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(The treatment of leukorrhea is the same as that for seminal emission and turbid urine in men.)

The *Suwen* (Basic Questions) states: When the Ren Mai (Conception Vessel) is diseased, men develop internal accumulations known as the seven types of hernia; women develop leukorrhea and zha ju (abdominal masses).

It further states: When pathogenic factors transmit from the Spleen to the Kidney, it is called shan jia (hernia and abdominal mass). There is pain due to oppression and knotting in the lower abdomen, accompanied by the discharge of white fluid, which is called gu.

It also states: There is oppressive heat in the lower abdomen, and white fluid is discharged during urination.

Furthermore, it states: Endless thinking, unfulfilled desires, mental lust directed outward, and excessive sexual intercourse can lead to bai yin (white seminary fluid or leukorrhea discharge without sexual activity).

Shen Yaofeng stated: The etiology of leukorrhea includes wind-cold invading the bladder collaterals, as held by Chao Yuanfang, Sun Simiao, Yan Yonghe, Yang Renzhai, and Lou Quanshan; damp-heat, as held by Liu Hejian, Zhang Jiegu, Zhang Daren, and Luo Zhouyan; Spleen deficiency and Qi deficiency, as held by Zhao Yangkui and Xue Lizhai; damp-phlegm, as held by Zhu Danxi; Spleen-Kidney deficiency, as held by Zhang Jingyue and Xue Xinpu; and Liver wood depression in the middle jiao, as held by Fang Yuezhi and Miao Zhongchun. Regarding the nature of the discharged substance, Yan Yonghe believed it was blood that failed to transform into red; Zhang Jingyue believed it was blood accumulating over time; Liu Hejian believed it was body fluids overflowing due to extreme heat. Their therapeutic methods included using major acrid-hot herbs, major bitter-cold herbs, strong purgatives, and major tonics. Although their theories and prescriptions had their own logic, they ultimately did not clarify what the discharged substance actually was. Only Zhu Danxi stated: "Women's leukorrhea is identical to men's nocturnal emission." This clearly refers to female essence/jing, breaking through a millennium-old mystery with a single statement. However, the causes of seminal slipperiness differ. It is a pity that his prescribed formulas were confined within the concept of "phlegm-fire"! From this perspective, white leukorrhea is equivalent to white turbidity, and red leukorrhea is equivalent to red turbidity; these are all slippery and viscous like semen. As for substances resembling rice water or foul-smelling non-viscous fluids, these are products of the Spleen, caused by Qi deficiency sinking downward. Elderly people may also suffer from this, but it is not a disease of essence/jing and should not be treated indiscriminately.

Yaofeng further stated: Dai Yuanli discussed red turbidity, saying: "Essence is transformed from blood." If too much turbid fluid is lost, the transformation of essence cannot keep up, and the red color does not turn white, resulting in red turbidity; this indicates severe deficiency. How do we know this? Consider someone whose Tian Gui (menstruation) has not yet arrived, who indulges in forceful sexual desire, discharging half essence and half blood. If the urine is not red and there are no other heat signs, even if red turbidity is observed, one should not assume redness indicates heat; instead, treat it using methods for white turbidity. Observing this, the view that red leukorrhea is caused by heat is erroneous.

Wang Mengying added notes: Leukorrhea exists in women from birth, moistening them constantly; originally, it is not a disease. Thus, Bian Que called himself a "leukorrhea physician," which corresponds to modern gynecology. The *Jinkui Yaolue* also categorizes thirty-six diseases under leukorrhea. However, excessive discharge becomes pathological. Damp-heat pouring downward constitutes excess syndrome; failure to retain essence/jing constitutes deficiency syndrome. For individuals with strong constitution and robust Qi, even abundant discharge is not harmful; only dryness indicates severe illness. Because depletion of Ying (Nutritive) fluids and Jin (Body Fluids) constitutes Xu Lao (Consumptive Disease). In cases where menstruation is delayed while leukorrhea is profuse, it is due to internal heat forcing fluids out before they can transform into red; if accompanied by complete dryness and lack of moisture, it is a sign of Gan Xue Lao (Dry Blood Consumptive Disease). Synthesizing these views: Essence, fluids, phlegm, dampness, and blood can all descend via the Ren Mai to form leukorrhea; however, there are distinctions among Cold Deficiency, Heat Deficiency, and Excess Heat. The treatment of seminal emission is similar. Cold deficiency is less common; therefore, Ye Tianshi always uses Huang Bo (Phellodendron Bark) as an assistant herb in treating leukorrhea.

Miaoxiang San: Treats cases with small pulse, poor appetite, or loose stools.
Long Gu (Dragon Bone), Yizhi Ren (Alpinia Oxyphylla Fruit), Renshen (Ginseng Root) [each 1 liang], Baifuling (Poria Cocos), Yuanzhi (Polygala Root, remove woody core), Fushen (Poria Cocos with hostwood) [each 5 qian], Zhusha (Cinnabar) [2.5 qian], Zhi Gancao (Honey-fried Licorice Root) [1.5 qian]. Grind into powder; take several qian per dose according to discretion.

Dihuang Yinzi (Rehmannia Decoction) minus Guizhi (Cinnamon Twig) and Fuzi (Aconite Lateral Root): Suitable for cases of insufficient Kidney Yin, where Liver Yang generates internal wind causing seminal slipperiness, characterized by a wiry and large pulse. Ye Tianshi said: "When Heaven and Earth are mild and warm, wind and waves subside naturally." He also said: "When the Yang in Kan (Kidney) is weak, the Lower Jiao loses its ability to receive and retain." He also said: "The Liver is a rigid organ; it should not be treated with warming herbs, but rather nourished with gentle methods."
Shu Dihuang (Prepared Rehmannia Root, water-processed) [8 qian], Chuan Shihu (Dendrobium Officinale Stem), Maidong (Ophiopogon Japonicus Tuber), Fuling (Poria Cocos) [each 1.5 qian], Shichangpu (Acorus Tatarinowii Rhizome), Yuanzhi Rou (Polygala Root flesh), Bajirou (Morinda Officinalis Root bark), Dan Congrong (Cistanche Deserticola Stem) [each 1 qian], Wuweizi (Schisandra Berry), Shanzhuyu (Cornus Officinalis Fruit). (Shen Yaofeng noted: The last two sour herbs may be omitted.)

Bu Shen Yin Qing Gan Yang Fang (Formula to Tonify Kidney Yin and Clear Liver Yang): Wang Yutai said: "The Kidney is Yin, governing the storage of essence; the Liver is Yang, governing dispersion and excretion. Therefore, when Kidney Yin is deficient, essence is not stored; when Liver Yang is hyperactive, Qi is not secured."
Ou Jie (Lotus Node Joint), Qingsong Ye (Green Pine Needle), Ce Bai Ye (Biota Tops) [each 1 jin], Shengdi (Rehmannia Root), Yuzhu (Polygonatum Odoratum Rhizome), Tiandong (Asparagus Cochinchinensis Tuber) [each 8 liang], Nvzhenzi (Ligustrum Lucidum Fruit), Hanliancao (Eclipta Prostrata Herb) [each 4 liang]. Decoct into paste and take.
Shen Yaofeng noted: This formula clears the Liver using aromatic and refreshing herbs, avoiding bitter-cold herbs that damage Qi.

Bawei Wan (Eight-Ingredient Pill): Dai Yuanli said: "There are patients with red and white turbidity who do not respond to Xuantu Dan but are cured by Fuzi Bawei Wan; this must be known."
Shen Yaofeng noted: This embodies the meaning of weak Yang in Kan and loss of retention in the Lower Jiao; it has been effective repeatedly.

Wang Mengying added notes: For Yin deficiency combined with damp-fire, Liuwang Wan (Six-Ingredient Pill with Rehmannia) is suitable. For severe cases, adding Huang Bo is particularly excellent.

Appendix: Xuantu Dan (Imperial Bureau Formula)
Tusizi (Cuscuta Seed) [10 liang], Wuweizi (Schisandra Berry) [7 liang], Fuling (Poria Cocos), Lianrou (Lotus Seed Flesh) [each 3 liang], Shanyao (Dioscorea Opposita Rhizome) [6 liang].

Songliu Wan: This is an extra-formula prescription for treating red and white turbidity/leukorrhea that persists for a long time without heat signs; its efficacy is miraculous.
Mix Songxiang (Colophony) and Liuhuang (Sulfur); melt in an iron pot, frequently sprinkling vinegar until the medicine resembles malt sugar. Move the pot to a cold place. Moisten hands with cold water, and roll into pills the size of beans. Many people are required for preparation, otherwise it hardens and is difficult to roll. Take 1 qian per dose.
Wang Mengying added notes: This formula should ultimately be used with caution.

Gu Jing Wan (Stabilize Essence Pill): *Xuanzhu* states: "Yang deficiency means there is no Qi to control the essence. Thus, during sleep, Yang sinks, and the essence pathway is not closed, leading to leakage upon any contact, not necessarily requiring dreams. One must raise Yang and secure Qi to achieve success."
Lurong (Deer Antler Glue), Lu Jiaoshuang (Deer Antler Horn Frost) [same weight as antler glue], Jiu Zi (Chinese Chives Seed), Dan Congrong (Cistanche Deserticola Stem) [each 1 liang], Wuweizi (Schisandra Berry), Fuling (Poria Cocos), Shu Fuzi (Prepared Aconite Lateral Root), Bajirou (Morinda Officinalis Root bark), Longgu (Dragon Bone), Chishizhi (Red Halloysite) [each 5 qian]. Form pills with wine paste.

Wen Rou Se Fa (Gentle Astringent Method): Ye Tianshi's treatment for Bai Yin (white seminal discharge).
Bai Longgu (White Dragon Bone), Sangpiaoxiao (Mantis Egg Case), Hulian (Lake Lotus Seed), Qianshi (Euryale Seed), Fuling (Poria Cocos), Fushen (Poria Cocos with hostwood), Jinyingzi (Cherokee Rose Fruit), Fupenzi (Raspberry), Yuanzhi Rou (Polygala Root flesh). Form honey pills.

Duaben Wan from *Chuishui Xuanzhu*: Treats cases with generally obese pulse, morning diarrhea with incomplete evacuation, and damp-heat seminal emission; extremely effective. Ye Tianshi said: "In damp-heat diseases, a bright red complexion serves as evidence."
Kushen (Sophora Root), Chuanbai (Phellodendron Amurense Bark) [each 2 liang], Muli (Oyster Shell), Hafeng (Clam Powder), Gegen (Pueraria Root), Qinghao (Artemisia Annua Herb), Bailuosiqiao (White Snail Shell, calcined) [each 1 liang], Shenqu (Medicated Leaven). Form pills together.

Qingxin Wan from *Baoshi Fang*: Dai Yuanli said: "For those with meridian heat causing slipperiness, this formula is best." Chan Master Dazhi said: "Those with heat in the waist and spine causing emission have heat-induced emission."
Huang Bo (Phellodendron Bark), Bingpian (Borneol). Form pills with salted water.

Xu Aihui stated: "There are also cases of extreme Yin deficiency causing heat in the legs, feet, waist, spine, and Liver/Kidney regions leading to emission. These require tonifying Yin and astringing to consolidate, to gather deficient Yang. One should not recklessly administer fire-clearing herbs; careful differentiation of pulse and symptoms is necessary."

Daochi San (Direct Red Powder): Li Binhu said: "A young man suffered from nocturnal emission and white turbidity, with Qi rushing upward in the lower abdomen, daily heat in the waist, occurring at Mao hour (5-7 AM) and cooling at You hour (5-7 PM). Waist heat caused cold hands and feet and lack of sensation in the anterior yin; when waist heat subsided, Qi moved in the anterior yin, and hands and feet warmed. He passed gas frequently in the morning and belched frequently in the evening, trembled occasionally, and emitted every ten days. His pulse was wiry, slippery, and large. After accidentally taking astringent herbs, he emitted twice in one night. Then, a large dose of this formula was decocted and taken, stopping both emission and turbidity."
Shengdi (Rehmannia Root), Mutong (Akebia Stem), Gancaoshao (Licorice Root Tip).

Wang Mengying added notes: In cases of Ren Mai deficiency where leukorrhea is not retained, often tonification fails to cure. I use Haipiaoxiao (Cuttlefish Bone) ground into powder, boiled Guang Yubiao (Fish Swim Bladder) until soft, pounded into pills the size of mung beans, and taken with Clam Broth. Long-term use yields results invariably; truly a brilliant method.