胡氏(孝)曰∶男女交 ,其所以凝结而成胎者,虽不离乎精血,犹为后天滓质之物,而
一点先天真一之灵气,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,因人无子,语男则主于精,语女则主于血。着
论立方,男以补肾为要,女以调经为先,而又参之以补气行气之说。察其脉络,究其亏
盈,审而治之,夫然后一举可孕。天下之男无不父,女无不母矣。
〔诊脉〕
陈楚良曰∶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
有十二经,应十二时,一日一周,与天同运,循环无端。其至也即不宜太过而数,数则热
矣。又不宜不及而迟,迟则寒矣;不宜太有力而实,实非正气能自实也,正气虚而火邪
来乘以实之也。治法先当散郁以伐其邪,邪去而后正可补也。不宜太无力而虚,虚乃正
气正血虚也,治法惟当补其气血耳。亦有男妇上热下寒,表实里虚而未得子者,法当临
睡时服凉膈之药以清其上,每晨食未入口时,服补药以温其下,暂进升散之药以达其表,久
服浓味之药以实其里。又有女人气多血少,寒热不调,月水违期,或后或先,白带频下而
无子者,皆当诊脉而以活法治之,务欲使其夫妇之脉皆和平有力,不热不寒,交合有期,
不妄用精,必能生子,子不殇妖。故欲得子者,必须对脉立方,因病用药。
〔仲〕男子脉浮弱而涩,为无子,精气清冷。
〔脉〕妇人少腹冷恶寒久,年少者得之,此为无子,年大者得之绝产。脉微弱而涩,年
少得此为无子,中年得此为绝产。肥人脉细,胞有寒,故令少子。其色黄者,胸上有寒。少
阴脉浮而紧,紧则疝瘕,腹中痛,半产而堕伤;浮则亡血,绝产恶寒。
〔调经〕
〔娄〕胎前之道,始于求子。求子之法,莫先调经。每见妇人之无子者,其经必或前
或后,或多或少,或将行作痛,或行后作痛,或紫或黑或淡,或凝而不调,不调则血气乖
争,不能成孕矣,详夫不调之由,其或前或后,及行后作痛者虚也。其少而淡者血虚也,
多者气虚也。其将行作痛及凝块不散者,滞也。紫黑色者,滞而挟热也。治法∶血虚者
四物,气虚者四物加参、 。滞者香附、缩砂、木香、槟榔、桃仁、玄胡。滞久而沉痼
者,吐之下之。脉证热者,四物加芩、连。脉证寒者,四物加桂、附及紫石英之类是也。直
至积去、滞行、虚回,然后血气和平,能孕子也。予每治经不调者,只一味香附末,醋
为丸服之,亦百发百中也。《素问》云∶督脉生病,女子不孕。
妇人经事不调,即非受孕光景,纵使受之,亦不全美,宜服加味六味地黄丸。
熟地黄(四两) 山茱萸肉 山药(各二两) 牡丹皮白茯苓(各一两五钱) 泽泻
香附米(童便浸三次,炒,各一两) 蕲艾叶(去筋醋煮,五钱)
上为末,炼蜜丸如梧子大。每服七十丸,白沸汤送下。随后证作汤使,或另作煎剂服。
经水过期者,乃血虚也,宜四物汤加参、 ,陈皮、白术服之。若肥白人是痰多,宜
二陈加南星、苍术、滑石、芎、归、香附之类。经水不及期者,血热也,四物加芩、连。
肥人亦兼痰治,色紫黑者同血热论。经将行而作疼者,气滞也,用归身、尾、香附米及
桃仁、红花、黄连以行之,或加四物、莪术、玄胡索、木香。热加黄芩、柴胡。经行后作
疼者,血气虚也,八物汤。
〔丹〕妇人肥盛者多不能孕育,以身中有脂膜闭塞子宫,以致经事不行。瘦弱妇人
不能孕育,以子宫无血,精气不聚故也。肥人无子,宜先用调理药。
当归(一两,酒洗) 茯苓(二两) 川芎(七钱半) 白芍药 白术 半夏(汤洗) 香附米
陈皮 甘草(各一两)
作十帖,每帖姜三片,水煎吞后丸子。
白术(二两) 半夏曲 川芎 香附米(各一两) 神曲(炒) 茯苓(各半两) 橘红(四钱)
甘草(二钱,以上并为末)
粥丸,每服八十丸。如热多者加黄连、枳实(各一两)服前药讫,却服后螽斯丸。
附子 茯苓(各六钱) 浓朴 杜仲 桂心 秦艽 白薇 半夏 干姜 牛膝 沙参(各二钱)
人参(四钱) 细辛(五钱)
上为末,炼蜜和丸小豆大。每服五丸,空心酒下,加至十丸不妨。觉有娠,三月后不
可更服。忌食牛马肉。则难产当出月。
按∶此方即秦桂丸也。丹溪忌服之者,盖忌于瘦人无血者,若肥人湿多者,又兼前调
理药,而所服丸数十减其九,只服五分无妨也。上三方得之于丹溪之子朱懋诚者,累试
有效。
抑气散 治妇人气盛于血,所以无子。寻常头眩晕,膈满体疼怔忡,皆可服。
香附子(炒净,二两) 陈皮(焙,二两) 茯神 甘草(炙,各一两)
上为细末,每服二三钱,不拘时,白汤调下。
〔海〕大五补丸
天门冬 麦门冬(去心) 菖蒲 茯苓 人参 益智 枸杞子 地骨皮 远志肉
熟地黄(各等分)
上为细末,炼蜜丸如桐子大。空心酒下三十丸。服本方数服后,以七宣丸泄之。
增损三才丸
天门冬(酒浸,去心) 熟地黄(酒蒸) 人参(去芦) 远志(去骨) 五味子
茯苓(酒浸) 鹿角(酥炙)
一法加白马茎(酥炙。)一法加麦门冬,令人有力。一法加续断以续筋骨。
一法加沉香,暖下焦虚冷。
上为细末,炼蜜和杵千下,丸如桐子大。每服五十丸,空心好酒下。年老欲补,加混
元衣全个入药。(混元衣者是胎衣,头生儿者方佳,用酒浸晒干,细锉为末。)
紫石门冬丸 (又名紫石英丸)
紫石英 钟乳石(鹅管通明者,二味各七日研之,得上浮即熟) 天门冬(以上各三两)
当归 芎 紫葳 卷柏 肉桂 干地黄 牡蒙 禹余粮( ,醋淬) 石斛
辛夷(以上各二两) 人参 桑寄生 续断 细辛 浓朴(姜制) 干姜 食茱萸 艾叶
白薇 薯蓣 乌贼骨 甘草(炙,以上各一两半) 柏子仁(一两)
上件捣罗为末,炼蜜丸如梧桐子大。酒服十丸,三日渐增至三十丸,以腹中热为度。
不禁房室,夫行不在不可服,禁如药法。比来服者不至尽剂,即有娠。
此方旧用乌头、牡丹、牛膝,据药证此三物俱堕胎,求子药中用之,盖胎未着之时。
若服之已着,已着而未觉,服之未已,反为害也。今悉去之,增钟乳、艾叶、白薇,兹
无疑矣。
白薇丸 治妇人无子或断绪,上热下冷,百病皆主之。
白薇 熟干地黄 川椒(去目及闭口者,微炒出汗) 白龙骨(以上各一两)
麦门冬(去心焙,一两半) 本 卷柏 白芷 覆盆子 桃仁(汤浸去皮尖双仁,麸炒微黄)
人参 桂心 菖蒲 白茯苓 远志(去心,以上各七钱半) 车前子 当归(锉,微炒)
芎 蛇床子 细辛 干
姜(炮制,各半两)
上件药杵罗为末,炼蜜为丸梧子大。每服三十丸,空心日午以温酒下三十丸。予之
故友江君雅,曾仲容俱无嗣,因以此方赠之,逾年而皆有子。后有艾君肃,黄翰公者亦然,
故述之。
赵氏苁蓉菟丝子丸
肉苁蓉(一两三钱) 覆盆子 蛇床子 川芎 当归 菟丝子(各一两二钱)
白芍药(一两) 牡蛎(盐泥固济 ) 乌贼鱼骨(各八钱) 五味子 防风(各六钱) 条苓(五钱)
艾叶(三钱)
此方不寒不热,助阴生子。前药俱焙干为末,炼蜜丸如桐子。每服三四十丸,清盐
汤下,早晚皆可服。
加味香附丸 男服聚精丸,女服此。
香附(一斤四两,老酒浸两宿,炒,捣碎,再焙干磨为末。四两米醋浸,同上。四两童便
浸,同上。四两用山栀四两,煎浓汁,去渣,入香附浸,同上。) 泽兰(净叶六两,酒洗)
海螵蛸(六两,捣稍碎,炒) 当归(四两,酒洗) 川芎(三两) 白芍药(四两,酒炒)
怀熟地(八两,捣膏焙干)
各为末,用浮小麦粉,酒醋水打糊为丸如绿豆大。每日早晚服两次,忌食莱菔及牛
肉、生冷。
调经丸
香附(半斤,童便、酒、醋各浸一分,生一分,俱酒炒) 川杜仲(姜汁炒,半斤)
大川芎 白芍药 当归(去尾) 怀生地 广陈皮 小茴香(酒炒) 延胡索(略炒) 肉苁蓉(酒浸)
旧青皮(麸炒) 台乌药(炒) 枯黄芩(酒炒) 乌贼鱼骨(酥炙,以上各四两)
上十四味足秤,真正好料醋和面打糊为丸如梧桐子大。每服百丸,空心好酒送下。一方无陈皮、
地黄,有人参、黄 各二两。
正元丹 调经种子。
香附(一斤,同艾三两,先以醋同浸一宿,然后分开制之,酒、盐、酥、童便各制四两)
阿胶(蛤粉炒,二两) 枳壳(四两,半生用,半麸炒) 怀生地(酒洗) 熟地(酒浸)
当归身(酒洗) 川芎(炒,各四两) 白芍药(八两,半生,半酒炒) 加白茯苓、琥珀治带。
末之,醋糊丸如桐子大。空心盐汤吞五六十丸。
〔子和〕戴人过谯都营中饮,会有一卒说出妻事。戴人问其故,答曰∶吾妇为室女
时,心下有冷积如覆盆,按之如水声,以热手熨之如冰,娶来已十五年矣,恐断吾嗣,是
以去之。戴人曰∶公勿黜也,如用吾药,病可除,孕可得。卒从之。戴人诊其脉,寸脉
沉而迟,尺脉洪大有力,非无子之候也,可不逾年而孕。其良人叹曰∶试之。先以三圣
散吐涎一斗,心下平软,次服白术调中汤、五苓散,后以四物汤和之,不再月,气血合度,
数月而娠一子。戴人常曰∶用吾此法,无不子之妇。此言不诬。一妇人年三十四岁,梦
与鬼神交,惊怕异常,及见神堂、阴司、舟楫、桥梁,如此一十五年,竟无妊娠,巫祈
觋祷,无所不至,钻肌炙肉,孔穴万千,黄瘦发热引饮,中满足肿,委命于天。一日苦
请戴人,戴人曰∶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。
〔大〕荡胞汤 治妇人立身以来,全不产育,及断绝久不产三十年者宜服。
朴硝 牡丹皮 当归 大黄(蒸一饭久) 桃仁(去皮尖,各三两) 细辛 浓朴(姜汁炙)
桔梗 赤芍药 人参 茯苓 桂心 甘草 牛膝(去苗) 陈橘皮(以上各二两)
附子(炮,一两半) 虻虫(去翅足,炒焦) 水蛭(炒枯,各十枚)
上件以清酒五升,水六合,煮取三升,分四服,日三夜一,每相去三辰,少时更服。如
常覆被少时取汗,汗不出,冬月着火笼,必下积血及冷赤脓如赤小豆汁,本为妇人子宫
内有此恶物冷然。或天阴脐下痛,或月水不调,为有冷血不受胎。若斟酌下尽,气久弱
大困不堪,更服亦可,二三服即止。如大闷不堪,可食酢饮冷浆一口即止。然恐去恶物
不尽,不大得药力,若能忍服尽大好,一日后仍着坐导药。
坐导药 治全不产及断绪,服前荡胞汤恶物不尽,用此方。
皂角(去皮子) 吴茱萸 当归(各二两) 细辛(去苗) 五味子 干姜(炮,各一两)
黄葵花 白矾(枯) 戎盐 蜀椒(各半两)
上为细末,以绢袋大如指,长三寸余,盛药令满,缚定,纳妇人阴中,坐卧任意,勿
行走,小便时去之,更安。一日一度易新者,必下清黄冷汁,汁尽止。若未见病出,可十
日安之。本为子宫有冷恶物,故令无子,值天阴冷则发疼痛,须候病出尽方已,不可中
辍,每日早晚用 菜煎汤薰之。
〔丹〕秦桂丸论 无子之因,多起于妇人,医者不求其因起于何处,遍阅古方,惟
秦桂丸,其辞确,其意专,用温热药近乎人情,欣然受之,锐然服之,甘受燔灼之祸,犹
懵然不悔。何者?阳精之施,阴血能摄之,精成其子,血成其胞,胎孕乃成。今妇人之无
子者,率由血少不足以摄精也。血之少也,固非一端,然欲得子者,必须调补阴血,使无
亏欠,乃可推其有余以成胎孕,何乃轻用热剂,煎熬脏腑,血气沸腾,祸不旋踵矣。或
曰∶春气温和则万物发生,冬气寒凛则万物消陨,非秦桂丸之温热,何以得子脏温暖而
成胎耶?予曰∶诗曰∶妇人和平,则乐有子。和则血气均,平则阴阳不争。今得此药,经
血必转紫黑,渐成衰少,或先或后,始则饮食骤进,久则口苦而干,阴阳不平,血气不
和,疾病蜂起,焉能成胎,纵然成胎,生子亦多病而不寿,以秦桂丸耗损天真之阴也。戒
之慎之。按∶秦桂丸施于肥人而少其丸数,兼服调理补药亦无妨,但忌施于瘦人火多者也。
〔东〕妇人无子,胞门。(在关内左边二寸,灸五十壮。)又法∶气门。(在关元
傍各开三寸,灸五十壮。)
〔集〕又法∶子宫(在中极傍各开三寸,针入二寸,灸三七壮。)中极
〔垣〕又法∶(关元二十壮,三报穴。)
〔甲〕绝子,灸脐中,令人有子。女子手脚拘挛,腹满疝,月水不下,乳余疾,绝
子,阴痒,阴交主之。腹满疝,积聚余疾,绝子,阴痒,刺石门。(《千金》云∶奔豚上少腹坚
胡氏(胡孝)说:男女交合,其所以凝结而成胎的,虽然离不开精血,但终究是后天形成的有形质之物。而一点先天的真一灵气,萌发于情欲之感之中,奇妙地融合在精血之间,这就是朱熹所说的“禀赋于生命之初”,《悟真篇》所说的“生身受气之初”的情形。高明的医生,针对夫妻无子的情况,对男性主要着眼于精,对女性主要着眼于血。撰写论著、制定方药时,治疗男性以补肾为关键,治疗女性以调经为先务,同时又参酌补气、行气的理论。观察患者的脉络,探究气血的盈亏,审慎地进行治疗,这样之后才能一举受孕。天下的男子没有不能做父亲的,女子没有不能做母亲的。
〔诊脉〕
陈楚良说:人身的气血,各有虚实寒热的不同,只有诊察脉象才能知晓,舍弃脉象而单独谈论用药是荒谬的。脉象对应十二经脉,应合十二时辰,一天循环一周,与天体运行同步,循环往复没有尽头。脉象到来时,既不宜过快而数急,数急则主热;也不宜过慢而迟缓,迟缓则主寒;不宜过于有力而实,所谓“实”并非正气充足而自实,而是正气虚弱,火邪乘虚侵袭而表现为实证。治疗方法应当先疏散郁结以祛除邪气,邪气去除后正气才可补益。不宜过于无力而虚,所谓“虚”乃是正气和正血亏虚,治疗方法只应当补益气血罢了。也有男女上热下寒、表实里虚而不能受孕的,治法应当在临睡前服用凉膈散之类的药物以清泄上部之热,每天早晨进食前,服用补药以温养下部,暂时进用升散的药物以通达肌表,长期服用滋味浓厚的药物以充实里部。又有女人气多血少,寒热不调,月经周期紊乱,或提前或推后,白带频下而不能受孕的,都应当诊察脉象而以灵活的方法治疗,务必使夫妇双方的脉象都平和有力,不热不寒,交合有定时,不妄泄精气,必定能生子,且孩子不会夭折或畸形怪异。所以想要得子的人,必须根据脉象制定方药,因病用药。
〔脉象〕妇人少腹寒冷、恶寒日久,年轻女性出现这种情况,这是无子的征兆;年长女性出现这种情况则是绝产。脉象微弱而涩,年轻女性出现这是无子,中年女性出现这是绝产。肥胖女性脉象细,说明胞宫有寒,所以导致子女稀少。面色发黄,说明胸中有寒。少阴脉浮而紧,紧脉主疝瘕,腹痛,半产及堕胎损伤;浮脉主亡血,绝产及恶寒。
〔调经〕
〔娄全善〕孕育之道,始于求子。求子的方法,没有比调经更优先的了。常见到妇女无子的,她们的月经必定或提前或推后,或量少或多量,或在行经前作痛,或在行经后作痛,颜色或紫或黑或淡,或凝滞而不调。不调则血气乖争,不能成孕了。详细考察不调的原因,那些月经或提前或推后,以及行经后作痛的,属于虚证。量少色淡的是血虚,量多的是气虚。行经前作痛及有凝块不散的,属于气滞。颜色紫黑的,是气滞兼夹热邪。治疗方法:血虚的用四物汤,气虚的用四物汤加人参、黄芪。气滞的用香附、缩砂仁、木香、槟榔、桃仁、玄胡索。气滞久而成为沉痼疾病的,用吐法或下法。脉证属热的,四物汤加黄芩、黄连。脉证属寒的,四物汤加肉桂、附子及紫石英之类。直到积滞去除、气滞通行、虚损恢复,然后血气和平,能够受孕了。我每次治疗月经不调者,只用一味香附末,醋糊为丸服用,也百发百中。《素问》说:督脉生病,女子不孕。
妇人月经不调,就不是受孕的状态,即使受孕,胎儿也不健全完美,适宜服用加味六味地黄丸。
熟地黄(四两) 山茱萸肉 山药(各二两) 牡丹皮 白茯苓(各一两五钱) 泽泻 香附米(童便浸三次,炒,各一两) 蕲艾叶(去筋醋煮,五钱)
以上研为细末,炼蜜为丸如梧桐子大。每服七十丸,白开水送下。随后根据症状煎汤送服,或另作煎剂服用。
月经过期不来的,是血虚,适宜四物汤加人参、黄芪,陈皮、白术服用。如果是形体肥白之人,多是痰多,适宜二陈汤加南星、苍术、滑石、川芎、当归、香附之类。月经提前来的,是血热,四物汤加黄芩、黄连。肥人也要兼治痰,颜色紫黑的按血热论治。月经将要来时作痛的,是气滞,用当归身、当归尾、香附米及桃仁、红花、黄连以行气活血,或者加四物汤、莪术、玄胡索、木香。热象明显的加黄芩、柴胡。月经结束后作痛的,是血气虚,用八物汤。
〔朱丹溪〕妇人身体肥胖壮盛的多不能孕育,因为体内有脂膜闭塞子宫,以致月经不行。瘦弱的妇人不能孕育,是因为子宫无血,精气不聚的缘故。肥胖人无子,适宜先用调理药。
当归(一两,酒洗) 茯苓(二两) 川芎(七钱半) 白芍药 白术 半夏(汤洗) 香附米 陈皮 甘草(各一两)
制成十帖,每帖加生姜三片,水煎,吞服后面的丸子。
白术(二两) 半夏曲 川芎 香附米(各一两) 神曲(炒) 茯苓(各半两) 橘红(四钱) 甘草(二钱,以上均研为细末)
粥糊为丸,每服八十丸。如果热象多的加黄连、枳实(各一两)。服用前面的药完后,再服用后面的螽斯丸。
附子 茯苓(各六钱) 浓朴 杜仲 桂心 秦艽 白薇 半夏 干姜 牛膝 沙参(各二钱) 人参(四钱) 细辛(五钱)
以上研为细末,炼蜜和丸如小豆大。每服五丸,空腹酒送下,加至十丸也无妨。感觉怀孕后,三个月后不可再服。忌食牛马肉。这样难产会在产后一个月解决。
按语:此方即秦桂丸。丹溪忌讳服用它,大概是忌讳用于瘦人无血的人,如果是肥胖人多湿的人,又兼服前面的调理药,并且将所服的丸药数量减少十分之九,只服五分也无妨。以上三方是从丹溪的儿子朱懋诚处得到的,多次试验有效。
抑气散 治疗妇人气盛于血,所以无子。寻常头眩晕,膈满体疼怔忡,都可以服用。
香附子(炒净,二两) 陈皮(焙,二两) 茯神 甘草(炙,各一两)
以上研为细末,每服二三钱,不拘时间,白开水调下。
〔海藏〕大五补丸
天门冬 麦门冬(去心) 菖蒲 茯苓 人参 益智 枸杞子 地骨皮 远志肉 熟地黄(各等分)
以上研为细末,炼蜜丸如桐子大。空腹酒送下三十丸。服用本方几服后,以七宣丸泄之。
增损三才丸
天门冬(酒浸,去心) 熟地黄(酒蒸) 人参(去芦) 远志(去骨) 五味子 茯苓(酒浸) 鹿角(酥炙)
一种方法加白马茎(酥炙)。一种方法加麦门冬,使人有力。一种方法加续断以续筋骨。一种方法加沉香,暖下焦虚冷。
以上研为细末,炼蜜和杵千下,丸如桐子大。每服五十丸,空腹好酒送下。年老想要进补,加混元衣全个入药。(混元衣即是胎衣,头生儿者的为佳,用酒浸晒干,细锉为末。)
紫石门冬丸 (又名紫石英丸)
紫石英 钟乳石(鹅管通明者,这两味各研七日,得上浮即为成熟) 天门冬(以上各三两) 当归 川芎 紫葳 卷柏 肉桂 干地黄 牡蒙 禹余粮(煅,醋淬) 石斛 辛夷(以上各二两) 人参 桑寄生 续断 细辛 浓朴(姜制) 干姜 食茱萸 艾叶 白薇 薯蓣 乌贼骨 甘草(炙,以上各一两半) 柏子仁(一两)
以上捣罗为末,炼蜜丸如梧桐子大。酒服十丸,三天逐渐增至三十丸,以腹中发热为度。不禁房事,丈夫出行不在家时不可服,禁忌同药法。近来服用者未到尽剂,就有妊娠。
此方旧时用乌头、牡丹、牛膝,据药证这三物都堕胎,求子药中使用它们,大概是在胎未着床之时。如果服药时胎已着床,已着床而未察觉,继续服用,反而有害。现在全部去掉,增加钟乳、艾叶、白薇,这就没有疑问了。
白薇丸 治疗妇人无子或断绝子嗣,上热下冷,百病皆主治。
白薇 熟干地黄 川椒(去目及闭口者,微炒出汗) 白龙骨(以上各一两) 麦门冬(去心焙,一两半) 藁本 卷柏 白芷 覆盆子 桃仁(汤浸去皮尖双仁,麸炒微黄) 人参 桂心 菖蒲 白茯苓 远志(去心,以上各七钱半) 车前子 当归(锉,微炒) 川芎 蛇床子 细辛 干姜(炮制,各半两)
以上药杵罗为末,炼蜜为丸梧子大。每服三十丸,空腹日午以温酒送下三十丸。我的故友江君雅、曾仲容都没有后代,因此将此方赠给他们,过了一年都有儿子。后来艾君肃、黄翰公也是这样,所以记述此事。
赵氏苁蓉菟丝子丸
肉苁蓉(一两三钱) 覆盆子 蛇床子 川芎 当归 菟丝子(各一两二钱) 白芍药(一两) 牡蛎(盐泥固济煅) 乌贼鱼骨(各八钱) 五味子 防风(各六钱) 条苓(五钱) 艾叶(三钱)
此方不寒不热,助阴生子。前面的药都焙干为末,炼蜜丸如桐子大。每服三四十丸,清盐汤送下,早晚皆可服。
加味香附丸 男服聚精丸,女服此方。
香附(一斤四两,老酒浸两宿,炒,捣碎,再焙干磨为末。四两米醋浸,同上。四两童便浸,同上。四两用山栀四两,煎浓汁,去渣,入香附浸,同上。) 泽兰(净叶六两,酒洗) 海螵蛸(六两,捣稍碎,炒) 当归(四两,酒洗) 川芎(三两) 白芍药(四两,酒炒) 怀熟地(八两,捣膏焙干)
各为末,用浮小麦粉,酒醋水打糊为丸如绿豆大。每日早晚服两次,忌食莱菔及牛肉、生冷。
调经丸
香附(半斤,童便、酒、醋各浸一分,生一分,俱酒炒) 川杜仲(姜汁炒,半斤) 大川芎 白芍药 当归(去尾) 怀生地 广陈皮 小茴香(酒炒) 延胡索(略炒) 肉苁蓉(酒浸) 旧青皮(麸炒) 台乌药(炒) 枯黄芩(酒炒) 乌贼鱼骨(酥炙,以上各四两)
以上十四味足秤,真正好料醋和面打糊为丸如梧桐子大。每服百丸,空腹好酒送下。一方无陈皮、地黄,有人参、黄芪各二两。
正元丹 调经种子。
香附(一斤,同艾三两,先以醋同浸一宿,然后分开制之,酒、盐、酥、童便各制四两) 阿胶(蛤粉炒,二两) 枳壳(四两,半生用,半麸炒) 怀生地(酒洗) 熟地(酒浸) 当归身(酒洗) 川芎(炒,各四两) 白芍药(八两,半生,半酒炒) 加白茯苓、琥珀治带。
研为末,醋糊丸如桐子大。空腹盐汤吞五六十丸。
〔张子和〕戴人经过谯都军营中饮酒,遇到一个士兵说出休妻的事。戴人问他原因,回答说:我的妻子在做闺女时,心下有冷积像倒扣的盆,按压时有水声,用热手抚摸像冰一样,娶来已经十五年了,恐怕断了我的后代,所以休了她。戴人说:您不要休弃她,如果用我的药,病可除,孕可得。士兵听从了他。戴人诊察她的脉,寸脉沉而迟,尺脉洪大有力,不是无子的征候,可以不逾年而孕。她的丈夫叹息说:试一试吧。先用三圣散吐涎一斗,心下平软,接着服白术调中汤、五苓散,后用四物汤调和,不到一个月,气血合度,几个月后怀孕生一子。戴人常说:用我的这种方法,没有不能生育的妇人。这话不虚假。有一个妇人年三十四岁,梦见与鬼神交合,惊怕异常,以及见到神堂、阴司、舟楫、桥梁,如此十五年,竟然没有妊娠,巫祈觋祷,无所不至,钻肌炙肉,孔穴万千,黄瘦发热引饮,中充满肿,委命于天。一天苦苦请求戴人,戴人说:阳火盛于上,阴水盛于下。见鬼神者是阴之灵,神堂者是阴之所,舟楫、桥梁是水之用。两手寸脉皆沉而伏,知道胸中有实痰。凡三次涌吐,三次泄下,三次发汗,不到十天就没有梦,一个月就怀孕了。
〔大方〕荡胞汤 治疗妇人立身以来,全不产育,及断绝久不产三十年者适宜服用。
朴硝 牡丹皮 当归 大黄(蒸一饭久) 桃仁(去皮尖,各三两) 细辛 浓朴(姜汁炙) 桔梗 赤芍药 人参 茯苓 桂心 甘草 牛膝(去苗) 陈橘皮(以上各二两) 附子(炮,一两半) 虻虫(去翅足,炒焦) 水蛭(炒枯,各十枚)
以上用清酒五升,水六合,煮取三升,分四次服用,日三夜一,每次间隔三个时辰,稍后再服。如果像平常那样盖被稍时取汗,汗不出,冬天用火笼取暖,必定会排出积血及冷赤脓如赤小豆汁,本来是因为妇人子宫内有此恶物冷积。或者天阴脐下痛,或者月经不调,是有冷血不受胎。如果斟酌排尽,气久弱大困不堪,再服也可以,二三服即止。如果大闷不堪,可以吃醋饮冷浆一口即止。然而恐怕去恶物不尽,不大得药力,如果能忍服尽大好,一日后仍坐导药。
坐导药 治疗全不产及断绪,服用前面荡胞汤恶物不尽,用此方。
皂角(去皮子) 吴茱萸 当归(各二两) 细辛(去苗) 五味子 干姜(炮,各一两) 黄葵花 白矾(枯) 戎盐 蜀椒(各半两)
以上研为细末,以绢袋大如指,长三寸余,盛药令满,缚定,纳入妇人阴中,坐卧任意,勿行走,小便时去之,更安。一日一度换新的,必定会下清黄冷汁,汁尽停止。如果未见病出,可以十日安之。本来是因为子宫有冷恶物,所以令无子,值天阴冷则发疼痛,须候病出尽方已,不可中途停止,每日早晚用萝卜菜煎汤熏之。
〔丹溪〕秦桂丸论 无子的原因,多起于妇人,医者不求其原因起于何处,遍阅古方,只有秦桂丸,其辞确切,其意专一,使用温热药近乎人情,欣然接受,锐然服用,甘愿遭受燔灼之祸,仍然懵懂不悔。为什么呢?阳精施予,阴血能摄受它,精形成子,血形成胞,胎孕乃成。现在妇人无子的,大都由于血少不足以摄精。血的少,固然不止一端,然而想要得子的人,必须调补阴血,使其无亏欠,才可以推其有余以成胎孕,怎么可以轻用热剂,煎熬脏腑,血气沸腾,祸患随即而至呢?有人说:春气温和则万物发生,冬气寒凛则万物消陨,不是秦桂丸的温热,怎么能得子脏温暖而成胎呢?我说:诗说:妇人和平,则乐有子。和则血气均,平则阴阳不争。现在得到此药,经血必转紫黑,渐渐衰少,或先或后,开始饮食骤进,久了口苦而干,阴阳不平,血气不和,疾病蜂起,怎么能成胎,纵然成胎,生子也多病而不寿,因为秦桂丸耗损天真之阴啊。戒之慎之。按语:秦桂丸施用于肥人而减少其丸数,兼服调理补药也无妨,但忌讳施用于瘦人火多者也。
〔东垣〕妇人无子,胞门。(在关内左边二寸,灸五十壮。)又法:气门。(在关元旁各开三寸,灸五十壮。)
〔集验〕又法:子宫(在中极旁各开三寸,针入二寸,灸三七壮。)中极
〔垣〕又法:(关元二十壮,三报穴。)
〔甲乙经〕绝子,灸脐中,令人有子。女子手脚拘挛,腹满疝,月水不下,乳余疾,绝子,阴痒,阴交主之。腹满疝,积聚余疾,绝子,阴痒,刺石门。(《千金》云:奔豚上少腹坚
Hu (Xiao) stated: In the intercourse between man and woman, although the condensation into a fetus relies on essence and blood, these are ultimately postnatal material substances. However, a spark of pre-natal true one spiritual energy,萌 (sprouting/arising) from the sensation of desire, wondrously merges within them. This is what Zhu Xi referred to as "endowed at the beginning of life," and what the *Wuzhen Pian* (Awakening to Reality) describes as the "beginning of receiving life and qi." The superior physician, addressing infertility in couples, focuses on essence for men and blood for women. When writing treatises and prescribing formulas, treatment for men prioritizes tonifying the Kidney, while treatment for women prioritizes regulating menstruation, supplemented by theories of tonifying Qi and promoting Qi circulation. By observing the pulse and meridians, investigating deficiencies and excesses, and treating with prudence, pregnancy can be achieved in one attempt. Thus, no man in the world will be unable to be a father, nor any woman unable to be a mother.
[Diagnosis of Pulse]
Chen Chuliang stated: Human Qi and Blood vary in deficiency, excess, cold, and heat; only by examining the pulse can this be known. To discard the pulse and speak solely of herbs is absurd. The pulses correspond to the twelve meridians and twelve double-hours, completing one cycle daily, moving in harmony with Heaven, circulating endlessly. When the pulse arrives, it should not be too rapid and frequent (*Shu*), as frequency indicates Heat. It should not be too slow and delayed (*Chi*), as slowness indicates Cold. It should not be too forceful and Excess (*Shi*); "Excess" does not mean healthy Qi is naturally robust, but rather that Healthy Qi is deficient and Fire Pathogen has invaded to create an Excess pattern. The treatment method should first dissipate stagnation to eliminate the pathogen; only after the pathogen is gone can Healthy Qi be tonified. It should not be too weak and Deficient (*Xu*); "Deficiency" means Healthy Qi and Blood are depleted, so the treatment method is solely to tonify Qi and Blood. There are also cases of men and women with Upper Heat and Lower Cold, Exterior Excess and Interior Deficiency who cannot conceive. The method is to take cooling medications like *Liangge San* before sleep to clear Upper Heat, and take tonifying medications every morning before eating to warm the Lower part. Temporarily use ascending and dispersing medications to reach the Exterior, and long-term use of rich-flavored medications to solidify the Interior. Furthermore, for women with abundant Qi and scanty Blood, irregular cold and heat, menstrual cycles arriving early or late, and frequent leukorrhea leading to infertility, all must be diagnosed by pulse and treated with flexible methods. The goal is to ensure both husband and wife have harmonious and forceful pulses, neither hot nor cold, with timed intercourse and no reckless ejaculation, ensuring they can bear children who will not die young or be deformed. Therefore, those seeking offspring must prescribe formulas based on the pulse and medicate according to the disease.
[Zhang Zhongjing] A man's pulse floating, weak, and choppy indicates infertility, signifying clear and cold essence and Qi.
[Pulse] If a woman suffers from coldness and aversion to cold in the lower abdomen for a long time, in a young woman this indicates infertility; in an older woman, it indicates sterility. A faint and choppy pulse in a young woman indicates infertility; in a middle-aged woman, it indicates sterility. A thin pulse in an obese woman indicates Cold in the Uterus, hence few children. Yellowish complexion indicates Cold in the Chest. A Floating and Tight pulse in the Shaoyin position: Tight indicates hernia and masses, abdominal pain, miscarriage and abortion injuries; Floating indicates loss of Blood, sterility, and aversion to cold.
[Regulating Menstruation]
[Lou Quanshan] The way to conception begins with seeking offspring. The method for seeking offspring prioritizes regulating menstruation above all else. I often see women who cannot conceive have menstrual cycles that are either early or late, scanty or profuse, painful before menstruation, or painful after menstruation, with color varying from purple to black to pale, or coagulated and irregular. Irregularity causes a conflict between Blood and Qi, preventing conception. Examining the causes of irregularity: early/late cycles and post-menstrual pain indicate Deficiency. Scanty and pale flow indicates Blood Deficiency; profuse flow indicates Qi Deficiency. Pain before menstruation and undissipated clumps indicate Stagnation. Purple-black color indicates Stagnation combined with Heat. Treatment methods: For Blood Deficiency, use *Siwu Tang*; for Qi Deficiency, use *Siwu Tang* plus Ginseng and Astragalus. For Stagnation, use Cyperus, Amomum, Aucklandia, Areca Seed, Peach Kernel, and Corydalis. For chronic and stubborn stagnation, use emesis or purgation. For Heat patterns indicated by pulse and symptoms, use *Siwu Tang* plus Scutellaria and Phellodendron. For Cold patterns, use *Siwu Tang* plus Cinnamon Twig, Aconite, and Fluorite. Only when accumulations are removed, stagnation passes, and deficiency recovers will Blood and Qi become harmonious, allowing conception. Whenever I treat irregular menstruation, I use only powdered Cyperus pills made with vinegar, which proves effective almost every time. The *Suwen* states: Disease of the Du Mai leads to female infertility.
When a woman's menstruation is irregular, she is not in a state suitable for conception; even if conceived, the fetus may not be fully sound. She should take *Jiawei Liuwei Dihuang Wan*.
Prepared Rehmannia Root (4 liang), Cornus Fruit, Dioscorea Rhizome (each 2 liang), Moutan Bark, Poria (each 1.5 liang), Alisma Tuber, Cyperus Rhizome (steeped in child's urine three times, stir-fried, 1 liang each), Qiai Leaf (veins removed, boiled in vinegar, 0.5 liang).
Grind into powder, mix with refined honey to make pills the size of mulberry seeds. Take 70 pills each time, washed down with boiling water. Subsequently, decoct herbs according to symptoms or prepare separate decoctions.
For delayed menstruation, it is Blood Deficiency; take *Siwu Tang* plus Ginseng, Astragalus, Tangerine Peel, and Atractylodes Macrocephala Rhizome. For obese and fair-skinned individuals, there is much phlegm; take *Erchen Decoction* plus Pinellia, Atractylodes Lancea, Talcum, Ligusticum, Angelica, and Cyperus. For early menstruation, it is Blood Heat; take *Siwu Tang* plus Scutellaria and Phellodendron. Obese individuals should also be treated for phlegm; purple-black color is discussed under Blood Heat. Pain before menstruation indicates Qi Stagnation; use Angelica Sinensis root and tail, Cyperus, Peach Kernel, Safflower, and Coptis to promote movement, or add *Siwu Tang*, Curcuma, Corydalis, and Aucklandia. Add Scutellaria and Bupleurum for Heat. Pain after menstruation indicates Qi and Blood Deficiency; use *Bawu Tang* (Eight-Ingredient Decoction).
[Zhu Danxi] Obese women often cannot conceive because fat membranes block the Uterus, causing amenorrhea. Emaciated women cannot conceive because the Uterus lacks Blood, and Essence and Qi do not gather. For obese women without children, use regulating medicines first.
Angelica Sinensis (1 liang, washed in wine), Poria (2 liang), Ligusticum Chuanxiong Rhizome (0.75 liang), White Peony Root, Atractylodes Macrocephala Rhizome, Pinellia Tuber (washed in water), Cyperus Rhizome, Tangerine Peel, Licorice Root (each 1 liang).
Make ten doses, adding three slices of ginger per dose, decoct in water, and swallow the following pills.
Atractylodes Macrocephala Rhizome (2 liang), Prepared Pinellia, Ligusticum Chuanxiong Rhizome, Cyperus Rhizome (each 1 liang), Medicated Leaven (stir-fried), Poria (each 0.5 liang), Tangerine Pith (0.4 liang), Licorice Root (0.2 liang, all ground into powder).
Make pills with congee paste, take 80 pills each time. If Heat is predominant, add Coptis and Immature Bitter Orange (each 1 liang). After taking the previous medicine, take the subsequent *Zhongsi Wan*.
Prepared Aconite Root, Poria (each 0.6 liang), Magnolia Bark, Eucommia Bark, Cinnamon Heart, Gentian Root, Anemone Root, Pinellia Tuber, Dried Ginger, Achyranthes Root, Codonopsis Root (each 0.2 liang), Ginseng (0.4 liang), Asarum (0.5 liang).
Grind into powder, mix with refined honey to make pills the size of soybeans. Take 5 pills each time, washed down with wine on an empty stomach; increasing to 10 pills is acceptable. Once pregnancy is felt, stop taking it after three months. Avoid beef and horse meat. This prevents difficult labor until the month postpartum.
Note: This formula is *Qingui Wan*. Danxi advised against it, mainly for emaciated women lacking Blood. For obese women with dampness, combined with the preceding regulating medicine, reducing the dosage by nine-tenths to just 0.5 fen is acceptable. These three formulas were obtained from Danxi's son, Zhu Maocheng, and have proven effective repeatedly.
*Yiqi San* treats women whose Qi exceeds Blood, causing infertility. It can also be used for dizziness, chest fullness, body pain, and palpitations.
Cyperus Rhizome (stir-fried clean, 2 liang), Tangerine Peel (roasted, 2 liang), Spirit of Poria, Licorice Root (honey-fried, each 1 liang).
Grind into fine powder, take 2-3 qian each time, at any time, mixed with warm water.
[Hai Zang] *Da Wu Bu Wan*
Asparagus Fern Stem, Ophiopogon Tuber (heart removed), Acorus Rhizome, Poria, Ginseng, Yizhi Fruit, Goji Berry, Lycium Cortex Root-Bark, Polygala Root (prepared heart removed), Prepared Rehmannia Root (equal parts).
Grind into fine powder, mix with refined honey to make pills the size of sesame seeds. Take 30 pills with wine on an empty stomach. After several doses of this formula, take *Qi Xuan Wan* to purge.
*Zengsun Santian Wan*
Asparagus Fern Stem (steeped in wine, heart removed), Prepared Rehmannia Root (steamed in wine), Ginseng (rhizome removed), Polygala Root (bone removed), Schisandra Berry, Poria (steeped in wine), Deer Antler (roasted with butter).
One method adds Horse Penis (roasted with butter). One method adds Ophiopogon Tuber to strengthen vitality. One method adds Drynaria Rhizome to strengthen bones and tendons. One method adds Agarwood to warm Lower Jiao deficiency-cold.
Grind into powder, mix with refined honey and pound a thousand times, make pills the size of sesame seeds. Take 50 pills each time, washed down with good wine on an empty stomach. For the elderly seeking tonification, add one whole placenta. (Placenta is best from a first-born child, steeped in wine, dried, finely chopped, and powdered.)
*Zishi Mudong Wan* (also known as *Zhiyingshi Wan*)
Fluorite, Gypsum Fibrosum (choose transparent goose-tube type, grind these two for seven days until they float, indicating readiness), Asparagus Fern Stem (each 3 liang), Angelica Sinensis, Ligusticum Chuanxiong Rhizome, Tecoma Stem, Serissa Root, Cinnamon Bark, Dried Rehmannia Root, *Mumeng* (unknown herb, likely a typo for *Mumu* or similar), Limonite (calcined, quenched in vinegar), Dendrobium Stem, Xin Yi Flower (each 2 liang), Ginseng, Mulberry Mistletoe, Drynaria Rhizome, Asarum, Magnolia Bark (processed with ginger juice), Dried Ginger, Edible Evodia Fruit, Mugwort Leaf, Anemone Root, Chinese Yam, Cuttlefish Bone, Licorice Root (honey-fried, each 1.5 liang), Biota Seed (1 liang).
Pulverize all ingredients, mix with refined honey to make pills the size of tung tree seeds. Take 10 pills with wine, gradually increasing to 30 pills over three days, stopping when warmth is felt in the abdomen. Sexual intercourse is permitted. Do not take if the husband is traveling; observe other medication restrictions. Recent users have conceived before finishing the course.
This formula originally used Aconite Root, Moutan Bark, and Achyranthes Root, which are abortifacient. They were included in fertility formulas likely because the fetus had not yet implanted. If taken after implantation, it causes harm. Now, these are removed, and Gypsum Fibrosum, Mugwort Leaf, and Anemone Root are added, removing doubt.
*Baiwei Wan* treats female infertility or cessation of menstruation, Upper Heat and Lower Cold, and various diseases.
Anemone Root, Prepared Dried Rehmannia Root, Sichuan Pepper (remove eyes and closed ones, lightly stir-fried to release moisture), White Dragon Bone (each 1 liang), Ophiopogon Tuber (heart removed, roasted, 1.5 liang), Ligusticum Wallichii Rhizome, Serissa Root, Angelica Dahurica Root, Raspberry, Peach Kernel (soaked in water, remove skin and tips, stir-bran fried until slightly yellow), Ginseng, Cinnamon Heart, Acorus Rhizome, White Poria, Polygala Root (heart removed, each 0.75 liang), Plantago Seed, Angelica Sinensis (cut, lightly stir-fried), Ligusticum Chuanxiong Rhizome, Cnidium Fruit, Asarum, Dried Ginger (processed, each 0.5 liang).
Pulverize all ingredients, mix with refined honey to make pills the size of tung tree seeds. Take 30 pills each time, washed down with warm wine on an empty stomach at noon. My old friend Jiang Junya and Zeng Zhongrong had no heirs, so I gave them this formula; within a year, both had sons. Later, Ai Junsu and Huang Hangong did the same, so I record this.
Zhao's *Congrong Tusizi Wan*
Cistanche Deserticola (1.3 liang), Raspberry, Cnidium Fruit, Ligusticum Chuanxiong Rhizome, Angelica Sinensis, Dodder Seed (each 1.2 liang), White Peony Root (1 liang), Oyster Shell (sealed with salt mud and calcined), Cuttlefish Bone (each 0.8 liang), Schisandra Berry, Saposhnikovia Root (each 0.6 liang), Scutellaria Baicalensis Root (0.5 liang), Mugwort Leaf (0.3 liang).
This formula is neither cold nor hot; it assists Yin and promotes conception. Roast all previous herbs until dry, grind into powder, mix with refined honey to make pills the size of sesame seeds. Take 30-40 pills each time, washed down with light salt water, suitable for morning and evening.
*Jiawei Xiangfu Wan* Men take *Jujing Wan*, women take this.
Cyperus Rhizome (1 jin 4 liang, soaked in old wine for two nights, stir-fried, crushed, dried again, and ground. 4 liang steeped in rice vinegar, same process. 4 liang steeped in child's urine, same process. 4 liang steeped in concentrated decoction of Gardenia and 4 liang Gardenia, strain, steep Cyperus, same process). Clean Leaves of Lycopus (6 liang, washed in wine), Cuttlefish Bone (6 liang, slightly crushed, stir-fried), Angelica Sinensis (4 liang, washed in wine), Ligusticum Chuanxiong Rhizome (3 liang), White Peony Root (4 liang, stir-fried in wine), Prepared Rehmannia Root from Huai (8 liang, crushed into paste, dried).
Grind each into powder, use floating wheat flour, wine, vinegar, and water to make paste for pills the size of mung beans. Take twice daily, morning and evening. Avoid radish, beef, and raw/cold foods.
*Tiaojing Wan*
Cyperus Rhizome (0.5 jin, steeped in child's urine, wine, and vinegar separately for one part each, one part raw, all stir-fried in wine), Eucommia Bark (processed with ginger juice, 0.5 jin), Large Ligusticum Chuanxiong Rhizome, White Peony Root, Angelica Sinensis (tails removed), Prepared Rehmannia Root from Huai, Guang Chenpi, Small Fennel Fruit (stir-fried in wine), Corydalis Rhizome (lightly stir-fried), Cistanche Deserticola (steeped in wine), Old Green Orange Peel (bran-roasted), Taizhou Lindera Root (stir-fried), Scorched Scutellaria Baicalensis Root (stir-fried in wine), Cuttlefish Bone (roasted with butter, each 4 liang).
Weigh fourteen ingredients accurately, use high-quality materials, mix with vinegar and flour paste to make pills the size of tung tree seeds. Take 100 pills each time, washed down with good wine on an empty stomach. Another version excludes Tangerine Peel and Rehmannia, adding Ginseng and Astragalus (each 2 liang).
*Zhengyuan Dan* Regulates menstruation and promotes conception.
Cyperus Rhizome (1 jin, with 3 liang Mugwort, steeped together in vinegar overnight, then processed separately: wine, salt, butter, and child's urine each process 4 liang), Donkey-hide Gelatin (fried with clam powder, 2 liang), Aurantium Fructus Immaturus (4 liang, half raw, half bran-roasted), Prepared Rehmannia Root from Huai (washed in wine), Prepared Rehmannia Root (steeped in wine), Angelica Sinensis Root Body (washed in wine), Ligusticum Chuanxiong Rhizome (stir-fried, each 4 liang), White Peony Root (8 liang, half raw, half stir-fried in wine). Add White Poria and Amber to treat leukorrhea.
Grind into powder, make pills with vinegar paste the size of sesame seeds. Take 50-60 pills swallowed with salt water on an empty stomach.
[He He/Zihe Zheng Da Cheng - Zhang Zhongjing's disciple Dai Ren] Dai Ren passed through the Qiao Army Camp drinking, where a soldier mentioned divorcing his wife. Dai Ren asked why. The soldier replied: "When my wife was a maiden, she had a cold accumulation in her epigastrium like an inverted basin, making a water sound when pressed, feeling like ice to hot hands. We have been married fifteen years; I fear our line will end, so I divorced her." Dai Ren said: "Do not divorce her. Use my medicine, the illness will be cured, and pregnancy obtained." The soldier agreed. Dai Ren diagnosed her pulse: Cun pulse deep and slow, Chi pulse洪大 (surging and large) and forceful, not a sign of infertility; she would conceive within a year. Her husband sighed and said: "Let us try." First, use *Sansheng San* to induce vomiting of one dou of saliva/phlegm; the epigastrium became soft. Then take *Baizhu Tiaozhong Tang* and *Wuling San*, followed by *Siwu Tang* to harmonize. Within a month, Qi and Blood were balanced, and she conceived a son after several months. Dai Ren often said: "Using my method, there is no woman who cannot conceive." This statement is not false. A thirty-four-year-old woman dreamed of intercourse with ghosts and gods, experiencing extreme fear, seeing divine halls, underworld offices, boats, and bridges for fifteen years, never conceiving. She tried witchcraft and prayers extensively, drilling skin and moxibusting flesh, thousands of acupoints, becoming yellow, thin, feverish, thirsty, with swollen abdomen, resigning to fate. One day she bitterly begged Dai Ren. Dai Ren said: "Yang Fire is excessive above, Yin Water is excessive below. Seeing ghosts/gods is the spirit of Yin; divine halls are the residence of Yin; boats/bridges are uses of water. Both Cun pulses are deep and hidden, indicating real phlegm in the chest." He performed emesis three times, purgation three times, and sweating three times. Within ten days, dreams ceased; within one month, she conceived.
[Dafang] *Dangbao Tang* Treats women who have never borne children since birth, or have been sterile for thirty years.
Mirabilite, Moutan Bark, Angelica Sinensis, Rhubarb (steamed for the duration of a meal), Peach Kernel (skin and tip removed, each 3 liang), Asarum, Magnolia Bark (processed with ginger juice), Platycodon Root, Red Peony Root, Ginseng, Poria, Cinnamon Heart, Licorice Root, Achyranthes Root (tips removed), Dried Tangerine Peel (each 2 liang), Prepared Aconite Root (1.5 liang), Blister Beetle (wings and feet removed, stir-fried until scorched), Leech (stir-fried until dry, each 10 pieces).
Decoct in 5 sheng of clear wine and 6 he of water to obtain 3 sheng. Divide into four doses: three during the day, one at night, spacing each dose by three chen (hours). Drink again shortly after. Cover with blankets to induce sweat. If no sweat, use a fire basket in winter. Expect expulsion of accumulated blood and cold red pus resembling adzuki bean juice, caused by evil cold matter in the uterus. Or umbilical pain on cloudy days, or irregular menstruation due to cold blood preventing conception. If expelled adequately, but Qi is weak and exhausted, further doses may be taken, but stop after 2-3 doses. If severe oppression occurs, eat vinegar or drink cold liquid to stop. Fear that evil matter is not fully expelled due to insufficient drug power; enduring the full course is best. After one day, continue with sitz导药 (suppository/enema medicine).
*Sitz Medicine* Treats total infertility and cessation of menstruation, used when *Dangbao Tang* fails to expel all evil matter.
Gleditsia Sinensis Pod (skin and seeds removed), Evodia Fruit, Angelica Sinensis (each 2 liang), Asarum (tips removed), Schisandra Berry, Dried Ginger (processed, each 1 liang), Yellow Hibiscus Flower, Alum (calcined), Sea Salt, Sichuan Pepper (each 0.5 liang).
Grind into fine powder, place in a silk bag the size of a finger, over 3 cun long, fill with medicine, tie securely, insert into the vagina. Sit or lie down as desired, do not walk. Remove during urination, then reinsert. Change to a new one once a day. Expect discharge of clear yellow cold fluid; stop when fluid ceases. If no disease discharge is seen, keep it in for ten days. Originally due to cold evil matter in the uterus causing infertility; pain occurs on cold/cloudy days. Wait until disease is fully expelled before stopping; do not interrupt. Steam with radish leaf decoction morning and evening.
[Danxi] Discussion on *Qingui Wan*: Infertility often originates in women. Physicians do not seek the root cause, but browse ancient formulas, finding only *Qingui Wan* precise in wording and intent. Using warming herbs appeals to human nature; people accept it gladly, take it eagerly, endure burning harm, yet remain ignorant and unrepentant. Why? Yang Essence is applied, Yin Blood receives it; Essence forms the child, Blood forms the sac, thus conception occurs. Women infertile usually lack sufficient Blood to receive Essence. Scanty Blood arises from many causes. Those seeking offspring must regulate and tonify Yin Blood to prevent deficiency, pushing surplus to form the fetus. How can one lightly use hot agents to fry the zang-fu, boil Blood and Qi, bringing disaster swiftly? Some say: Spring warmth generates all things, Winter cold destroys them. Without *Qingui Wan*'s warmth, how can the Zi Zang (Uterus) be warmed to conceive? I say: The *Shijing* states: "If a woman is harmonious and peaceful, she joyfully bears children." Harmony means equal Qi and Blood; Peace means Yin and Yang do not contend. With this medicine, menstrual blood turns purple-black, gradually decreasing, irregular. Initially appetite increases, later bitter/dry mouth. Yin and Yang unequal, Qi and Blood disordered, diseases arise. How can conception occur? Even if conceived, the child will be sickly and short-lived, as *Qingui Wan* consumes Pre-heaven Yin. Beware! Note: *Qingui Wan* applied to obese women with reduced dosage, combined with regulating tonics, is acceptable, but contraindicated for emaciated women with excess Fire.
[Dong Yuan] For female infertility, Moxibustion on Baomen. (Located 2 cun left of Guanyuan, 50 moxa cones.) Another method: Qimen. (3 cun lateral to Guanyuan, 50 moxa cones.)
[Jiyi] Another method: Zigong. (3 cun lateral to Zhongji, needle 2 cun, moxa 21 cones.) Zhongji.
[Yuan] Another method: Guanyuan 20 cones, Sanbao point.
*[Jia Yi Jing]* Sterility: Moxibustion on the navel promotes conception. For women with limb spasms, abdominal fullness/hernia, amenorrhea, breast disorders, sterility, vaginal itching, Yinjiao governs. Abdominal fullness/hernia, accumulations/masses, sterility, vaginal itching: puncture Shimen. (*Qianjin Fang* says: Ben Tun rising to lower abdomen hardness...)