朱丹溪曰∶妇人久无子者，冲任脉中伏热也。夫不孕由于血少，血少则热，其原必起于真阴不足。真阴
不足，则阳胜而内热，内热则荣血枯，故不孕。益阴除热，则血旺易孕矣。《脉诀》曰∶血旺易胎，气旺难孕
是也。
缪仲淳曰∶女子血海虚寒而不孕者，诚用暖药。但妇人不孕，亦有阴虚火旺，不能摄受精血，又不可纯用
辛温药矣。
朱丹溪曰∶人之育胎，阳精之施也，阴血能摄之，精成其子，血成其胞，胎孕乃成。今妇人无子，率由血
少不足以摄精也。血少固非一端，然欲得子者，必须补其精血，使无亏欠，乃可成胎孕。若泛用秦桂丸之剂，
熏戕脏腑，血气沸腾，祸不旋踵矣。又曰∶瘦弱妇人，性躁多火，经水不调，不能成胎。以子宫干涩无血，不能
摄受精血故也。益水养阴，宜大五补丸、增损三才丸加减，以养血主之。东垣有六味丸。补妇人阴血不足无子，
服之能胎孕。
朱丹溪曰∶无子之因，多起于妇人。医者不求其因起于何处，遍阅古方，唯秦桂丸，用温热药，人甘受燔灼
之祸而不悔，何也？或曰春气温和，则万物发生，冬气寒冽，则万物消陨，非秦桂温热，何以得子脏温暖成胎？
予曰∶妇人和平，则乐有子。和则气血匀，平则阴阳不争。今服此药，经血必紫黑，渐成衰少。始则饮食渐进，
久则口苦而干，阴阳不平，血气不和，病反蜂起，以秦桂丸耗损真阴故也，戒之。
按∶秦桂丸为妇人子宫虚寒积冷不孕者设。若血虚火旺，真阴不足，不能摄精者服
之，则阴血反耗，而燥热助邪矣。
慎斋按∶以上六条，序妇人不孕，有虚寒、伏热、肾虚、血少，为不足之病也。
朱丹溪说：妇女长期不孕，是因为冲脉和任脉（调节生殖功能的两条主要经脉）中有潜伏的热邪。不孕是由于血虚，血虚则生热，其根源必然在于真阴（人体根本的阴液）不足。真阴不足，则阳气偏胜而产生内热，内热导致营血（行于脉中、具有营养作用的血液）枯槁，所以不能受孕。通过滋补阴液以清除内热，使血液旺盛，就容易怀孕。《脉诀》中说：血液旺盛容易受孕，气机旺盛反而难以怀孕，说的就是这个道理。
缪仲淳说：女子如果因血海（指子宫及所藏之血）虚寒而不孕，确实应当使用温暖的药物。但是妇女不孕，也有因为阴虚火旺，无法摄受精血的情况，这种情况下就不可以单纯使用辛温性质的药物了。
朱丹溪说：人类孕育胎儿，是阳精施予的结果，阴血能够摄纳它，精形成子体，血形成胞宫，胎孕才得以形成。现在妇女无子，大多是因为血少，不足以摄纳精气的缘故。血少的原因固然不止一种，然而想要生育子女的人，必须补充精气与血液，使其没有亏欠，才可以成胎受孕。如果广泛使用秦桂丸这类药剂，会熏灼损伤脏腑，导致血气沸腾，灾祸很快就会降临。他又说：瘦弱的女性，性情急躁且多火，月经不调，不能成胎。这是因为子宫干涩无血，无法摄受精血的缘故。应当滋补肾水、养护阴液，适宜使用大五补丸、增损三才丸进行加减，以养血为主要治疗原则。李东垣创制的六味丸，用于补益妇人阴血不足导致的不孕，服用后能够恢复生育能力。
朱丹溪说：导致不孕的原因，多起于女性方面。医生不探究病因究竟起源于何处，遍阅古方，只看到秦桂丸，使用温热药物，人们甘愿承受被焚烧灼伤的灾祸而不知悔改，为什么呢？有人说：春天气候温和，万物发生生长；冬天气候寒冷凛冽，万物凋零衰败，如果不是秦桂丸这样的温热药，怎么能让子宫温暖而成胎呢？我说：妇女身体平和，就乐于有子嗣。气血调和均匀，阴阳就不会相争。现在服用这种药，经血必定变成紫黑色，逐渐变得衰少。起初饮食可能逐渐增加，但时间久了就会口苦口干，导致阴阳失衡，血气不和，疾病反而蜂拥而起，这都是因为秦桂丸耗损真阴的缘故，对此要警惕。
按语：秦桂丸是为子宫虚寒、积冷导致不孕的妇女设立的。如果是血虚火旺、真阴不足、无法摄纳精气的患者服用它，反而会耗伤阴血，助长燥热邪气。
Zhu Danxi stated: In women who have been infertile for a long time, there is latent heat within the Chong and Ren meridians (two primary meridians regulating reproductive functions). Infertility stems from blood deficiency; blood deficiency generates heat, the root of which must lie in the insufficiency of True Yin (the fundamental yin fluids of the body). When True Yin is insufficient, Yang becomes excessive, leading to internal heat. Internal heat causes Ying Blood (nutritive blood circulating within the vessels) to wither, thus preventing conception. By nourishing Yin and eliminating heat, blood volume increases, making pregnancy easier. The *Mai Jue* states: "When blood is abundant, conception is easy; when Qi is abundant, conception is difficult." This refers to this principle.
Miao Zhongchun said: For women whose infertility is due to deficiency-cold in the Sea of Blood (referring to the uterus and the blood it stores), it is indeed appropriate to use warming medicines. However, some cases of female infertility are caused by Yin deficiency with hyperactive fire, where the body cannot retain fertilized essence and blood; in such cases, one must not solely employ acrid-warm herbs.
Zhu Danxi stated: Human fetal development begins with the bestowal of Yang Essence, which is retained by Yin Blood. The essence forms the fetus, and the blood forms the uterine sac, thereby establishing pregnancy. Currently, women without children mostly suffer from insufficient blood that fails to retain essence. Although blood deficiency arises from various causes, those wishing to conceive must replenish their essence and blood until no deficiency remains, so that conception can occur. If one indiscriminately uses formulas like Qingu Wan (Cinnamon Pill), it will scorch and damage the Zang-Fu organs, causing blood and Qi to boil, bringing disaster swiftly. He also stated: Thin and weak women often have irritable temperaments and excess fire, resulting in irregular menstruation and an inability to conceive. This is because the uterus is dry and lacks blood, failing to retain fertilized essence and blood. One should tonify Kidney Water and nourish Yin, preferably using Dabu Wujia Wan (Great Five Tonification Pill) or Zengsun Sancai Wan (Modified Three Capabilities Pill) with modifications, focusing primarily on nourishing blood. Li Dongyuan's Liuwei Wan (Six-Ingredient Pill) is used to tonify Yin and blood deficiency in women causing infertility; taking it can restore fertility.
Zhu Danxi stated: The causes of infertility often originate in women. Physicians fail to investigate the specific origin of the cause, yet perusing ancient prescriptions, they only find Qingu Wan, employing warm-hot herbs. People willingly endure the disaster of being scorched without repentance. Why? Some say: Spring warmth is mild, allowing all things to grow; Winter cold is biting, causing all things to wither. Without warm-hot herbs like Qingu Wan, how can the uterus be warmed to form a fetus? I reply: When a woman's constitution is harmonious, she joyfully bears children. Harmony ensures balanced Qi and Blood; equilibrium prevents conflict between Yin and Yang. Now, taking this medicine, menstrual blood inevitably turns purple-black and gradually diminishes. Initially, appetite may increase, but over time, bitterness and dryness in the mouth appear, leading to imbalance of Yin and Yang and disharmony of Qi and Blood. Diseases then arise in swarms, precisely because Qingu Wan depletes True Yin. Beware of this.
Commentary: Qingu Wan is designed for women with uterine deficiency-cold and accumulated cold causing infertility. If taken by those with blood deficiency and hyperactive fire, or True Yin insufficiency unable to retain essence, it will instead consume Yin and Blood and aggravate dryness-heat pathogenic factors.
Shen Zhai commented: The above six sections discuss female infertility, covering deficiency-cold, latent heat, Kidney deficiency, and blood deficiency, categorizing them as diseases of insufficiency.