脉
遗精、便浊，当验于尺，结芤动紧，二证之的。
病
夫精者，五脏六腑皆有，而肾为都会关司之所，又听命于心焉。盖遗精之证有四∶一曰梦中交而遗者，
乃心虚神交也；二曰下元虚败，精不禁而遗者，乃肾虚精滑过也；三曰壮年气盛，久节劳欲，经络壅滞而遗精，
乃旷夫满而溢也；四曰情纵于中，所愿不得而遗者，乃情不遂欲而泄也。若夫壮年气盛，及情动于中者，但舒
其情自愈；至若梦中交泄，则当治其心；肾虚精滑，则当固其真。斯治之要也。
夫梦遗精滑者，世人多作肾虚治，而用补肾涩精之药不效，殊不知此证多属脾胃，饮食浓味，痰火
湿热之人多有之。盖肾藏精，精之所生，由脾胃饮食化生，而输归于肾。今脾胃伤于浓浓，湿热内郁，中气浊
而不清，则其化生之精亦得浊气，肾主秘藏，阴静则宁，今所输之精既有浊气，则邪火动于肾中，而火不得宁
静，故遗而滑也。此证与白浊同。丹溪论白浊为胃中浊气下流，渗入膀胱，而云无人知此。其色心太重，
妄想过度而致遗滑者，自从心肾治之，但兼脾胃者多，又当审察治之。
治
凡二八童男，阳气暴盛，故情动于中，志有所慕而不得，遂成
夜梦而遗精也，其心脉数，肾脉涩，慎不可补，清心乃安，惟清心莲子饮临卧服，及定主丸主之。
夜梦鬼交而遗，宜温胆汤去竹茹，加人参、远志、石莲肉、酸枣仁（炒）、白茯神。
方
养心汤 治用心过度，心热遗精，恍惚多梦，或惊而不寐者。
人参 山药 茯神 麦门冬 当归身 白芍 石莲肉 远志 酸枣仁 鸡头实 莲花须 子芩（酒洗）
上锉一剂，加生姜三片，枣一枚，水煎服。气虚，加黄 、白术；血虚，加熟地黄；遗
久气陷，加川芎、升麻，去子芩。
定心丸〔批〕（按此方治妄想太过遗精之剂） 治妄想太过遗精。
人参 白术 茯苓 枳实（面炒） 石莲肉（去心） 陈皮 韭子（炒，各一
两） 半夏 远志（去骨） 酸枣仁（各五钱） 牡蛎（煨，三钱） 甘草（多，一钱半）
上为末，神曲糊为丸，如梧子大。每服五十丸，空心盐汤下。
久则加干姜炒黑三钱，樗根白皮五钱。
加味二陈汤〔批〕（按此方治痰渗下遗精之剂） 治遗精。
陈皮（一钱） 半夏（一钱半，姜泡） 茯苓（一钱半，盐水炒） 白术（一钱） 桔梗
（一钱） 石菖蒲（七分） 黄柏（二分） 知母（三分） 栀子（炒黑，一钱半） 升麻（一钱，
酒炒） 柴胡（一钱，酒炒） 甘草（一钱）
上锉一剂。生姜煎服。
樗根白皮丸〔批〕（按此方治湿热伤脾遗精之剂） 治湿热伤脾遗精之剂。
白术 枳实（面炒） 茯苓 柴胡 升麻（各二钱） 黄柏（盐水炒） 知母（盐
水炒） 牡蛎（ ，各三钱） 韭子（炒，一两） 芍药（炒，五钱）
上为末，神曲糊为丸。每服五十丸，空心盐汤下。久不止，加樗根白皮（七钱）
黄连清心汤 治心有所慕而作梦遗，此君火既动，而相火随之，治在心。
黄连 生地黄 当归 人参 远志 茯神 酸枣仁（炒） 石莲肉 甘草
上锉作剂，水煎服。
三黄丸 治遗精有热者。
黄芩（泻肺炎） 黄柏（降阴火） 大黄（泻阳明之湿热）
上为末，炼蜜为丸，如梧桐子大，每服五七十丸，白汤下。
〔批〕（按此方治实热遗精之剂） 西园曰∶遗精是用心过度，积热所致，
当用黄连，今用黄芩，未知孰是。
保精汤（云林制） 治阴虚火动，夜梦遗精，或发热。
当归 川芎 白芍 生地黄（姜汁炒） 沙参 麦门冬（去心） 黄柏（酒
炒） 知母（蜜炒） 黄连（姜汁炒） 栀子（童便炒） 干姜（炒黑） 牡蛎（火 ） 山茱萸（去复选肉）
上锉，水煎，空心服。
固精丸 治心神不安，肾虚精自泄。
黄柏（酒炒） 知母（酒炒，各一两） 牡蛎（ ） 芡实 莲蕊 茯苓 远志（去
心） 山茱萸肉（各三钱）
上为末，煮山药糊为丸，如梧子大，朱砂为衣。每服五十丸，空心盐汤送下。
百粉丸（西园公制）〔批〕（按此方治肾虚火动遗精之剂） 治肾虚火动遗精。
黄柏（童便炒） 知母（童便炒） 蛤粉（略炒） 牡蛎（火 ） 山药（酒炒）
上为末，捣烂饭为丸，如梧子大。每服五七十丸，空心盐汤、温酒任下。
固本锁精丹（秘方）〔批〕（按此方治精气两虚遗精之剂） 治元阳虚惫，精气不
固，梦寐遗精，夜多盗汗，遗泄不禁，并治，此药大补元气，涩精固阳，神效。
黄 （二两半） 人参（二两半） 枸杞子（二两） 锁阳（二两） 五味子（二两半）
石莲肉（二两半） 山药（二两） 海蛤粉（二两半） 黄柏（二两，酒拌晒干，炒黑色）
上为末，用白术六两，水五碗，煎至二碗，倒过术汁，另放；再用水四碗，煎至二碗，去渣，与前二碗
同煎，熬至一碗如膏，搜和前药末为丸，如梧子大。每服五十丸，加至六七十丸，空心温酒，或淡盐汤下。
白龙丸（贾阁老传）〔批〕（按此方治精滑止涩之剂） 治虚劳肾损，梦中遗精，白淫滑泄，盗汗等症。
鹿角霜（二两） 龙骨（生用、一两） 牡蛎（火 ，二两）
上为细末，酒打面糊为丸，如梧子大。每三五十丸，空心服，
或盐汤，或酒下。不惟治遗之疾，且能固精壮阳，神效。
缩阳秘方（张岭南传）
水蛭寻起九条，入水碗养住，至七月七日，取出阴干，秤有多
少，入麝香、合香，三味一般多，研细末，蜜少许为饼。遇阳兴时，即将少许擦左脚心，实时痿缩。过日复兴，再擦。
Pulse Diagnosis
For spermatorrhea (spermatorrhea) and turbid urine (turbid urination), the pulse should be examined at the Chi position (radial artery position corresponding to the Kidney). If the pulse presents as Knotted (Jie, intermittent with irregular pauses), Hollow (Kou, floating and large but empty in the middle), Agitated (Dong, rolling like a bean), or Tight (Jin, tense like a bowstring), these are definitive indicators of these two conditions.
Etiology and Pathogenesis
Essence (Jing, the fundamental substance for growth, development, and reproduction) is generated by all five Zang and six Fu organs, but the Kidney is the central repository and control center, which is also subject to the command of the Heart Spirit (Shen). Generally speaking, there are four types of spermatorrhea: First, emission during sexual dreams, caused by Heart deficiency and spiritual interaction; Second, leakage due to the deficiency and decline of the lower Yuan (lower burner/origin), where essence cannot be retained, indicating Kidney deficiency with slippery essence; Third, emission in vigorous youth after long-term abstinence from labor and desire, causing stagnation in meridians and collaterals, similar to a bachelor's essence overflowing due to fullness; Fourth, emission due to unrestrained desires within and unfulfilled wishes, resulting from frustrated emotions and suppressed lust. For cases involving vigorous youth and emerging desires, soothing the emotions leads to self-healing. For emissions during sexual dreams, treatment should focus on the Heart. For Kidney deficiency with slippery essence, treatment should focus on consolidating the True Yuan (Zhen Yuan, original vitality). This is the key to treatment.
Those suffering from nocturnal emissions and seminal slippage are often treated by laypeople as Kidney deficiency, using herbs that tonify the Kidney and astringe essence without effect. They fail to realize that this condition often belongs to the Spleen and Stomach. It is common in individuals with rich diet-induced phlegm-fire and damp-heat. The Kidney stores essence; the generation of essence originates from the transformation of food and drink by the Spleen and Stomach, which then transport it back to the Kidney. Now, if the Spleen and Stomach are damaged by rich and greasy foods, damp-heat accumulates internally, and the Middle Qi becomes turbid and unclear, the generated essence will also carry turbid qi. The Kidney governs closure and storage; Yin stillness brings peace. However, since the transported essence now carries turbid qi, pathogenic fire moves within the Kidney, preventing tranquility, thus causing emission and slippage. This condition is identical to Bai Zhuo (white turbidity, cloudy urine resembling rice water). Danxi argued that Bai Zhuo is caused by turbid qi from the Stomach flowing downward and seeping into the Bladder, lamenting that few understand this. For those whose excessive mental burden and wild fantasies lead to emission and slippage, treatment should naturally address the Heart and Kidney. However, since many cases involve the Spleen and Stomach, careful examination and treatment are required.
Treatment Principles
For sixteen-year-old boys, Yang Qi suddenly becomes vigorous, leading to emotional arousal within and unfulfilled aspirations, resulting in nocturnal emissions during dreams. Their Heart pulse is rapid (Shu), and their Kidney pulse is choppy (Se). Tonification must strictly be avoided; clearing the Heart brings peace. One should take Qingxin Lianzi Yin (Clear the Heart Lotus Seed Decoction) before bed and treat primarily with Dingxin Wan (Stabilize the Heart Pill).
For emissions accompanied by dreams of demonic intercourse, use Wendan Tang (Warm the Gallbladder Decoction) removing Zhu Ru (Bambusae Caulis in Taeniam), adding Renshen (Ginseng Radix et Rhizoma), Yuanzhi (Polygalae Radix), Shilian Rou (Nelumbinis Semen endocarp), Chao Suanzaoren (Fried Ziziphi Spinosomi Semen), and Baifushen (Poria with Hostwood).
Formulas
Yangxin Tang (Nourish the Heart Decoction): Treats excessive mental exertion, Heart heat causing spermatorrhea, mental confusion with many dreams, or insomnia due to fright.
Herbs: Renshen (Ginseng Radix et Rhizoma), Shanyao (Dioscoreae Rhizoma), Fushen (Poria with Hostwood), Maimendong (Ophiopogonis Radix), Dangguishen (Angelicae Sinensis Radix root part), Baishao (Paeoniae Radix Alba), Shilian Rou (Nelumbinis Semen endocarp), Yuanzhi (Polygalae Radix), Suanzaoren (Ziziphi Spinosomi Semen), Jitou Shi (Euryales Semen), Lianhua Xu (Nelumbinis Plumula), Zi Qin (Scutellariae Radix washed with wine).
Preparation: Coarsely crush one dose, add three slices of Shengjiang (Zingiberis Rhizoma Recens) and one Zao (Jujubae Fructus), decoct in water and drink. For Qi deficiency, add Huangqi (Astragali Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma); for Blood deficiency, add Shudihuang (Rehmanniae Radix Preparata); for prolonged emission with Qi sinking, add Chuanxiong (Ligustici Chuanxiong Rhizoma) and Shengma (Cimicifugae Rhizoma), remove Zi Qin.
Dingxin Wan [Commentary] (According to this commentary, this formula treats spermatorrhea caused by excessive delusion): Treats spermatorrhea due to excessive delusion.
Herbs: Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Zhishi (Aurantii Fructus Immaturus stir-fried with flour), Shilian Rou (Nelumbinis Semen endocarp, heart removed), Chenpi (Citri Reticulatae Pericarpium), Jiu Zi (Allii Tuberosi Semen fried, each 1 liang), Banxia (Pinelliae Rhizoma), Yuanzhi (Polygalae Radix, woody core removed), Suanzaoren (Ziziphi Spinosomi Semen, each 5 qian), Muli (Ostreae Concha calcined, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, used generously, 1.5 qian).
Preparation: Grind into fine powder, bind with Shenqu (Massae Fermentatae Medicinales paste) into pills the size of Wutong seeds. Take 50 pills per dose, with salted water on an empty stomach. If chronic, add Ganjiang (Zingiberis Rhizoma) charred black (3 qian) and Chugen Bapi (Bignoniae Cortex, 5 qian).
Jiawei Erchen Tang [Commentary] (According to this commentary, this formula treats spermatorrhea caused by phlegm-dampness descending): Treats spermatorrhea.
Herbs: Chenpi (Citri Reticulatae Pericarpium, 1 qian), Banxia (Pinelliae Rhizoma soaked in ginger juice, 1.5 qian), Fuling (Poria stir-fried with salt water, 1.5 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian), Jiegeng (Platycodonis Radix, 1 qian), Shichangpu (Acori Tatarinowii Rhizoma, 7 fen), Huangbai (Phellodendri Cortex, 2 fen), Zhimu (Anemarrhenae Rhizoma, 3 fen), Zhizi (Gardeniae Fructus charred, 1.5 qian), Shengma (Cimicifugae Rhizoma stir-fried with wine, 1 qian), Chaihu (Bupleuri Radix stir-fried with wine, 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian).
Preparation: Coarsely crush one dose. Decoct with Shengjiang (Zingiberis Rhizoma Recens) and drink.
Chugen Bapi Wan [Commentary] (According to this commentary, this formula treats spermatorrhea caused by damp-heat injuring the Spleen): Treats spermatorrhea caused by damp-heat injuring the Spleen.
Herbs: Baizhu (Atractylodis Macrocephalae Rhizoma), Zhishi (Aurantii Fructus Immaturus stir-fried with flour), Fuling (Poria), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma, each 2 qian), Huangbai (Phellodendri Cortex stir-fried with salt water), Zhimu (Anemarrhenae Rhizoma stir-fried with salt water), Muli (Ostreae Concha calcined, each 3 qian), Jiu Zi (Allii Tuberosi Semen fried, 1 liang), Shaoyao (Paeoniae Radix Alba fried, 5 qian).
Preparation: Grind into fine powder, bind with Shenqu (Massae Fermentatae Medicinales paste) into pills. Take 50 pills per dose, with salted water on an empty stomach. If persistent, add Chugen Bapi (Bignoniae Cortex, 7 qian).
Huanglian Qingxin Tang (Coptis Clear the Heart Decoction): Treats nocturnal emissions due to dreaming of objects of affection, where the Minister Fire follows the Sovereign Fire. Treatment focuses on the Heart.
Herbs: Huanglian (Coptidis Rhizoma), Shengdihuang (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix et Rhizoma), Yuanzhi (Polygalae Radix), Fushen (Poria with Hostwood), Chao Suanzaoren (Fried Ziziphi Spinosomi Semen), Shilian Rou (Nelumbinis Semen endocarp), Gancao (Glycyrrhizae Radix et Rhizoma).
Preparation: Coarsely crush one dose, decoct in water and drink.
Sanhuang Wan (Three Yellows Pill): Treats spermatorrhea with heat signs.
Herbs: Huangqin (Scutellariae Radix, clears Lung heat), Huangbai (Phellodendri Cortex, descends Yin fire), Dahuang (Rhei Radix et Rhizoma, clears damp-heat in Yangming).
Preparation: Grind into fine powder, bind with refined honey into pills the size of Wutong seeds. Take 50-70 pills per dose, with plain warm water.
[Commentary] (According to this commentary, this formula treats spermatorrhea due to excess heat): Xiyuan said: Spermatorrhea is caused by excessive mental exertion and accumulated heat, so Coptis (Huanglian) should be used. Using Scutellaria (Huangqin) here is questionable.
Baojing Tang (Preserve Essence Decoction, formulated by Yunlin): Treats Yin deficiency with hyperactive fire, nocturnal emissions during dreams, or fever.
Herbs: Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Shengdihuang (Rehmanniae Radix stir-fried with ginger juice), Shashen (Glehniae Radix), Maimendong (Ophiopogonis Radix, heart removed), Huangbai (Phellodendri Cortex stir-fried with wine), Zhimu (Anemarrhenae Rhizoma stir-fried with honey), Huanglian (Coptidis Rhizoma stir-fried with ginger juice), Zhizi (Gardeniae Fructus stir-fried with child's urine), Ganjiang (Zingiberis Rhizoma charred black), Muli (Ostreae Concha calcined), Shanzhuyu (Corni Fructus, flesh selected repeatedly).
Preparation: Coarsely crush, decoct in water, take on an empty stomach.
Gu Jing Wan (Consolidate Essence Pill): Treats unsettled Heart spirit and spontaneous seminal discharge due to Kidney deficiency.
Herbs: Huangbai (Phellodendri Cortex stir-fried with wine), Zhimu (Anemarrhenae Rhizoma stir-fried with wine, each 1 liang), Muli (Ostreae Concha calcined), Qianshi (Euryales Semen), Lian Rui (Nelumbinis Plumula), Fuling (Poria), Yuanzhi (Polygalae Radix, heart removed), Shanzhuyu Rou (Corni Fructus flesh, each 3 qian).
Preparation: Grind into fine powder, bind with cooked Shanyao (Dioscoreae Rhizoma) paste into pills the size of Wutong seeds, coat with Zhusha (Cinnabaris). Take 50 pills per dose, with salted water on an empty stomach.
Baifen Wan (Hundred Powders Pill, formulated by Xiyuan Gong) [Commentary] (According to this commentary, this formula treats spermatorrhea due to Kidney deficiency with hyperactive fire): Treats spermatorrhea due to Kidney deficiency with hyperactive fire.
Herbs: Huangbai (Phellodendri Cortex stir-fried with child's urine), Zhimu (Anemarrhenae Rhizoma stir-fried with child's urine), Gafen (Concha Meretricis et Cyclinae slightly fried), Muli (Ostreae Concha calcined), Shanyao (Dioscoreae Rhizoma stir-fried with wine).
Preparation: Grind into fine powder, mash cooked rice into pills the size of Wutong seeds. Take 50-70 pills per dose, with salted water or warm wine on an empty stomach.
Guben Suojing Dan (Root-Fixing Essence-Locking Elixir, Secret Recipe) [Commentary] (According to this commentary, this formula treats spermatorrhea due to dual deficiency of Qi and Essence): Treats exhaustion of Primordial Yang, insecurity of Essence and Qi, nocturnal emissions in sleep, night sweats, and uncontrollable seminal discharge. This medicine greatly tonifies Primordial Qi, astringes Essence, and secures Yang, with miraculous effects.
Herbs: Huangqi (Astragali Radix, 2.5 liang), Renshen (Ginseng Radix et Rhizoma, 2.5 liang), Gouqizi (Lycii Fructus, 2 liang), Suoyang (Cynomorii Herba, 2 liang), Wuweizi (Schisandrae Chinensis Fructus, 2.5 liang), Shilian Rou (Nelumbinis Semen endocarp, 2.5 liang), Shanyao (Dioscoreae Rhizoma, 2 liang), Haige Fen (Concha Meretricis et Cyclinae, 2.5 liang), Huangbai (Phellodendri Cortex, 2 liang, mixed with wine, sun-dried, charred black).
Preparation: Grind into fine powder. Take 6 liang of Baizhu (Atractylodis Macrocephalae Rhizoma), add 5 bowls of water, decoct to 2 bowls, filter out the Baizhu juice and set aside separately. Add another 4 bowls of water, decoct to 2 bowls, remove dregs, combine with the previous 2 bowls of juice, and simmer until 1 bowl remains as a paste. Use this paste to mix with the herbal powder to form pills the size of Wutong seeds. Take 50 pills per dose, increasing to 60-70 pills, with warm wine or light salted water on an empty stomach.
Bailong Wan (White Dragon Pill, transmitted by Jia Gelao) [Commentary] (According to this commentary, this formula treats seminal slippage and astringency): Treats deficiency consumptive disease with Kidney damage, nocturnal emissions, white turbidity/slippage, night sweats, etc.
Herbs: Lu Jiao Shuang (Cornu Cervi Degelatinatum, 2 liang), Long Gu (Os Draconis raw, 1 liang), Muli (Ostreae Concha calcined, 2 liang).
Preparation: Grind into fine powder, bind with wheat flour paste made with wine into pills the size of Wutong seeds. Take 30-50 pills per dose, on an empty stomach, with salted water or wine. It not only treats emission diseases but also consolidates Essence and strengthens Yang, with miraculous effects.
Suoyang Secret Formula (Transmitted by Zhang Lingnan)
Find nine leeches (Shuizhi, Hirudo), keep them in a bowl of water until the seventh day of the seventh lunar month, then take them out and dry in the shade. Weigh them, and add She Xiang (Moschus) and He Xiang (Agarwood/Aquilaria resin), ensuring equal amounts of the three ingredients. Grind into fine powder, add a little honey to make cakes. When erection occurs, apply a small amount to the sole of the left foot immediately, causing immediate flaccidity and shrinking. If erection recurs the next day, apply again.