脉
两尺脉洪数，必便浊遗精。心脉短小，因心虚所致，必遗精便浊。
病
夫赤、白浊者，由肾水虚少，膀胱火盛，小便去涩，所以成浊也。盖思虑过度，嗜欲无节，俾心肾不交，
精元失守，为赤、白二浊之患焉。赤者，心虚有热，由思虑而得之；白者，肾虚有寒，因嗜欲而致也。河间
谓白浊亦属乎热，丹溪谓胃中浊气下流，渗入膀胱。赤者，湿热伤血分；白者，湿热伤气分。
治
大率皆是湿痰流注，宜燥中宫之湿，用二陈汤以治痰，加苍术、
白术以燥湿，加柴胡、升麻以提胃中之气，全在活法以治之也。
如醉饱后，色欲不节，伤脾损肾，脾来乘肾，土克水也，至小便黄浊，其脉脾部洪数，肾脉微涩，其
证尿下桶如山栀子汁；澄下桶底，如锻石脚，或如血点凝结在内。法当补养脾胃，宜四炒固真丹主之。
方
清心莲子饮〔批〕（按此方治赤浊之剂） 治心中发热烦躁，思虑忧愁抑郁，小便赤浊，或有沙漠夜
梦走泄，遗沥涩痛便赤。如或酒色过度，上盛下虚，心火炎上，肺金受克，故口苦咽干，渐成消渴，四
肢倦怠，男子五淋，妇人带下赤白，五心烦热。此药温平，清心养
神，秘精，大有奇效。
石莲肉 人参（各二钱半） 黄 赤茯苓（各二钱） 麦门冬 地骨皮
黄芩 车前子（各一钱半） 甘草（一钱） 一方有木通
上锉一剂，水煎温服。热，加柴胡。薄荷（各一钱半） 上盛下虚，加酒炒黄柏、知母（各一钱）
滋肾饮 治白浊初起半月者，极效。
川萆 （去皮） 麦门冬（去心） 远志（去心） 黄柏（酒浸） 菟丝子（酒炒） 五味子（酒炒）
上各等分，锉作剂，竹叶三个，灯草七根，大黄少许，水煎，空心服。
萆 饮 治真元不足，下焦虚寒，小便白浊，频数无度，漩白如油，光彩不定，漩脚澄下，凝而膏糊。
益智仁 川萆 石菖蒲 乌药
一方加茯苓、甘草。
上锉作剂，水煎，入盐一捻，空心温服。肾虚加山药、牛膝、杜仲；便浊加泽泻、麦门冬。
三神汤（东泉叔方）〔批〕（按此方治白浊之剂） 治遗精、白浊。
苍术（七钱） 川萆 （七钱） 小茴香（一两）
上锉，生姜三片，煎，入盐一捻同服。
水火厘清饮〔批〕（按此方赤白浊兼治之剂） 治赤白浊。
益智仁（一钱） 萆 （一钱） 石菖蒲（一钱） 赤茯苓（一钱二分） 猪苓（一钱）
车前子（一钱） 泽泻（一钱） 白术（一钱） 陈皮（一钱） 枳壳（一钱） 甘草（五分） 麻黄（一钱）
上锉一剂，半酒半水煎，空心温服。久病去麻黄，易升麻。
Pulse Diagnosis
When the pulses at both Chi positions (Kidney positions) are surging and rapid, it inevitably indicates turbid urine and seminal emission. A short and small Heart pulse indicates deficiency of the Heart Qi, which inevitably leads to seminal emission and turbid urine.
Disease Pathogenesis
The so-called red turbidity and white turbidity arise from a deficiency of Kidney Yin (Kidney Water) and an excess of Fire in the Bladder, causing dysuria and resulting in turbidity. Generally, this is caused by excessive mental worry and unregulated sexual desire, preventing the communication between the Heart and the Kidney, leading to the loss of essence retention, thereby giving rise to red and white turbidity. Red turbidity results from Heart deficiency with heat, caused by excessive mental worry; white turbidity results from Kidney deficiency with cold, caused by excessive sexual indulgence. Liu Hejian stated that white turbidity also belongs to heat syndromes. Zhu Danxi believed that turbid Qi from the Stomach flows downward and infiltrates the Bladder. Red turbidity involves damp-heat injuring the Blood level; white turbidity involves damp-heat injuring the Qi level.
Treatment Principles
Generally, these conditions involve the flow and accumulation of damp-phlegm. It is appropriate to dry the dampness in the Middle Jiao (Spleen/Stomach), using Er Chen Tang (Two-Cured Decoction) to treat phlegm, adding Cang Zhu (Atractylodis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to dry dampness, and adding Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma) to raise the Qi of the Stomach. The key lies in flexible application of treatment methods.
If after drunkenness or overeating, sexual activity is not regulated, damaging the Spleen and Kidney, the Spleen Earth overacts on the Kidney Water (Earth overcoming Water), leading to yellow and turbid urine. The pulse at the Spleen position is surging and rapid, while the pulse at the Kidney position is slightly choppy. The symptoms include urine resembling juice of Gardenia fruits poured into a bucket; sediment at the bottom resembles red mineral deposits, or clots resembling blood points condensed inside. The method should be to tonify and nourish the Spleen and Stomach, primarily using Si Chao Gu Zhen Dan (Four-Fried True-Securing Pill).
Formulas
Qing Xin Lian Zi Yin (Clear the Heart Lotus Seed Decoction) [Commentary: This formula treats red turbidity.] It treats fever and irritability in the heart, mental worry, sorrow, depression, red turbid urine, nocturnal emissions due to dreaming, post-micturition dribbling with painful dysuria, and red urine. If excessive alcohol and sexual activity lead to excess above and deficiency below, with Heart Fire flaring upward and impairing Lung Metal, causing bitter taste in the mouth and dry throat, gradually developing into Xiao Ke (Wasting-Thirst syndrome), fatigue in the four limbs, five types of Lin syndrome (dysuria) in men, and red-and-white leukorrhea in women, along with five-palm heat. This medicine is warm and neutral, clearing the Heart, nourishing the Spirit, and securing essence, with remarkable efficacy.
Shi Lian Rou (Stone Lotus Seed), Ren Shen (Ginseng Radix et Rhizoma) (each 2.5 qian), Huang Qin (Scutellariae Radix), Chi Fu Ling (Poria with Red Hostwood) (each 2 qian), Mai Men Dong (Ophiopogonis Tuber), Di Gu Pi (Lycii Cortex), Huang Qin (Scutellariae Radix), Che Qian Zi (Plantaginis Semen) (each 1.5 qian), Gan Cao (Licorice Root) (1 qian). Another version includes Mu Tong (Akebiae Caulis).
Crush all ingredients for one dose, decoct in water, and take warm. If there is heat, add Chai Hu (Bupleuri Radix) and Bo He (Menthae Haplocalycis Herba) (each 1.5 qian). For excess above and deficiency below, add Jiu Chao Huang Bai (Phellodendri Cortex prepared with wine) and Zhi Mu (Anemarrhenae Rhizoma) (each 1 qian).
Zi Shen Yin (Nourish the Kidney Decoction) Extremely effective for white turbidity occurring within half a month.
Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma) (peeled), Mai Men Dong (Ophiopogonis Tuber) (heart removed), Yuan Zhi (Polygalae Radix) (heart removed), Huang Bai (Phellodendri Cortex) (soaked in wine), Tu Si Zi (Cuscutae Semen) (stir-fried with wine), Wu Wei Zi (Schisandrae Fructus) (stir-fried with wine).
Take equal parts of each, crush for one dose, add three bamboo leaves, seven roots of Deng Cao (Junci Medulla), and a little Da Huang (Rhei Radix et Rhizoma). Decoct in water and take on an empty stomach.
Bi Xie Yin (Dioscorea Hypoglauca Decoction) Treats insufficiency of true Yuan (Original Qi), deficiency-cold in the Lower Jiao, white turbid urine, frequent urination without limit, urine white like oil, unstable luster, and sediment condensing into a paste-like consistency.
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Shi Chang Pu (Acori Tatarinowii Rhizoma), Wu Yao (Linderae Radix).
Another version adds Fu Ling (Poria) and Gan Cao (Licorice Root).
Crush for one dose, decoct in water, add a pinch of salt, and take warm on an empty stomach. For Kidney deficiency, add Shan Yao (Dioscoreae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix), and Du Zhong (Eucommiae Cortex); for turbid urine, add Ze Xie (Alismatis Rhizoma) and Mai Men Dong (Ophiopogonis Tuber).
San Shen Tang (Three-Essence Decoction) (Formula by Uncle Dongquan) [Commentary: This formula treats white turbidity.] Treats seminal emission and white turbidity.
Cang Zhu (Atractylodis Rhizoma) (7 qian), Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma) (7 qian), Xiao Hui Xiang (Foeniculi Fructus) (1 liang).
Crush all, add three slices of Sheng Jiang (Zingiberis Rhizoma Recens), decoct, and take together with a pinch of salt.
Shui Huo Li Qing Yin (Water-Fire Clarifying Decoction) [Commentary: This formula treats both red and white turbidity.] Treats red and white turbidity.
Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) (1 qian), Bi Xie (Dioscoreae Hypoglaucae Rhizoma) (1 qian), Shi Chang Pu (Acori Tatarinowii Rhizoma) (1 qian), Chi Fu Ling (Poria with Red Hostwood) (1.2 qian), Zhu Ling (Polyporus) (1 qian), Che Qian Zi (Plantaginis Semen) (1 qian), Ze Xie (Alismatis Rhizoma) (1 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (1 qian), Chen Pi (Citri Reticulatae Pericarpium) (1 qian), Zhi Ke (Aurantii Fructus Immaturus) (1 qian), Gan Cao (Licorice Root) (0.5 qian), Ma Huang (Ephedrae Herba) (1 qian).
Crush for one dose, decoct in half wine and half water, and take warm on an empty stomach. For chronic cases, remove Ma Huang (Ephedrae Herba) and substitute with Sheng Ma (Cimicifugae Rhizoma).