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Yi Zhuo (Spermatorrhea and Turbid Urine) originally refers to two syndromes. "Yi" refers to spermatorrhea, and "Zhuo" refers to turbid urine or leukorrhea. Spermatorrhea is divided into dream-elicited and non-dream-elicited; turbid urine/leukorrhea is divided into red-colored and white-colored. Dream-elicited spermatorrhea is caused by the exuberance of Ministerial Fire (Xiang Huo, a physiological fire residing in the Liver and Kidney governing reproductive functions); non-dream-elicited spermatorrhea is caused by the decline of Heart and Kidney functions. Red-colored turbid urine/leukorrhea is caused by Blood deficiency with intense Heat; white-colored turbid urine/leukorrhea is caused by Qi deficiency combined with Damp-Heat. However, the symptoms of spermatorrhea vary. Generally speaking, semen flowing out uncontrollably after urination belongs to Damp-Heat pouring downward; semen slipping out spontaneously without urination belongs to the sliding and incontinence of the Essence Gate (Jing Guan). If there is pain and itching in the urethra, accompanied by a frequent urge to urinate, this is caused by the obstruction of stale essence. Overindulgence in alcohol and sexual activity, along with endless mental worry, leads to the exhaustion of True Yuan (the root Qi of the human body) and the rampant flow of Deficient Fire, often resulting in these diseases. Furthermore, the symptoms of turbid urine/leukorrhea also vary. Roughly speaking, if it dries and covers the urethral orifice, it is a Fire syndrome; if it does not dry and cover, it is a Dampness syndrome. Reddish, astringent, and painful urination, or turbid discharge with red color, indicates Damp-Heat in the Small Intestine. Urination that is neither reddish nor painful, but the discharged secretion is white, or where the draining sensation worsens, indicates the sinking of Spleen Qi. Itching and pain in the urethra accompanied by alternating chills and fever, or nodular pain, indicates invasion by toxic pathogens. Zhu Danxi attributed this to turbid phlegm from the Stomach seeping into the Bladder, which is insufficient to explain all cases. If these symptoms are accompanied by eye diseases: Spermatorrhea is an Essence disease due to Kidney deficiency, suitable for formulas like Zhenyuan Wuzi Yin (Cure Origin Five Seeds Decoction). Turbid urine/leukorrhea is a Qi disease due to Bladder failure in transformation, suitable for formulas like Tongguan Wuling San (Passage Through Five Ling Powder). If the eyes have excessive discharge, tearing, redness, and swelling, this is due to Damp-Heat and Ministerial Fire, suitable for Bixie Fenqing Yin (Grass Root Differentiating Clear Decoction). If there are visual obscurations, misty vision, and photophobia, this is due to dual deficiency of Spleen and Kidney, suitable for Shipen Shuangbu Wan (Spleen-Kidney Dual Tonifying Pill). If the pupil appears pale white, this signifies the depletion of True Essence and severe deficiency of Original Qi, which is incurable. Only large doses of tonifying substances can be used, hoping for one chance in a hundred.

Nüe (Malaria), is the general term for this category of diseases. Malaria refers to the acute onset of malarial illness. The Classics state: Summer injury by Summerheat leads to Autumn malaria. This is because Summerheat damages Yin, and Summerheat invariably carries Dampness. When Dampness and Heat combine, if it does not result in dysentery, it results in malaria. It is also said: Malaria arises from the struggle between Yin and Yang. When Yin struggles with Yang, it manifests as cold; when Yang struggles with Yin, it manifests as heat. Like two people fighting, if one wins, the other loses. Because Yin and Yang alternate in victory and defeat, chills and fever occur alternately. Generally speaking, malaria cannot form without Phlegm. External contraction of the Four Qi (Wind, Cold, Summerheat, Dampness), internal injury by the Seven Emotions, dietary irregularities, and sexual fatigue can all cause it. Their common mechanism is the stagnation of Middle Jiao Qi, stirring up Phlegm-Saliva. The Three Yang meridians represent shallow levels, while the Three Yin meridians represent deep levels. Taiyang Malaria involves pain in the waist, back, head, and neck, starting with chills followed by fever, ending with sweating upon fever cessation. Yangming Malaria involves dry nose and tongue, extreme cold before heat, and extreme heat before sweating, with a preference for sunlight. Shaoyang Malaria involves bitter taste, hypochondriac pain, vomiting, alternating chills and fever, and bodily lassitude. Shaoyin Malaria involves less chills and more fever, severe vomiting, dry tongue and mouth, and a desire to stay in closed rooms. Taiyin Malaria involves melancholic sighing, abdominal fullness, aversion to food, vomiting upon onset, and symptom relief after vomiting. Jueyin Malaria involves lower back pain, lower abdominal fullness, frequent but difficult urination, fearfulness, and inner depression. If accompanied by eye diseases, treatment should target the specific meridian: clear Summerheat, dry Dampness, disperse Wind, tonify deficiency, harmonize cold and heat, and treat with warm and cool methods. For treating the primary disease, Zhang Zhongjing's Xiaochaihu Tang (Minor Bupleurum Decoction), with modifications based on clinical presentation, is indeed the most appropriate and unchangeable method, and should not be overlooked.