两尺脉洪数必便浊失精。
精之主宰在心。精之藏制在肾。凡人酒色无度。思虑过情。心肾气虚。不能管摄。往往
小便
频数。便浊之所由生也。因小便而出者。曰尿精。因见闻而出者。曰漏精。心不足而挟热者
为赤浊。心不足而肾冷者。为白浊。阴不升。阳不降。上下乖捩。是以有清浊不分之症
大抵多是湿痰流注。直燥中宫之湿。兼降火升举之法。此为至要之语也。
一论便浊之症。因脾胃之湿热下流。渗入膀胱。故使便溺赤白混浊不清也。宜燥中宫之
湿。用升麻、柴胡提气。使大便润而小便长。不宜用寒凉伤血之药。
主方
陈皮（八分） 半夏（八分） 茯苓（一钱） 苍术（米泔浸炒七分） 黄柏（酒炒七分） 柴
胡（七
分） 升麻（三分） 白术（去芦五分） 神曲（炒五分） 牡蛎（五分） 栀子（炒一钱）
蛤粉（三分） 滑石（一钱） 甘草（三分）
上锉一剂。生姜二片。白果九枚。水煎。空心服。渣再煎服。忌煎炒辛辣物。
一论心中烦躁。思虑忧愁抑郁。小便赤浊。或有砂膜。夜梦遗精。遗沥疼痛。便赤。或
酒色
过度。上盛下虚。心火上炎。致肺经受克。故口苦咽干。渐成消渴。四肢倦怠。男子五淋。
妇人带下赤白。五心烦躁。此药温平清心。养神秘精。
清心莲子饮
石莲肉 人参（各二钱五分） 黄 （蜜炙） 赤茯苓（各二钱） 麦冬（去心） 地骨皮
黄芩（各一钱五分） 车前子（一钱五分） 甘草（三分）
热。加柴胡、薄荷各一钱五分。
上锉一剂。灯草十根。生姜三片。水煎。空心服。上盛下虚。加酒炒黄柏、知母各一钱
一论心经伏暑。小便赤浊而有热也。
加味四苓散
人参（减半） 白术（去芦） 赤茯苓（去皮） 猪苓 泽泻 香薷 石莲肉 麦冬（去心各
等分）
上锉。水煎。空心。温服。
一论小便白浊。溺数无度。溺白如油。光彩不定。溺脚澄下。凝如膏糊。此真元不足。
下焦虚寒之所致也。
萆 散
益智仁 （一钱五分） 川萆 （三钱） 石菖蒲（一钱） 乌药（一钱） 一方。加茯苓三钱
甘草八分。
上各等分。锉一剂。水煎。入盐一捻。空心。温服。肾虚。加牛膝三钱。杜仲三钱。山
药三钱。便赤。加泽泻二钱。麦冬二钱。
一论白浊初起。或半月者。下焦虚热之所致也。
滋肾散
川萆 （二钱） 麦冬（二钱） 远志（一钱） 黄柏（二钱） 菟丝子（三钱） 五味子（酒炒
四分）
上锉一剂。竹叶三片。灯草一团。水煎。空心服。
一论赤白浊。乃水火之不分也。
水火厘清散
益智仁（一钱五分） 石菖蒲（一钱） 赤茯苓（三钱） 车前子（三钱） 猪苓（三钱） 泽泻
（二
钱） 白术（一钱五分） 枳壳（一钱） 萆 （二钱） 麻黄（三分） 甘草（八分） 陈皮（
二钱）
上锉。水酒各半煎。空心服。若久病。去麻黄。易升麻。
一治遗精白浊。
玉还丹 弟云嵩传。
五色龙骨 左顾牡蛎 莲花须 芡实 石菖蒲 五味子 黄柏（酒炒各一两） 一方。用
石莲子。去石菖蒲。
上为细末。用金樱子煎汤为糊。入臼内捣千余下。成剂为丸。如梧桐子大。每服五十丸
盐汤下。干物压之。
一治遗精白浊。
山药（一两） 黄柏（酒炒二两） 牡蛎（火 醋淬七次五钱） 白茯苓（去皮一两）
上共为细末。酒糊为丸。如梧桐子大。每服五十丸。空心水下。
一论白浊梦遗。及精滑出而不收者。
樗根丸
樗根白皮（有荚者是） 黄柏（炒褐色） 蛤粉（炒） 青黛 干姜（炒黑） 滑石（各等分）
上为末。水糊为丸。如梧桐子大。每服百丸。空心。温酒送下。虚劳。四物汤下。
一论白浊经年不愈。或时梦遗。形体瘦弱。当作心虚治之。
定志丸
远志（甘草水浸去心） 石菖蒲（各二两） 人参（一两） 白茯神（去木二两） 黄柏（酒炒
二两） 蛤粉（炒一两）
上为末。炼蜜为丸。如梧桐子大。朱砂为衣。每服三十丸。空心。米汤送下。
一治小便白浊。出髓条者。
人参 白术 白茯苓 青盐 破故纸 大茴香 益智仁 酸枣仁（炒） 左牡蛎（ 各一
两）
上为末。酒糊为丸。如梧桐子大。每服三十丸。温酒米饮任下。
一论瘦人阴虚火动。患赤白浊下。清离滋坎汤。（方见劳瘵）根据本方加萆 、牛膝、山栀
、蓄赤芍。
一论久患白浊不止。而作头昏者。以益气汤加白茯苓、半夏。
一论发热口干。小便频数。大便闭结。盗汗遗精。甚至废寝。用当归六黄汤二剂。盗汗
顿止。用六味丸。二便调和。用十全大补汤。及前丸兼服。月余悉愈。
一论肥人湿痰。患赤白渴者。二陈汤。（方见痰饮）根据本方加苍术、白术、人参、当归、
生地、麦冬、山栀、黄柏、萆 、牛膝、 蓄。
一论肝肾脾肺虚损。赤白浊久不愈者。六味丸、补中益气汤。早晚兼服。六味丸（方见
补益）补中益气汤（方见内伤）根据本方加白茯苓、半夏。
一人久患白浊。发热体倦。用补中益气汤加炮姜。四剂。白浊稍止。再用六味丸兼服。
诸症悉愈。
一人患头晕白浊。余用补中益气汤加茯苓、半夏。愈而复患腰痛。用山药、山茱萸、五
味、
萆、远志。顿愈。又因劳心。盗汗白浊。以归脾汤加五味而愈。后不时晕眩。用八味丸而
愈。
The pulse at both Chi positions (Kidney positions) is surging and rapid, inevitably leading to turbid urine or spermatorrhea.
The control of essence (Jing) is governed by the Heart. The storage and restraint of essence are managed by the Kidneys. Individuals who indulge in alcohol and sexual activity without moderation, and who overthink, suffer from Qi deficiency of the Heart and Kidneys, failing to secure and hold essence. This often results in frequent urination, which is the origin of turbid urine. When essence is discharged during urination, it is called "urinary sperm" (Niao Jing). When essence flows out due to visual or auditory stimuli, it is called "leaking sperm" (Lou Jing). If Heart Qi is deficient accompanied by Heat, it is called Red Turbidity (Chi Zhuo). If Heart Qi is deficient accompanied by Kidney Cold, it is called White Turbidity (Bai Zhuo). When Yin fails to ascend and Yang fails to descend, the Qi mechanism above and below becomes disordered and inverted, thus resulting in symptoms where clear and turbid substances are not separated.
Generally, this is mostly due to damp-phlegm flowing and accumulating; directly drying the dampness of the Middle Palace (Spleen/Stomach), combined with methods to descend Fire and raise the clear Yang, is the most crucial principle.
One discussion on the syndrome of turbid urine: It arises because Damp-Heat of the Spleen and Stomach flows downward, infiltrating the Bladder, causing urine to be red, white, mixed, and turbid. One should dry the dampness of the Middle Palace, using Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) to lift the Qi, making the stool moist and the urine flow long. Medicines that are cold and damaging to Blood should not be used.
Main Formula:
Chenpi (Citri Reticulatae Pericarpium, 8 fen) Banxia (Pinelliae Rhizoma Praeparatum, 8 fen) Fuling (Poria, 1 qian) Cangzhu (Atractylodis Rhizoma, soaked in rice water and stir-fried, 7 fen) Huangbai (Phellodendri Cortex, wine-fried, 7 fen) Chaihu (Bupleuri Radix, 7 fen) Shengma (Cimicifugae Rhizoma, 3 fen) Baizhu (Atractylodis Macrocephalae Rhizoma, de-gutted, 5 fen) Shenqu (Massa Medicata Fermentata, stir-fried, 5 fen) Muli (Concha Ostreae, 5 fen) Zhizi (Gardeniae Fructus, stir-fried, 1 qian) Gafen (Calcitum, 3 fen) Huashi (Talcum, 1 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 3 fen)
Crush these into one dose. Add two slices of Shengjiang (Zingiberis Rhizoma Recens) and nine seeds of Baiguo (Ginkgonis Semen). Decoct in water. Take on an empty stomach. Decoct the dregs again and take. Avoid fried, roasted, and spicy foods.
One discussion on irritability in the Heart: Overthinking, worry, sorrow, and depression lead to red turbid urine, possibly with sand-like membranes, nocturnal emission of semen, pain after dribbling emission, and red urine. Or, due to excess alcohol and sexual indulgence, there is upper excess and lower deficiency, Heart Fire flaring upward, attacking the Lung Meridian, causing bitter taste in the mouth and dry throat, gradually developing into Xiao Ke (Wasting and Thirsting Syndrome), fatigue in the four limbs. Men suffer from Wu Lin (Five Types of Strangury); women suffer from red and white leukorrhea, and five-palm heat. This medicine is warm and neutral, clearing the Heart and nourishing Spirit and Essence.
Qingxin Lianzi Yin (Clear the Heart Lotus Seed Decoction):
Shilianrou (Nelumbinis Plumula, 2.5 qian each) Ren Shen (Ginseng Radix et Rhizoma, 2.5 qian each) Huangqi (Astragali Radix, honey-fried) Chifuling (Poria with Red Host, 2 qian each) Maidong (Ophiopogonis Radix, de-heart) Digupi (Lycii Cortex, 1.5 qian each) Huangqin (Scutellariae Radix, 1.5 qian each) Cheqianzi (Plantaginis Semen, 1.5 fen) Gancao (Glycyrrhizae Radix et Rhizoma, 3 fen)
If there is Heat, add Chaihu (Bupleuri Radix) and Bohe (Menthae Haplocalycis Herba), 1.5 qian each.
Crush these into one dose. Add ten stalks of Dengcao (Junci Medullae) and three slices of Shengjiang (Zingiberis Rhizoma Recens). Decoct in water. Take on an empty stomach. For upper excess and lower deficiency, add Huangbai (Phellodendri Cortex, wine-fried) and Zhimu (Anemarrhenae Rhizoma), 1 qian each.
One discussion on latent Summer-Heat in the Heart Meridian: Red turbid urine with a sensation of heat.
Jiawei Siling San (Modified Four Porias Powder):
Ren Shen (Ginseng Radix et Rhizoma, halved) Baizhu (Atractylodis Macrocephalae Rhizoma, de-gutted) Chifuling (Poria with Red Host, peeled) Zhuling (Polyporus, equal parts) Zexie (Alismatis Rhizoma, equal parts) Xiangru (Elsholtziae Herba, equal parts) Shilianrou (Nelumbinis Plumula, equal parts) Maidong (Ophiopogonis Radix, de-heart, equal parts)
Crush these. Decoct in water. Take warm on an empty stomach.
One discussion on white turbid urine: Frequent urination without limit, urine white like oil, luster unstable, sediment at the bottom solidifies like paste. This is caused by insufficiency of True Yuan (Original Qi) and deficiency-cold of the Lower Jiao.
Bixie Fenqing Yin (Dioscoreae Hypoglaucae Decoction for Separating Turbidity):
Yizhiren (Alpiniae Oxyphyllae Fructus, 1.5 qian) Chuanbixie (Dioscoreae Hypoglaucae Rhizoma, 3 qian) Shichangpu (Acori Tatarinowii Rhizoma, 1 qian) Wuyao (Linderae Radix, 1 qian) Another prescription adds Fuling (Poria, 3 qian) and Gancao (Glycyrrhizae Radix et Rhizoma, 8 fen).
Take equal parts, crush into one dose. Decoct in water, add a pinch of salt. Take warm on an empty stomach. For Kidney deficiency, add Niuxi (Achyranthis Bidentatae Radix, 3 qian), Duzhong (Eucommiae Cortex, 3 qian), and Shanyao (Dioscoreae Rhizoma, 3 qian). For red urine, add Zexie (Alismatis Rhizoma, 2 qian) and Maidong (Ophiopogonis Radix, 2 qian).
One discussion on the initial onset of white turbidity, or lasting half a month: Caused by deficiency-heat of the Lower Jiao.
Zishen San (Nourish Kidney Powder):
Chuanbixie (Dioscoreae Hypoglaucae Rhizoma, 2 qian) Maidong (Ophiopogonis Radix, 2 qian) Yuanzhi (Polygalae Radix, 1 qian) Huangbai (Phellodendri Cortex, 2 qian) Tusizi (Cuscutae Semen, 3 qian) Wuweizi (Schisandrae Chinensis Fructus, wine-fried, 4 fen)
Crush these into one dose. Add three leaves of Zhuye (Bambusae Folium) and a bundle of Dengcao (Junci Medullae). Decoct in water. Take on an empty stomach.
One discussion on red and white turbidity: This is a manifestation of Water and Fire not being separated.
Shuihuo Liqing San (Water-Fire Clarifying Powder):
Yizhiren (Alpiniae Oxyphyllae Fructus, 1.5 qian) Shichangpu (Acori Tatarinowii Rhizoma, 1 qian) Chifuling (Poria with Red Host, 3 qian) Cheqianzi (Plantaginis Semen, 3 qian) Zhuling (Polyporus, 3 qian) Zexie (Alismatis Rhizoma, 2 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian) Zhiqiao (Aurantii Fructus, 1 qian) Bixie (Dioscoreae Hypoglaucae Rhizoma, 2 qian) Mahuang (Ephedrae Herba, 3 fen) Gancao (Glycyrrhizae Radix et Rhizoma, 8 fen) Chenpi (Citri Reticulatae Pericarpium, 2 qian)
Crush these. Decoct with half water and half wine. Take on an empty stomach. For chronic illness, remove Mahuang (Ephedrae Herba) and replace with Shengma (Cimicifugae Rhizoma).
One treatment for spermatorrhea and white turbidity:
Yuhuan Dan (Jade Return Pill), transmitted by Di Yunsong.
Wuse Longgu (Fossilized Bones of Five Colors) Zuogu Muli (Concha Ostreae facing left) Lianhua Xu (Nelumbinis Stamen) Qianshi (Euryales Semen) Shichangpu (Acori Tatarinowii Rhizoma) Wuweizi (Schisandrae Chinensis Fructus) Huangbai (Phellodendri Cortex, wine-fried, 1 liang each) Another prescription uses Shilianshi (Stone Lotus Seed) and removes Shichangpu (Acori Tatarinowii Rhizoma).
Grind into fine powder. Use Jin Yingzi (Rosa Laevigatae Fructus) decoction as paste. Pound in a mortar over a thousand times. Form pills the size of Sophora seeds. Take 50 pills per dose with salt water, followed by dry food to settle them.
Another treatment for spermatorrhea and white turbidity:
Shanyao (Dioscoreae Rhizoma, 1 liang) Huangbai (Phellodendri Cortex, wine-fried, 2 liang) Muli (Concha Ostreae, calcined and quenched in vinegar seven times, 5 qian) Baifuling (Poria, peeled, 1 liang)
Grind all into fine powder. Make pills with wine paste, size of Sophora seeds. Take 50 pills per dose with warm water on an empty stomach.
One discussion on white turbidity with nocturnal emission, and slippery essence that cannot be retained:
Chugen Wan (Toona Pill):
Chugen Baipi (Cinnamomi Cognatae Cortex, those with pods are authentic) Huangbai (Phellodendri Cortex, stir-fried until brown) Gafen (Calcitum, stir-fried) Qingdai (Indigo Naturalis) Ganjiang (Zingiberis Rhizoma, stir-fried until black) Huashi (Talcum, equal parts)
Grind into powder. Make pills with water paste, size of Sophora seeds. Take 100 pills per dose on an empty stomach with warm wine. For consumptive disease, take with Siwu Tang (Four Substances Decoction).
One discussion on white turbidity persisting for years, or occasional nocturnal emission, with emaciation: Should be treated as Heart deficiency.
Dingzhi Wan (Calming Spirit Pill):
Yuanzhi (Polygalae Radix, soaked in Licorice water, de-heart) Shichangpu (Acori Tatarinowii Rhizoma, 2 liang each) Ren Shen (Ginseng Radix et Rhizoma, 1 liang) Baifushen (Poria with Pine Root, de-wood, 2 liang) Huangbai (Phellodendri Cortex, wine-fried, 2 liang) Gafen (Calcitum, stir-fried, 1 liang)
Grind into powder. Make pills with refined honey, size of Sophora seeds, coated with Cinnabar. Take 30 pills per dose on an empty stomach with rice soup.
One treatment for white turbid urine with discharge of marrow-like strips:
Ren Shen (Ginseng Radix et Rhizoma) Baizhu (Atractylodis Macrocephalae Rhizoma) Baifuling (Poria, peeled) Qingyan (Green Salt) Poguzhi (Kuzhenzi/Buguzhi, i.e., Cuscutae Semen) Dahuixiang (Foeniculi Fructus) Yizhiren (Alpiniae Oxyphyllae Fructus) Suanzaoren (Ziziphi Spinosae Semen, stir-fried) Zuomuli (Concha Ostreae facing left, 1 liang each)
Grind into powder. Make pills with wine paste, size of Sophora seeds. Take 30 pills per dose with warm wine or rice drink.
One discussion on thin individuals with Yin deficiency and hyperactive Fire, suffering from red and white turbidity: Qingli Zikan Tang (Clear Li Nourish Kan Decoction). (Formula see Lao Zhai chapter). Based on this formula, add Bixie (Dioscoreae Hypoglaucae Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Shanzhi (Gardeniae Fructus), Jiquan (Polygoni Avicularis Herba), and Chishao (Paeoniae Radix Rubra).
One discussion on chronic white turbidity not stopping, accompanied by dizziness: Use Yiqi Tang (Qi-Boosting Decoction) plus Baifuling (Poria, peeled) and Banxia (Pinelliae Rhizoma Praeparatum).
One discussion on fever, dry mouth, frequent urination, constipation, night sweats, and spermatorrhea, even to the point of neglecting sleep: Use Danggui Liu Huang Tang (Angelica Six-Huang Decoction) for two doses; night sweats stop immediately. Use Liuwei Wan (Six-Ingredient Pill with Rehmannia) to harmonize bowel and bladder movements. Then use Shiquan Dabu Tang (Ten-Tonifying Decoction) and the aforementioned pills concurrently. All cured within a month.
One discussion on obese individuals with damp-phlegm, suffering from red/white turbidity and thirst: Erchen Tang (Two-Aged Decoction). (Formula see Tan Yin chapter). Based on this formula, add Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Maidong (Ophiopogonis Radix), Shanzhi (Gardeniae Fructus), Huangbai (Phellodendri Cortex), Bixie (Dioscoreae Hypoglaucae Rhizoma), Niuxi (Achyranthis Bidentatae Radix), and Jiquan (Polygoni Avicularis Herba).
One discussion on deficiency and damage of Liver, Kidney, Spleen, and Lung, with chronic red/white turbidity: Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Buzhong Yiqi Tang (Middle-Boosting Qi-Enhancing Decoction). Take both morning and evening. Liuwei Wan (Formula see Bu Yi chapter) Buzhong Yiqi Tang (Formula see Nei Shang chapter) Based on this formula, add Baifuling (Poria, peeled) and Banxia (Pinelliae Rhizoma Praeparatum).
One person suffered from chronic white turbidity, fever, and body fatigue. Used Buzhong Yiqi Tang (Middle-Boosting Qi-Enhancing Decoction) plus Paojiang (Prepared Zingiberis Rhizoma). After four doses, white turbidity slightly stopped. Then took Liuwei Wan (Six-Ingredient Pill with Rehmannia) concurrently. All symptoms cured.
One person suffered from dizziness and white turbidity. I used Buzhong Yiqi Tang (Middle-Boosting Qi-Enhancing Decoction) plus Fuling (Poria) and Banxia (Pinelliae Rhizoma Praeparatum). Cured, but later relapsed with lower back pain. Used Shanyao (Dioscoreae Rhizoma), Shanzhuyu (Corni Fructus), Wuwei Zi (Schisandrae Chinensis Fructus), Bixie (Dioscoreae Hypoglaucae Rhizoma), and Yuanzhi (Polygalae Radix). Instantly cured. Later, due to mental labor, suffered from night sweats and white turbidity. Used Guipi Tang (Restore the Spleen Decoction) plus Wuwei Zi (Schisandrae Chinensis Fructus). Cured. Later suffered from intermittent vertigo. Used Bawei Wan (Eight-Ingredient Pill) and cured.