经义
肾者主水，受五脏六腑之精而藏之。五脏盛，乃能泻。○丈夫二八肾气盛，天癸至，精气溢泻，阴阳和，
故能有子。○肾者主蛰，封藏之本，精之处也。（《素问》）
人始生，先成精，精成而脑髓生。○故生之来谓之精；两精相搏谓之神；随神往来谓之魂；并精而出入者
谓之魄。○怵惕思虑则伤神；神伤，则恐惧流淫而不止。○恐惧不解则伤精；精伤，则骨酸痿厥，精时自下。（《灵枢》）
哲言
有谓生来之精者，先身生之精也。有谓食气入胃，散精于五脏者；有谓水饮自脾肺输肾而四布，五经并行
之精者；此水谷日生之精也。然饮食日生之精，皆从生来元精之所化，而后分布，其藏盈溢，则输之于肾，肾
乃元气之本，生成之根，以始终化之养之之道也。（《证治准绳》）
精藏于肾，人尽知之，至精何以生？何以藏？何以出？则人不知也。夫精，即肾中之脂膏也，有长存者，
有日生者。肾中有藏精之处，充满不缺，如井中之水日夜充盈，此长存者也；其欲动交媾所出之精，及有病而
滑脱之精，乃日生者也。其精旋去旋生，不去亦不生，犹井中之水，日日汲之，不见其亏，终年不汲，不见其
溢。《易》云∶井道不可不革。故受之以革，其理然也。曰∶然则纵欲可无害乎？曰∶是又不然。盖天下之理，
总归自然，有肾气盛者，多欲无伤；肾气衰者，自当节养。《左传》云∶女不可近乎？对曰∶节之。若纵欲不
节，如浅狭之井，汲之无度，则枯竭矣。曰∶然则强壮之人，绝欲何如？曰∶但必浮火不动，阴阳相守则可；
若浮火日动而强制之，则反有害。盖精因火动而离其位，则必有头眩、目赤、身痒、腰疼、遗泄、偏坠等证，
甚者或发痈疽，此强制之害也。故精之为物，欲动则生，不动则不生，能自然不动则有益，强制则有害，过用
则衰竭，任其自然而无所勉强，则保精之良法也。（徐灵胎）
五脏皆有精，精者人之本也。然肾为藏精之都会，听命于心君，若能遣欲澄心，精气内守，阴平阳秘，精
元固密矣。或纵欲劳神，则心肾不交，关键不固。《经》曰∶怵惕思虑则伤神；神伤，则恐惧流淫而不止。又
曰∶肾者主水，受五脏六腑之精而藏之。又曰∶厥气客于阴器，则梦接内。奈古今方论，皆以遗精为肾病，若
与他脏不相干涉，不知《内经》言五脏六腑各有精，肾则受而藏之。以不梦而自遗者，心肾之伤居多；梦而后
遗者，相火之强为害。若五脏各得其职，则精藏而治；苟一脏不得其正，
甚则必移害心肾之主精者焉。治法∶因肾病而遗者治其肾；由他脏而致者，则以他脏与肾两治之。如心病而遗
者，血脉空虚，本纵不收；肺病而遗者，皮革毛焦，喘急不利；脾病而遗者，色黄肉消，四肢懈惰；肝病而遗
者，色青而筋痿；肾病而遗者，色黑而髓空。更当以六脉参详，昭然可辨。（《医宗必读》）
夫精生气，气生神，精伤则无以生气，故瘦弱少气；气弱则不能生神，故目 不明。精不内固，水不济火，
故遗泄而精愈耗也。然百病皆生于心，皆根于肾，肾水不升，心火不降，梦遗所由来也。夫肾水不上，则气不
固而阴虚；心火不下，则妄动而相火从之；阳旺阴虚，则水火不交。《经》曰∶阴阳离决，精气乃绝。此也。
梦遗本心火为病，然肝肾二经之火相挟以成之。盖心藏神，肝藏魂，肾藏精。梦中所生，即心之神；梦中所见，
即肝之魂；梦中所泄，即肾之精。心为君主，肝肾为相，梦中神游，则魂化为形，相火翕然鼓之。此精之所
以泄也，总由心虚不能入肾阴以藏，肾虚不能延心气以纳，心失拱默之德，肾失封藏之功，而为不交不固之患
矣。有梦而遗者，思想所致，心气不足而不摄也；无梦而遗者，多欲所致，肾精滑泄而不固也。有醉饱劳倦，
清气不升，脾精不运而遗者；有肾水不足，淫火熏蒸，精离其位而遗者；有相火旺而脾胃有伤，水谷日生之精，
不得入与元精俱藏而遗者；有火炎上而水下趋，心肾不交而滑者；有年壮气盛，久无色欲，精满而溢者；有脾
虚下陷者；有痰火湿热扰动精腑者。治惟养心滋肾，因湿、因热、因寒兼而治之，更须补其中气，以使元气升
举，不可轻服涩药。（《冯氏锦囊》）
肾主闭藏，肝主疏泄，二脏皆有相火，而其系上属于心。心，君火也，为物所感，则易于动，心动则相火
翕然随之，虽不交会，精亦暗流而渗漏矣。所以圣人教人收心养心，其旨微矣。○或问∶夜梦交接之理何如？
曰∶《灵枢·淫邪发梦篇》云∶厥气客于阴器，则梦接内。盖阴器者，宗筋之所系也，而足太阴、阳明、少
阴、厥阴之筋，皆结聚于阴器，与冲、任、督三脉之所会。厥阴主筋，故诸筋皆统属于厥阴也。肾为阴，主藏
精；肝为阳，主疏泄。阴器乃泄精之窍，是故肾之阴虚，则精不藏；肝之阳强，则气不固。若遇阴邪客于其窍，
与所强之阳相感，则精脱出而成梦矣。所谓阳强者，非肾脏之真阳强也，乃肝脏所寄之相火强耳。曰∶如子所
言，梦遗则从肝肾得之乎？曰∶不然。病之初起，亦有不在肝肾，而在心脾胃之不足者，然必传于肝肾而后精
方走也。故精脱之后，其气未能卒复，未免形体衰惫，不比平人接内之后，其气一、二时便可复也。曰∶治当
何如？曰∶病从他脏而起，则以初感病者为本，肾肝聚病处为标；若由肾肝二脏自得者，独治肾肝；由阴阳离
决，水火不交者，则既济之；阴阳不相抱负者，则因而和之；阳虚者，补其气；阴虚者，补其血；阳强者，泻
其火。火有正治反治，从多从少，随其攸利。（《推求师意》）
梦遗有数种∶有下元虚惫，精元不禁者；有年壮气盛久旷，经络壅滞者；有情欲淫动，所愿不遂者。如
瓶煎汤，气盛盈溢者；如瓶中汤沸而溢，欲动心邪者；如瓶倾倒而出，虚惫不禁者；如瓶有罅而漏。不可一概
用药。（《赤水玄珠》）
遗精证状，亦复不同∶或小便后出多不可禁者；或不小便而自出者；或茎中痛痒，常如欲小便者；或睡
中无梦，流出不自觉者。太抵夜睡自遗者轻，昼觉自遗者重。（《证治汇补》）
遗精之证有九∶凡有所注恋而梦者，此精为神动也，其因在心；有欲事不遂而梦者，此精失其位也，其
因在肾；有值劳倦即遗者，此筋力不胜，肝脾之气弱也；有因用心思索过度辄遗者，此中气不足，心脾之虚陷
也；有因湿热下流，或相火妄动而遗者，此脾肾之火不清也；有无故滑而不禁者，此下元之虚，肺肾之不固也；
有素禀不足，而精易滑者，此先天元气之单薄也；有久服冷利等剂，以致元气失守而滑泄者，此误药之所致也；
有壮年气盛，久节房欲而遗者，此满而溢者也。凡此之类，是皆遗精之病。
然心主神，肺主气，脾主湿，肝主疏泄，肾主闭藏，凡此诸病，五脏皆有所主，治当各求所因。至若满而溢者，
则去者自去，生者自生，势出自然，无足虑也。○因梦而出精者，谓之梦遗；不因梦而精自出者，谓之滑精。梦
遗者，有情，有火，有虚，有溢，有因情动而梦者，有因精动而梦者。情动者，清其心；精动者，固其肾。滑
精者，无非肾气不守而然；若暴滑而兼痛者，则当从赤白浊门论治。（张景岳）
久病而忽梦遗，是湿热注于膀胱而泄，火气得以下行，犹为佳兆。若房劳，则心之相火动，真精一泄，祸
将滔天矣。（查了吾）
补编
遗精一证，不越乎有梦、无梦、湿热三者范围。有梦为心病，无梦为肾病，湿热为小肠膀胱病。夫精之藏
制虽在肾，而精之主宰则在心。其精血下注，湿热混淆而遗滑者，责任在小肠膀胱；其治，不外养心益肾，填
精固摄，清热利湿诸法。如肾精亏乏，相火易动，阴虚阳冒而为遗精者，治用浓味填精，介类潜阳，养阴固涩；
如无梦而肾关不固，精窍滑脱者，治用桑螵蛸散，填阴固摄及滑涩互施；如有梦而遗，烦劳过度，及脾胃受伤，
心肾不交，上下交损者，用归脾汤、妙香散、参术膏、补心丹等方，心脾肾兼治；如阴虚不摄，湿热下注而遗
滑者，用黄柏、萆 、黄连、苓、泽等味，苦泄厥阴郁热，兼通腑气为主；如下虚上实，火风震动，脾肾液枯
而为遗滑者，用二至、百补丸及通摄下焦之法；如龙相交炽，阴精走泄者，用三才封髓丹、滋肾丸、大补阴丸，
峻补真阴，承制相火，以泻阴中伏热为主；又有房劳过度，精竭阳虚，寐则阳陷而精道不禁，随触随泄，不梦
而遗者，当用固精丸，升固八脉之气；又有膏粱酒肉，饮醇浓味，脾胃酿成湿热，留伏阴中而为梦泄者，当用
猪肚丸，清其脾胃蕴蓄之湿热。（《临证指南》）
梦遗者，治其心；精滑者，固其精；满而溢者，舒其情；浊
而赤者，调其经，养其神。心安神定，火来坎户，水利离宫，水火交养，遗浊皆清。（《冯氏锦囊》）
遗精之源有三∶有斫丧太过，肾气不藏，无梦而遗者，当益精以壮火，如鹿茸丸、安肾丸、聚精丸、金
锁玉关丸。有劳心太过，心肾不交，酣卧而遗者，当实土以堤水，如归脾汤、妙香散、远志丸、补中益气汤、
朱砂安神丸。有思想无穷，所愿不得，妄梦而遗者，当泻火以益水，如滋肾丸、威喜丸、本事猪苓丸、清心莲
子饮。三者其源各异，若当清利而反补涩，滋患愈甚；当补涩而反清利，阳气愈微；当升阳而反滋阴，元气愈
陷。不可不求其故而为施治也。（陆丽京）
《经》曰∶思想无穷，所愿不得，意淫于外，入房太甚，宗筋弛纵，发为白淫、梦遗等证。昔贤治法有
五∶其一，意淫于外者，用辰砂、磁石、龙骨之类，镇坠神之浮游是也。其二，思想结成痰饮，迷于心窍者，
许学士用猪苓丸，导利其痰是也。其三，思想伤阴者，洁古用珍珠粉丸，降火补阴是也。其四，思想伤阳
者，谦甫用鹿茸、苁蓉、菟丝等补阳是也。其五，阴阳俱虚者，丹溪治一人形瘦便浊梦遗，作心虚治，用定志丸
是也。○遗精，治作肾虚，补涩罔效，不知此因脾胃湿热所乘，饮酒浓味，痰火之人，多有此疾。肾虽藏精，其
精本于脾胃饮食生化而输于肾，若脾胃受伤，湿热内郁，使中气淆而不清，则所输皆浊气，邪火扰动，水不得
安，故令遗滑。治以苍白二陈，加黄柏、升、柴，俾清升浊降，脾胃健运，则自止矣。○尝谓治遗滑以涩剂不
能止，不若泻心火；泻心火不能止，不若用升阳之剂。非此能止之也，举其气上而不下也。（《证治准绳》）
童男阳盛，情动于中，志有所慕而不得遂，以致夜梦遗精，不可补涩，清心乃安，朝服清心莲子饮，
暮服定志丸。（龚云林）
梦遗属郁滞者居多，庸医不知，但用固涩，愈涩愈郁，其病反甚。（娄全善）
大抵梦遗多是阴亏、火气用事，苟非确系阳虚，桂、附助阳之药慎勿轻用；非确系气虚，参、术益气之味
不可漫施。试观梦遗必在黎明，阳气发动之时，其为阴虚阳扰可知矣。（《张氏医通》）
脉候
男子脉浮弱而涩，为无子，精气清冷。○夫失精家，少腹弦急，阴头寒，目眩发落。脉极虚芤迟，为清谷、
亡血、失精；脉得诸芤动紧，男子失精，女子梦交。（《金匮》）
选案
一人因劳心太过患梦遗，数日一发，发过则虚火上炎，面赤烘热，手足逆冷，终夜不寐，服补心肾及涩药
不效。予用黄柏为君，佐以地黄、枸杞、莲须、膘胶、山萸、五味子、车前、麦冬，治之而痊。人疑黄柏大寒，
讵知肾欲坚，急食苦以坚之。肾得坚，则心经虽有火而精自固。○一人患遗精，闻妇人声即泄，瘠瘦欲死。予用
远志为君，莲须、石莲为臣，龙骨、茯神、沙苑、牡蛎为佐，服药虽止，然终不断，于前方内加膘胶一味即愈。（缪仲淳）
郑鲁叔攻举子业，四鼓犹不卧，遂成此病，卧间玉茎但着被与腿，便梦交接脱精，食减倦怠。此由用心太
过，二火俱起，夜不得睡，血不归肝，肾水不足，火乘阴虚，入客下焦，鼓起精房，则精不得聚藏，因玉茎着
物，厥气客之，故作接内之梦。上用补心安神，中用调脾升阳，下用益精生阴，三月乃痊。（《推求师意》）
萧方来子，天资聪敏，十岁时即患梦遗、盗汗。余用六味丸加龟版、龙骨潜藏灵物，久服渐止。毕姻后，
竟以损证早逝。（许宣治）
一男子病后用心过度，遂患梦遗，多痰瘦削，久服清心莲子饮无效。诊脉紧涩，知其冷药利水太过，致使
肾气独降。初以升提之法，升坎水而济离火，降阳气而滋阴血；次用鹿胶、人乳填补精血，逾月而愈。（吴茭山）
一人常患梦遗，诊其关中有动脉如大豆圆，此痰凝中焦，幸
梦遗，免致鼓胀。但尺寸俱不起。方用补中益气汤加茯苓、半夏、菖蒲，一升一降之道。（查了吾）
一人夏感伤寒五、六日，左寸脉浮紧，他部洪数，外证头疼、目痛，鼻干口渴，体汗寒热，闭目则遗精。
医曰∶闭目遗精，虚之极也。予思头痛未止，表证未罢；目痛鼻干口渴，阳明证也；寒热往来，又兼少阳。梦
[Scriptural Principles]
The Kidney governs water metabolism and receives and stores the essence from the five zang and six fu organs. Only when the essence of the five zang organs is abundant can it be discharged. ○ When a man reaches sixteen years of age (2 × 8), his kidney qi becomes vigorous, Tian Gui (substances that promote reproductive maturation) arrives, essence overflows and is discharged, yin and yang interact, thus enabling procreation. ○ The Kidney governs hibernation and storage; it is the root of sealing and storing, and the residence of essence. (From *Su Wen*)
At the beginning of human life, essence forms first; once essence is formed, brain marrow develops. ○ Therefore, the origin of life is called essence; the interaction of paternal and maternal essence gives rise to Shen (Spirit); Hun (Ethereal Soul) follows Shen in its activities; Po (Corporeal Soul) enters and exits with essence. ○ Fear and anxiety injure Shen; when Shen is injured, fear and involuntary seminal emission occur without cessation. ○ Unrelieved chronic fear injures Jing (Essence); when Jing is injured, there is soreness and coldness in the bones, flaccidity and coldness of the limbs, and spontaneous leakage of essence. (From *Ling Shu*)
[Philosophical Discourses]
Some refer to "innate essence," which is the essence generated prior to physical formation. Others refer to "acquired essence," which is the refined material from food and drink entering the stomach and dispersing to the five zang organs; still others refer to fluids transported from the Spleen and Lungs to the Kidneys, spreading throughout the body and circulating through the five meridians; these constitute the daily-generated "acquired essence." However, this daily acquired essence is transformed from innate primordial essence, distributed throughout the body, and when stored abundantly, is further transmitted to the Kidneys. The Kidney is the root of Yuan Qi (Primordial Qi) and the source of generation, serving as the continuous process of transformation and nourishment. (From *Zheng Zhi Zhun Sheng*)
It is widely known that essence is stored in the Kidneys, but few understand how essence is generated, stored, or discharged. Essence refers to the fatty substance within the Kidneys; some parts are long-lasting, while others are generated daily. The place in the Kidney where essence is stored remains full and un-depleted, like water in a well that fills day and night; this represents the long-lasting essence. The essence discharged due to sexual desire or lost during illness represents the daily-generated essence. This essence is replenished as it leaves; if not used, it is not generated, similar to well water: drawing from it daily shows no depletion, while leaving it undisturbed for a year shows no overflow. The *I Ching* states: "The way of the well must not remain unchanged." Hence, it is followed by the hexagram Ge (Revolution). Someone asks: Is indulgence in sex harmless? The answer is: Not so. All principles return to nature. Those with vigorous Kidney qi may indulge without harm; those with declining Kidney qi should naturally practice moderation and nourishment. As stated in *Zuo Zhuan*: "Should one avoid women?" The reply: "One must exercise restraint." Indulgence without restraint is like a shallow, narrow well drawn from excessively; it will dry up. Someone asks: What about strong individuals who abstain completely? The answer: As long as floating fire does not move and yin and yang remain harmonious, it is acceptable. If floating fire agitates daily yet one forces abstinence, it causes harm. Because essence moves away from its position due to fire, symptoms such as dizziness, red eyes, itching, lower back pain, seminal emission, and testicular swelling may occur, and severe cases may develop carbuncles. This is the harm of forced suppression. Thus, essence is generated when desire moves and not generated when it does not. Natural non-movement benefits, forced suppression harms, excessive use leads to exhaustion, and following nature without coercion is the best method for preserving essence. (Xu Lingtai)
All five zang organs contain essence, which is the foundation of human life. However, the Kidney is the repository of essence, obeying the command of the Heart Monarch. If desires are dispelled and the mind clarified, essence remains internal, yin and yang are balanced, and essence is firmly secured. Indulgence in sex and mental labor cause Heart-Kidney non-interaction and insecurity of the key mechanisms. The Classics state: "Fear and anxiety injure Shen; when Shen is injured, fear and involuntary seminal emission occur without cessation." It also states: "The Kidney governs water, receiving and storing essence from the five zang and six fu organs." And: "Jue Qi lodging in the genitalia causes dreams of intercourse." Unfortunately, ancient and modern theories treat seminal emission solely as a Kidney disease, ignoring other organs. Yet the *Nei Jing* teaches that all five zang and six fu organs have their own essence, which the Kidney receives and stores. Non-dream emission usually results from Heart-Kidney injury; dream emission is often caused by hyperactive Ministerial Fire. If the five zang organs function properly, essence is stored and health is maintained; if one organ is dysfunctional, it may eventually damage the Heart and Kidney, which govern essence. Treatment: For Kidney-originated emission, treat the Kidney; for emissions caused by other organs, treat both the affected organ and the Kidney. Heart-related emission involves empty blood vessels and laxity; Lung-related emission involves dry skin and hair, wheezing, and difficulty urinating; Spleen-related emission involves yellow complexion, muscle wasting, and limb fatigue; Liver-related emission involves blue complexion and tendon flaccidity; Kidney-related emission involves black complexion and empty marrow. Pulse diagnosis clarifies differentiation. (From *Yi Zong Bi Du*)
Essence generates Qi, and Qi generates Shen. Injury to essence impairs Qi generation, leading to emaciation and shortness of breath; weak Qi fails to generate Shen, causing blurred vision. If essence is not internally secured and Kidney Water fails to control Heart Fire, seminal emission occurs, further depleting essence. All diseases originate in the Heart and root in the Kidney. When Kidney Water does not ascend and Heart Fire does not descend, dream emission arises. Ascending failure leads to insecure Qi and Yin deficiency; descending failure leads to erratic movement and Ministerial Fire activation. Yang excess and Yin deficiency result in non-interaction of Water and Fire. The Classics state: "When Yin and Yang separate and rupture, Jing and Qi perish." Dream emission is primarily a Heart Fire disorder, exacerbated by Liver and Kidney fire. The Heart houses Shen, the Liver houses Hun, and the Kidney houses Jing. In dreams, Shen arises, Hun is perceived, and Jing is discharged. The Heart is the monarch, and Liver/Kidney are ministers. During dream travel, Hun takes form, and Ministerial Fire surges, causing discharge. This results from Heart deficiency failing to enter Kidney Yin for storage, and Kidney deficiency failing to receive Heart Qi. With loss of Heart's supportive virtue and Kidney's sealing function, non-interaction and insecurity occur. Dream emission stems from thoughts and insufficient Heart Qi control; non-dream emission stems from excessive desire and insecure Kidney essence. Emission can result from drunkenness/fatigue with failing clear Qi and Spleen essence transport; Kidney Yin deficiency with flaming fire displacing essence; hyperactive Ministerial Fire damaging Spleen/Stomach, preventing daily essence from storing with primordial essence; fire rising and water sinking causing Heart-Kidney non-interaction; youthful vigor with prolonged abstinence causing overflow; Spleen Qi deficiency with sinking; or Phlegm-Fire-Dampness disturbing the essence chamber. Treatment requires nourishing Heart and moistening Kidney, addressing dampness, heat, or cold, tonifying Middle Qi to raise Yuan Qi, and avoiding astringents. (From *Feng Shi Jin Nang*)
The Kidney governs storage, and the Liver governs dispersion; both contain Ministerial Fire connected to the Heart. The Heart, as Sovereign Fire, is easily moved by external stimuli. When the Heart moves, Ministerial Fire surges, causing secret leakage even without intercourse. Thus, sages taught restraining and nourishing the Heart. Regarding nocturnal emissions: *Ling Shu* states that Jue Qi lodging in the genitalia causes dreams of intercourse. The genitalia are the site of Zong Jin (confluence of sinews), where foot Taiyin, Yangming, Shaoyin, and Jueyin sinews converge with the Chong, Ren, and Du vessels. Jueyin governs sinews. Kidney (Yin) stores essence; Liver (Yang) governs dispersion. The genitalia are the aperture for ejaculation. Kidney Yin deficiency leads to insecure essence; Liver Yang excess leads to insecure Qi. If Yin pathogens lodge in the aperture and interact with strong Yang, essence escapes, causing dreams. This "Yang excess" refers not to true Kidney Yang, but to hyperactive Ministerial Fire in the Liver. While disease may start in Heart, Spleen, or Stomach, it must transmit to Liver and Kidney for essence loss. After essence loss, Qi cannot recover immediately, causing debility unlike normal recovery after intercourse. Treatment depends on origin: if from other organs, treat the primary organ as root and Liver/Kidney as branch; if from Liver/Kidney alone, treat them directly; if from Yin-Yang separation and Water-Fire non-interaction, use Ji Ji (Mutual Completion) methods; if Yin/Yang do not embrace, harmonize them; tonify Qi for Yang deficiency, Blood for Yin deficiency, and drain fire for Yang excess. (From *Tui Qiu Shi Yi*)
Dream emission types include: lower yuan deficiency with uncontrollable essence; youthful vigor with prolonged abstinence causing meridian stagnation; sexual desire unfulfilled. Analogies: boiling water overflowing (excess Qi); pouring out from a tilted bottle (deficiency); leaking from a cracked bottle. Medication must not be uniform. (From *Chi Shui Xuan Zhu*)
Symptoms vary: emission after urination uncontrollably; spontaneous emission without urination; penile pain/itching resembling urge to urinate; unconscious emission during sleep without dreams. Nocturnal emission is mild; diurnal emission is severe. (From *Zheng Zhi Hui Bu*)
Nine causes of emission: attachment causing dreams (Heart); unfulfilled desire causing dreams (Kidney); fatigue-induced emission (weak Liver/Spleen Qi); overthinking-induced emission (insufficient Middle Qi, Heart/Spleen deficiency); damp-heat or Ministerial Fire-induced emission (unclear Spleen/Kidney fire); spontaneous sliding (lower yuan deficiency, Lung/Kidney insecurity); congenital weakness (thin primordial Qi); misuse of cold/purgative drugs (Qi loss); youthful vigor with abstinence (overflow). All are emission diseases. Heart governs Shen, Lung Qi, Spleen Damp, Liver dispersion, Kidney storage. Treatment seeks specific causes. Overflow is natural and harmless. Dream emission involves emotion, fire, deficiency, or overflow; regulate Heart for emotional triggers, secure Kidney for essence triggers. Sliding emission is Kidney Qi insecurity; acute sliding with pain treats as Red/White Turbidity. (Zhang Jingyue)
Sudden emission after chronic illness indicates damp-heat draining via Bladder, allowing fire to descend—a good sign. Sexual exhaustion moves Ministerial Fire, losing true essence—a catastrophic outcome. (Cha Liaowu)
[Supplement]
Emission falls into three categories: dream (Heart disease), non-dream (Kidney disease), damp-heat (Small Intestine/Bladder disease). Though stored in Kidney, governed by Heart. Damp-heat confusion involves Small Intestine/Bladder; treatment includes nourishing Heart/Kidney, filling essence, securing, clearing heat, and promoting diuresis. For Kidney essence deficiency with floating Yang, use rich flavors to fill essence, shell substances to anchor Yang, and Yin-nourishing astringents. For non-dream insecurity, use Sang Piao Xiao San. For dream emission with mental labor and Spleen/Stomach injury, use Gui Pi Tang, Miao Xiang San, Shen Zhu Gao, or Xin Dan. For Yin deficiency with damp-heat, use Huang Bo, Bi Xie, Huang Lian, Fu Ling, Ze Xie. For lower deficiency with upper excess, use Er Zhi Wan or Bai Bu Wan. For Dragon/Tiger fire agitation, use San Cai Feng Sui Dan or Zi Shen Wan. For sexual exhaustion with Yang deficiency, use Gu Jing Wan. For diet-induced damp-heat, use Zhu Du Wan. (From *Lin Zheng Zhi Nan*)
Treat dream emission by calming the Heart; sliding emission by securing essence; overflow by soothing emotions; turbid/red discharge by regulating meridians and nourishing Shen. A calm Heart stabilizes Shen, allowing Water and Fire to nourish each other, clearing turbidity. (From *Feng Shi Jin Nang*)
Three sources: excessive depletion causing non-dream emission (tonify essence/fire with Lu Rong Wan, etc.); mental labor causing Heart-Kidney non-interaction (strengthen Earth to dam Water with Gui Pi Tang, etc.); endless longing causing dream emission (drain fire/nourish water with Zi Shen Wan, etc.). Do not confuse clearing/drying with tonifying/astringing. (Lu Lijing)
Classics state: endless thoughts, unfulfilled desires, and excessive sex cause White Yin and dream emission. Five treatments: suppress floating Shen with Chen Sha/Ci Shi/Long Gu; drain phlegm from Heart orifices with Zhu Ling Wan; clear fire/nourish Yin with Zhen Zhu Fen Wan; tonify Yang with Lu Rong/Rong Cao/Tu Si Zi; treat Heart deficiency with Ding Zhi Wan. Emission misdiagnosed as Kidney deficiency often stems from Spleen/Stomach damp-heat and phlegm-fire. Treat with Cang Zhu, Bai Zhu, Er Chen Tang, Huang Bo, Sheng Ma, Chai Hu to clear turbidity and strengthen digestion. Elevating Qi stops emission better than astringents. (From *Zheng Zhi Zhun Sheng*)
Young men with strong Yang and unfulfilled desires should avoid tonification/astringency; clear the Heart. Take Qing Xin Lian Zi Yin in morning, Ding Zhi Wan at night. (Gong Yunlin)
Dream emission is often due to stagnation; astringents worsen it. (Lou Quanshan)
Most dream emission involves Yin deficiency and fire activity; avoid Gui Zhi/Fu Zi unless Yang deficiency is certain; avoid Ren Shen/Bai Zhu unless Qi deficiency is certain. Occurring at dawn when Yang rises indicates Yin deficiency with Yang disturbance. (From *Zhang Shi Yi Tong*)
[Pulse Diagnosis]
Floating, weak, and choppy pulses in men indicate infertility and cold, clear essence. Loss-of-essence patients show tight hypogastrium, cold glans, dizziness, and hair loss. Extreme deficiency, knotted, slow pulses indicate loose stools, blood loss, or essence loss. Knotted, moving, tight pulses indicate male essence loss or female dream intercourse. (From *Jin Gui Yao Lue*)
[Selected Cases]
Case 1: Mental overwork caused dream emission every few days, with false fire rising, red face, hot flashes, cold extremities, and insomnia. Tonics and astringents failed. I used Huang Bo as sovereign, assisted by Di Huang, Gou Qi, Lian Xu, Ejiao, Shan Yu, Wu Wei Zi, Che Qian Zi, Mai Dong. Cure achieved. Some doubted Huang Bo's cold nature, but bitterness hardens the Kidney; hardened Kidney secures essence despite Heart fire.
Case 2: Emission upon hearing women's voices, emaciated. Used Yuan Zhi as sovereign, Lian Xu/Shi Lian as ministers, Long Gu/Fu Shen, Sha Yuan/Mu Li as assistants. Stopped but recurred; adding Ejiao cured. (Miao Zhongchun)
Case 3: Zheng Lushe studied late, causing emission upon touching legs/bedding. Mind overwork raised two fires, blood didn't return to Liver, Kidney Water deficient, fire invaded lower Jiao. Treated with Heart-calming, Spleen-raising, and Kidney-nourishing methods over three months. (From *Tui Qiu Shi Yi*)
Case 4: Xiao Fanglai's son had dream emission and night sweats at age ten. Used Liu Wei Wan plus Gui Ban/Long Gu. Cured initially, but died young after marriage from consumption. (Xu Xuanzhi)
Case 5: Post-illness mental overwork caused emission, phlegm, emaciation. Qing Xin Lian Zi Yin failed. Tight/choppy pulse indicated excessive cold/diuretic drugs lowering Kidney Qi. First raised Kan Water to aid Li Fire, lowered Yang to nourish Yin. Then used Lu Jiao and Human Milk to fill essence/blood. Cured in a month. (Wu Jiaoshan)
Case 6: Frequent dream emission, pulsation at Guan like a bean (phlegm in Middle Jiao). Emission prevented abdominal distension. Chi/Cun pulses weak. Used Bu Zhong Yi Qi Tang plus Fu Ling, Ban Xia, Chang Pu for ascending/descending balance. (Cha Liaowu)
Case 7: Summer cold for 5-6 days, left Cun floating/tight, other positions flooding/fast. Headache, eye pain, dry nose/thirst, sweating/chills. Closing eyes caused emission. Doctor said extreme deficiency. I reasoned: headache means exterior syndrome persists; eye/nose/thirst indicates Yangming; chills/fever indicates Shaoyang. Dream...