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A prescription for treating frequent urination accompanied by painful and difficult voiding, seminal emission, and white turbidity, where the pulse is surging, slippery, and forceful, indicating a definite excess-heat syndrome.

*Zhimu* (Tianhuafen Rhizome, *Anemarrhenae Rhizoma*) [4 qian]
*Huangbai* (Phellodendri Cortex, *Phellodendri Chinensis Cortex*) [4 qian]
Raw *Longgu* (Fossilized Mammal Bones, *Os fossile Mamuthi*) [4 qian, crushed into fine powder]
Raw *Muli* (Oyster Shell, *Concha Ostreae*) [3 qian, stir-fried and crushed]
*Haipiaoxiao* (Cuttlefish Bone, *Endoconcha Sepiae*) [3 qian, crushed into fine powder]
*Qiancao* (Rubia Root, *Radix Rubiae Cordifoliae*) [2 qian]
Raw *Hangshaoyao* (White Peony Root, *Radix Paeoniae Alba*) [4 qian]
Raw *Shanyao* (Dioscorea Rhizome, *Rhizoma Dioscoreae Oppositae*) [4 qian]
*Zexie* (Alisma Rhizome, *Rhizoma Alismatis*) [1.5 qian]

A question was raised: Longgu and Muli are astringent herbs. You used them in your proposed Lixue Tang (Blood Regulating Decoction) to treat blood strangury; you used them in the previous formula for frequent urination possibly complicated by strangury and difficulty; and now you use them in this formula for frequent urination with painful and difficult voiding. Are you not worried that their astringent nature might hinder the relief of pain and difficulty? The answer is: Longgu and Muli consolidate the righteous qi without retaining the pathogenic factors. They yield rapid effects in cases of dissipating heart qi, rebellious lung qi, floating liver qi, and slipping kidney qi. Even if the syndrome involves blood stasis, pain, or external contraction, they can be used boldly without any hindrance. This has been discussed in detail in my works Bu Luo Bu Guan Tang (Decoction for Supplementing Collaterals and Vessels), Li Yu Sheng Xian Tang (Decoction for Resolving Stagnation and Raising Sinking Qi), Cong Long Tang (Decoction Following the Dragon), and Qing Dai Tang (Decoction for Clearing Leukorrhea). Readers may consult those texts for reference.

An elderly man in his seventies suffered from seminal emission, white turbidity, and frequent urination, with slight pain and difficulty in voiding. His six pulses were generally harmonious, but the two chi positions were forceful upon heavy pressure. This indicated that although he was advanced in age, there was indeed excess heat in the Kidney channel. This decoction was administered, and he was completely cured after five doses.

Another man, around thirty years old, suffered from seminal emission and white turbidity. His urination was extremely painful, as if cut by a knife, and very difficult and frequent. His pulse was slippery and forceful, indicating an excess-heat syndrome. Because he was young, it was suspected that he might also have toxic strangury caused by sexually transmitted diseases. Therefore, this decoction was administered with the addition of Moyao (Myrrh, *Resina Myrrhae*) [3 qian, oil not removed] and Yadanzi (Strychnos Seed, *Semen Strychni*) [40 grains, peeled], taken with the decoction juice. He was cured after several doses.

For frequent urination, seminal emission, and white turbidity caused by contracting wind-cold, the pulse is wiry and long, especially on the left side.

Guizhi Jian (Tip of Cinnamon Twig, *Ramulus Cinnamomi Cassiae*) [4 qian]
Raw *Huangqi* (Astragalus Root, *Radix Astragali Membranacei*) [3 qian]
*Xuduan* (Teasel Root, *Radix Dipsaci*) [3 qian]
*Sangjisheng* (Taxillus Branch, *Ramulus Taxilli*) [3 qian]
*Zhimu* (Tianhuafen Rhizome, *Anemarrhenae Rhizoma*) [3 qian]

If the illness is not fully cured after several doses of this decoction, remove Guizhi and add Longgu and Muli (both uncalcined) [6 qian each].

A fisherman from the East Sea, in his thirties, suffered severely from "Pianbai" syndrome (severe seminal emission and white turbidity). Within ten days, he became extremely weak and fatigued. Fearing greatly, he traveled far to seek a prescription. His left and right pulses were both wiry, with the left position being wiry and long. A wiry and long pulse indicates hyperactivity of Liver Wood. Wood and Wind are of the same category; regardless of which organ or part of the body contracts Wind, the Wind corresponds to the Liver Wood. This is what the *Neijing* (Inner Canon) states in the chapter "Yin Yang Ying Xiang Da Lun": "Wind Qi communicates with the Liver." Given such pulse manifestations, the Liver becomes excessively active due to the assistance of Wind, losing its harmony. Moreover, the patient stated that after sexual intercourse, he contracted wind while urinating, leading to slight swelling of the external genitals, which confirmed the presence of Wind. After sexual activity, the Kidney channels and collaterals are deficient and open, allowing Wind to invade vacuously. The Wind agitates the Kidney, preventing it from performing its function of storing and hiding (as the *Neijing* states, the Kidney governs storage and hiding). Meanwhile, the Liver Wood, which assists the Kidney's qi transformation, responds to the Wind, further aiding the agitation and exacerbating the dispersing and draining functions (as the *Neijing* states, the Liver governs dispersing and draining). Thus, the disease became so severe. This decoction was prescribed to transform the wiry and long pulse into a relaxed and harmonious one. After one dose, symptoms improved; after several doses, he was completely cured. Henceforth, whenever encountering similar syndromes with identical pulse characteristics, administering this decoction invariably yields immediate results.