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The *Neijing* (Yellow Emperor's Inner Classic) states: "All diseases involving turbid fluids belong to heat." There are four types of yellow and red urine: First, it belongs to Liver Heat. The classic says, "In Liver Heat disease, the urine turns yellow first," which is this case. Second, it belongs to Stomach Heat. The classic says, "The Foot-Yangming Stomach Meridian, when Qi is abundant, causes heat in the anterior part of the body, rapid digestion with easy hunger, and yellow urine," which is this case. Third, it belongs to Lung Deficiency. The classic says, "The Hand-Taiyin Lung Meridian, when Qi is deficient, causes shoulder and back pain; if cold, shortness of breath and insufficient respiration; and changes in urine color," which is this case. Fourth, it belongs to Kidney Deficiency. The classic says, "The Winter Pulse corresponds to the Kidney. If the Winter Pulse is inadequate (weak), it causes a person to feel cold, spine pain, lower abdominal fullness, and abnormal urination," which is this case. Excessive sweating with red and astringent urine is common in summer months. In midsummer, excessive sweating causes the Bladder to become closed and astringent, so water cannot be transported downward. One may use Sijunzi Tang (Four Gentlemen Decoction) combined with Wuling San (Five-Ingredient Powder with Poria), or Wuling San combined with Shengmai San (Generate the Pulse Powder), or Shengmai San combined with Baoyuan Tang (Preserve the Origin Decoction), or select Xiaoshu Wan (Summerheat Relief Pill) or Qingzao Tang (Clear Dryness Decoction). For cases with red and short urine, fatigue, poor appetite, and pain in the collarbone fossa (Quepen point), this indicates deficiency of the Spleen, Lung, and Kidney. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) combined with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to nourish the source of transformation and self-heal. Misusing diuretic herbs will surely lead to danger. If this occurs after already undergoing diuretic treatment, or post-illness, it belongs to Spleen and Lung Qi Deficiency, unable to transform fluids. Use Buzhong Yiqi Tang with added Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Fruit). If the Chi pulse is rapid and large, with Yin Fire flaming upward and scanty red urine, use Liuwei Dihuang Wan with added Maidong and Wuweizi. For Liver Heat, there is frequent urge to urinate but with red, astringent, obstructive pain, often feeling chilly or having alternating chills and fever. Use Liuwei Dihuang Wan with added Niuxi (Achyranthes Root). If the pulse is vigorous and Qi is excess, use Longhui Wan (Dragon Gallbladder Pill). For Stomach Heat, there is dry mouth with desire to drink, intense skin heat, use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). For severe Bladder Heat, use Zishen Wan (Nourish the Kidney Pill).

The *Neijing* states: "Fear and overthinking damage the Shen (Spirit). When the Shen is damaged, fear and seminal emission occur uncontrollably." The Kidney governs hibernation and sealing/storing; it is the root of Jing (Essence). The Five Zang organs all store Essence. Injury leads to loss of control, meaning if the true Qi of one organ fails to maintain its normal state, disease arises in that organ. Jue (Rebellious) Qi lodging in the genitalia causes dreams of intercourse. Jueyin governs sinews, so all sinews are connected to the Liver. The Kidney is Yin, governing the storage of Essence; the Liver is Yang, governing dispersion and excretion. Thus, Kidney Yin deficiency leads to uncontained Essence; Liver Yang hyperactivity leads to unsecured Qi. If Yin pathogenic factors lodge in the orifice and interact with the hyperactive Yang, Essence depletion and dream emission result. The so-called "Yang hyperactivity" refers to the strong Minister Fire lodged in the Liver. Therefore, treatment focuses primarily on the Kidney and Liver. There are also cases not involving the Kidney and Liver, but due to insufficiency in the Heart, Lung, Spleen, or Stomach; however, the Essence only escapes after transmission to the Kidney and Liver. If treatment originates from other Zang organs, the initially affected organ is the root (Ben), and the pathological accumulation in the Kidney and Liver is the branch (Biao). If the disease originates solely in the Kidney and Liver, treat them exclusively. For separation of Yin and Yang with lack of communication between Water and Fire, apply the method of mutual completion (Jiji). For Yin and Yang failing to embrace each other, apply harmonization. Tonify Qi for Yang deficiency; tonify Blood for Yin deficiency; drain Fire for Yang hyperactivity. Treatment includes direct and reverse methods, varying dosage based on convenience. Dreaming of sexual intercourse is "Dream Emission," caused by strong Minister Fire. Spontaneous emission without dreaming is called "Slippery Essence," mostly due to Heart-Kidney injury. Caused by endless thoughts and unfulfilled desires leading to "White Turbidity," there are five treatment methods. For floating Shen Qi, use Buzhong Yiqi Tang with added Shichangpu (Acorus Rhizome), followed by Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill). For long-term thinking forming Phlegm confusing the Heart orifice, first use Siqui Tang to resolve Phlegm, then regulate with Zhuling Wan and Weixi Wan. For thinking injuring Yin, use Bawei Wan (Eight-Ingredient Pill) removing Fuzi (Prepared Aconite Root), adding Jiuhuangbai (Wine-fried Phellodendron Bark) to nourish. For excessive mental work causing the Heart to fail to control the Kidney leading to essence loss, use Yuanzhi Wan. Due to unfulfilled desires, hearing or seeing things triggers immediate essence release, named "White Turbidity"; use Chensha Miaoxiang San. For excessive lust leading to lower Yuan deficiency and uncontrollable slipping, use Liuwei Dihuang Wan with added Lurong (Deer Antler Velvet), Wuweizi, and Longgu (Fossilized Bone). Dream emission due to constrained Fire: young adults with strong Fire often have overflow. Using hot herbs for deficiency-cold will worsen essence loss. Use Zishen Wan with added Shengdi (Rehmannia Root), Fushen (Poria with Hostwood), Zaoren (Ziziphus Seed), and Shichangpu. Dream emission is often Liver Heat and Gallbladder Cold; Liver Heat allows Fire to invade outward, causing Hun (Ethereal Soul) to fail to stay inward, leading to erotic dreams and essence loss, sometimes palpitations, common in obese people. Clear the Liver, do not tonify the Kidney. Use Wendan Tang (Warm the Gallbladder Decoction) with added Renshen (Ginseng Root), Fushen, Zaoren, and Lianrou (Lotus Seed Flesh). For dream emission with lower back pain, use Liuwei Dihuang Wan with added Duzhong (Eucommia Bark), Wuweizi, Tusizi (Cuscuta Seed), and Congrong (Cistanche Stem). After middle age, use Huanshao Dan. For insufficient Essence and Qi, shortness of breath, dream emission, and night sweats, use Jisheng Lurong Wan. For excessive debauchery, uncontrollable slipping, combined with Heart-Spleen Qi deficiency and poor appetite, use Jin suo Yuguan Wan with added Renshen and Baizhu (Atractylodes Macrocephala Rhizome). For dual Spleen-Kidney deficiency, failed Essence losing its pathway, and insecure slippery essence, use Jiulong Dan removing Danggui (Angelica Sinensis Root), adding Bibi (Dioscorea Hypoglauca Rhizome) and Wuweizi. However, Cuixian Wan is superior. "Failed Essence losing its pathway" does not mean retained failed Essence, but rather the Essence orifice opening repeatedly, failing to close tightly, losing its normal degree and overflowing continuously; thus, astringent agents are suitable. For excessive urination with post-void slippery essence, use Buzhong Yiqi Tang administered with Suoquan Wan (Lock the Fountain Pill). For painful frequent urination, strictly avoid Suoquan Wan, as Yizhi (Alpinia Oxyphylla Fruit) strengthens Fire and Wuyao (Lindera Root) consumes Qi, unsuitable for Yin deficiency with much Fire. For dream emission with penile itching and uncontrolled urinary passage, indicating Yang deficiency with Fire, use Jiabajia Wei Wan (Modified Eight-Ingredient Pill). For Spleen deficiency failing to dam water, and Water deficiency failing to control Fire, use Ju Jing Wan with added Renshen, Baizhu, Qianshi (Euryale Seed), Lianxu (Lotus Stamen), and Wuweizi; effective with long-term use. Generally, dream emission is mostly caused by Yin deficiency and Fire activity. Unless clearly Yang deficiency, do not lightly use Yang-tonifying drugs like Guizhi (Cinnamon Twig), Fuzi, or Lurong. Unless clearly Qi deficiency, do not casually administer Qi-tonifying flavors like Renshen, Baizhu, or Yuanzhi (Polygala Root). Observe that dream emission occurs when Yang Qi moves at dawn, indicating Yin deficiency and Yang disturbance. Any body heat with a洪滑 (Surging-Slippery) pulse is due to Heat; use Xijiao (Rhinoceros Horn - substitute with Buffalo Horn), Shanzhi (Gardenia Fruit), Maidong, Fushen, Zhuye (Bamboo Leaf), Mutong (Akebia Stem), Zhuling (Polyporus), Shengdi, and Lianrou. For stagnation and accumulated heat, the key is dispersion and drainage. Physicians who do not understand this and use only astringents will worsen the disease. Use Zishen Wan or Zhuling Wan for clearing and draining. For obese people with turbid discharge, Gun Tan Wan (Rolling Phlegm Pill) is best. For people with Spleen-Stomach Damp-Heat, excessive rich food intake, or alcoholics suffering from Phlegm-Fire, non-dream emission occurs; use Erchen Tang (Two-Aged Decoction) and Er Zhu Tang (Two-Atractylodes Decoction), adding Houpo (Magnolia Bark), Huangbai (Phellodendron Bark), Shengma (Cimicifuga Rhizome), and Chaihu (Bupleurum Root) to raise clear Qi and descend turbid Qi. When the Spleen and Stomach are healthy, emission stops. Zhang Zhongjing treats lost essence and dream intercourse with tight lower abdomen, deficient-slow pulse, or hollow-moving-tight pulse, using Guizhi Jia Longgu Muli Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell). For five-center heat, dry throat and mouth, palpitations, or epistaxis, where Yang rises and does not descend, leaving Yin alone inside causing dreams, use Xiao Jianzhong Tang (Minor Construct the Middle Decoction) to harmonize. This is unknown to the secular world.

Lu Lijing states: The sources of dream emission are threefold. 1. Excessive debauchery, Kidney Qi failing to store, spontaneous emission without dreams: Tonify Essence to strengthen Fire, using Lurong Wan, Anshen Wan, Ju Jing Wan, Jiulong Dan, Jin suo Yuguan Wan, etc. 2. Overwork of the Heart, Heart-Kidney non-interaction, emission during deep sleep: Solidify Earth to dam Water, using Guipi Tang (Restore the Spleen Decoction), Miaoxiang San, Yuanzhi Wan, Buzhong Yiqi Tang, Zhusha Anshen Wan, etc. 3. Endless thoughts, unfulfilled desires, emission with wild dreams: Drain Fire to calm Water, using Zishen Wan, Weixi Wan, Ben Shi Zhuling Wan, Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Drink), etc. The sources differ. If clearing/draining is needed but astringency is used, illness worsens. If astringency is needed but clearing/draining is used, Yang Qi diminishes. If ascending/tonifying is needed but Yin-nourishing is used, Original Qi sinks. One must seek the cause before treating.

Danxi treated a man in his twenties studying for exams, sleeping late. In bed, any contact of the penis with bedding or thighs caused dreams of intercourse and essence loss. Appetite decreased daily, fatigue and shortness of breath occurred. This was excessive mental effort, rising of two Fires, inability to sleep at night, Blood not returning to the Liver, Kidney Water insufficient, Fire exploiting Yin deficiency, invading the Lower Jiao, stirring the Essence chamber, causing Essence to fail to gather and escape. Contact acted like Jue Qi lodging, creating dreams of intercourse. Treatment: Upper tonified Heart and calmed Spirit; Middle regulated Spleen and Stomach, raised Yang; Lower tonified Essence, generated Yin, secured Yang. Cured in three months.

Shen Langzhong treated Wang Yuquan, a young man with weak Qi, continuous dripping of essence after urination. Liuwei Dihuang Wan failed; Babei Dihuang Wan worsened astringency and pain. Chi pulses were rapid, Qi Kou pulse was deficient and large. This was Earth deficiency failing to dam Water. Prescribed Buzhong Yiqi Tang with Maidong and Wuweizi. Cured in ten doses.

Han Mulu, Scholar of the Zongbo Academy, son of the Third Duke Zhao, had a clear constitution but suffered from chronic slippery essence. Invited Shiwan for diagnosis. Pulse was slightly wiry and rapid, Chi position showed slight discontinuity. This indicated not only Kidney Qi insufficiency but also Qi stagnation and dysfunction, further impairing the command of sealing and storing. Prescribed Liuwei Dihuang Wan removing Ze Xie (Alisma Rhizome), adding Biaojiao (Fish Maw) and Wuweizi, with minor Chenxiang (Agarwood) to promote circulation within tonification. Although the method was sound, long-term slipping means loose orifices, making quick recovery unlikely. Do not blame the medicine for ineffectiveness.