《素问》云，女子二七而天癸至，任脉通，太冲脉盛，月事以时下，故有子；七七而任脉虚，太冲脉衰
少，天癸竭，地道不通，故形坏而无子。
沈尧封曰∶求子全赖气血充足，虚衰即无子。故薛立斋曰∶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；张子和主胞中实痰；丹溪于肥盛妇人，主脂膜塞胞；陈良甫谓二三十年全不产
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。
荡胞汤
朴硝 丹皮 当归 大黄 桃仁（生用，各三铢） 浓朴 桔梗 人参 赤芍 茯苓 桂心 甘草 牛膝
橘皮（各二铢） 附子（六铢） 虻虫 水蛭（各十枚）
上十七味 咀，以清酒五升，水五升，合煮取三升，分四服，日三、夜一，每服相去三时。更服如前，
覆被取微汗。天寒汗不出，着火笼之，必下脓血，务须斟酌下尽，二三服即止。如大闷不堪，可食酢饭
冷浆一口，即止。然恐去恶不尽，忍之尤妙。
王孟英按∶子不可以强求也，求子之心愈切，而得之愈难。天地无心而成化，乃不期然而然之事，非
可以智力为者。惟有病而碍于孕育之人，始可用药以治病。凡无病之人，切勿妄药以求子，弄巧反拙，岂徒
无益而已耶？纵使有效，而药性皆偏，其子禀之，非夭札，即顽悖。余历验不爽。
王孟英按∶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，最为稳妙。（方见下卷）
王孟英又按∶世有愚夫愚妇，一无所知，而敏于生育者，此方灵皋所谓此事但宜有人欲，而不可有天理
也。观于此，则一切求子之法，皆不足凭。况体气不齐，岂容概论！有终身不受孕者；有毕世仅一产者；有
一产之后，逾十余年而再妊者；有按年而妊者；有娩甫弥月而即妊者；有每妊必骈胎者；且有一产三胎
或四胎者。骈胎之胞，有合有分。其产也，有接踵而下者；有逾日而下者；甚有逾一旬半月而下者。谚云∶
十个孩儿十样生，是以古人有宁医十男子，莫医一妇人之说。因妇人有胎产之千态万状，不可以常理测也。
世之习妇科者，不可不究心焉。
王孟英又按∶古人五种不男∶曰螺、纹、鼓、角、脉，而人多误解。余谓螺乃骡字之讹。骡形之人，交
骨如环，不能开坼，如受孕，必以产厄亡。纹则阴窍屈曲，如纹之盘旋，碍于交合，俗谓之实女是也。后
人不知骡形之异而改为螺，遂以纹之似螺者，又混于鼓。鼓者，阴户有皮鞔如鼓，仅有小窍通溺而已。设
幼时以铅作铤，逐日 之，久则自开，尚可以人力为也。角则阴中有物，兴至亦有能举者，名曰二阴人，
俗云雌雄人是也。脉则终身不行经者，理难孕育，然暗经亦可受胎。钱国宾云∶兰溪篾匠之妻，自来无经，
而生四子一女。故五种之中，惟三者非人力所能治，而
纹、角二种，并不可交也。特考定之，以正相传之讹。又骡形之女，初生时，稳婆技精者，扪之即知。其可
男可女之身，名人 者，亦角类也。
《素问》说，女子十四岁时天癸（促进生殖功能成熟的物质）到来，任脉通畅，太冲脉旺盛，月经按时来潮，所以能够怀孕生子；到了四十九岁，任脉虚弱，太冲脉衰少，天癸枯竭，月经停止，所以身体衰老而不能生育。
沈尧封说：求子完全依赖气血充足，如果气血虚衰就不能生育。所以薛立斋说：关键在于审察男女的尺脉（手腕内侧桡动脉近腕横纹处的脉搏），如果右尺脉细弱，或虚大无力，使用八味丸（金匮肾气丸）；左尺脉洪大，但重按无力，使用六味丸（六味地黄丸）；两尺脉都微细或浮大，使用十补丸。这是遵循《内经》理论并通过诊察脉象来选用方剂，可以说是很好的方法。然而这仅仅说的是体质本虚而不能受孕的情况。如果体质不虚而不能受孕，必定有其他疾病。缪仲淳主张是风冷之邪侵袭子宫；朱丹溪主张是冲任二脉潜伏热邪；张子和主张胞宫中有实痰；朱丹溪对于肥胖妇人，主张是脂膜阻塞胞宫；陈良甫认为二三十年完全不生育的人，胞宫中一定有积血，主张使用荡胞汤。各位贤者论述不同，但道理都是存在的，应当通过诊察脉象、辨证施治。荡胞汤在《千金方》中是妇女求子的第一方，孙真人非常郑重地推崇它。
荡胞汤
朴硝、丹皮、当归、大黄、桃仁（生用，各三铢）、浓朴、桔梗、人参、赤芍、茯苓、桂心、甘草、牛膝、橘皮（各二铢）、附子（六铢）、虻虫、水蛭（各十枚）。
以上十七味药，切碎，用清酒五升、水五升，混合煎煮取汁三升，分四次服用，白天服三次，晚上服一次，每次服药间隔三个时辰。继续按此法服用，盖被取微微出汗。天气寒冷不出汗时，用火笼取暖，必然排出脓血，务必斟酌排尽，服用二三剂后即停止。如果出现极度烦闷难以忍受，可以吃一口醋拌冷饭或喝一口冷浆，症状即可停止。然而恐怕恶露排不干净，忍耐一下尤其好。
王孟英按语：子嗣不可以强求。求子的心越急切，得到孩子的机会反而越难。天地无心而成化育，是不期然而然的事情，不是靠智力和人力可以强求的。只有因病而妨碍孕育的人，才可以用药治病。凡是无病的人，千万不要乱吃药以求子，弄巧成拙，难道只是没有益处而已吗？即使有效，但药性都有偏颇，孩子禀受这些药性，要么夭折早亡，要么愚顽叛逆。我多次验证，从未出错。
王孟英按语：荡胞汤虽然用意深远，但药性太峻猛，不可轻易使用。只有保胎神佑丸，善于舒展气郁，缓慢消除积血，不仅是保胎的良药，也是调经易孕的仙丹。每天服用七丸，频繁服用效果很好。我多次使用都有验效，最为稳妥奇妙。（方剂见下卷）
王孟英又按语：世间有愚昧的夫妇，一无所知，却善于生育，这是陈灵皋所说的这件事只宜有人欲，而不可有天理。看这种情况，那么一切求子的方法，都不值得凭借。况且体质气息各不相同，怎么能一概而论！有的人终身不能受孕；有的人一辈子只生产一次；有的人生产之后，过了十多年再次怀孕；有的人每年怀孕；有的人刚满月就再次怀孕；有的人每次怀孕必生双胞胎；甚至有一产三胎或四胎的。双胞胎的胎盘，有合有分。分娩时，有的接连生下；有的过一天才生下；甚至有超过十天半个月才生下的。谚语说：十个孩子十样生，所以古人说有“宁医十男子，莫医一妇人”的说法。因为妇人有胎产的千态万状，不能用常理推测。世上传习妇科的人，不可不深入研究。
王孟英又按语：古人说的五种不男（此处原文虽写不男，但后文描述多为女性生理异常，结合语境及“螺纹鼓角脉”通常指女性五不女，故此处依原文文字翻译，但需注意中医语境中这通常指女性不孕的五种形态）：叫螺、纹、鼓、角、脉，但人们大多误解。我认为“螺”是“骡”字的讹误。骡形之人，交骨如环，不能分开，如果受孕，必定因产厄死亡。“纹”则是阴窍屈曲，像纹路一样盘旋，妨碍性交，俗称为实女。后人不知道骡形的差异而改为“螺”，于是把像螺一样的“纹”，又混淆于“鼓”。“鼓”是指阴户有皮覆盖如鼓面，仅有小孔通尿而已。如果在幼年时用铅做的锭子，每日插入，久了自然会张开，还可以用人力治疗。“角”是指阴中有物，兴奋时也能举起，名叫二阴人，俗云雌雄人是也。“脉”则是指终身不来月经的人，按理难以孕育，但暗经也可以受孕。钱国宾说：兰溪篾匠的妻子，从来不来月经，却生了四子一女。所以五种之中，只有三种不是人力所能治疗的，而“纹”、“角”两种，也不可以进行性交。特此考证确定，以纠正相传的错误。另外，骡形的女子，出生时，技术精湛的稳婆，摸一下就能知道。那种可男可女的身体，叫做“人”，也属于“角”类。
The *Suwen* (Basic Questions) states: When a girl reaches fourteen years of age, Tian Gui (substances that promote reproductive maturation) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) flourishes. Menstruation occurs regularly, enabling conception and childbirth. By forty-nine years of age, the Ren Mai becomes deficient, the Chong Mai declines, Tian Gui is exhausted, menstruation ceases, the body deteriorates, and childbearing becomes impossible.
Shen Yaofeng stated: Conception relies entirely on sufficient Qi and Blood; deficiency leads to infertility. Therefore, Xue Lizhai said: The key lies in examining the Chi pulse (pulse at the radial artery near the wrist crease) of both men and women. If the right Chi pulse is thready or large and empty without force, use Ba Wei Wan (Eight-Ingredient Pill with Rehmannia). If the left Chi pulse is surging but empty upon deep pressure, use Liu Wei Wan (Six-Ingredient Pill with Rehmannia). If both Chi pulses are faint and thready or floating and large, use Shi Bu Wan (Ten-Ingredient Tonifying Pill). This follows the *Neijing* principles and selects formulas based on pulse diagnosis, which is excellent. However, this specifically addresses cases where the constitution is inherently deficient and unable to conceive. If the constitution is not deficient yet conception fails, there must be other diseases. Miu Zhongchun attributed it to wind-cold invading the uterus; Zhu Danxi attributed it to latent heat in the Chong and Ren vessels; Zhang Zihe attributed it to phlegm-dampness obstructing the Baozhong (uterus); Zhu Danxi, regarding obese women, attributed it to fatty membranes blocking the uterus; Chen Liangfu believed that women who have not conceived for twenty or thirty years must have accumulated blood in the uterus, prescribing Dang Bao Tang (Uterus-Cleansing Decoction). Although these sages differed in their theories, all were logically sound. One should examine the pulse and differentiate syndromes to determine treatment. Dang Bao Tang was considered the premier formula for seeking offspring in *Qianjin Fang*, highly esteemed by Sun Simiao.
**Dang Bao Tang (Uterus-Cleansing Decoction)**
Poxiao (Mirabilite), Danpi (Moutan Cortex), Danggui (Angelicae Sinensis Radix), Dahuang (Rhei Radix et Rhizoma), Taoren (Persicae Semen, used raw, each 3 zhu), Houpo (Magnoliae Officinalis Cortex), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix), Chishao (Paeoniae Radix Rubra), Fuling (Poria), Guixin (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Juapi (Citri Reticulatae Pericarpium, each 2 zhu), Fuzi (Aconiti Lateralis Radix Praeparata, 6 zhu), Mengchong (Tabanidae), Shuizhi (Hirudo, each 10 specimens).
The above seventeen ingredients are coarsely crushed. Boil with five sheng of clear wine and five sheng of water until three sheng remain. Divide into four doses. Take three times during the day and once at night, with an interval of three shichen (six hours) between doses. Continue as before, covering with blankets to induce slight sweating. In cold weather, if sweating does not occur, apply warmth using a fire pot. Pus and blood will inevitably discharge. Ensure thorough evacuation; stop after two or three doses. If severe oppression and discomfort arise, consume one mouthful of vinegar-mixed cold rice or cold liquid to alleviate symptoms. However, to ensure no pathogenic factors remain, enduring mild discomfort is preferable.
Wang Mengying commented: Offspring cannot be forced. The more urgent the desire for children, the harder it becomes to conceive. Heaven and Earth accomplish transformation without intent, a spontaneous process beyond human intellect or effort. Medication should only be used for those whose illness hinders conception. Healthy individuals must never take drugs indiscriminately to seek pregnancy; doing so backfires. Even if effective, drug properties are biased. The child inherits these biases, leading to either premature death or stubbornness and rebellion. My clinical experience confirms this without exception.
Wang Mengying further commented: Although Dang Bao Tang has profound intent, its action is too harsh and should not be used lightly. Only Baotai Shenyao Wan (Fetus-Safeguarding Divine Protection Pill) is suitable. It effectively soothes Qi stagnation and gradually resolves accumulated blood. It is not only an excellent medicine for preserving the fetus but also a miraculous pill for regulating menstruation and facilitating conception. Take seven pills daily, frequently administered, yielding good results. I have verified its efficacy repeatedly; it is the most stable and ingenious option. (See formula in the lower volume.)
Wang Mengying added: There are ignorant couples who know nothing yet are fertile. This is what Chen Lingao referred to as "only human desire applies, not heavenly principle." Observing this, all methods for seeking offspring are unreliable. Moreover, constitutions vary greatly; generalizations are inappropriate. Some women never conceive; some bear only one child in a lifetime; some conceive again after more than ten years postpartum; some conceive annually; some conceive immediately after the first month postpartum; some always deliver twins; some even deliver triplets or quadruplets. Twin placentas may be fused or separate. Delivery may occur consecutively, after a day, or even after ten to fifteen days. As the proverb says, "Ten children, ten different births," hence the ancient saying, "Better to treat ten men than one woman." Women's obstetric conditions are myriad and unpredictable by common logic. Practitioners of gynecology must study this deeply.
Wang Mengying further commented: The ancients described five types of female sexual anomalies (often termed "Five Unfemales"): Luo (Snail), Wen (Line/Pattern), Gu (Drum), Jiao (Horn), and Mai (Vessel/Menstruation). These are often misunderstood. I believe "Luo" is a corruption of "Luo" (Mule). A person with the "Mule" form has fused pubic bones that cannot separate; conception would lead to fatal dystocia. "Wen" refers to a tortuous vaginal opening, spiraling like a pattern, hindering intercourse, commonly called "Solid Female." Later generations, unaware of the distinction from the mule form, changed it to "Luo" (Snail) and confused it with "Gu." "Gu" describes a vagina covered by skin like a drumhead, with only a small aperture for urination. If treated in childhood with daily insertion of a lead weight, it may open naturally and can be managed by human intervention. "Jiao" refers to a structure within the vagina that can erect upon arousal, known as an intersex individual or hermaphrodite. "Mai" refers to amenorrhea throughout life; while conception is theoretically difficult, "hidden menstruation" allows for pregnancy. Qian Guobin reported that the wife of a bamboo-weaver from Lanxi had no menstruation yet bore four sons and one daughter. Thus, among the five types, only three are incurable by human effort. Furthermore, the "Wen" and "Jiao" types are unsuitable for intercourse. I have verified these facts to correct transmission errors. Additionally, females with the "Mule" form can be identified by experienced midwives at birth. Bodies that are ambiguous in sex, called "Ren" (Human), also belong to the "Jiao" category.