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Zhu Danxi said: A woman near sixty years of age, with a fat physique and a diet rich in fatty and strong flavors, suffered from unclear Qi in the Middle Jiao (Middle Burner). This accumulated to form turbid Qi, which flowed into the Bladder and descended to become White Turbidity (White Cloudy Urine).
This turbid Qi is essentially Damp-Phlegm. Using Er Chen Tang (Two-Cured Decoction) added with Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Cang Zhu (Atractylodis Rhizoma), and Bai Zhu (Atractylodis Macrocephalae Rhizoma), after four doses, the turbidity decreased by half. The patient felt chest fullness because Sheng Ma and Chai Hu had lifted and disturbed Stomach Qi, causing Phlegm obstruction and stuffiness. Therefore, Er Chen Tang was modified with fried flour, Bai Zhu, and Xiang Fu (Cyperi Rhizoma) to drain the fullness. Those who do not normally have Phlegm will not feel stuffy even if lifting herbs are used. Subsequently, Qing Dai (Indigo Naturalis), Chu Pi (Stemonae Radix Bark), Ge Fen (Concha Meretricis et Cyclinae), Huang Bo (Phellodendri Cortex), Gan Jiang (Zingiberis Rhizoma), and Hua Shi (Talcum) were powdered, mixed with Shen Qu (Massa Medicata Fermentata) as a binder to make pills, which cured her completely.

Danxi also treated a man who had suffered from turbid urine for half a year, occasionally experiencing nocturnal emissions and emaciation. Diagnosed as Heart Deficiency, he was treated with Zhen Zhu Fen Wan (Pearl Powder Pill) combined with Ding Zhi Wan (Calming Will Pill), which cured him.

[Appendix] Zhang Rubi, Prefect of Nan'an, once suffered from thirst disease and white turbidity. Long-term use of Kidney-tonifying medicines was ineffective. He met a Daoist priest who advised him to take Wine-steamed Coptis Pills. One jin of Chuan Lian (Coptidis Rhizoma) was soaked in wine overnight, then steamed repeatedly over a steamer until black, dried, powdered, and honey-pilled to the size of paulownia seeds. Taken thirty pills at noon and before bed with wine, he was completely cured.

Pan Jiansuo suffered from white turbidity at the age of twenty. Medical treatment for three years failed. His pulse was short and weak at both Cun (inch) positions, slippery at both Guan (middle) positions, and surging and slippery at both Chi (cubit) positions. Sun Dongsu said, "Your illness is easy to cure; simply wait until mid-spring next year. One dose will suffice. But now is not the time." When asked why it must wait until next year, Sun replied, "The Classics state that ascending, descending, floating, and sinking must follow natural laws. It also states that one should not violate the timing of Heaven and Earth. Your pulse indicates a syndrome of Damp-Phlegm flowing downward. A surging pulse appearing at the Chi position indicates Yang invading Yin. The treatment method should be to draw Yang from Yin. However, it is currently winter, the season of closure and storage. Winter's closure and storage are actually the root for the generation of life in the coming spring. Heaven and humanity share the same principle. If one ignores the seasonal timing and forcibly uses lifting methods, it destroys the harmony of Heaven and leaks Yuan Qi. Once the root is depleted, how can life generate in the coming spring?" Pan did not believe this, sought other medical treatments, but remained ineffective. At the Spring Equinox, Dongsu used Si Li Ke (Shell of White River Snail) calcined to preserve its nature (four liang), Mu Li (Ostreae Concha) (two liang), Ban Xia (Pinelliae Rhizoma), Ge Gen (Puerariae Lobatae Radix), Chai Hu (Bupleuri Radix), Ku Shen (Sophorae Flavescentis Radix), and Chuan Bai (Phellodendri Amurensis Cortex) (one liang each), made into pills with Qu paste, taken morning and evening, named Duan Ben Wan (Root-Establishing Pill). He was completely cured without finishing one dose.

Yu Zhen commented: Medical books have traditionally distinguished between Jing Zhuo (Essence Turbidity) and Niao Zhuo (Urine Turbidity). Based on my experience, turbidity necessarily originates from the Essence chamber; urinary diseases have Lin syndrome but not turbidity. Patients with turbidity often have foul discharge sticking and oozing from the orifice, sometimes forming a crust. Before urination, a few drops appear, followed by clear urine. Only when Fire is excessive does the color turn yellow, but it remains not turbid. Ancient texts describe urine surface like oil, with unstable luster, and sediment at the bottom condensing like paste. This is Gao Lin (Paste-like Lin Syndrome) and Xia Xiao (Lower Wasting-Thirst), not white turbidity. The causes of white turbidity include unfulfilled sexual desire, prostitution with males, drunkenness, use of aphrodisiacs during intercourse, and retaining semen. All these cause Ministerial Fire to be depressed, leading to the stasis and putrefaction of ruined essence. Thus, white turbidity often prolongs into severe conditions like Chancre. How can this be a urinary disease? The Inner Canon states that turbid fluids all belong to Heat. Excessive heat becomes Red Turbidity. Or, long-standing white turbidity where blood fails to transform into essence may also change into red turbidity, which is critical. Treatment methods mainly involve nourishing Yin and clearing Heat, assisted by firming the Kidney and promoting urination. Since the Gui Qiao (Essence Orifice) should be closed and the Ren Qiao (Urinary Orifice) should be open, early cases should include herbs that vent ruined essence, such as Hua Shi (Talcum), Dong Kui Zi (Malvae Semen), Niu Xi (Achyranthis Bidentatae Radix), and Bi Xie (Dioscoreae Hypoglaucae Rhizoma). For long-standing cases, herbs that tonify Yuan and secure the lower body, such as Ren Shen (Ginseng Radix et Rhizoma), Shu Di Huang (Rehmanniae Radix Preparata), Xiang Lian (Nelumbinis Semen), and Qian Shi (Euryales Semen), should be included. It is not difficult. Here I select four cases, two of which are Damp-Phlegm and Damp-Heat syndromes. This is likely to prevent people from only adhering to the single method of treating the Kidney. Although Damp-Phlegm and Damp-Heat seem unrelated to essence disorders, if Damp-Heat invades the Kidney internally, essence becomes unclear and turbid. As seen in Sheng Shengzi's case, and when laypeople use fermented slurry with Hua Shi or Bai Guo (Ginkgo Seed) paste to remove Damp-Heat, essence naturally consolidates. If Damp-Phlegm flows downward to the Kidney, essence becomes restless and turbid. As in Danxi's first case and Li Shicai's treatment of a military candidate surnamed Zhang, eliminating Damp-Phlegm allows essence to remain stable. If it were a urinary disease, why not use Shi Wei San (Pyrosperma Powder) or Ba Zheng San (Eight-Ingredient Corrective Powder) from the Lin syndrome section? Even if long-standing depletion leads to sinking of Yuan Qi, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) may be used because tonified Yuan Qi can lift essence and prevent leakage. Only in summer cases of turbid urine due to Summerheat, treated with Chen Sha Liu Yi San (Cinnabar Six-to-One Powder); and in Jin Shan (Sinew Chancre) where white substance like essence follows urine, treated with Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver), are these truly urinary diseases. However, these differ originally from the condition of red and white turbidity.