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There are two types: Jing Zhuo (Essence Turbidity) and Bian Zhuo (Urine Turbidity). Jing Zhuo originates from the essence orifice, which is significantly different from Bian Zhuo that exits through the urinary orifice. The discharge does not mix with urine; instead, at the tip of the urethra, there is often a traction of thread-like, greasy secretions resembling pus or eye discharge. It appears frequently even after wiping, and the penis may feel itchy or painful, sometimes severely as if scraped by a knife or burned by fire. (Generally, in the early stage when Fire is excessive, pain predominates; in later stages when Fire is diminished, itching predominates.) Meanwhile, the urine itself remains clear, without mixing with the turbid discharge. This condition mostly arises because during sexual intercourse, the essence has already deviated from its proper position, or due to forcibly suppressing ejaculation, or being obstructed causing mid-coitus cessation. The deviated essence transforms into spoiled turbidity, flowing out from the orifice, thus resembling pus or eye discharge with a foul, putrid odor. If ejaculation does not occur, Kidney Fire becomes stagnant and cannot disperse; the spoiled essence carries this stagnant Fire out, causing penile swelling, urethral astringency, and pain. After a long period, once all spoiled essence is expelled, the symptoms cease. However, if symptoms persist, although the Fire pathogen has declined, the prolonged illness leads to slipping and incontinence; the spoiled essence attracts unspoiled essence to exit together, resulting in a continuous flow. If the Fire pathogen does not decline but rather intensifies, it drives even the unspoiled essence to exit. In severe cases, the essence may be exhausted, and blood that has not yet transformed into essence also flows out, leading to Chi Zhuo (Red Essence Turbidity). (Essence is transformed from Blood.) (Observing boys who have just received Tian Gui [menstruation/seminal fluid], if they exert themselves strongly and indulge in lust, the discharged material being half essence and half blood demonstrates this.) Later, the Fire pathogen may also decline, and the syndrome may transform into deficiency-cold. The old classification of Chi Zhuo as Heat and Bai Zhuo (White Essence Turbidity) as Cold is incorrect. For individuals with low libido suffering from this, it is mostly caused by Damp-Heat flowing into the Jing Fang [Essence Chamber], forcing the essence and preventing it from resting quietly; this shares the same principle as Damp-Heat spermatorrhea. For Heat patterns, Qing Xin Lian Zi Yin (Clear Heart Lotus Seed Decoction) is used. For Cold patterns, Bi Li Qing Yin (Bi Li Clearing Decoction) is used. For deficiency exhaustion, Yin is nourished. For weak Stomach Qi, Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Rhizome) are added with Sheng Ma (Cimicifugae Rhizome) and Chai Hu (Bupleuri Radix). For Damp-Heat flow-in, Er Chen Tang (Two-Cured Decoction) [see Phlegm chapter] is used with added Bai Zhu, Sheng Ma, and Chai Hu. For Summer-Heat sensation, Si Ling San (Four-Poria Powder) [see Injury by Dampness chapter] is used with added Xiang Ru (Moslae Herba), Mai Dong (Ophiopogonis Radix), Ren Shen, and Shi Lian Rou (Nelumbinis Semen). When Bai Zhuo begins with intense momentum, where spoiled essence blocks the orifices causing abnormal astringency and pain, Wu Ling San (Five-Poria Powder) [see Injury by Dampness chapter], Miao Xiang San (Wonderful Fragrance Powder), and Qing Xin Lian Zi Yin are combined. Treatment for Bai Zhuo focuses primarily on clearing Fire, with tonification as secondary. Treatment for Chi Zhuo focuses primarily on tonification, with clearing Fire as secondary. Clearing the Heart, strengthening the Spleen, nourishing the Kidney, and securing leakage are indispensable; Qing Zhuo Yin (Qing Zhuo Decoction) is the principal formula.

Bian Zhuo is mostly caused by Damp-Heat from the Stomach flowing downward. If it injures the Qi level, it presents as white, known as Gao Lin (Paste Strangury), treated principally with Bian Zhuo Yin. If it injures the Blood level, it presents as red, known as Xue Lin (Blood Strangury); if the amount is large, it is Hematuria, with treatment detailed in the Strangury Syndrome and Bleeding from Urine sections under the Blood category.