；当归身酒拌炒三两，养血宣血，调和营分作为臣药；酸枣仁炒熟捣碎五两，宁心益肝，兼养脾土作为臣药；熟地六两，滋水润燥，与白术同用，则白术补脾气，熟地滋脾阴，也作为臣药；于潜白术，人乳拌透晒干炒黄四两，专补脾元作为臣药；远志肉用甘草浓汁煮去辣水，二两，养心神生脾土，下济肾气，使真精藏固，用作佐药；麦冬同老米炒燥去米三两，保护肺金，以济白术之燥，用作佐药；白芍蜜酒拌炒二两四钱，甘寒入脾，酸敛入肝，既佐当归以和肝营，复佐白术以养脾阴，用作佐药；杜仲酒拌炒三两，接引诸药深达至阴之所，川续断酒拌炒三两，熟地补肾精，杜仲补肾气，续断专调理于骨节筋络之间，用作使药；川牛膝酒拌蒸三两，焙干引诸药强壮下元，用作使药。莲子三斤，清水煮汁三十多碗，去渣入前药，煎取头二汁，去渣熬膏。用人参二两，茯苓、茯神各三两，研细末，和前膏为丸。临睡前白开水送下四钱。
沈尧封说：求子全赖气血充足，虚衰即无子，所以薛立斋说，最重要的地方，在于审察男女尺脉。如果右尺脉细，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。这是遵循《内经》而察脉用方，可以说是善于用药了。但这特指本体虚，而不受胎的情况。如果本体不虚，而不受胎的，必有其他病。缪仲淳主张风冷乘袭子宫，朱丹溪主张冲任伏热；张子和主张胸中实痰；丹溪对于肥胖妇人，主张脂膜塞胞；陈良甫对于二三十年全不产育者，胞中必有积血，主张用荡胞汤。各位贤士论述不同，但都是理之所有，应当察脉辨证施治。荡胞汤在《千金方》中是妇人求子第一方，孙真人非常重视。
雄按：荡胞汤，虽然有深意，但其药太峻烈，不可轻用。
只有保胎神佑丸，善于舒解气郁，缓慢消除积血，不仅是保胎的良药，也是调经易孕的仙丹。每日七丸，频服很有效。我历次使用都有验证，因此附录于此。白茯苓二两，于潜术米泔浸一日，黄土炒香一两，益母草净叶去梗一两，真没药瓦上焙干去油三钱。以上为末，蜜丸桐子大，每服七丸，白滚水下。若胎动，一日可服三五次，不可多服一丸。务必嘱咐。
Background Information:
Book: *Xu Mingyi Leian* (Continued Cases of Famous Physicians)
Author: Wei Zhixiu
Dynasty: Qing
Chapter: Seeking Offspring
Category: Medical Discussion
Jianping Xiaowang's concubines, ladies-in-waiting, and attendants were all beautiful but childless. He selected young, unmarried women from good families to enter the palace, yet still had no offspring. The King asked Chancellor Chu Cheng, "Is there a method to conceive a male child?" Cheng replied, "When men and women unite, their ages must be appropriate. Although a man's essence may flow freely at sixteen, he should not marry until thirty; although a woman's Tian Gui (menstruation) may arrive at fourteen, she should not marry until twenty. Only after both parties' Yin and Yang qi are fully mature and solid should they engage in intercourse. Then, conception will occur, pregnancy will proceed smoothly, and the born child will be robust and long-lived. Now, those young girls whose Tian Gui has just arrived are engaging with men prematurely. Their Yin qi leaks early, damaging them before they are fully developed, and moving them before their vitality is solid. Thus, they fail to conceive upon intercourse, or if pregnant, fail to carry to term, or if they give birth, the child is fragile and short-lived. This is why the King has no children. However, some women bear only daughters, while others bear only sons. If Your Highness could seek out women who have borne many sons and bring them into the palace through matchmakers, there would be a way to have sons." The King said, "Good." Within one year, six boys were born. The principle that Old Yang meets Young Yin, and Old Yin meets Young Yang, is also a method for procreation. (From *Chushi Yishu*.)
Zhu Danxi stated: Obese women who cannot conceive do so because phlegm-dampness (lipid membranes) obstructs the uterus, preventing menstruation. Formulas such as Daotan Tang (Phlegm-Draining Decoction) can be used. Emaciated women who cannot conceive do so because the uterus lacks blood, and essence and qi do not gather. Siwu Tang (Four Substances Decoction) and other blood-nourishing and Yin-nourishing medicines can be used. My niece had a robust constitution and strong Qi, but due to late conception, she took Shenxian Jubao Dan (Immortal Treasure Gathering Pill). She subsequently developed a carbuncle on her back, presenting with critical symptoms. I diagnosed her pulse as scattered, large, and choppy. Urgently, I administered over one hundred doses of Jiajian Siwu Tang (Modified Four Substances Decoction) to tonify her Yin and blood. Fortunately, her thick constitution allowed for easier recovery. For those with thin constitutions, regret would come too late.
Gong Zicai treated Liu Xiaoting, aged forty, who was childless, impotent, and produced semen as cold as ice. Upon consultation, his Cun (inch) pulses on both hands were flooding, while his Chi (cubit) pulses were deep, faint, and powerless. This indicated exhaustion of the True Yuan (Original Qi) due to excessive depletion. Gong prescribed Guben Jianyang Dan (Root-Firming Yang-Strengthening Pill) added with Ren Shen (Ginseng), Fu Zi (Aconite), Gouqi (Goji Berry), and Fupenzi (Raspberry), each two liang. After finishing one dose, the patient felt warmth in the lower Jiao. A second dose was prepared similarly; upon consuming half of it, pregnancy occurred, resulting in the birth of a son. Later, Liu Baiting and Liu Min'an took this prescription and also fathered children.
Wang Shishan treated a woman who was obese with a pale-purple complexion, nearly thirty years old, and struggling to conceive. Her Chi pulses on both sides were deep and faint. According to principles, blood should be tonified. Given her obesity, which indicates Qi deficiency, Qi should also be tonified. He instructed her to take Babawu Tang (Eight Substance Decoction) frequently, along with Buyin Wan (Nourish-Yin Pill) added with Ren Shen (Ginseng) [missing herb], taken on an empty stomach. After more than three months, she became pregnant. Upon re-examination, her Chi pulses remained unchanged. Rationally, pregnancy should present differently. As ancients said, "Pulses cannot be entirely relied upon," likely referring to such cases.
Xue Lizhai treated the wife of the scholar Qian Sixi, who was over thirty and childless, suffering from prolonged, irregular uterine bleeding. They had lived apart for years. Qian wished to take a secondary wife and consulted Xue. Xue reasoned that this was caused by depression and anger injuring the Liver, Spleen deficiency with fire agitation, leading to blood failing to return to its vessels—Liver failing to store blood and Spleen failing to control it. He advised clearing Liver fire and tonifying Spleen Qi, prescribing Jiawei Guipi Tang (Modified Restore the Spleen Decoction) and Xiaoyao San (Free and Easy Wanderer Powder), four doses of each. He delivered them home and informed the mother-in-law that the illness would resolve naturally and conception would follow, negating the need for a secondary wife. Indeed, the illness resolved, and a son was born the following year.
Concubines in the harem who were not jealous bore many sons. In contrast, Prince Jing of Zhongshan, who loved wine and women, had 112 sons. It is said that Quanlu Wan (Whole Deer Pill) was formulated by King Wen of Zhou, and frequent use led to numerous offspring. Did Prince Jing also frequently consume this pill? Why did he have more children than King Wen? (From *Zhangshi Liyan*.)
Feng Chuzhan treated Jin Shaolao, who suffered from persistent morning diarrhea. His Cun and Guan pulses on both hands were deep, weak, and powerless, with Chi pulses even deeper and fainter. Feng said, "Acquiring this pulse pattern in youth not only makes cure difficult but also suggests difficulty in procreation, likely resulting in more daughters than sons." Mr. Xu, who happened to visit, had the same pulse. Both reported having several daughters but no sons. Feng prescribed Bawei Wan (Eight Ingredient Pill) minus Mudanpi (Moutan Cortex) and Zexie (Alisma), adding Buguzhi (Psoralea Fruit, 3 liang), Tusizi (Cuscuta Seed, 4 liang), and Wubeizi (Schisandra Fruit, 2 liang). Taken five qian before meals morning and evening, both later fathered sons. *Jingyao* states: "Long-term use makes one fat, healthy, and fertile." Truly so.
Wu Fuxian treated Cai Xiaolian, aged fifty, who suffered from lack of heirs. After ten years of trying various seed-conceiving prescriptions without success, his Right Chi pulse showed vigorous spirit, indicating the True Fire was not deficient. However, the Left Chi was weak, indicating dryness of True Water. Wu prescribed Liujun Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Yuanwu Jiao (Turtle Shell Glue). Two years later, a son was born.
Wan Mizhai stated: I have often seen men with impotence leading to infertility, which must be considered. Due to urgency in seeking heirs, they are easily misled by mediocre physicians. Some use Fuzi (Aconite), Chuangxi (Cnidium Fruit), and Guozhi (Psoralea) for internal tonification. Others use Chansu (Toad Venom) and Afuyou (Opium) for external aid. Before sexual arousal, internal heat arises; although the penis becomes erect, it remains useless like rotten wood, leading to lifelong infertility or premature death. Seeing these innocent people harmed by medicine, I searched various formulas and found none superior to this one, which I named Zhuangyang Dan (Yang-Strengthening Pill). Shudihuang (Prepared Rehmannia Root, 4 liang), Bajitian (Morinda Root, heart removed, 2 liang), Guozhi (Psoralea, stir-fried, 2 liang), Xianlingpi (Epimedium, 1 liang), Sangpiaoxiao (Mantis Egg Case, genuine, salt-roasted, half liang), and Yangqishi (Calcined Augite, separately ground and water-washed, half liang). These six ingredients correspond to the number of Yin. Grind into powder, refine with honey, and make pills the size of sesame seeds. Take thirty pills on an empty stomach once, with warm wine. Do not rely on this to indulge oneself. Beware. (Xiong's Note: The use of mineral drugs causes severe harm.)
Shengdi (Raw Rehmannia Root, 4 liang), Shudihuang (Prepared Rehmannia Root, 4 liang), Tiandong (Asparagus Tuber, 4 liang), Maidong (Ophiopogon Tuber, 4 liang), Danggui (Angelica Sinensis, 2 liang), Gouqi (Goji Berry, 1 liang), and Xianlingpi (Epimedium, 8 liang) are crushed, placed in a silk bag, soaked in strong wine, and boiled in a double boiler from Mao hour to You hour. Buried underground for seven days, the couple drinks five to six cups daily. Women with irregular menstruation will have regular cycles and conceive. This formula is carved in the *Jiyan Fang* (Collected Effective Prescriptions) of Zou Nangao Renwen Academy. Wu Yintai and Xu Guanglu both claimed it was often effective, so I recorded it. (Li Rizhang, *Liuyan Zhai Biji*. Xiong's Note: This is the Jiling Gao formula.)
Wu Qiao treated Hu Yiqing. Hu enjoyed humor, hence his familiarity with Wu. Hu sought a Yang-strengthening prescription due to prolonged infertility. Wu diagnosed: "Your Cun pulse is flooding, and Chi is deep and choppy. Fire flares upward without descending, Water dries up without ascending. Water and Fire do not interact; this is the Hexagram Wei Ji (Before Completion). The treatment should be to nourish Yin and tonify Kidney. Perhaps then they will assist and generate each other. Using Yang-strengthening methods again will increase Fire and dry Water further, leading to hemoptysis and hematemesis, which will be incurable and dangerous." Hu laughed loudly, saying, "At fifty, I eat well, unlike young men. What illness? I only suffer from impotence and spermatorrhea and wish for medicine to strengthen me. Moreover, taking Yin-nourishing medicines is like holding a leaking vessel—it is useless." Wu said, "My skill ends here." Hu later met an older man from the state who fathered a child, obtained a Yang-strengthening prescription, and eagerly consumed it in the capital. He developed cough and loss of voice, followed by hemoptysis. Eventually, he emaciated and suffered frequent urination/defecation disturbances. He sent for Wu Qiao, who declined to visit due to busyness. When the illness deepened and Wu returned, Hu sighed, "I reached this state by ignoring your advice. Fortunately, my pulse is not rapid, voice is not hoarse, bones do not feel hot, and I do not cough blood; only frequent bowel movements remain." Wu replied, "No, no. If the pulse were rapid, voice hoarse, bones steaming, and blood coughed, the Yang Fire would not have subsided, and it could still be driven. Now it has extinguished; even ashes in the furnace are of no avail." Shortly after, Hu died.
Feng Chuzhan stated: The essence of the Five Viscera rotates to the Kidney. Thus, the Classics say, "Only when the Five Viscera are abundant can they excrete." Each viscera has its own essence, which pours into the Kidney as needed. Is it merely stored by the Kidney? Essence is generated from Blood; if Blood is scant, how can Essence be generated? The Heart governs Blood; thus, infertility is blamed on the Heart, and white hair on the Kidney. Therefore, those valuing procreation should not only tonify the Kidney but especially nourish the Heart. Not only nourish the Heart, but harmonize the Five Viscera, keeping their essence and Qi abundant, so that the Kidney's reservoir is full. If the other four viscera are dry and barren, what substance will transport to the Kidney to serve as the root of lineage? Thus, I formulated Yangxin Yupi (Nourish Heart, Nurture Spleen), He Gan Qing Fei (Harmonize Liver, Clear Lung), Zishen (Nourish Kidney), and Buying Yiwei (Tonify Ying and Wei) pastes and pills, taken concurrently with Bawei Wan. One tonifies congenital insufficiency; the other assists postnatal generation. Blood and Qi will grow daily, and descendants will multiply, which is certain. Formula: Huangqi (Astragalus Root, tender, 4 liang), stir-fried with honey water, combined with Ren Shen (Ginseng) to tonify Qi as Sovereign; Dangguishen (Angelica Sinensis Root Body, 3 liang), stir-fried with wine to nourish and circulate Blood, harmonizing Ying as Minister; Suanzaoren (Ziziphus Seed, roasted and crushed, 5 liang), calms Heart and benefits Liver, simultaneously nourishing Spleen Earth as Minister; Shudihuang (Prepared Rehmannia Root, 6 liang), nourishes Yin and moistens dryness. Combined with Baizhu (Atractylodes Macrocephala), Baizhu tonifies Spleen Qi, and Shudihuang nourishes Spleen Yin, also as Ministers; Yuqian Baizhu (Atractylodes Macrocephala from Yuqian, 4 liang), soaked in human milk, dried, and stir-fried yellow, specifically tonifies Spleen Origin as Minister; Yuanzhi (Polygala Root, 2 liang), boiled in strong Licorice juice to remove pungency, nourishes Heart Spirit and generates Spleen Earth, descends to aid Kidney Qi, securing True Essence, used as Assistant; Maidong (Ophiopogon Tuber, 3 liang), stir-fried with old rice to remove moisture, protects Lung Metal, alleviating Baizhu's dryness, used as Assistant; Baishao (White Peony Root, 2.4 liang), stir-fried with honey and wine. Sweet-cold enters Spleen; sour-astringent enters Liver. It assists Danggui to harmonize Liver Ying and assists Baizhu to nourish Spleen Yin, used as Assistant; Duzhong (Eucommia Bark, 3 liang), stir-fried with wine, guides herbs to the deepest Yin; Chuanxuduan (Dipsacus Root, 3 liang), stir-fried with wine. Shudihuang tonifies Kidney Essence; Duzhong tonifies Kidney Qi; Xuduan regulates joints and sinews, used as Envoy; Chuan Niuxi (Achyranthes Root, 3 liang), steamed with wine, dried, and ground, guides herbs to strengthen the Lower Yuan, used as Envoy. Lianzi (Lotus Seeds, 3 jin) are boiled in clear water to yield over thirty bowls of juice. Filter residue, add previous herbs, decoct to obtain the first and second juices. Filter residue and boil into paste. Add Ren Shen (2 liang), Fuling (Poria, 3 liang), and Fushen (Poria with Hostwood, 3 liang), ground fine, mixed with paste to form pills. Take 4 qian with warm water before sleep.
Shen Yaofeng stated: Conception relies entirely on sufficient Qi and Blood; deficiency leads to infertility. Thus, Xue Lizhai said the crucial point is examining the Chi pulses of men and women. If the Right Chi pulse is fine or hollow and large/powerless, use Bawei Wan (Eight Ingredient Pill); if the Left Chi is flooding and large but powerless upon pressure, use Liujun Wan (Six-Ingredient Pill); if both Chi pulses are minute/fine or floating/large, use Shibu Wan (Ten Tonifying Pill). Following the *Neijing* to diagnose via pulse and prescribe is excellent. However, this specifically addresses constitutional deficiency unable to conceive. If constitution is not deficient but conception fails, there must be another disease. Miao Zhongchun attributes it to Wind-Cold invading the uterus; Zhu Danxi attributes it to latent Heat in Chong and Ren vessels; Zhang Hezi attributes it to Phlegm-Excess in the Chest; Danxi attributes lipid membrane obstruction in obese women; Chen Liangfu attributes accumulated Blood in women sterile for decades, prescribing Dangbao Tang (Uterus-Cleansing Decoction). Although theories differ, they are all logically sound. One must examine pulses and differentiate syndromes for treatment. Dangbao Tang is the premier formula for seeking offspring in *Qianjin Fang*, highly valued by Sun Simiao.
Xiong's Note: Dangbao Tang has profound intent, but its herbs are too harsh; it should not be used lightly.
Baotai Shenyao Wan (Fetus-Preserving Divine Blessing Pill) is good at resolving Qi Stagnation and slowly eliminating Blood Stasis. It is not only an excellent fetal-preserving drug but also a fairy elixir for regulating menstruation and facilitating conception. Take seven pills daily; frequent administration is very effective. I have verified its efficacy repeatedly and append it here. Baifuling (Poria, 2 liang), Yuqian Baizhu (Atractylodes Macrocephala, soaked in rice wash for one day, fried in yellow soil until fragrant, 1 liang), Yimucao (Motherwort Leaf, clean, stems removed, 1 liang), and Zhen Moyao (True Myrrh, baked on tile to remove oil, 3 qian). Grind into powder, make pills the size of sesame seeds with honey. Take seven pills with boiling water. If fetal movement occurs, take three to five times a day; do not exceed one extra pill. Strictly adhere to this.