陈 厥后。吸短多遗。议摄下焦。（阴虚阳动）
熟地（四钱） 桑螵蛸（二钱） 覆盆子（一钱） 五味（一钱） 湖莲（三钱） 芡实（二钱）
茯神（三钱） 山药（二钱）
某（四十）梦遗精浊。烦劳即发。三载不痊。肾脏精气已亏。相火易动无制。故精不能固。由烦动而泄。
当填补下焦。俾精充阳潜。可以图愈。
熟地（八两） 麦冬（二两） 茯神（二两） 五味（二两） 线胶（四两） 川斛膏（四两） 沙苑（二两） 远
志（一两） 芡实（三两） 湖莲（三两） 金樱膏丸。
马（二二）阴虚体质。常有梦泄之疾。养阴佐以涩剂。仍参入通药可效。六味去丹泽加湖莲芡实
五味远志秋石 金樱膏丸。
张 阴精走泄。阳失根据附。上冒为热。坎水中阳不藏。古人必以浓味填之。介类潜之。乃从阴以
引阳。与今人见热投凉不同。
熟地 龟甲 淡菜 青盐 茯神 柏子仁 女贞子 山药 旱莲草
某（二一）脉左弦右濡。梦遗。咳逆气急。
熟地 麦冬 萸肉 五味 牡蛎 茯神 女贞子 山药 湖莲 川斛膏 芡实
金樱膏加蜜丸。每服四五钱。淡盐汤下。
杨 脉垂入尺。有梦遗精。议填阴摄固其下。
熟地 萸肉 五味 山药 茯神 覆盆子 远志 线胶 湖莲 芡实 金樱膏丸盐汤下。
刘 先患目疾。流泪。嘈杂不欲食。内郁勃。阳气过动。阴虚不主摄纳。春半连次遗泄。腰脊酸
楚。皆肝肾病矣。
熟地 龙骨 萸肉 茯神 丹皮 湖莲 芡实 远志
某 劳损漏疡。大便时溏。阴火上升。下则遗滑。
熟地 龟版 芡实 山药 女贞 建莲 炙草 豆皮
某 少年频频遗精。不寐心嘈。乃属肾中有火。精得热而妄行。日后恐有肾消之累。
焦黄柏 生地 天冬 茯苓 牡蛎 炒山药
某 脉虚色白。陡然大瘦。平昔形神皆劳。冬至初阳动。精摇下泄。加以夜坐不静养。暴寒再折
其阳。身不发热。时时惊惕烦躁。从仲景亡阳肉 例。用救逆汤法。必得神气凝静。不致昏 螈 之变。 救逆汤去芍。
费 色苍脉数。烦心则遗。阳火下降。阴虚不摄。有湿热下注。此固涩无功。（阴虚湿热）
萆 黄柏 川连 远志 茯苓 泽泻 桔梗 苡仁
吴（二二）病形在肾肝。但得泻头中痛微缓。少腹阴囊亦胀。想阴分固虚。而湿热留着。致腑经之气。
无以承流宣化。理固有诸。先泄厥阴郁热。兼通腑气再议。
龙胆草 胡黄连 萆 丹皮 茯苓 泽泻
又 阅病原。是脏阴阴精之亏。致阳浮头痛。兼有遗精。月数发。下虚上实。纯以补涩。决不应病。
性不耐丸剂。与通摄两用。
龟版 秋石 熟地 女贞 远志 芡实 湖莲 茯苓 熬膏。
钱（二十）脉右弦左垂。阴虚湿热。遗精疮蚀。
黄柏 知母 熟地 萆 茯苓 远志 蜜丸。
某 梦遗病。乃是阴气走泄。而湿热二气乘虚下陷。坠自腰中至囊。环跳膝盖诸处可见。久遗
八脉皆伤。议用通药。兼理阴气。 猪苓汤
又 熟地 五味 芡实 茯苓 湖莲 山药
宋（二三）无梦频频遗精。乃精窍已滑。古人谓有梦治心。无梦治肾。肾阴久损。阳升无制。喉中贮痰
不清。皆五液所化。胃纳少而运迟。固下必佐健中。（下损及中兼治脾胃）
人参 桑螵蛸 生龙骨 锁阳 芡实 熟地 茯神 远志 金樱膏丸。
华（二九）神伤于上。精败于下。心肾不交。久伤精气不复谓之损。内经治五脏之损。治各不同。越人
有上损从阳。下损从阴之议。然必纳谷资生。脾胃后天得振。始望精气生于谷食。自上秋至
今日甚。乃里真无藏。当春令泄越。生气不至。渐欲离散。从来精血有形。药饵焉能骤然充长。
攻病方法。都主客邪。以偏治偏。阅古东垣丹溪辈。于损不肯复者。首宜大进参术。多至数
斤。谓有形精血难生。无形元气须急固耳。况上下交损。当治其中。若得中苏加谷。继参入摄
纳填精敛神之属。方今春木大泄。万花尽放。人身应之。此一月中。急挽勿懈矣。
参术膏 米饮调送。
接进寇氏桑螵蛸散去当归。
此宁神固精。收摄散亡。乃涩以治脱之法。
又 半月来。服桑螵蛸散以固下。参术膏以益中。遗滑得止。其下关颇有收摄之机。独是昼夜
将寝。心中诸事纷纷来扰。神伤散越。最难敛聚。且思虑积劳。心脾营血暗损。血不内涵。神
乃孤独。议用严氏济生归脾方。使他脏真气。咸归于脾。今夏前土旺司令。把握后天。于理最合。归脾汤。
又 立夏四日。诊左脉百至余。颇有敛聚之意。右关及尺。芤动若革。按脐下过寸。动气似若穿
梭。此关元内空。冲脉失养。而震跃不息。此女子胞胎。男子聚精之会也。大凡内损精血形气。
其胃旺纳食者。务在滋填。今食减不纳。假寐片晌。必烦惊惕。醒而汗。自述五心热炽。四肢骨
节热痿如堕。明是阴精内枯。致阳不交阴。转枯转涸。自下及中至上。前投桑螵蛸散。固涩精
窍。遗滑经月不来。奈寝食不加。后天生气不醒。 浓填补。于理难进。即参术甘温益气。又恐
益其枯燥。宜参生脉以滋三焦。晨进人乳一杯。使气血阴阳。引之导之。迎夏至一阴来复。早
用人乳一盏。隔汤炖热服。午后略饥。用生脉四君子汤。
又 一月来。虽经反复。参脉症形色。生阳颇有根蒂。近食蚕豆滞气。腹中微膨。食后口味酸浊。
是久卧重者。脾阳运动之机尚少。而火升心烦。动气汗出遗精。虽减于昔。未得平复。总是内
损已深。若调治合宜。只要精气复得一分。便减一分病象。长夏脾胃主令。培土助纳为要。而
精气散越。仍兼摄固之法。刻下味酸微膨。补脾少佐疏胃宜晚进。其早上另制补摄丸剂。益
脏真以招纳散失之气。
（晚服方） 人参 茯苓 白术 炙草 广皮 麦冬 五味 神曲 麦芽 炒黄柏
（早上丸方） 人参 桑螵蛸 白龙骨 淡苁蓉 五味 芡实 茯神 枣仁 金箔 金樱膏丸。淡盐汤送三四钱。
又 形色有渐复之象。较之夏至。病去三四。但诊右脉弦大。尚少冲和。左脉细促未静。谷进运
迟。有吞酸 胀。寐中仍欲遗精。此中焦之阳。宜动则运。下焦之阴。固则能守。乃一定成法。
午后服异功散加炒谷芽。
（晨服）遗症固涩下焦。乃通套治法。想精关已滑。涩剂不能取效。必用滑药引导。同气相求。古法有诸。
牛骨髓 羊骨髓 猪脊髓 麋角胶 白龙骨 生牡蛎 熟地 萸肉 茯神 五味 山药 芡实 湖莲 远志 砂仁
胶髓代蜜丸。晨服四钱。秋石二分化水下。
毛（二六）长夏暑温热郁。都令脾胃受伤。色黄神倦。气分自馁。因有遗泄一症。在盛年阴虚为多。及
询纳食未为强旺。遗发必劳烦而来。脉象非数搏。议以养脾立法。归脾去黄 桂圆加益智龙骨。
项 脉左弱右弦。色黄食少。腹胀便溏。常有梦遗泄。此非阴柔涩腻可服。用煦阳以涵阴。
生菟丝子 覆盆子 蛇床子 五味子 韭子 益智仁（煨） 补骨脂 龙骨 建莲粉丸。
丁 阴精走泄。阳不内根据。欲寐即醒。心动震悸。所谓气因精夺。当养精以固气。从前暖药不
错。但不分刚柔为偏阳。是以见血。莫见血投凉。（心肾兼治）
龟版（去墙削光一两） 桑螵蛸壳（三钱） 人参（一钱） 当归（一钱） 青花龙骨（三钱飞） 抱木茯神（三
钱）
姚（二四）始于念萌不遂其欲。阳下坠而精泄。先梦者。心阳注肾。久则精血日损。不充养筋骨为痛。
下损及中。食不运化。此非萸地腻膈。以及涩精可效。妙香散。
许（十八）阴气走泄遗精。务宜滋填塞固。今纳谷少而不甘。胃气既弱。滋腻先妨胃口。议用桑螵蛸
散。蜜丸服三四钱。
戈 遗精数年。不但肾关不固。阳明脉络亦已空乏。欲得病愈。宜戒欲宁心一年。寒暑更迁。阴
阳渐交。用桑螵蛸散治之。
顾（十九）滑精。用阴药顿然食减。药先伤胃。据述梦寐惊狂。精走无以护神。当固无形矣。
人参 生龙骨 桑螵蛸 益智仁 茯神 茯苓 远志 木香
吕（三七）有梦乃遗。是心有所触而致。经营操持。皆扰神动心。说商贾客于外。非关酒色矣。妙香散。
俞（三七）壮年形质伟然。脉来芤虚。述心悸怔。多畏惧。夜寐不甚宁静。此阳不易交于阴。过用劳心
使然。用妙香散。
张（二四）形壮脉小。自述心力劳瘁。食减遗精。仿景岳精因气而夺。当养气以充精。理其无形。以固
有形。妙香散。
支（二二）痰多鼻塞。能食。有梦遗精。医投疏泄肺气消痰。六十剂不效。问读书夜坐。阳气必升。充塞
上窍。上盛下衰。寐则阳直降而精下注为遗。用补心丹。
黄（三一）真阴损伤。而五志中阳。上燔喉痛。下坠为遗。精髓日耗。骨痿无力。必延枯槁而后已。药饵
何足久恃。
早服补心丹 晚服桑螵蛸散。
胡 遗精四年。精关久滑不固。阴久伤。阳气不入阳跷穴。夜寤不寐。前以镇摄小效。独心中怔
悸不已。以桑螵蛸散。从心肾治。
毕（二六）有梦遗精。是心肾病。清心固肾。是为成法。得以水火交合。病当渐减。内伤病。从内起。岂得
与外来六气混治。
熟地 龙骨 远志 五味 茯神 芡实 建莲 金樱膏丸。
程 左脉刚坚。火升。神气欲昏。片刻平复。宛若无病。此皆劳心五志之阳动。龙相无制。常有遗
泄之状。先用滋肾丸三钱。淡盐汤送。
又 早服补阴丸 晚服三才加炒黄柏砂仁。
又 交霜降。络中陡然热蒸。肢节皆麻。火风震动。多因脾肾液枯。议用二至百补丸意。斑龙二
至百补丸加黄柏。
林（十八）诊脉细涩。寐则遗精。心热口渴。不时寒热。此肾阴内损。心阳暗炽。补心丹三钱四服。
某 冬令烦倦嗽加。是属不藏。阳少潜伏。两足心常冷。平时先梦而遗。由神驰致精散。必镇心
以安神。犹喜胃强纳谷。若能保养。可望渐愈。
桑螵蛸 金樱子 覆盆子 芡实 远志 茯神 茯苓 龙骨 湖莲
煎膏。炼蜜收。饥时服七八钱。
杨（十八）冲年遗精。知识太早。难成易亏。真阴不得充长。及壮盛未有生育。而久遗滑漏。褚氏谓难
状之疾者。盖病伤可复。精损难复也。诊脉上动尺芤。心动神驰。神驰精散。草木性偏。焉得见
长。务宜断欲百日。以妙香散桑螵蛸散方。理心脾以交肾。固肾气以宁心。早晚并进。百日以验之。
吕（二四）成婚太早。精血未满久泄。必关键不摄。初则精腐变浊。久则元精滑溢。精浊之病。巢氏分
晰彰着。经言肾虚气漫为胀。咸为肾味。上溢口舌。皆下失摄纳之权。（肾气不摄）
生菟丝子粉 蛇床子 覆盆子 陕沙苑子 家韭子 五味子
鳇鱼胶丸。
许（十九）脉虚芤。应乎失血遗精。先天既薄。更易泄少藏。正褚氏所云难状之疾。冲年须潜心静处。
冀水火自交。可以精固。莫但图药饵。须坚守瞬刻强制之功。
鲜河车膏 九蒸熟地 五味 萸肉 山药 湖莲 砂仁 芡实 金樱膏丸。
李（二五）脉小色白。失血遗精屡发。犹喜纳谷胃安。封藏固补。使其藏聚。若再苦寒泻火。胃伤废食。
坐以待困矣。
熟地 萸肉 五味 覆盆子 河车膏 生菟丝粉 山药 湖莲 茯苓 芡实 金樱膏丸
某 脉左部数。有锋芒。初夏见红。久遗滑。入夜痰升肋痛。肝阳上冒。肾弱不摄。固摄助纳。必佐凉肝。
熟地 湖莲 芡实 生白龙骨 茯神 川石斛
章 脉数虚。气冲心热。呛咳失血。屡因嗔怒。肝阳升则血涌。坠则精遗。春末土旺。入夏正当发
泄主令。暮热晨汗。阴阳枢纽失固。议进摄真。其清寒肺药须忌。（兼失血）
鱼鳔胶 生龙骨 桑螵蛸 芡实 茯苓 五味 秋石（调入）
陆（二一）肌肉松柔。脉小如数。常有梦遗。阴精不固。上年冬令过温。温则腠理反疏。阳动不藏。诸气
皆升。络血随气上溢。见症如头面热。目下肉 心悸怔忡。四末汗出。两足跗肿。常冷不温。走
动数武。即吸短欲喘。何一非少阴肾气失纳。阳浮不肯潜伏之征。况多梦纷扰。由精伤及神
气。法当味浓填精。质重镇神。佐酸以收之。甘以缓之。勿因血以投凉。莫见下寒。辄进燥热。恪
守禁忌以安之。经年冀有成功。所虑冲年志虑未纯。贻忧反复。
水制熟地 人参（秋石拌） 白龙骨 炒杞子 五味 炒山药 茯神 牛膝炭
遗精一症。前贤各有明辨。其义各载本门。兹不复赘。大抵此症。变幻虽多。不越乎有梦。无
梦。湿热。三者之范围而已。古人以有梦为心病。无梦为肾病。湿热为小肠膀胱病。夫精之
藏制虽在肾。而精之主宰则在心。其精血下注。湿热混淆而遗滑者。责在小肠膀胱。故先
生于遗精一症。亦不外乎宁心益肾。填精固摄。清热利湿诸法。如肾精亏乏。相火易动。阴
虚阳冒而为遗精者。用浓味填精。介类潜阳。养阴固涩诸法。如无梦遗精。肾关不固。精窍
滑脱而成者。用桑螵蛸散填阴固摄。及滑涩互施方法。如有梦而遗。烦劳过度。及脾胃受
Patient Chen, after the condition had progressed to cold extremities (Jue). Shortness of breath and frequent seminal emission during dreams. Proposal: Secure the Lower Jiao. (Pathogenesis: Yin deficiency with Yang hyperactivity)
Prescription: Shu Di Huang (Prepared Rehmannia Root, 4 qian), Sang Piao Xiao (Mantis Egg-case, 2 qian), Fu Pen Zi (Raspberry Fruit, 1 qian), Wu Wei Zi (Schisandra Berry, 1 qian), Hu Lian (Lotus Seed from Lake, 3 qian), Qian Shi (Euryale Seed, 2 qian), Fu Shen (Poria with Hostwood, 3 qian), Shan Yao (Chinese Yam, 2 qian).
Certain patient (40 years old), seminal emission during dreams with turbid semen. Triggered by even slight fatigue, unhealed for three years. Kidney essence and Qi are already depleted; Ministerial Fire (Xiang Huo, the fire of Ming Men residing in Liver and Kidney) is prone to hyperactivity without restraint, thus essence cannot be secured. Emission occurs due to disturbance by fatigue.
Treatment should tonify the Lower Jiao, allowing essence to fill and Yang to submerge, so that recovery can be planned.
Prescription: Shu Di Huang (8 liang), Mai Dong (Ophiopogon Tuber, 2 liang), Fu Shen (2 liang), Wu Wei Zi (2 liang), Xian Jiao (Donkey-hide Gelatin/Ejiao, 4 liang), Chuan Hu Gao (Dendrobium Paste, 4 liang), Sha Yuan (Astragalus Complanatus Seed, 2 liang), Yuan Zhi (Polygala Root, 1 liang), Qian Shi (3 liang), Hu Lian (3 liang). Prepared as Jin Ying Gao Wan (Golden Rose Paste Pills).
Patient Ma (22 years old), Yin-deficient constitution. Frequently suffers from dream-emission. Treatment nourishes Yin assisted by astringents, while incorporating draining/dispersing herbs can be effective. Formula: Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) minus Mu Dan Pi and Ze Xie, plus Hu Lian, Qian Shi, Wu Wei Zi, Yuan Zhi, Qiu Shi. Prepared as Jin Ying Gao Wan.
Patient Zhang, Yin essence leaks out, Yang loses its attachment. Rising Yang manifests as heat in the head. The Yang within Kan Water (Kidney Water) does not hide. Ancients would necessarily use rich/flavorful substances to tonify, and shell-type (bivalve/turtle) heavy substances to anchor/submerge Yang. This draws Yang back from Yin, differing from modern practitioners who immediately use cooling herbs upon seeing heat.
Prescription: Shu Di Huang, Gui Jia (Tortoise Shell), Dan Cai (Edible Mussel Meat), Qing Yan (Green Salt), Fu Shen, Bai Zi Ren (Biota Seed), Nu Zhen Zi (Ligustrum Fruit), Shan Yao, Han Lian Cao (Eclipta Herb).
Certain patient (21 years old), Pulse is Left Wiry and Right Soft/Sluggish. Dream emission, cough with rebellious Qi and rapid breathing.
Prescription: Shu Di Huang, Mai Dong, Yu Rou (Cornus Fruit), Wu Wei Zi, Mu Li (Oyster Shell), Fu Shen, Nu Zhen Zi, Shan Yao, Hu Lian, Chuan Hu Gao, Qian Shi. Prepared as Jin Ying Gao with Honey Pills. Take 4-5 qian per dose, swallowed with light salt water.
Patient Yang, Pulse sinks into the Chi position. Has dream emission and spermatorrhea. Proposal: Tonify Yin and secure the Lower Jiao.
Prescription: Shu Di Huang, Yu Rou, Wu Wei Zi, Shan Yao, Fu Shen, Fu Pen Zi, Yuan Zhi, Xian Jiao, Hu Lian, Qian Shi. Prepared as Jin Ying Gao Wan, taken with salt water.
Patient Liu, previously suffered from eye disease, tearing, stomach discomfort (zao re) and loss of appetite. Internal stagnation caused Qi to surge, Yang moved excessively. Yin deficiency failed to govern retention. In mid-spring, consecutive episodes of emission occurred, with soreness and pain in the waist and spine. These are diseases of the Liver and Kidney.
Prescription: Shu Di Huang, Long Gu (Fossilized Bone), Yu Rou, Fu Shen, Mu Dan Pi, Hu Lian, Qian Shi, Yuan Zhi.
Certain patient, suffering from Lao Sun (chronic debility) with leaking ulcers, loose stools. Yin Fire rises, lower part experiences emission and slipping.
Prescription: Shu Di Huang, Gui Ban (Tortoise Plastron), Qian Shi, Shan Yao, Nu Zhen, Jian Lian (Lotus Seed), Zhi Cao (Honey-fried Licorice), Dou Pi (Phellodendron Bark).
Certain patient, young man frequently emitting semen, insomnia with heart discomfort. This belongs to Fire in the Kidney. Essence moves recklessly due to heat. Later, it may lead to complications of Shen Xiao (Kidney Consumption, resembling diabetes).
Prescription: Jiao Huang Bo (Charred Phellodendron), Sheng Di Huang (Raw Rehmannia), Tian Dong (Asparagus Tuber), Fu Ling (Poria), Mu Li, Chao Shan Yao (Stir-fried Chinese Yam).
Certain patient, pulse deficient, complexion pale, sudden significant emaciation. Usually, both form and spirit are overworked. At Winter Solstice, initial Yang activates, causing essence to shake and leak downward. Added to this is night sitting without quiet rest, and violent cold again damaging Yang. Body does not fever, but there is frequent fright, palpitations, and irritability. Following Zhang Zhongjing’s example of Yang exhaustion with muscle twitching, use the method of Jiu Ni Tang (Rescue the Counterflow Decoction). Must achieve calm and stillness of Spirit, avoiding changes of coma and convulsions. Prescription: Jiu Ni Tang minus Shao Yao (Peony).
Patient Fei, complexion dark, pulse rapid. Heart vexation leads to emission. Yang Fire descends, Yin deficiency fails to retain. Damp-Heat pours downward. Astringents alone are ineffective. (Pathogenesis: Yin Deficiency with Damp-Heat)
Prescription: Bi Xie (Dioscorea Hypoglauca Rhizome), Huang Bo, Chuan Lian (Coptis Rhizome), Yuan Zhi, Fu Ling, Ze Xie (Alisma Rhizome), Jie Geng (Platycodon Root), Yi Yi Ren (Coix Seed).
Patient Wu (22 years old), pathology involves Kidney and Liver. Headache in the vertex relieves slightly with purging, distension in lower abdomen and scrotum. Presumed Yin aspect is originally deficient, while Damp-Heat lingers, preventing Fu-Jing Qi from flowing and transforming smoothly. This is logical. First, clear Stagnant Heat of Jue Yin, simultaneously unblock Fu Qi, then discuss further.
Prescription: Long Dan Cao (Gentiana Root), Hu Huang Lian (Coptis Chinensis var. wutaiensis or similar), Bi Xie, Mu Dan Pi, Fu Ling, Ze Xie.
Second visit: Reviewing the etiology, it is the deficiency of Zang Yin and Jing Essence that causes floating Yang headache, accompanied by emission, occurring several times a month. Lower Deficiency and Upper Excess. Purely using tonifying and astringent methods will definitely not match the disease. The patient cannot tolerate pills. Use a combination of draining and securing methods.
Prescription: Gui Ban, Qiu Shi (Mineral Salt), Shu Di Huang, Nu Zhen, Yuan Zhi, Qian Shi, Hu Lian, Fu Ling. Decocted into a paste.
Patient Qian (20 years old), pulse Right Wiry, Left Sinking. Yin Deficiency with Damp-Heat, emission with ulcerative lesions.
Prescription: Huang Bo, Zhi Mu (Anemarrhena Rhizome), Shu Di Huang, Bi Xie, Fu Ling, Yuan Zhi. Prepared as Honey Pills.
Certain patient, dream emission disease. This is Yin Qi leaking, while Damp-Heat pathogens sink downward taking advantage of deficiency. The sensation of heaviness drops from the waist to the scrotum, visible at Huantiao and knee areas. Long-term emission injures the Eight Extraordinary Vessels. Proposal: Use draining herbs, simultaneously regulating Yin Qi. Formula: Zhu Ling Tang (Polyporus Decoction).
Second visit: Shu Di Huang, Wu Wei Zi, Qian Shi, Fu Ling, Hu Lian, Shan Yao.
Patient Song (23 years old), frequent emission without dreams, indicating the essence aperture has become slippery. Ancients said: "Treat the Heart for dream emission, treat the Kidney for non-dream emission." Kidney Yin has been damaged for a long time, Yang rises without restraint. Phlegm stored in the throat is unclear, all transformed from the Five Fluids. Stomach intake is low and transport is slow. Securing the Lower must be assisted by strengthening the Middle. (Lower damage affecting Middle, treating Spleen and Stomach concurrently)
Prescription: Ren Shen (Ginseng), Sang Piao Xiao, Sheng Long Gu (Raw Fossilized Bone), Suo Yang (Cynomorium Stem), Qian Shi, Shu Di Huang, Fu Shen, Yuan Zhi. Prepared as Jin Ying Gao Wan.
Patient Hua (29 years old), Spirit injured above, essence corrupted below. Heart and Kidney do not interact. Long-term injury to essence and Qi without recovery is called "Sun" (Damage). Nei Jing treats damage to the Five Zang differently. Yue Ren (Bian Que) proposed "Upper damage follows Yang, Lower damage follows Yin." However, one must rely on food intake for nourishment; only when the Post-Heaven Spleen/Stomach is revitalized can one hope for essence generated from grain. From last autumn to today, the condition worsened significantly. This is internal True Yuan having no storage. When Spring command releases, Sheng Qi (Vital Energy) does not arrive, gradually leading to dispersion. Essence and Blood are tangible; how can medicine suddenly replenish them?
Methods of attacking disease usually target external pathogens, using bias to treat bias. Reading Li Dongyuan and Zhu Danxi, for those with damage unwilling to recover, first greatly advance Ren Shen and Bai Zhu, up to several jin. It is said: "Tangible essence and blood are hard to generate; intangible Yuan Qi must be urgently secured." Moreover, when Upper and Lower are mutually damaged, one should treat the Middle. If Middle Qi revives and appetite increases, then introduce securing, tonifying essence, and calming Spirit methods. Currently, Spring Wood is heavily releasing, flowers blooming everywhere. The human body responds. In this month, urgently rescue without slackening.
Prescription: Shen Zhu Gao (Ginseng and Atractylodes Paste), mixed with Rice Drink.
Subsequently administer Kou Shi Sang Piao Xiao San, removing Dang Gui.
This calms Spirit, secures essence, gathers dispersion, employing astringency to treat prolapse.
Second visit: For half a month, took Sang Piao Xiao San to secure the Lower, Shen Zhu Gao to benefit the Middle, emission and slipping stopped. The Lower Guan has some mechanism of retrieval. However, day and night when about to sleep, various matters disturb the mind. Spirit is injured and dispersed, hardest to gather. Furthermore, worry and accumulated labor secretly damage Heart and Spleen Ying Blood. Blood does not contain internally, Spirit becomes lonely. Proposal: Use Yan Shi Ji Sheng Gui Pi Fang (Regulate Spleen Formula from Ji Sheng), so that True Qi of other Zang organs returns to the Spleen. Before Summer, Earth commands, grasping the Post-Heaven, most consistent with principle. Formula: Gui Pi Tang (Restore the Spleen Decoction).
Second visit: Fourth day of Start of Summer, diagnose Left pulse over 100 beats, showing signs of gathering. Right Guan and Chi positions, pulse is Kou (Hollow) and Dong (Fluttering) like Ge (Leather). Pressing below the navel past Cun, moving Qi seems like weaving through. This is Kong Yuan (CV4) being empty inside, Chong Mai (Penetrating Vessel) lacking nourishment, jumping incessantly. This is the meeting place for female uterus and male essence accumulation. Generally, for internal damage to essence, blood, form, and Qi, if Stomach is strong and accepts food, focus must be on tonifying and filling. Now food intake is reduced, cannot accept. Brief nap brings vexation and fright, sweating upon waking. Self-reports five-center heat blazing, limbs and bone joints hot and weak as if falling. Clearly, internal Yin essence is dried up, causing Yang not to join Yin, turning drier and more depleted, from Lower to Middle to Upper. Previously administered Sang Piao Xiao San, securing essence aperture, emission stopped for a month. But sleep and food have not improved, Post-Heaven Sheng Qi is not awakened. Rich tonification is difficult to advance logically. Even Shen Zhu Gan Wen (Sweet and Warm) tonifying Qi might increase dryness. Should combine Sheng Mai (Generate the Pulse) to moisten San Jiao. Morning: one cup of Human Milk, guiding Qi, Blood, Yin, and Yang, welcoming the return of Yin at Summer Solstice. Early morning: one cup Human Milk, stewed hot in water bath. Afternoon slight hunger: use Sheng Mai Si Jun Zi Tang (Generate the Pulse and Four Gentlemen Decoction).
Second visit: Over the past month, although repeated, examining pulse, symptoms, form, and color, Sheng Yang has roots. Recently ate broad beans causing Qi stagnation, slight abdominal distension, sour and turbid taste after eating. Due to prolonged lying down, the mechanism of Spleen Yang movement is scarce, while Fire rises causing vexation, moving Qi, sweating, and emission, though reduced from before, not yet flat. Always deep internal damage. If treatment is appropriate, for every point of essence recovered, one point of disease symptom decreases. Late Summer Spleen/Stomach commands, cultivating Earth to assist acceptance is key. While essence disperses, still combine securing methods. Currently sour taste and slight distension, tonifying Spleen with slight Stomach-soothing is suitable for evening intake. Morning separately prepare tonifying and securing pills, benefiting Zang True Qi to attract scattered Qi.
(Evening Formula): Ren Shen, Fu Ling, Bai Zhu, Zhi Cao, Guang Pi (Tangerine Peel), Mai Dong, Wu Wei Zi, Shen Qu (Medicated Leaven), Mai Ya (Malt), Chao Huang Bo.
(Morning Pill Formula): Ren Shen, Sang Piao Xiao, Bai Long Gu, Dan Cong Rong, Wu Wei Zi, Qian Shi, Fu Shen, Zao Ren (Jujube Seed), Jin Po (Gold Foil), Jin Ying Gao Wan. Swallow 3-4 qian with light salt water.
Second visit: Form and color show gradual recovery. Compared to Summer Solstice, disease gone by 30-40%. But Right pulse is Wiry and Large, lacking harmony. Left pulse is Fine and Rapid, not yet calm. Grain intake, transport is slow, with acid regurgitation and distension. Still desire emission during sleep. This Middle Jiao Yang, when active, transports. Lower Jiao Yin, when secured, guards. This is a fixed standard method.
Afternoon: Yi Gong San (Extra Efficacy Powder) plus Chao Gu Ya (Stir-fried Millet Sprout).
(Morning): Standard method for residual illness securing Lower Jiao is general. Presuming Jing Guan (Essence Gate) is slippery, astringents cannot take effect. Must use slippery drugs to guide, seeking same energy, ancient methods exist.
Prescription: Niu Marrow, Yang Marrow, Pig Spinal Cord, Mi Jiao (Elk Antler Gelatin), Bai Long Gu, Sheng Mu Li, Shu Di Huang, Yu Rou, Fu Shen, Wu Wei Zi, Shan Yao, Qian Shi, Hu Lian, Yuan Zhi, Sha Ren (Amomum Fruit). Gelatin and marrow replace honey for pills. Morning take 4 qian. Dissolve 2 fen Qiu Shi in water to swallow.
Patient Mao (26 years old), Long Summer damp-heat and warmth stagnate, all injuring Spleen/Stomach. Yellow complexion, tired spirit, Qi branch self-depleted. Because of emission symptom, in prime youth, Yin deficiency is common. Inquiry shows appetite not strong, emission must come with fatigue. Pulse is not rapid and forceful. Proposal: Establish law of nourishing Spleen. Gui Pi Tang minus Huang Qi and Gui Yuan, add Yi Zhi Ren and Long Gu.
Patient Xiang, pulse Left Weak, Right Wiry. Yellow complexion, little food, abdominal distension, loose stools. Frequent dream emission. This is not suitable for Yin-nourishing, soft, astringent, and cloying herbs. Use warming Yang to contain Yin.
Prescription: Sheng Tu Si Zi (Dodder Seed), Fu Pen Zi, She Chuang Zi (Cnidium Fruit), Wu Wei Zi, Jiu Zi (Leek Seed), Yi Zhi Ren (Roasted Alpinia Oxyphylla Fruit), Bu Gu Zhi (Psoralea Fruit), Long Gu. Jian Lian Fen Wan (Lotus Root Starch Pills).
Patient Ding, Yin essence leaks, Yang does not root internally. Desire to sleep but wakes immediately, heart palpitations and trembling. So-called Qi is seized because of Essence. Should nourish Essence to secure Qi. Previous warming medicines were not wrong. But not distinguishing rigid and soft led to biased Yang, hence bleeding. Do not see bleeding and immediately use cooling. (Heart and Kidney treated concurrently)
Prescription: Gui Ban (Remove wall, scrape smooth, 1 liang), Sang Piao Xiao Ke (Mantis Egg-case Shell, 3 qian), Ren Shen (1 qian), Dang Gui (1 qian), Qing Hua Long Gu (Blue-flower Fossilized Bone, 3 qian, flown), Bao Mu Fu Shen (Wood-wrapped Poria, 3 qian).
Patient Yao (24 years old), began with thoughts arising unsatisfied, Yang sinks downward and essence leaks. First dreaming, Heart Yang notes to Kidney. Long term, essence and blood daily decrease, failing to nourish sinews and bones causing pain. Lower damage affects Middle, food not transported and transformed. This is not solved by Yu Di (cloying Chest) and astringing essence. Miao Xiang San (Wonderful Incense Powder).
Patient Xu (18 years old), Yin Qi leaks causing emission. Must tonify and fill to secure. Now intake is small and not sweet, Stomach Qi is weak, cloying tonics first obstruct appetite. Proposal: Use Sang Piao Xiao San, Honey Pills, take 3-4 qian.
Patient Ge, emission for years, not only Kidney Gate not secured, Yangming meridians also empty. To cure, must abstain from desires and calm Heart for one year. Cold and heat change, Yin and Yang gradually interact. Treat with Sang Piao Xiao San.
Patient Gu (19 years old), slippery emission. Using Yin medicines suddenly reduces food intake, medicine first injures Stomach. Reports dream madness, essence leaving cannot protect Spirit. Must secure the Intangible.
Prescription: Ren Shen, Sheng Long Gu, Sang Piao Xiao, Yi Zhi Ren, Fu Shen, Fu Ling, Yuan Zhi, Mu Xiang (Costus Root).
Patient Lv (37 years old), has dreams then emits, caused by Heart being touched. Business management and handling all disturb Spirit and move Heart. Speaking of merchants traveling outside, not related to wine and women. Miao Xiang San.
Patient Yu (37 years old), strong physique in prime, pulse Kou (Hollow) and Deficient. Reports heart palpitations, much fear, night sleep not very peaceful. This Yang is difficult to join Yin, caused by overusing mental labor. Miao Xiang San.
Patient Zhang (24 years old), robust form, small pulse. Self-reports mental and physical exhaustion, reduced food, emission. Imitate Jing Yue's "Essence is lost because of Qi," should nourish Qi to fill Essence. Regulate the Intangible to secure the Tangible. Miao Xiang San.
Patient Zhi (22 years old), much phlegm, nasal congestion, able to eat, has dream emission. Doctor administered dispersing Lung Qi and eliminating phlegm, 60 doses ineffective. Asked about reading and night sitting, Yang must rise, filling upper apertures, Upper Excess Lower Deficiency. Sleep then Yang directly descends and essence pours downward causing emission. Use Bu Xin Dan (Tonify Heart Pill).
Patient Huang (31 years old), True Yin damaged, while Yang among Five Emotions burns upward causing throat pain, sinks downward causing emission. Essence and marrow daily consumed, bone weakness and无力. Must extend to withering before ending. How can medicine suffice for long reliance?
Morning: Bu Xin Dan. Evening: Sang Piao Xiao San.
Patient Hu, emission for four years, Jing Guan slippery and not secured for long, Yin damaged for long, Yang Qi does not enter Yang Qiao vessel, night wakefulness insomnia. Previously used anchoring/securing with small effect, only heart palpitations continue. Use Sang Piao Xiao San, treating from Heart and Kidney.
Patient Bi (26 years old), has dream emission, this is Heart and Kidney disease. Clear Heart and secure Kidney, this is established method. Achieve Water and Fire interaction, disease should gradually reduce. Internal injury diseases arise from within, how can they be mixed-treated with external Six Qi?
Prescription: Shu Di Huang, Long Gu, Yuan Zhi, Wu Wei Zi, Fu Shen, Qian Shi, Jian Lian, Jin Ying Gao Wan.
Patient Cheng, Left pulse rigid and firm, Fire rises, Spirit wants to faint, recovers in moments, as if no disease. All these are Labor Heart and Five Emotions Yang moving, Dragon and Ministerial Fire unrestrained, often having emission appearance. First use Zi Shen Wan (Nourish Kidney Pill) 3 qian, taken with light salt water.
Second visit: Morning: Bu Yin Wan (Nourish Yin Pill). Evening: San Cai (Three Capabilities) plus Chao Huang Bo and Sha Ren.
Third visit: Entered Frost Descent, meridians suddenly steaming with heat, limb joints all numb, Fire-Wind shaking. Mostly due to Spleen and Kidney fluid drying up. Proposal: Use intent of Er Zhi Bai Bu Wan. Ban Long Er Zhi Bai Bu Wan plus Huang Bo.
Patient Lin (18 years old), diagnose pulse Fine and Choppy, sleep then emission, Heart heat, thirst, intermittent chills and fever. This Kidney Yin internal damage, Heart Yang secretly blazing. Bu Xin Dan 3 qian, four doses.
Certain patient, Winter season vexation, fatigue, cough increases, belonging to not hiding. Yang lacks submergence, soles of feet often cold. Usually first dreams then emits, due to Spirit galloping causing essence scattering. Must anchor Heart to calm Spirit. Still pleased with strong Stomach accepting food, if can maintain, hope for gradual recovery.
Prescription: Sang Piao Xiao, Jin Ying Zi (Cherokee Rose Fruit), Fu Pen Zi, Qian Shi, Yuan Zhi, Fu Shen, Fu Ling, Long Gu, Hu Lian. Decoct into paste, refine with honey. Take 7-8 qian when hungry.
Patient Yang (18 years old), adolescent emission, knowledge too early, hard to form easy to lose, True Yin cannot grow. In prime without offspring, but long emission leakage. Chu Shi said difficult-to-describe disease, because illness injury can recover, essence damage is hard to recover. Diagnose pulse Upper moving, Chi Kou (Hollow), Heart moves Spirit gallops, Spirit gallops essence scatters, herbal nature is biased, how can growth be seen? Must abstain from desire for 100 days, use Miao Xiang San and Sang Piao Xiao San formulas, regulate Heart/Spleen to interact with Kidney, secure Kidney Qi to calm Heart. Morning and evening advance together, verify in 100 days.
Patient Lv (24 years old), married too early, essence and blood not full, long leakage, surely gate not retaining. Initially essence rots becoming turbid, long term primal essence slips and overflows. Jing Zhuo (Essence Turbidity) disease, Chao Shi analyzed clearly. Classics say Kidney deficiency Qi overflows causing distension, Salty is Kidney flavor, overflowing mouth/tongue, all lower losing retention power. (Pathogenesis: Kidney Qi failing to retain)
Prescription: Sheng Tu Si Zi Fen (Dodder Seed Powder), She Chuang Zi, Fu Pen Zi, Shan Sha Yuan Zi (Shaanxi Astragalus Complanatus Seed), Jia Jiu Zi (Home Leek Seed), Wu Wei Zi. Huang Yu Jiao Wan (Sturgeon Gelatin Pills).
Patient Xu (19 years old), pulse Void and Kou, corresponding to blood loss and emission. Innate is thin, easier to leak less to store. Exactly Chu Shi's said difficult disease. Adolescent must concentrate mind and stay quiet, hoping Water and Fire self-interact, can essence be secured. Do not just seek medicine, must persist in momentary forced effort.
Prescription: Xian He Che Gao (Fresh Placenta Paste), Jiu Zheng Shu Di (Nine-steamed Prepared Rehmannia), Wu Wei Zi, Yu Rou, Shan Yao, Hu Lian, Sha Ren, Qian Shi, Jin Ying Gao Wan.
Patient Li (25 years old), pulse small, complexion pale, blood loss and emission recurring. Still pleased with accepting food and Stomach peace. Seal and store, solidly tonify, making it gather. If again bitter-cold clearing Fire, Stomach injured, food abandoned, sit waiting for困境.
Prescription: Shu Di Huang, Yu Rou, Wu Wei Zi, Fu Pen Zi, He Che Gao (Placenta Paste), Sheng Tu Si Fen (Raw Dodder Powder), Shan Yao, Hu Lian, Fu Ling, Qian Shi, Jin Ying Gao Wan.
Certain patient, pulse Left section Rapid, has sharp edge, early summer sees red (blood), long emission slipping, night phlegm rises, rib pain, Liver Yang rises, Kidney weak not retaining. Securing and assisting acceptance, must assist cooling Liver.
Prescription: Shu Di Huang, Hu Lian, Qian Shi, Sheng Bai Long Gu (Raw White Fossilized Bone), Fu Shen, Chuan Shi Hu (Dendrobium).
Patient Zhang, pulse Rapid and Deficient, Qi rushes to Heart heat, choking cough blood loss, repeatedly due to anger, Liver Yang rises then blood surges, sinks then essence emits. Late Spring Earth旺盛, entering Summer正当 release command, evening heat morning sweat, Yin-Yang hub lost security. Proposal advance securing True Yuan, its cooling-cold Lung medicines must be avoided. (Accompanied by blood loss)
Prescription: Yu Biao Jiao (Fish Bladder Gelatin), Sheng Long Gu, Sang Piao Xiao, Qian Shi, Fu Ling, Wu Wei Zi, Qiu Shi (mixed in).
Patient Lu (21 years old), muscles loose and soft, pulse small as if rapid, often dream emission, Yin essence not secured. Last winter over-warmed, warmth then pores open, Yang moves not hiding, all Qi rise, collateral blood follows Qi upward溢. Symptoms like head/face heat, under-eye muscle twitching, heart palpitations, four extremities sweating, two foot dorsum swelling, often cold not warm, walking few steps, then short breath wanting asthma. Which one is not Shao Yin Kidney Qi failing to receive, Yang floating refusing to submerge sign? Moreover many dreams disturbing, due to essence injury affecting Spirit Qi. Method should be rich flavor filling essence, heavy quality anchoring Spirit, assist Sour to collect, Sweet to缓. Do not because of blood use cooling, do not see Lower cold immediately advance dry-hot. Strictly observe taboos to calm. Year-long hope for success. Worried adolescent mind not pure, causing worry recurrence.
Prescription: Shui Zhi Shu Di (Water-processed Prepared Rehmannia), Ren Shen (mixed with Qiu Shi), Bai Long Gu, Chao Qi Zi (Stir-fried Goji Berry), Wu Wei Zi, Chao Shan Yao, Fu Shen, Niu Xi Tan (Burnt Achyranthes Root).
Emission symptom, ancients each had clear differentiation, their meanings each recorded in their own schools, here no longer repeat. Generally this symptom, changes although many, do not exceed the scope of Having Dreams, No Dreams, Damp-Heat, three categories. Ancients considered Having Dreams as Heart disease, No Dreams as Kidney disease, Damp-Heat as Small Intestine/Bladder disease. Although essence storage/control is in Kidney, essence mastery is in Heart. Its essence/blood pouring downward, Damp-Heat confusing causing emission/slipping, responsibility lies in Small Intestine/Bladder. Thus Mr. [Ye Tianshi] on emission symptom, also not outside Calming Heart, Benefiting Kidney, Filling Essence, Securing, Clearing Heat, Draining Dampness methods. Like Kidney essence depletion, Ministerial Fire prone to move, Yin deficiency Yang floating causing emission, use rich flavor filling essence, shell-type anchoring Yang, nourishing Yin securing astringency methods. Like No Dream emission, Kidney Gate not secured, essence aperture slipping becoming, use Sang Piao Xiao San filling Yin securing, and slippery/astringent mutual application methods. Like Having Dream emission, fatigue excessive, and Spleen/Stomach receiving...