有梦为心病,无梦为肾病,湿热为小肠膀胱失精之藏。制虽在肾,而精之主宰则在心。
其精血下注,湿热混淫而遗滑,所致者责在小肠膀胱,故治是症,不外宁心益肾,填精固摄,
清热利湿诸法。有梦治心,无梦治肾。
左肾藏精右气火,相火一动精不固。外动酒浆湿热欲,内动多思多想故。精者有水本静
居,无以扰之凝然如。一扰便动且妄行,遗精滑精渐致虚。年少元阳气极盛,如瓶之满满而
溢。心有妄念邪火乘,如瓶之侧侧而出。相火易动真元虚,精道不固肾液竭。如瓶之罅漏渐
干,此病最重最难涩。安神降火主治之,四物归脾收涩吃。
阴虚阳越兼遗滑(用浓味填精,介类潜阳,养阴固摄诸法)
熟地 覆盆子 芡实 山药 湖连 桑螵蛸 茯神 川斛 沙苑 线鱼胶 生地
萸肉 麦冬 远志肉 天冬 川柏 女贞 金樱膏 柏仁 青盐 牡蛎 炙坎版 淡菜 炙草
阴虚湿热遗滑(苦泄兼通腑)
川柏 川萆 知母 泽泻 川莲 苡米仁 芡实 茯苓 猪苓汤
下损及中梦遗(有梦而遗,烦劳过度,致脾胃两伤,心肾不交,上下两损,当培土固摄)
妙香散、补心汤、生脉、四君、归脾汤、冬术膏、桑螵蛸散。
肾气不摄,梦遗兼滑
熟地 山萸肉 山药 湖莲 金樱子 五味 紫河车 芡实 龙骨 菟丝子 覆盆子 沙苑子
兼失血
熟地 五味 山药 人参 枸杞 茯神 牛膝 鱼螵蛸花 龙骨 桑螵蛸
何书田曰∶房劳过度,精竭阳虚,寐则阳陷而精道不禁,随浊随泄,不梦而遗,当用《济
生》固精丸(花龙骨、左牡蛎、菟丝子、家韭子、白茯苓、五味子、桑螵蛸、白石脂)升固八脉之
气。饮食宜浓,脾胃酿成湿热,留伏阴中而梦泄者,当用刘檀石脂肚丸(白术、牡蛎,以猪
肚、苦参一具同煎),清脾胃蕴蓄之温热。无梦遗精,肾关不固,精窍滑脱而成也用桑螵蛸散
(人参、菖蒲、远志、秦当归、茯神、龙骨、龟版、桑螵蛸)与阴固摄滑涩互施。上实下虚,火风
震动,脾肾液枯,用斑龙二至百补丸(人参、鹿角、菟丝子、熟地、杞子、山萸肉、五味子、天
冬、茯苓、淮牛膝、芡实、龙眼、西黄 、麦冬、山药、金樱子、楮实)通摄下焦。龙相交炽,阴
精走漏,用三才封髓丹及滋肾丸、大补阴丸(熟地、金狗脊、知母、川柏、炙龟版)峻补真
阴,承制相火,以泻阴中伏热。
Dream emission is attributed to Heart pathology, while non-dream emission is attributed to Kidney pathology; damp-heat is the cause of essence loss in the Small Intestine and Bladder. Although the Kidneys govern the storage of essence, the Master (Zhu Zai) of essence lies in the Heart.
When essence and blood flow downward, mixed with damp-heat causing excessive discharge leading to emission and slipping, the responsibility lies with the Small Intestine and Bladder. Therefore, treating this condition involves methods such as calming the Heart and benefiting the Kidneys, replenishing essence and securing retention, clearing heat and draining dampness. For dream emission, treat the Heart; for non-dream emission, treat the Kidneys.
The Left Kidney stores essence, while the Right Kidney governs Qi and Fire. When Ministerial Fire (Xiang Huo) moves, essence is not secured. External factors include desires from alcohol and damp-heat; internal factors arise from excessive thinking. Essence originates from Water and is inherently still; without disturbance, it remains calm. Once disturbed, it moves recklessly, gradually leading to emission, slipping, and deficiency. In youth, Yuan Qi (Original Qi) is extremely abundant, like a bottle full to overflowing. If the Heart harbors delusional thoughts and Evil Fire takes advantage, it is like a tilted bottle pouring out. Ministerial Fire is easily stirred while True Yuan is deficient, the essence pathway is insecure, and Kidney fluids are exhausted. This is like a cracked bottle slowly drying up; this disease is the most severe and difficult to stop. The main treatment is to calm the Spirit and descend Fire, using Si Wu Tang (Four Substances Decoction) and Gui Pi Tang (Restore the Spleen Decoction) combined with astringent herbs.
Yin Deficiency with Yang Hyperactivity accompanied by emission and slipping (Use strong-flavored herbs to fill essence, shell-type minerals to subdue Yang, and Yin-nourishing methods to secure retention):
Shu Di Huang (Rehmanniae Radix Praeparata), Fu Pen Zi (Rubae Fructus), Qian Shi (Euryales Semen), Shan Yao (Dioscoreae Rhizoma), Hu Lian (Coptidis Rhizoma), Sang Piao Xiao (Mantidis Oötheca), Fu Shen (Poria cum Radix Pini), Chuan Hu (Dendrobii Caulis), Sha Yuan (Astragali Complanati Semen), Xian Yu Jiao (Ichthyoscolaris Colla), Sheng Di Huang (Rehmanniae Radix), Yu Rou (Corni Fructus), Mai Dong (Ophiopogonis Radix), Yuan Zhi Rou (Polygalae Radix), Tian Dong (Asparagi Radix), Chuan Bai (Phellodendri Cortex), Nv Zhen (Ligustri Lucidi Fructus), Jin Ying Gao (Chrysanthemi Fructus Extract), Bai Ren (Ziziphi Spinosomi Semen), Qing Yan (Sal), Mu Li (Ostreae Concha), Zhi Kan Ban (Testudinis Carapax et Plastrum Praeparatum), Dan Cai (Mytili Corpus), Zhi Cao (Glycyrrhizae Radix et Rhizoma Praeparata).
Yin Deficiency with Damp-Heat causing emission and slipping (Bitter-draining combined with purging the bowels):
Chuan Bai (Phellodendri Cortex), Chuan Bi (Dioscoreae Hypoglaucae Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Ze Xie (Alismatis Rhizoma), Chuan Lian (Meli Fructus), Yi Mi Ren (Coicis Semen), Qian Shi (Euryales Semen), Fu Ling (Poria), Zhu Ling Tang (Polypori Decoction).
Lower Damage affecting the Middle causing Dream Emission (Dream emission due to excessive mental labor, injuring both Spleen and Stomach, failing communication between Heart and Kidney, damaging upper and lower parts; one should tonify Earth to secure retention):
Miao Xiang San (Miraculous Fragrance Powder), Bu Xin Tang (Tonify Heart Decoction), Sheng Mai San (Generate Pulse Powder), Si Jun Zi Tang (Four Gentlemen Decoction), Gui Pi Tang (Restore the Spleen Decoction), Dong Shu Gao (Winter Atractylodes Paste), Sang Piao Xiao San (Mantis Egg-case Powder).
Kidney Qi failing to secure, Dream Emission with Slipping:
Shu Di Huang (Rehmanniae Radix Praeparata), Shan Yu Rou (Corni Fructus), Shan Yao (Dioscoreae Rhizoma), Hu Lian (Nelumbinis Semen), Jin Ying Zi (Chrysanthemi Fructus), Wu Wei Zi (Schisandrae Fructus), Zi He Che (Placentae Hominis), Qian Shi (Euryales Semen), Long Gu (Fossilia Ossis Mastodi et Dentis), Tu Si Zi (Cuscutae Semen), Fu Pen Zi (Rubae Fructus), Sha Yuan Zi (Astragali Complanati Semen).
Accompanied by Blood Loss:
Shu Di Huang (Rehmanniae Radix Praeparata), Wu Wei Zi (Schisandrae Fructus), Shan Yao (Dioscoreae Rhizoma), Ren Shen (Ginseng Radix), Gou Qi (Lycii Fructus), Fu Shen (Poria cum Radix Pini), Niu Xi (Achyranthis Bidentatae Radix), Yu Piao Xiao Hua (Ichthyoscolaris Oötheca), Long Gu (Fossilia Ossis Mastodi et Dentis), Sang Piao Xiao (Mantidis Oötheca).
He Shutian stated: Excessive sexual activity leads to essence depletion and Yang deficiency. During sleep, Yang sinks and the essence pathway cannot restrain, resulting in non-dream emission accompanying turbid discharge. One should use Gu Jing Wan (Secure Essence Pill) from *Ji Sheng Fang* (Flower Long Gu, Left Mu Li, Tu Si Zi, Jia Jiu Zi, Bai Fu Ling, Wu Wei Zi, Sang Piao Xiao, Bai Shi Zhi) to ascend and secure the Qi of the Eight Extraordinary Vessels. If diet is rich and heavy, generating damp-heat in the Spleen and Stomach which lingers in the Yin causing dream emission, one should use Liu Tan Shi Zhi Du Wan (White Zhu, Mu Li, decocted together with one pig stomach and Ku Shen) to clear the accumulated warm-heat in the Spleen and Stomach. For non-dream emission due to insecure Kidney gate and slipping of the essence orifice, use Sang Piao Xiao San (Ren Shen, Chang Pu, Yuan Zhi, Qin Dang Gui, Fu Shen, Long Gu, Gui Ban, Sang Piao Xiao) combined with methods that nourish Yin, secure retention, and address slipping. For Upper Excess and Lower Deficiency, with Fire and Wind shaking, and dryness of Spleen and Kidney fluids, use Ban Long Er Zhi Bai Bu Wan (Ren Shen, Lu Jiao, Tu Si Zi, Shu Di Huang, Qi Zi, Shan Yu Rou, Wu Wei Zi, Tian Dong, Fu Ling, Huai Niu Xi, Qian Shi, Long Yan, Xi Huang, Mai Dong, Shan Yao, Jin Ying Zi, Chu Shi) to unblock and secure the Lower Jiao. When Dragon and Tiger fire interact intensely causing Yin essence leakage, use San Cai Feng Sui Dan (Three Talents Sealing Marrow Pill), Zi Shen Wan (Nourish Kidney Pill), and Da Bu Yin Wan (Great Tonify Yin Pill) (Shu Di Huang, Jin Gou Ji, Zhi Mu, Chuan Bai, Zhi Gui Ban) to vigorously tonify True Yin, control Ministerial Fire, and drain latent heat within Yin.