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发出疙瘩，瘙痒和疼痛无常，抓破后形成疮疡，脓水淋漓不断。内在症状表现为月经周期不固定，小便排泄不调畅，夜间发热并伴有盗汗，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，多加胡麻子；随后改用归脾汤，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。其表现是时而笑时而哭，不想见人，好像与人发生冲突一样。其脉象迟缓沉伏，或像乌鸦啄食般急促断续，或绵绵而来不知节律，忽大忽小，忽短忽长，总归是因为七情（喜、怒、忧、思、悲、恐、惊）亏损了心血，神气失去保护而造成的。适宜使用安神定志等药物，待正气恢复，神气自然安定。外用方法是将患者两手拇指并拢，用线扎紧，在指甲与皮肤交界处的缝隙间，即名为“鬼哭穴”的地方，施灸七壮。如果确实是邪祟作怪，病人会乞求停止艾灸，病自然会好。然而人的五脏各有其所藏的精神要素：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，夜晚就会梦见鬼神邪祟，仿佛有所看见一样，这其实是我自身的魂魄在作祟，难道真有什么鬼神邪祟与我交感吗？薛立斋判断这是由七情亏损，心血不足，神气失去保护所致，真正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”，生生之气固然流行遍布天地，怎么会唯独到我这里就断绝了呢！人类的繁衍继承，上接亘古以来的传承，下衍无穷无尽的血脉，这难道不重要吗？祖宗的至德遗训不知延续了几千几百年，一旦到我这里就断绝了，作为孝子慈孙，怎能不向天祝寿、向地祈福，猛省内心自我责备呢？袁了凡先生说：“爱，是生命的根本，忍（指节制欲望）则是自绝其根本。”《素问》说：“懂得养生之道的人，能抗拒衰老而保全形体，年龄都过百岁，还能有子女。”所以从来没有断绝后代的圣贤。谁不以行善乐道为根本，再付诸行动，那么麒麟送子般的祥瑞呈现，难道会有尽头吗！
妇女不能生育的原因，不外乎四种：或者月经不规律，或者血液不足，或者有疾病，或者性交不合时宜。调理月经以补充血液，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”，宜用燥湿化痰的药，如半夏、天南星、苍术、川芎、香附、陈皮，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，宜用凉血降火的药，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，必须适龄。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（月经）来潮，但一定要二十岁才出嫁。都要等到阴阳精气完善充实，然后交合才能受孕，受孕才能养育，养育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，形体未完善就已受伤，精气未充实就已妄动，所以交合而不能受孕，受孕而不能养育，养育的孩子脆弱且不长寿。
天地是巨大的形体，阴阳是巨大的气。只有形与气相互依赖才能成立，从未偏废。男女交合精气，万物由此化生，天地的阴阳之形气蕴含其中。说到七八之数，七是少阳数，八是少阴数。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，这就是阴阳交合的开始。《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。假如父精母血不及却能有孕，是从未有过的。所以想要求子的人，必须先审视妇人的月经是否调顺。经，就是常道。每月按时到来，按期停止，没有改变常规。如果经期不调，有的提前，有的推后，有的一个月来两次，有的隔月一次，有的闭经不通，有的频繁来潮不止，有的先痛后行，有的先行后痛，有的颜色黑，有的颜色紫，有的颜色淡，有的白带、白淫、白浊，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。有肾虚精液滑脱的，有精冷精清的，或者临房时阴茎不坚硬，坚硬了也只流出不射精。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，有小便浑浊淋沥涩痛的，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，或者阳虚而气弱，或者阴亏而精衰，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顺，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。
既然已经调和了阴阳，又适宜按照方法来操作。口诀说：“二十个时辰中两天半，二十八九你要计算清楚，落红满地是好时机，金水过后时空乱，空乱之时枉费功夫，树头树底寻找残红，只要懂得花开能结子，何必担心丹桂不成丛？”这大概是说妇人月经刚结束，金水（指经血后的生理状态）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，精胜过了血，受孕则成男孩，这是“干道成男”的道理。第四日、第六日交合，新血逐渐增长，血胜过了精，受孕则成女孩，这是“坤道成女”的道理。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，这是精胜过了血，所以阳为主宰，男孩的形态由此形成。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，这是血胜过了精，所以阴为主宰，女孩的形态由此形成。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“干道成男，坤道成女”。想要后代广远的人，必须从这里寻求，也从这里得到。如果不这样做，只是侥幸于偶然罢了。虽然怀孕也多流产，虽然生产也多艰难，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，宜减少浓味肥甘食物，使浊气清而真精固守。如果脾胃不和，食少倦怠，每次房事后更加严重，而不能成胎的，这是中气弱而不能施化，宜多服补中益气汤。如果黑瘦，脉弦数，身体多热，肠胃燥涩，不能成胎的，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、枸杞做成丸药服用，务必使阴阳和平，才能生子，不一定非要用热药。
人到晚年没有后代，医生都责怪于肾，因为肾主精，精旺盛则怀孕成功。殊不知肾主相火，心主君火，一君一相，本于天成，君火安宁则相火服从，精血才能生成。大概心中所藏的是神，神所依附的是血，血所担忧的是火。心欲萌动而火动，则血沸腾，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，相火就随之翕然发动，相火既已发动，天君（心）也被扰动而不宁了。所以心肾有相互依存的意义，善于养生的人，贵在有无伤交养的方术。曾观察富贵之人，反而多缺乏后代，大概富人大多放纵欲望而伤精，贵人每每劳心而损神。总之，肾精妄泄，常因火迫使然；心火上炎，也是由于水乏不能制约。况且人年过三十以后，精气逐渐减少，不仅饮食男女的欲望足以损害败坏，一与事物接触，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他呢？所以要么伤精，要么劳神，有一于此而不知道节制，就不是保养天和、广延后代的方法。
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”就是这个意思。高明的医生，治疗无子症，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，各有虚实寒热的差异，只有通过诊脉才能知道，舍弃脉象只谈药物的做法是荒谬的。脉象不宜过大而数，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。应当疏散郁结以祛除邪气，邪气去除后才能补正气；不宜太无力而虚，虚乃是气血虚，只应当调补其气血。又有女子气多血少，寒热不调，月经违期，都应当诊脉而以灵活的方法治疗，务必使夫妇的脉象和平有力，交合有定期，不妄用药，才能生子。其种子的道理有四条：一是择地。地，指的是母血。二是养种。种，指的是父精。三是乘时。时，指的是精血交感的时刻。四是投虚。虚，指的是去旧生新的初始阶段。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。多欲的人，儿子多不育，因为怀孕后不节制，就会盗泄母阴，以夺取养胎的气。严冬之后，必有阳春，由此可知天地的道理，不收敛就不能发生，所以冬天寒冷得闭藏的命令，遇到阳春，无不发育，这是自然的道理。令人迷惑的是，既然不明白收藏的道理，放纵欲望竭尽精气，以耗损真气，等到没有后代，又说血冷，又说精寒，燥热之剂过量投用，而真阴更加耗损了，怎么能会有后代呢？所以无后代的原因，不仅仅在女方，也多由男方造成，房劳过度，施泄过多，精清如水，或冷如水，以及思虑无穷都难以有后代。大概心主神，有所思则神驰于外，导致君火受伤而不能下降；肾主智，有所劳则智乱于中，致使肾亏而不能上升，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，则脏腑储藏的精华输归于肾，以资助其作用。大概肾为水脏，是聚会关司之所，所以种子有“百脉齐到”的理论，而《内经》有“五脏盛乃能泻”的话语。袁了凡说：聚精的道理，一是寡欲，二是节劳，三是息怒，四是戒酒，五是慎味。肾是精的府库，凡是男女交接，必扰动其肾，肾动则精血随之而流，外边虽然没有泄出，精已经离开宫位，不能坚忍者，必定有几点真精，随着阳痿而溢出，这是验证。所以贵在寡欲。精由血生成，不仅仅是房室之交损伤我的精，凡是日常生活中损血的事情，都应当深戒。比如眼睛劳累于视物，则精因视而消耗；耳朵劳累于听声，则精因听而消耗；心劳累于思虑，则精因思而消耗。随事节制，则血得养而精与日俱积，所以贵在节劳。主管闭藏的是肾，主管疏泄的是肝。这两脏都有相火，其系上属于心。心，是君火。怒则伤肝，而相火动，动则疏泄用事，闭藏其职失职，虽然不交合，也暗流潜耗了，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，这是扰乱其血，血气既衰之人，数月无房事，精始浓而可用，一夜大醉，精随即变薄了，所以宜戒酒。《内经》说：“精不足，补以味。”浓郁的味道，不能生津，只有恬淡的，能补精罢了。大概万物都有真味，调和胜，真味就失去了。不论荤素，淡煮得法，自有一段冲和恬淡之气，益人肠胃。《洪范》论味道说：“稼穑作甘。”世间万物只有五谷得味之正，如果能淡食谷味，最能养精，比如煮粥饮中有浓汁滚作一团者，这是米的精液所聚。吃它最能生精，所以宜慎味。
天生各物，必有氤氲之时，万物化生，必有乐育之候，猫狗至微贱，将要受孕时，其中的雌性，必狂呼而奔跳，以氤氲乐育之气，触之不能自止，这是天然的节候，生化的真机。凡是妇人一月经行一度，必有一日氤氲之候，在一个时辰之间，气蒸而热，昏而闷，有欲交接不可忍的状态，这是确切的候期。此时逆而取之则成丹（指炼丹修道），顺而施之则成胎了。然而男女交媾之时，均有其精，何常有血？褚氏、东垣、丹溪，都以精血混言，几乎见男女媾精，而妇人以血施也。女子系胞于肾，及心包络，都是阴脏。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，走肾及心包，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，怎么作为化育之机呢！所以血海虚寒而不孕的，诚实用暖药，但人之孕胎，是阳精的施予，必须阴血能摄受它，精成其孕，血成其胞。如果有真阴不足，阴虚则火旺，阳胜则内热而血枯，是以不能摄受精血的，又不可纯用辛温之药了。《脉诀》说：“血旺易胎，气旺难孕”，所以贵在以脉象斟酌，所以不能废除诊脉。至于父少母老，生女必羸弱，母壮父衰，产男必弱，这是古人的成语。然而有老者强，而少者弱，难道中间没有变异吗？但有生之初，虽阳子为正，育而充之，必阴为之主。
有个妇人三十四岁，梦与鬼交，以及见到神堂阴司，舟楫桥梁，如此十五年，竟然没有怀孕，这是阳火盛于上，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。经过三次涌吐、三次泻下、三次发汗，不到十天就没有做梦，一个月就怀孕了。
妇人不孕，也有六淫七情之邪伤冲任，或者宿疾淹留，传遗脏腑；或者子宫虚冷；或者气旺血衰，或者血中伏热；或者脾胃受损，不能荣养冲任；或者有积血积痰，凝滞胞络。更应当审视男子体质如何？有肾虚精弱的；有禀受不足，气虚血损的；有嗜欲无度，阴精衰竭的，各自应当探求根源而治疗。又应当审视其男女尺脉，如果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。如果徒用辛热燥血之药，不但无益，反而受害。
世上有妇人血气充实，饮食健旺，而生育则少；有血气不足，饮食减少，而生育偏多的，为什么呢？大概卫府清肌，恒存辟谷（指道家修炼，此处比喻身体轻盈），楚宫细腰，得之忍饥，月满则亏，月亏乃盈，由此观之，弱者易育，实者难胎，这是定理。
褚氏说：男女之合，二情交畅，阴血先到，阳精后充，血打开包裹精，精进入成为骨，而男形成。阳精先入，阴血后参，精打开包裹血，血进入居于本位，而女形成。（这是以精血先后分男女。）
《圣济经》说：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，《易经》说：干道成男，坤道成女，这是男女的分别。（这是以左右阴阳之气动分男女。）
《易经》说：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
[Blood Wind Sore]
Women suffering from Blood Wind Sore (a skin condition characterized by wind-heat and blood dryness) are caused by the depression of wind-heat transforming into fire in the Liver and Spleen meridians, leading to blood dryness. The external symptoms manifest as nodules appearing on the body, with intermittent itching and pain; scratching breaks the skin forming sores that weep pus and fluid continuously. Internal symptoms include irregular menstrual cycles, dysuria, night fever accompanied by night sweats, aversion to cold and hatred of heat, fatigue, and poor appetite. Treatment should initially employ Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), or combine Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Si Wu Tang (Four Substances Decoction), adding a large amount of Sesame Seed (Humaizi). Subsequently, switch to Guipi Tang (Restore the Spleen Decoction), adding Prepared Rehmannia Root (Shudihuang) and removing Aucklandia Root (Muxiang).
[Dreaming of Intercourse with Ghosts]
"Dreaming of intercourse with ghosts" is due to deficiency and decline of Qi and Blood, excessive thinking, consumption of Shen (Spirit), allowing external pathogens to invade when resistance is low. The presentation includes laughing and crying intermittently, avoiding people, resembling conflict with others. The pulse may be slow and deep, or rapid and choppy like a crow pecking, or continuous without rhythm, varying in size and length. This is generally caused by the Seven Emotions damaging Heart Blood, leaving Shen unprotected. It is appropriate to use herbs such as Anshen Dingzhi Wan (Calming the Spirit and Stabilizing Will Pill). When Zheng Qi (Upright Qi) recovers, Shen naturally settles. Externally, bind the patient's two thumbs together tightly with thread. Between the nail and flesh at the seam, known as the Guiku Acupoint (Ghost Cry Point), apply moxibustion for seven moxa cones. If it is indeed a malevolent spirit, the patient will beg to stop the moxibustion, and the illness will depart. However, the Five Zang organs each store specific spiritual aspects: Heart stores Shen, Liver stores Hun (Ethereal Soul), Lungs store Po (Corporeal Soul), Spleen stores Yi (Intellect), and Kidneys store Jing (Essence) and Zhi (Will). If Heart Blood is deficient, Shen has no foundation; if Liver Blood is deficient, Hun has no attachment; if Lung Qi is deficient, Po has no return; if Spleen and Kidney are deficient, Yi and Zhi detach from the body, causing dreams of ghosts and evil spirits at night, as if seeing something. This is actually one's own Hun and Po acting up; how can there truly be ghosts and evil spirits interacting with us? Xue Lizhai judged this to be caused by damage from the Seven Emotions and insufficient Heart Blood, leaving Shen unprotected, which truly grasps the fundamental principle of the disease.
[Introduction to the Gate of Procreation]
The great virtue of Heaven and Earth is "Life." The Qi of generation flows everywhere; why should it cease uniquely for me? Human lineage connects upwards to ancient times and downwards to endless generations. Is this not important? The virtuous instructions of ancestors have lasted for thousands of centuries; if they end with me, how can filial sons and kind grandchildren not pray to Heaven for longevity and Earth for blessings, reflecting deeply and blaming themselves? Mr. Yuan Liaofan said: "Love is the root of life; restraint cuts off its root." The *Suwen* states: "Those who follow the Dao can resist aging and preserve their form, living to nearly a hundred years and still having children." Thus, there are no sages without descendants. Who does not take doing good and delighting in the Dao as the root, and then acts upon it? Then auspicious signs like the Qilin sending sons will appear endlessly!
Women unable to conceive may have four causes: irregular menstruation, insufficient Blood, existing diseases, or untimely intercourse. Regulate the menses and tonify Blood, remove diseases and restrain desires, ensure no disease and timely intercourse; how could pregnancy not occur? However, there are two other conditions: Obese women with strong constitution who indulge in alcohol and rich food cannot conceive; this is called "abdominal fat overflowing, blocking the uterus." Use drying-dampness and resolving-phlegm herbs such as Pinellia Tuber (Banxia), Aconite Root Processed (Fuzi - *Note: Text says Nanxing/Arisarum but context implies phlegm resolvents like Banxia, Cangzhu, etc. I will stick to text entities*), Atractylodes Rhizome (Cangzhu), Ligusticum Rhizome (Chuanxiong), Cyperus Rhizome (Xiangfu), Tangerine Peel (Chenpi), or Daotan Tang (Guiding Phlegm Decoction). Thin, irritable women with irregular menstruation cannot conceive; this is called "dry and astringent uterus without Blood," unable to capture sperm. Use cooling-blood and descending-fire herbs, such as Si Wu Tang added with Scutellaria Root (Huangqin) and Cyperus Rhizome (Xiangfu), Yangyin Buexue (Nourish Yin Tonify Blood), or Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill).
Regarding union, ages must match. Although males have clear essence at sixteen, they should marry at thirty; although females begin menstruation at fourteen, they should marry at twenty. Only when Yin and Yang are complete and solid should intercourse lead to conception, gestation, and birth of robust, long-lived children. Now, girls before puberty whose Tian Gui (menstrual essence) has just arrived approach men; Yin Qi leaks early, harming the unformed body, moving before solidity is achieved. Thus, intercourse fails to conceive, conception fails to nurture, and born children are fragile and short-lived.
Heaven and Earth are large forms; Yin and Yang are large Qi. Form and Qi support each other. Male and female union generates all things. Regarding the numbers seven and eight: seven is Shaoyang (Lesser Yang), eight is Shaoyin (Lesser Yin). Mutual induction leads to flow. Thus, females at 2x7 (14) have Tian Gui arrive, males at 2x8 (16) have essence pass; this is the beginning of Yin-Yang union. The *I Ching* says: "Heaven and Earth interact, all things become pure; male and female unite, all things are born." The way of Heaven requires Yin-Yang harmony for generation; the way of couples requires Yin-Yang harmony for offspring. If father's essence and mother's blood are insufficient yet pregnancy occurs, it has never happened. Therefore, seeking offspring requires first checking if the woman's menstruation is regular. "Jing" means constant. It comes on time every month and stops on time. Irregularities include early or late arrival, twice a month, every other month, amenorrhea, frequent bleeding, pain before or after flow, black, purple, pale colors, leukorrhea, white turbidity—all indicate Blood-Qi disharmony. Such cases must be treated according to symptoms. Men's diseases must also be known: Kidney deficiency with seminal emission, cold/clear essence, impotence, or erection without ejaculation. Erection indicates strong Liver Fire externally; non-ejaculation indicates weak True Yang internally. Night sweats, dream emission, turbid/dysuric urination, back fatigue, lust-induced Yin deficiency, labor fever, deficiency cold, Yang deficiency with weak Qi, Yin lack with depleted Essence—all indicate insufficient Essence-Qi. Treat accordingly. If female meridians are regulated and male essence sufficient, Yin-Yang harmonize, Blood-Qi balances, diseases do not arise, and offspring are healthy and long-lived.
After harmonizing Yin-Yang, methods should be followed. The rhyme states: "In twenty hours, two and a half days; calculate twenty-eight or twenty-nine. Red flow covering the ground is the good period; after Jin-Shui passes, chaos ensues. Wasted effort in chaos, search trees for remaining red. If you understand flowers bear seeds, why worry about cassia not clustering?" This refers to the time just after menstruation ends, when the uterus is open and empty, receptive to conception. This is the optimal time for Taihe (Great Harmony). Miss this window, and the uterus closes. Differences exist: Intercourse 1-3 days after menstruation, new Blood is not full, Essence dominates Blood, resulting in a male (Qian Dao Cheng Nan). Days 4-6, Blood grows, Blood dominates Essence, resulting in a female (Kun Dao Cheng Nu). Also: If Yin Blood arrives first and Yang Essence follows, Blood opens to wrap Essence, Essence enters as bone, Yang inside Yin outside forms Kan Trigram, Essence dominates, Yang rules, male form results. If Yang Essence enters first and Yin Blood follows, Essence opens to wrap Blood, Blood enters as root, Yin inside Yang outside forms Li Trigram, Blood dominates, Yin rules, female form results. Heaven and Earth intersect for prosperity; Yin-Yang harmonizes for offspring. Bias towards Yang creates male; bias towards Yin creates female. To expand lineage, seek this path. Otherwise, it is mere chance. Pregnancy may miscarry, birth difficult, children sickly.
Men with thick build and deep/small pulse, young but unstable Yang, have insufficient Yuan Qi. Take Renshen Gao (Ginseng Paste) or add Atractylodes Macrocephala Rhizome (Baizhu). Middle-aged men with weak Yang, increasing obesity, many concubines but no heirs, have abundant stomach fat but internal Qi weakness. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Deer Antler (Lujiao), Goji Berry (Gouqi), Processed Aconite Root (Zhi Fuzi), Cynomorium Herb (Suoyang), and Cistanche Stem (Rongrong) to tonify Mingmen Fire. Reduce rich/greasy foods to clarify turbid Qi and secure True Essence. Spleen-Stomach disharmony, poor appetite, fatigue worsening after sex, inability to conceive: Middle Qi weak, fail to transform. Take Buzhong Yiqi Tang. Black/thin, wiry/rapid pulse, body heat, dry intestines, inability to conceive: Insufficient Yin Water. Even if pregnant, fetus dies. Use Liuwei Dihuang Wan added with Anemarrhena Rhizome (Zhimu), Phellodendron Bark (Huangbai), Angelica Sinensis Root (Guishen), and Goji Berry (Gouqi) as pills. Ensure Yin-Yang peace to bear children; hot herbs are not mandatory.
Older adults without heirs are blamed on Kidneys. Kidney governs Essence; strong Essence leads to pregnancy. But Kidney governs Minister Fire, Heart governs Sovereign Fire. One Sovereign, one Minister, innate. Sovereign calm, Minister obeys, Essence-Blood generated. Heart stores Shen; Shen attaches to Blood; Blood fears Fire. Heart desire moves Fire, Blood boils, Shen depletes, cannot descend to Kidney. Kidney Water deficient/cold, Essence leaks. Heart Fire moves, Minister Fire follows. Minister Fire moves, Sovereign Lord disturbed. Heart-Kidney mutual dependence. Good health preservation requires mutual nourishment. Rich/noble people often lack heirs: Rich indulge desires, damaging Essence; Noble labor mind, damaging Shen. Essence leaks due to Fire forcing; Heart Fire flares due to Water lacking control. After age 30, Essence-Qi declines. Diet, sex, sensory input, mental labor all consume Shen/Qi. Unrestrained damage harms Tian He (Heavenly Harmony) and lineage.
Conception involves Essence-Blood but relies on a spark of Pre-Heaven Qi萌动 in desire. Zhu Xi called it "received at the beginning of life"; *Wuzhen Pian* calls it "initial reception of Qi." Expert doctors treat infertility focusing on Male Essence and Female Blood. Prescriptions emphasize Kidney tonification for men, Menses regulation for women, combined with Qi tonification/movement. Examine pulses, investigate deficiency/excess. Pulse should not be too large/rapid (Heat); not too slow (Cold); not too forceful/Excess (Deficient Righteous Qi invaded by Pathogenic Fire—disperse depression first, then tonify); not too weak/Empty (Blood-Qi deficiency—tonify). Women with excess Qi/deficient Blood, chills/fever, irregular menses: diagnose pulse, treat flexibly. Ensure couple's pulses are peaceful/strong, intercourse timed, no reckless medication. Seeds' principles: 1. Select Land (Mother's Blood). 2. Nourish Seed (Father's Essence). 3. Ride Time (Moment of Essence-Blood interaction). 4. Cast into Void (Initial stage of discarding old/generating new). Youthful fathers produce weak children (high desire, thin essence). Elderly fathers produce strong children (low desire, dense essence). High desire leads to infertile offspring (post-conception indulgence drains Mother Yin, stealing fetal nourishment). Winter leads to Spring; non-storage prevents generation. Cold winter storage meets spring warmth for development. People ignore storage, indulge desires, exhaust True Qi, claim cold Blood/Essence, overuse hot/dry drugs, deplete True Yin. How can they have children? Infertility stems from both sexes: excessive sex, excessive emission, clear/cold essence, endless thoughts. Heart governs Shen; thought scatters Shen, damages Sovereign Fire, prevents descent. Kidney governs Wisdom; labor confuses Wisdom, damages Kidney, prevents ascent. Upper/Lower disconnect, Water/Fire fail to interact. No fertility possible.
Five Zang store Essence. Peaceful Zang transfers essence to Kidney. Kidney is Water Organ, gathering point. "Hundred pulses arrive together" theory; *Neijing* says "Five Zang full, then discharge." Yuan Liaofan: Gather Essence via 1. Few desires, 2. Restraint of labor, 3. Calm anger, 4. Quit alcohol, 5. Careful diet. Kidney is Essence residence. Intercourse disturbs Kidney; Kidney moves, Essence-Blood flows. External retention doesn't mean internal retention; weak erection leaks true essence. Hence, few desires. Essence forms from Blood. Daily activities damaging Blood must be avoided. Eyes strain vision, ears strain hearing, mind strains thought—consume Essence. Rest conserves Blood, accumulates Essence. Hence, rest from labor. Kidney closes, Liver disperses. Both have Minister Fire, connected to Heart (Sovereign Fire). Anger injures Liver, moves Minister Fire, disrupts closure, causes hidden leakage. Hence, calm anger. Alcohol moves Blood (red face/hands). Weak Blood-Qi people abstaining months have dense essence; one night drunk thins it. Hence, quit alcohol. *Classic*: "Insufficient Essence, tonify with flavor." Rich flavors don't generate fluids; bland flavors tonify Essence. All things have true flavor; heavy seasoning loses it. Plain cooking preserves harmonious Qi benefiting Stomach/Intestines. *Hongfan*: "Grains taste sweet." Grains have correct flavor. Bland grain diet best nourishes Essence. Rice soup concentrate is grain essence. Eat to generate Essence. Hence, careful diet.
All things have yinyun (misty/interacting) times. Cats/dogs mating show wild behavior due to yinyun Qi. Women have one yinyun day per cycle, within one shichen (2 hours): steaming heat, dizziness, unbearable urge to mate. This is the exact timing. Reverse it for alchemy; follow it for conception. Both sexes have Essence; where is Blood? Chu Shi, Dongyuan, Danxi confused Essence/Blood. Women's uterus ties to Kidney and Pericardium (Yin organs). Deficiency allows Wind-Cold to invade uterus, stopping pregnancy. Need warm herbs to dispel Wind-Cold and aid transformation. Use acrid-warm agents, guiding to Lower Jiao, Kidney/Pericardium, warming uterus. Combine with Blood-Qi tonics. Without tonics, acrid-warm herbs increase dry-heat, hindering transformation. Blood Sea deficiency-cold needs warm herbs. But pregnancy is Yang Essence application, requiring Yin Blood to capture. Essence forms pregnancy, Blood forms placenta. True Yin deficiency leads to Fire hyperactivity, Yang excess, internal heat, Blood dryness, inability to capture. Do not use purely acrid-warm herbs. *Maijue*: "Full Blood easy conception, Full Qi hard conception." Pulse diagnosis essential. Young father/old mother produces weak daughters; strong mother/weak father produces weak sons. Ancient sayings, but variations exist. Initially Yang dominant, but nurturing requires Yin dominance.
Case: Woman, 34, dreamed of ghosts/spirit halls/boats for 15 years, no pregnancy. Yang Fire high above, Yin Water low below. Ghosts/spirit halls/boats represent Yin/Water. Cun pulses deep/fixed indicate real Phlegm in chest. Three emetics, three purgatives, three diaphoretics. Within 10 days, dreams stopped; within 1 month, pregnant.
Infertility causes: Six Evils/Seven Emotions damaging Chong/Ren, lingering old 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 essence, congenital insufficiency, Qi/Blood damage, excessive desires, Essence depletion. Treat root. Check Chi pulses: Fine/empty-large-weak → Bawei Wan. Left Chi large/forceless → Liuwei Wan. Both Chi micro-fine or floating-large → Shibu Wan. Pure acrid-hot/drying herbs harm.
Some women with strong Blood-Qi/eating little conceive less; some with weak Blood-Qi/eating more conceive more. Why? Light body/abstinence vs. thin waist/hunger. Full moon wanes, waning moon waxes. Weak easier to conceive, full harder. This is principle.
Chu Shi: Mutual affection, Yin Blood first/Yang Essence second, Blood wraps Essence, Essence becomes bone, male formed. Yang Essence first/Yin Blood second, Essence wraps Blood, Blood becomes root, female formed. (Gender determined by order.)
*Shengji Jing*: Heaven Virtue/Earth Qi, Yin-Yang harmony. Qi moving left is Yang, creates male. Qi moving right is Yin, creates female. *I Ching*: Qian creates male, Kun creates female. (Gender determined by directional Qi movement.)
*I Ching*: Qian creates male, Kun creates female. Father's Essence/Mother's Blood, mutual induction. Essence release is Yang application. Blood captures...