浊主湿热，有痰、有虚。赤属血，白属气。痢带同治，寒则坚凝，热则流通。
率皆是湿痰流注，宜燥中宫之湿，用二陈加苍术、白术燥去其湿。赤者，乃是湿伤血也，
白芍药，仍用珍珠粉丸加臭椿根白皮、滑石、青黛，作丸药。虚劳用补阴药，大概不宜热
（一作凉）药；肥白人必多痰，以二陈汤去其湿热。胃弱者，兼用人参，以柴胡、升麻升其
胃中之气；丸药，用黄柏炒褐色，干姜炒微黑，滑石、蛤粉、青黛，糊丸服。胃中浊气下
为赤白浊，用二陈加柴胡、升麻、苍术、白术；丸药用樗皮末、蛤粉、炒干姜、炒黄柏。胃
中浊气下流，渗入膀胱，青黛、蛤粉。肝脉弦者，用青黛以泻肝。又方∶炒黄柏一两，生
柏
曲糊
阴火间起，小便白浊，方在痛风类。一人便浊经年，或时梦遗，形瘦，作心虚主治，用珍
粉丸，和定志丸服。一妇人年近六十，形肥奉养膏粱，饮食肥美，中焦不清，浊气流入
膀胱，下注白浊，白浊即湿痰也，用二陈去痰，加升麻、柴胡升胃中清气，加苍术去
湿，白术补胃，全在活法。服四帖后，浊减大半，却觉胸满。因柴胡、升麻升动胃气，痰
阻满闷。又用本汤加炒曲、白术、香附。素无痰者，虽升动不满也。
入方
青黛 蛤粉 椿末 滑石 干姜（炒） 黄柏（炒褐色）
上为末，神曲糊丸。仍用前燥湿痰丸子，亦治带下病。
法云∶黄柏治湿热，青黛解郁热，蛤粉咸寒入肾，滑石利窍，干姜味苦，敛肺气下降，
使阴血生，干姜监制。
又方
黄柏（炒黑，一两） 生柏（二两，一云生地黄） 蛤粉（三两） 神曲（半两）
上为末，水丸服。
〔附录〕人之五脏六腑，俱各有精，然肾为藏精之府，而听命于心，贵乎水火升降，精气
内持。若调摄失宜，思虑不节，嗜欲过度，水火不交，精元失守，由是而为赤白浊之患。赤
是心虚有热，因思虑得之；白浊肾虚有寒，过于淫欲而得之。其状漩白如油，光彩不定，
脚澄下，凝如膏糊。治法∶赤者当清心调气，白者温补下元，又须清上，使水火既济，阴
阳协和，精气自固矣。
附方
定志丸方
远志（去心） 石菖蒲（各二两） 人参 白茯苓（各三两）
上为末，蜜丸梧子大，朱砂为衣。每服七丸，加至二十丸，空心米汤送下。
半夏丸 治白浊神效。
半夏（燥湿） 猪苓（分水） 肝脉弦，加青黛。
二陈汤 治浊，能使大便润而小便长。浊气只是温痰，有白浊人，服玄菟丹不愈，服附
丸即愈者，不可不知。有小便如常，停久才方漩浊。
清心莲子饮 心虚有热，小便赤浊，或有沙膜。方见淋类。
萆 厘清饮 治真元不足，下焦虚寒，小便白浊，频数无度，漩白如油，光彩不定，漩
脚澄下，凝如膏糊。
益智 川萆 石菖蒲 乌药（等分）
上锉。每服五钱，水煎，入盐一捻，食前服。一方加茯苓、甘草。
茯菟丸 治思量太过，心肾虚损，真阳不固，便溺余沥，小便白浊，梦寐频泄。
菟丝子（五两） 白茯苓（三两） 石莲肉（二两）
上为末，酒糊丸如梧子大。每三十丸，空心盐汤下。
瑞莲丸 治思虑伤心，小便赤浊。
白茯苓 莲肉 龙骨 天门冬 麦门冬 远志（去心） 柏子仁（另研） 紫石英（火 七
次，另研） 当归（酒浸） 酸枣仁（炒） 龙齿（各一两） 乳香（半两，研）
上为末，蜜丸梧子大，朱砂为衣。服七十丸，空心温酒枣汤任下。
又方 治小便白浊出髓条。
酸枣仁（炒） 白术 人参 白茯苓 故纸（炒） 益智 大茴香 左顾牡蛎（ ，各等分）
上为末，青盐酒为丸梧子大。每三十丸，温酒下。
又方 心经伏暑，小便赤浊。
人参 白术 赤茯苓 香薷 泽泻 猪苓 莲肉（去心） 麦门冬（去心等分）
上锉。水煎服。
珍珠粉丸 治白浊梦泄遗精，及滑出而不收。
真蛤粉（一斤） 黄柏（一斤，新瓦上炒赤）
上为末，滴水丸梧子大。每服一百丸，空心温酒送下。法曰∶阳盛阴虚，故精泄也。黄
柏降心火，蛤粉咸而补肾阴。
玄菟丹
菟丝子（酒浸，研，焙，取末，十两） 五味子（酒浸，研末，七两） 白茯苓 莲肉（各三两）
上为末，别研干山药末六两，将所浸酒余者，添酒煮糊，搜和，捣数千杵，丸如梧子大
。每服五十丸，米饮空心下。
附子八味丸 见补损。
Turbid discharge (Zhuo) is primarily caused by damp-heat, and may also involve phlegm-dampness or deficiency. Red turbidity belongs to the blood level, while white turbidity belongs to the qi level. The treatment for dysentery and leukorrhea is similar; cold causes stagnation and coagulation, while heat promotes flow.
These conditions are mostly due to the accumulation of damp-phlegm. It is appropriate to dry the dampness in the middle jiao (Spleen and Stomach), using Er Chen Tang (Two-Cured Decoction) added with Cang Zhu (Atractylodis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to dry and eliminate the dampness. In cases of red turbidity, it indicates that dampness has injured the blood. One should use Bai Shao Yao (Paeoniae Radix Alba) and still employ Zhen Zhu Fen Wan (Pearl Powder Pill) added with Chou Chun Gen Bai Pi (Bark of Toona Sinensis Root), Hua Shi (Talcum), and Qing Dai (Indigo Naturalis), prepared as pills. For deficiency consumption, yin-nourishing medicines should be used; generally, hot (or cool, depending on the version) medicines are not suitable. Obese individuals inevitably have much phlegm; use Er Chen Tang to remove their damp-heat. If the stomach qi is weak, add Ren Shen (Ginseng Radix et Rhizoma), and use Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma) to ascend the clear qi in the stomach. For pills, stir-fry Huang Bo (Phellodendri Cortex) until brown, stir-fry Gan Jiang (Zingiberis Rhizoma) until slightly black, then add Hua Shi (Talcum), Ge Fen (Concha Meretricis et Cyprinae), and Qing Dai (Indigo Naturalis), binding them with a paste for oral administration.
When turbid qi in the stomach descends to form red and white turbidity, use Er Chen Tang added with Chai Hu (Bupleuri Radix), Sheng Ma (Cimicifugae Rhizoma), Cang Zhu (Atractylodis Rhizoma), and Bai Zhu (Atractylodis Macrocephalae Rhizoma). For pills, use Chu Pi Mo (Powder of Bark of Toona Sinensis), Ge Fen (Concha Meretricis et Cyprinae), stir-fried Gan Jiang (Zingiberis Rhizoma), and stir-fried Huang Bo (Phellodendri Cortex). If turbid qi from the stomach flows downward and infiltrates the Bladder, use Qing Dai (Indigo Naturalis) and Ge Fen (Concha Meretricis et Cyprinae). If the Liver pulse is wiry (Xian), use Qing Dai (Indigo Naturalis) to drain Liver fire. Another prescription: Stir-fried Huang Bo (Phellodendri Cortex) 1 liang, mixed into pills with Sheng Bai Qu Paste.
Intermittent Yin-fire causing white turbidity in urine is discussed under the category of Gout (Tong Feng). A patient suffered from turbid urine for years, occasionally experiencing nocturnal emission, with a thin body. Treated as Heart deficiency, he took Zhen Zhu Fen Wan (Pearl Powder Pill) combined with Ding Zhi Wan (Stabilize Spirit Pill). A woman near sixty, obese, accustomed to rich food and fine diet, had unclear middle jiao. Turbid qi flowed into the Bladder, descending to cause white turbidity, which is essentially damp-phlegm. Use Er Chen Tang to resolve phlegm, add Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) to ascend clear qi in the stomach, add Cang Zhu (Atractylodis Rhizoma) to remove dampness, and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to tonify the stomach. Flexibility in application is key. After taking four doses, the turbidity reduced significantly, but chest fullness was felt. This was because Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma) ascended stomach qi, causing phlegm obstruction and fullness. Therefore, stir-fried Shen Qu (Massa Medicata Fermentata), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Xiang Fu (Cyperus Rhizoma) were added to the original formula. Those without pre-existing phlegm would not feel full even if stomach qi is ascended.
Prescription Ingredients: Qing Dai (Indigo Naturalis), Ge Fen (Concha Meretricis et Cyprinae), Chun Mo (Powder of Toona Sinensis Bark), Hua Shi (Talcum), Gan Jiang (Zingiberis Rhizoma, stir-fried), Huang Bo (Phellodendri Cortex, stir-fried to brown).
Grind all into powder, bind with Shen Qu (Massa Medicata Fermentata) paste to make pills. The previously mentioned damp-phlegm drying pills can also treat leukorrhea.
Medical Principle: Huang Bo (Phellodendri Cortex) treats damp-heat; Qing Dai (Indigo Naturalis) resolves constrained heat; Ge Fen (Concha Meretricis et Cyprinae) is salty and cold, entering the Kidney meridian; Hua Shi (Talcum) opens orifices; Gan Jiang (Zingiberis Rhizoma) is bitter, astringes Lung qi to descend, promoting Yin blood generation, and acts as a moderator.
Another Prescription: Huang Bo (Phellodendri Cortex, stir-fried black, 1 liang), Sheng Bai (2 liangs, some say Sheng Di Huang / Rehmanniae Radix), Ge Fen (Concha Meretricis et Cyprinae, 3 liangs), Shen Qu (Massa Medicata Fermentata, 0.5 liang).
Grind into powder, make water pills.
[Appendix] The five zang and six fu organs all possess essence and qi, but the Kidney is the storehouse of essence, subject to the command of the Heart. It relies on the ascending and descending of Water and Fire, and the internal retention of essence and qi. If regulation is improper, thoughts are uncontrolled, or desires are excessive, leading to a lack of interaction between Water and Fire, the primordial essence is lost, resulting in red and white turbidity. Red turbidity is due to Heart deficiency with heat, caused by excessive thinking; white turbidity is due to Kidney deficiency with cold, caused by excessive sexual indulgence. The condition presents as urine turbid like oil, with unstable luster, settling at the bottom, coagulating like paste. Treatment: Red turbidity requires clearing the Heart and regulating qi; white turbidity requires warming and tonifying the lower burner, while also clearing the upper burner, so that Water and Fire interact, Yin and Yang harmonize, and essence becomes secure.
Attached Prescriptions:
Ding Zhi Wan (Stabilize Spirit Pill): Yuan Zhi (Polygalae Radix, heart removed), Shi Chang Pu (Acori Tatarinowii Rhizoma) (each 2 liang), Ren Shen (Ginseng Radix et Rhizoma), Bai Fu Ling (Poria) (each 3 liang).
Grind into powder, make honey pills the size of wu zi (Chinese quince seeds), coat with Zhu Sha (Cinnabar). Take 7 pills per dose, increasing to 20, taken on an empty stomach with rice soup.
Ban Xia Wan (Pinellia Pill): Highly effective for white turbidity.
Ban Xia (Pinelliae Rhizoma, dries dampness), Zhu Ling (Polyporus). If Liver pulse is wiry, add Qing Dai (Indigo Naturalis).
Er Chen Tang (Two-Cured Decoction): Treats turbidity, moistening the stool and increasing urination. Turbid qi is merely warm phlegm. Some patients with white turbidity do not recover from Xuan Tu Dan but heal with Fu Wan. This must be known. Some have normal urine initially, which becomes turbid only after standing for a long time.
Qing Xin Lian Zi Yin (Clear Heart Lotus Seed Decoction): Treats Heart deficiency with heat, red turbid urine, or presence of sand/membrane. See under Lin syndrome (Strangury).
Bi Xi Li Qing Yin (Dioscorea Hypoglauca Clearing Decoction): Treats insufficiency of true yuan, cold-deficiency of the lower burner, white turbid urine, frequent and uncontrollable urination, urine white like oil, unstable luster, settling at the bottom, coagulating like paste.
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Chuan Bi Xi (Dioscoreae Hypoglaucae Rhizoma), Shi Chang Pu (Acori Tatarinowii Rhizoma), Wu Yao (Linderae Radix) (equal parts).
Cut into pieces. Take 5 qian per dose, decoct in water, add a pinch of salt, take before meals. One variation adds Fu Ling (Poria) and Gan Cao (Glycyrrhizae Radix et Rhizoma).
Fu Tu Wan (Poria and Cuscuta Pill): Treats excessive overthinking, Heart and Kidney deficiency, insecurity of true yang, dribbling after urination, white turbid urine, frequent nocturnal emissions.
Tu Si Zi (Cuscutae Semen, 5 liang), Bai Fu Ling (Poria, 3 liang), Shi Lian Rou (Mesocarp of Nelumbinis Semen, 2 liang).
Grind into powder, bind with wine paste to make pills the size of wu zi. Take 30 pills on an empty stomach with salt water.
Rui Lian Wan (Lotus Pill): Treats Heart injury from overthinking, red turbid urine.
Bai Fu Ling (Poria), Lian Rou (Mesocarp of Nelumbinis Semen), Long Gu (Fossilia Ossis Mastodi et Scapulae), Tian Men Dong (Asparagi Radix), Mai Men Dong (Ophiopogonis Radix), Yuan Zhi (Polygalae Radix, heart removed), Bai Zi Ren (Platycladi Semen, separately ground), Zi Shi Ying (Fluoritum, calcined seven times, separately ground), Dang Gui (Angelicae Sinensis Radix, soaked in wine), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried), Long Chi (Fossilia Ossis Frontis Bovis) (each 1 liang), Ru Xiang (Olibanum, 0.5 liang, ground).
Grind into powder, make honey pills the size of wu zi, coat with Zhu Sha (Cinnabar). Take 70 pills on an empty stomach with warm wine and jujube soup.
Another Prescription: Treats white turbid urine with marrow-like strands.
Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Bai Fu Ling (Poria), Gu Zhi (Psoraleae Fructus, stir-fried), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Da Hui Xiang (Foeniculi Fructus), Zuo Gu Mu Li (Ostreae Concha, each equal part).
Grind into powder, bind with green salt and wine to make pills the size of wu zi. Take 30 pills with warm wine.
Another Prescription: Treats latent summer-heat in the Heart channel, red turbid urine.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chi Fu Ling (Poria with red wood), Xiang Ru (Elsholtziae Herba), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus), Lian Rou (Mesocarp of Nelumbinis Semen, heart removed), Mai Men Dong (Ophiopogonis Radix, heart removed, equal parts).
Cut into pieces. Decoct in water and take.
Zhen Zhu Fen Wan (Pearl Powder Pill): Treats white turbidity, nocturnal emission, spermatorrhea, and slippery discharge that cannot be retained.
Zhen Ge Fen (True Concha Meretricis et Cyprinae, 1 jin), Huang Bo (Phellodendri Cortex, 1 jin, stir-fried red on a new tile).
Grind into powder, make pills with drops of water the size of wu zi. Take 100 pills on an empty stomach with warm wine. The method states: Excess Yang and deficiency Yin cause seminal emission. Huang Bo (Phellodendri Cortex) descends Heart fire; Ge Fen (Concha Meretricis et Cyprinae) is salty and tonifies Kidney Yin.
Xuan Tu Dan (Black Tortoise Pill):
Tu Si Zi (Cuscutae Semen, soaked in wine, ground, dried, powder taken, 10 liang), Wu Wei Zi (Schisandrae Chinensis Fructus, soaked in wine, ground, powder taken, 7 liang), Bai Fu Ling (Poria), Lian Rou (Mesocarp of Nelumbinis Semen) (each 3 liang).
Grind into powder. Separately grind 6 liang of dried Shan Yao (Dioscoreae Rhizoma) powder. Add the remaining wine used for soaking, boil with more wine to make a paste, mix thoroughly, pound thousands of times, make pills the size of wu zi. Take 50 pills on an empty stomach with rice drink.
Fu Zi Ba Wei Wan (Eight-Ingredient Pill with Aconite): See under Tonifying Deficiency and Injury.