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1. Nocturnal emission without dreaming is caused by deficiency of the Heart and Kidney; emission after dreaming is caused by hyperactivity of ministerial fire. Excessive sexual desire leads to seminal slip due to sinking of clear qi; prolonged abstinence leads to overflow and discharge, or rich food and alcohol damage the Spleen and Stomach, both resulting in this disease.

[Note] "Emission without dreaming" refers to spontaneous leakage of semen without mental stimulation, indicating insufficiency and lack of firmness in the Heart and Kidney. "Emission after dreaming" refers to forced discharge due to mental stimulation stirring up ministerial fire, indicating hyperactivity of the two fires (Heart fire and ministerial fire) and lack of firmness. It may also occur in individuals with excessive sexual desire who are accustomed to seminal slipping; those with insufficient clear qi where clear yang sinks and fails to secure; those who have abstained for a long time, causing abundant essence to overflow; or those consuming rich wine and heavy flavors, leading to strong internal heat and failure to secure. All these constitute the pathology of this disease.

Longgu Yuanzhi Wan (Dragon Bone and Polygala Pill), Kanli Jiji Tang (Kan-Li Intersection Decoction), Fengsui Dan (Marrow-Sealing Pill).

2. For Heart-Kidney deficiency, use Longgu Yuanzhi Wan (containing Cinnabar, Polygala, Spirit of Poria, Poria, Acorus, Ginseng); for prolonged abstinence with hyperactive fire, use Rehmannia, Anemarrhena, Phellodendron; for Spleen-Stomach deficiency, use Phellodendron, Licorice, Amomum.

[Note] Longgu Yuanzhi Wan treats emission without dreaming due to Heart-Kidney deficiency; its ingredients are Dragon Bone, Cinnabar, Polygala, Spirit of Poria, Poria, Acorus, and Ginseng. Kanli Jiji Tang treats emission with dreaming due to hyperactive fire or prolonged abstinence; its ingredients are Prepared Rehmannia Root, Phellodendron Bark, and Anemarrhena Rhizome. If the patient has weak Spleen-Stomach, poor appetite, and loose stools, Prepared Rehmannia, Anemarrhena, and Phellodendron should be avoided to prevent bitter-cold herbs from damaging the Stomach Qi; instead, Fengsui Dan is suitable, consisting of Phellodendron Bark, Licorice Root, and Amomum Fruit.

Bujing Wan (Essence-Replenishing Pill).

3. Continuous seminal discharge while maintaining an erection (priapism) is called "Qiangzhong" (Hyperactive Middle). This condition results from overconsumption of aphrodisiac tonics or excessive lust. If not treated urgently, prolonged depletion of essence leads to untransformable hyperactive Yang, forcing blood out, causing incessant pain, emaciation, and death. Alternatively, if death does not occur immediately, it may develop into Xiao Ke (Wasting-Thirst) or large carbuncles. For patterns of Yang excess and Yin deficiency, use a large dose of Kanli Jiji Tang with Raw Dragon Bone to clear heat and tonify. For patterns of excess heat, use Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) with Rhubarb to first purge the heat. After the heat subsides, use Bujing Wan for recovery, consisting of Psoralea Fruit, Leek Seed, Chinese Yam, Magnetite, Cistanche Stem, Ginseng Root, and Deer Antler.

[Note] Continuous seminal discharge with persistent priapism is named "Qiangzhong." This disease arises from overusing medicinal supplements for sexual health or indulging in excessive lust. Without urgent treatment, prolonged exhaustion of essence leads to hyperactive Yang that cannot transform, forcing blood to exit, causing unremitting pain, severe emaciation, and death. Even if survival occurs, Wasting-Thirst or major carbuncles will likely develop. In cases of Yang excess and Yin deficiency, a substantial dose of Kanli Jiji Tang added with Raw Dragon Bone is indicated to clear heat while tonifying. In cases of robust constitution with intense excess heat, Huanglian Jiedu Tang added with Rhubarb is indicated to purge the heat initially. Post-illness, when heat has cleared, Bujing Wan is used for regulation, comprising Psoralea Fruit, Leek Seed, Chinese Yam, Magnetite, Cistanche Stem, Ginseng Root, and Deer Antler.