梦而遗者，相火之强也，宜用龙胆泻肝汤，送下五倍子丸二钱。《经》云∶厥气客于阴器，
则梦接内。盖肝主疏泄，相火鼓之，则肾虽有闭藏之权，亦拱手授之矣。不梦而遗者，心肾
之虚也，以六味丸为主，煎补中益气汤送下，以升提之。或用心过度，心不能主令，而相火
用事者，亦前丸为主，而兼用归脾汤。有命门火衰，元精脱陷，玉关不闭者，急用八味丸以
壮阳气，使之涵乎阴精而不泄。此赵氏之法，本其师薛氏，实中庸之道也。至于景岳秘元煎
、固阴煎，苓术菟丝煎，皆见症治症之方，闽中多有此陋习。
张景岳云∶精之藏制虽在肾，而精之主宰则在心。凡少年多欲之人，或心有妄想，外有
妄遇，以致君火摇于上，相火炽于下，则水不藏而精随以泄。
《诀》云∶遗精白浊，当验之尺，结芤动紧，二症之的。
《正传》云∶两尺洪数，必便浊遗精。
龙胆泻肝汤（方见《时方》）
治胁痛，口苦耳聋，筋痿阴湿，热痒阴肿，白浊溲血。今借治梦泄，以肝实而火盛也。
大苦大寒，不宜常服，加味逍遥散可以代之。
五倍子丸
治遗精甚效。
五倍子（青盐煮，晒，焙） 茯苓（各二两）
蜜丸桐子大。每服二钱，日二服，空心盐汤送下，或以药汁送下。
又按∶有梦而泄者，于补肾摄精方加莲子心一钱，生枣仁二钱，所以治其妄梦也，多效
。又多梦者，神之乱也。龙为天地之神，故龙骨最能补神而治妄梦。合之牡蛎之咸寒，便能
引火归原。《金匮》桂枝龙骨牡蛎汤最为神妙，莲须为标药中之神品。
桂枝龙骨牡蛎汤（方见《金匮》。）
治男子失精，女子梦交。（梦交，梦与男交合也。
按∶虚羸浮热汗出者，除桂加白薇一钱、附子五分，名曰二加龙骨汤。（方见《时方》）。
秘元煎（景岳）
主治心脾。
远志（八分） 山药 芡实 枣仁（炒，各二钱） 白术（炒） 茯苓（各一钱五分）
炙草（一钱） 人参（一二钱） 五味（十四粒） 金樱子（去核，二钱）
水煎服。有火觉热者，加苦参一、二钱。气大虚者，加黄 二三钱。
固阴煎
主治肝肾。
人参（随宜） 熟地（三五钱） 山茱萸（一钱五分） 远志（七分） 山药（炒，
二钱） 菟丝子（炒香，三钱） 五味（十四粒） 炙草（一二钱）
水煎服。或加金樱子三钱。
苓术菟丝子煎
主治脾肾。
茯苓 白术（米泔洗，炒） 莲子肉（各四两） 五味（酒蒸） 山药（炒另研，各二两） 杜仲（酒炒，三两） 炙
草（五钱） 菟丝子（制，十两）
共研细末。用陈酒糊丸，桐子大。空心滚汤下百余丸。气虚不摄精，加人参四两。
张石顽曰∶梦遗为肝热胆寒，以肝热则火淫于外，魂不内守，故多淫梦失精。或时心悸
，肥人多此。宜清肝，不必补肾，温胆汤加人参、茯苓、枣仁、莲肉。又曰∶梦遗多是阴虚
火气用事，苟非确系阳虚，桂、附、鹿茸等助阳之药，慎勿轻用。非确系气虚，参、术、远
志辈益气之药，不可漫施。试观梦遗必在黎明阳气发动之时，其为阴虚阳扰可知矣。
沈芊绿云∶心藏神，肝藏魂，肾藏精。梦中所主之心，即心之神也。梦中所见之形，即
肝之魂也。梦中所泄之精，即肾之精也。要之心为君，肝肾为相，未有君火动而相火不随
之者。当先治其心火，而后及其余。宜黄连清心饮、茯苓汤加减。
黄连清心饮
黄连 生地 甘草 当归 人参 茯神 枣仁 远志 莲子（各等分）
水煎服。
茯神汤
茯神 远志 菖蒲 茯苓 黄连 生地 当归 甘草 莲子 枣仁 人参（随时加减）
水煎服。
文蛤津脐膏
治遗精。
文蛤（研细末），以小儿津调贴脐内，立止。
思仙丹（各见《种福堂》）
治阴虚火动梦遗神方。
莲须 石莲肉（去肉青翳并外皮） 芡实（各十两，去壳）
上为末，再以金樱子三斤去毛，子，水淘净，入大锅内水煎，滤过再煎，加饴糖和匀
前药。丸如桐子，每服七、八十丸。
封髓丹
治遗精。
砂仁（一两） 黄柏（三两） 甘草（炙，七钱）
上末，炼蜜丸。
四君子汤（方见《时方》。）
原方加龙骨、牡蛎、莲须。
温胆汤 即二陈汤加竹茹三钱，枳实八分。
梦中遗精，是由于相火（寄居于肝肾、具有推动生殖机能作用的火）过旺所致，适宜使用龙胆泻肝汤，送服五倍子丸二钱。《黄帝内经》说：厥逆之气侵袭阴器，就会梦见性交。这是因为肝主疏泄，在相火的鼓动下，即使肾有闭藏的功能，也会拱手让人而失守。无梦而遗精，是心肾两虚的表现，以六味地黄丸为主药，煎煮补中益气汤送服，以起到升提固摄的作用。如果是因用心过度，导致心神不能主宰，而相火妄动者，也以前述丸药为主，兼用归脾汤。如果有命门之火衰微，元精脱陷，导致玉关（指前阴及精关）不闭合的情况，急需使用八味丸来壮盛阳气，使其涵养阴精而不外泄。这是赵献可的方法，源自其师薛己，实为中庸之道。至于张景岳的秘元煎、固阴煎，以及苓术菟丝煎，都是见症治症的方剂，福建地区多有这种陋习。
张景岳说：精液的藏制虽然在于肾，但精液的主宰却在于心。凡是少年多欲之人，或者心中存有妄想，外界又有妄遇，导致君火（心火）在上摇动，相火在下炽盛，那么肾水就不能藏精，精液随之而泄。
《脉诀》说：遗精和白浊，应当诊察尺脉，出现结、芤、动、紧这四种脉象，是这两种病症的确切指征。
《医学正传》说：两尺脉洪大数急，必然导致便浊和遗精。
龙胆泻肝汤（方剂见《时方歌括》）
治疗胁痛、口苦、耳聋、筋痿、阴部潮湿、热痒、阴肿、白浊、尿血。现在借用此方治疗梦遗，是因为肝实且火势旺盛。
此方大苦大寒，不宜常服，可用加味逍遥散替代。
五倍子丸
治疗遗精非常有效。
五倍子（用青盐煮，晒干，焙干），茯苓（各二两）。
制成蜜丸，如梧桐子大小。每次服用二钱，每日两次，空腹时用盐汤或药汁送服。
又按语：有梦而泄的人，在补肾摄精的方剂中加入莲子心一钱，生酸枣仁二钱，用来治疗妄梦，效果很好。又多梦的人，是神志混乱的表现。龙是天地之神，所以龙骨最能补益神志而治疗妄梦。配合牡蛎的咸寒之性，便能引火归原。《金匮要略》中的桂枝甘草龙骨牡蛎汤最为神妙，莲须是治标药物中的神品。
桂枝甘草龙骨牡蛎汤（方剂见《金匮要略》）
治疗男子失精，女子梦交。（梦交，即梦中与男子交合。）
按语：如果伴有身体虚弱羸瘦、浮热、汗出等症状，去掉桂枝，加入白薇一钱、附子五分，名为二加龙骨汤。（方剂见《时方歌括》）。
秘元煎（张景岳方）
主治心脾两虚。
远志（八分），山药，芡实，酸枣仁（炒，各二钱），白术（炒），茯苓（各一钱五分），炙甘草（一钱），人参（一至二钱），五味子（十四粒），金樱子（去核，二钱）。
水煎服。如果有火气感觉发热者，加苦参一至二钱。如果气非常大虚者，加黄芪二三钱。
固阴煎
主治肝肾阴虚。
人参（随宜选用剂量），熟地黄（三至五钱），山茱萸（一钱五分），远志（七分），山药（炒，二钱），菟丝子（炒香，三钱），五味子（十四粒），炙甘草（一至二钱）。
水煎服。或者加入金樱子三钱。
苓术菟丝子煎
主治脾肾两虚。
茯苓，白术（米泔水洗，炒），莲子肉（各四两），五味子（酒蒸），山药（炒后另研，各二两），杜仲（酒炒，三两），炙甘草（五钱），菟丝子（制，十两）。
共研为细末。用陈年酒糊制作成丸，如梧桐子大小。空腹时用滚开水送服一百余丸。如果气虚不能摄精，加入人参四两。
张石顽说：梦遗是由于肝热胆寒，因为肝热则火气淫溢于外，魂不能内守，所以多淫梦失精。有时伴有心悸，肥胖人多见此证。适宜清肝，不必补肾，可用温胆汤加人参、茯苓、酸枣仁、莲子肉。又说：梦遗多是阴虚火气作祟，如果不是确凿属于阳虚，桂枝、附子、鹿茸等助阳的药物，千万不要轻率使用。如果不是确凿属于气虚，人参、白术、远志等益气的药物，也不可随意施用。试看梦遗必定发生在黎明阳气发动之时，可知其为阴虚阳扰所致。
沈芊绿说：心藏神，肝藏魂，肾藏精。梦中主导的是心，即心的神志；梦中见到的形体，即肝的魂；梦中泄出的精液，即肾的精。总之，心为君主，肝肾为宰相，没有君火动摇而相火不跟随的道理。应当先治疗心火，然后再处理其余部分。适宜用黄连清心饮、茯苓汤加减。
黄连清心饮
黄连，生地，甘草，当归，人参，茯神，酸枣仁，远志，莲子（各等分）。
水煎服。
茯神汤
茯神，远志，石菖蒲，茯苓，黄连，生地，当归，甘草，莲子，酸枣仁，人参（随时加减）。
水煎服。
文蛤津脐膏
治疗遗精。
文蛤（研成细末），用小儿唾液调和贴敷于肚脐内，立即停止。
思仙丹（各方均见《种福堂得效方》）
治疗阴虚火动引起的梦遗的神方。
莲须，石莲肉（去掉果肉、青色翳膜及外皮），芡实（各十两，去壳）。
以上研为粉末，再用金樱子三斤，去掉毛刺和种子，用水淘洗干净，放入大锅内加水煎煮，过滤后再煎，加入饴糖与前药混合均匀。制成如梧桐子大小的丸药，每次服用七、八十丸。
封髓丹
治疗遗精。
砂仁（一两），黄柏（三两），甘草（炙，七钱）。
以上研为粉末，炼蜜为丸。
Dream emission is caused by the excess of Ministerial Fire (Xiang Huo, a fire residing in the Liver and Kidney that promotes reproductive function). It is appropriate to use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) to administer Wubeizi Wan (Five-Accolade Pill), two qian. The *Classic* states: "When Jue Qi (rebellious Qi) invades the genitalia, one dreams of sexual intercourse." This is because the Liver governs Shuxie (free flow and discharge); when stirred by Ministerial Fire, even if the Kidney possesses the power of closure and storage, it will yield control and lose its hold. Non-dream emission is due to deficiency of both Heart and Kidney; Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) should be used as the main formula, decocted with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for administration, to lift and secure. If excessive mental exertion causes the Heart to fail in its governing role, allowing Ministerial Fire to act recklessly, the aforementioned pills should be used primarily, supplemented with Guipi Tang (Restore the Spleen Decoction). In cases where Mingmen Fire (Gate of Vitality Fire) is deficient, causing Yuanjing (Original Essence) to collapse and the Yu Guan (Jade Gate/Pre-orifice) to fail to close, Bawei Wan (Eight-Ingredient Pill) must be urgently employed to strengthen Yang Qi, enabling it to nourish Yin Essence and prevent leakage. This is the method of Zhao Xike, derived from his teacher Xue Ji, representing the Doctrine of the Mean. As for Zhang Jingyue's Miyuan Jian (Secret Source Decoction), Guyin Jian (Solidify Yin Decoction), and Lingzhu Tusisi Jian (Poria, Atractylodes, and Dodder Decoction), these are formulas treating symptoms upon their appearance; such practices are common but considered crude habits in Fujian.
Zhang Jingyue stated: Although the storage and regulation of semen reside in the Kidney, its mastery lies in the Heart. For young men with excessive desires, or those harboring delusional thoughts and encountering external temptations, Jun Fire (Heart Fire) shakes above while Ministerial Fire blazes below. Consequently, Water fails to store, and semen follows in leaking out.
The *Maijue* (Pulse Classic) states: For dream emission and white turbidity, examine the Chi pulse (Kidney position). The pulses of Jie (knotted), Kou (hollow), Dong (surging), and Jin (tight) are definitive indicators of these two conditions.
The *Zhengchuan* (Correct Transmission) states: A洪数 (rapid and forceful) Chi pulse inevitably leads to urinary turbidity and dream emission.
Longdan Xiegan Tang (Formula seen in *Shifang*)
Treats hypochondriac pain, bitter taste, deafness, sinew atrophy, dampness in the genitals, heat and itching with genital swelling, white turbidity, and hematuria. It is now borrowed to treat dream emission because of Liver excess and blazing fire.
This formula is extremely bitter and cold, unsuitable for long-term use; Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) can substitute it.
Wubeizi Wan
Highly effective for treating dream emission.
Wubeizi (Galla Chinensis) (boiled with Qingyan/Green Salt, sun-dried, baked), Fuling (Poria) (each 2 liang).
Make honey pills the size of paulownia seeds. Take 2 qian per dose, twice daily, on an empty stomach with salt water or the decoction itself.
Note: For those with emission accompanied by dreams, add Lianzixin (Lotus Plumule) 1 qian and Sheng Zaoren (Raw Sour Jujube Seed) 2 qian to kidney-tonifying and essence-astringing formulas to treat delusional dreams; this is often effective. Excessive dreaming indicates chaos of the Shen (Spirit). Since the Dragon represents the Spirit of Heaven and Earth, Longgu (Fossilized Bone) best tonifies the Spirit and treats delusional dreams. Combined with the salty-cold nature of Muli (Oyster Shell), it guides Fire back to its source. Guizhi Longgu Muli Tang (Cinnamon Twig, Fossilized Bone, and Oyster Shell Decoction) from the *Jingui Yaolue* is most miraculous; Lianxu (Lotus Stamen) is a supreme herb for treating superficial symptoms.
Guizhi Longgu Muli Tang (Formula seen in *Jingui Yaolue*)
Treats loss of essence in men and dream intercourse in women. (Dream intercourse refers to dreaming of sexual union with a man.)
Note: If accompanied by emaciation, floating heat, and sweating, remove Guizhi (Cinnamon Twig) and add Baiwei (Anemarrhenae Rhizoma) 1 qian and Fuzi (Aconiti Lateralis Radix Praeparata) 0.5 qian; this is named Erjia Longgu Tang (Double-Augmented Fossilized Bone Decoction). (Formula seen in *Shifang*).
Miyuan Jian (Secret Source Decoction) (Zhang Jingyue)
Mainly treats Heart and Spleen.
Yuanzhi (Polygalae Radix) (0.8 fen), Shanyao (Dioscoreae Rhizoma), Qianshi (Euryales Semen), Zaoren (Sour Jujube Seed) (stir-fried, each 2 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (stir-fried), Fuling (Poria) (each 1.5 qian), Zhigancao (Honey-fried Licorice Root) (1 qian), Renshen (Ginseng Root) (1-2 qian), Wuweizi (Schisandrae Fructus) (14 grains), Jinyingzi (Chrysobalani Fructus) (pitted, 2 qian).
Decoct in water and take orally. If feeling heat due to fire, add Kushen (Sophorae Flavescentis Radix) 1-2 qian. If Qi is severely deficient, add Huangqi (Astragali Radix) 2-3 qian.
Guyin Jian (Solidify Yin Decoction)
Mainly treats Liver and Kidney.
Renshen (Ginseng Root) (dose as appropriate), Shudi (Rehmanniae Radix Preparata) (3-5 qian), Shanzhuyu (Corni Fructus) (1.5 qian), Yuanzhi (Polygalae Radix) (0.7 fen), Shanyao (Dioscoreae Rhizoma) (stir-fried, 2 qian), Tusi Zi (Cuscutae Semen) (stir-fried until fragrant, 3 qian), Wuweizi (Schisandrae Fructus) (14 grains), Zhigancao (Honey-fried Licorice Root) (1-2 qian).
Decoct in water and take orally. Alternatively, add Jinyingzi (Chrysobalani Fructus) 3 qian.
Lingzhu Tusizi Jian (Poria, Atractylodes, and Dodder Decoction)
Mainly treats Spleen and Kidney.
Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma) (washed in rice water, stir-fried), Lianzirou (Lotus Seed Cotyledon) (each 4 liang), Wuweizi (Schisandrae Fructus) (steamed in wine), Shanyao (Dioscoreae Rhizoma) (stir-fried and ground separately) (each 2 liang), Duzhong (Eucommiae Cortex) (stir-fried in wine, 3 liang), Zhigancao (Honey-fried Licorice Root) (5 qian), Tusi Zi (Cuscutae Semen) (processed, 10 liang).
Grind into fine powder. Use aged wine paste to make pills the size of paulownia seeds. Take over 100 pills on an empty stomach with boiling water. If Qi deficiency fails to secure essence, add Renshen (Ginseng Root) 4 liang.
Zhang Shiwan said: Dream emission is caused by Liver heat and Gallbladder cold. Because Liver heat allows Fire to overflow externally, Hun (Ethereal Soul) fails to remain within, leading to frequent erotic dreams and loss of essence. Sometimes accompanied by palpitations, this is common in obese individuals. It is suitable to clear the Liver rather than tonify the Kidney; Wendan Tang (Warm the Gallbladder Decoction) with added Renshen (Ginseng Root), Fuling (Poria), Zaoren (Sour Jujube Seed), and Lianrou (Lotus Seed Cotyledon) is indicated. He also stated: Dream emission is mostly due to Yin deficiency and Fire acting recklessly. Unless it is definitively Yang deficiency, do not lightly use Yang-tonifying herbs like Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root), or Lurong (Deer Antler Velvet). Unless it is definitively Qi deficiency, do not casually apply Qi-tonifying herbs like Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala), or Yuanzhi (Polygala Root). Observe that dream emission invariably occurs at dawn when Yang Qi begins to move; thus, it is known to be caused by Yin deficiency and Yang disturbance.
Shen Qianlü said: The Heart stores Shen (Spirit), the Liver stores Hun (Ethereal Soul), and the Kidney stores Jing (Essence). The Heart dominating the dream is the Shen of the Heart; the form seen in the dream is the Hun of the Liver; the essence leaked in the dream is the Jing of the Kidney. Essentially, the Heart is the Sovereign, and the Liver and Kidney are the Ministers. There is no case where the Sovereign Fire moves without the Ministerial Fire following. One should first treat the Heart Fire, and then address the rest. Huanglian Qingxin Yin (Coptis Heart-Clearing Drink) and Fushen Tang (Poria Spirit Decoction) with modifications are suitable.
Huanglian Qingxin Yin (Coptis Heart-Clearing Drink)
Huanglian (Coptidis Rhizoma), Shengdi (Rehmanniae Radix), Gancao (Licorice Root), Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Root), Fushen (Poria with Hostwood), Zaoren (Sour Jujube Seed), Yuanzhi (Polygalae Radix), Lianzi (Nelumbinis Semen) (equal parts).
Decoct in water and take orally.
Fushen Tang (Poria Spirit Decoction)
Fushen (Poria with Hostwood), Yuanzhi (Polygalae Radix), Changpu (Acori Tatarinowii Rhizoma), Fuling (Poria), Huanglian (Coptidis Rhizoma), Shengdi (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Gancao (Licorice Root), Lianzi (Nelumbinis Semen), Zaoren (Sour Jujube Seed), Renshen (Ginseng Root) (adjust doses as needed).
Decoct in water and take orally.
Wenha Jin Qi Gao (Clam Juice Navel Paste)
Treats dream emission.
Wenhe (Venerupis Pulla Shell) (ground into fine powder), mixed with infant saliva, applied to the navel cavity; stops immediately.
Sixian Dan (Thinking Immortal Pill) (Formulas seen in *Zhongfutang*)
A divine prescription for dream emission caused by Yin deficiency and Fire agitation.
Lianxu (Lotus Stamen), Shilianrou (Stone Lotus Seed Cotyledon) (remove flesh, green film, and outer skin), Qianshi (Euryales Semen) (each 10 liang, shelled).
Grind the above into powder. Then take 3 jin of Jinyingzi (Chrysobalani Fructus), remove hairs and seeds, wash clean with water, boil in a large pot, filter, boil again, add Yitang (Maltose Sugar), and mix evenly with the previous powder. Make pills the size of paulownia seeds. Take 70-80 pills per dose.
Fengsui Dan (Seal Marrow Pill)
Treats dream emission.
Sharen (Amomi Fructus Rotundus) (1 liang), Huangbai (Phellodendri Cortex) (3 liang), Zhigancao (Honey-fried Licorice Root) (7 qian).
Grind into powder, make pills with refined honey.
Sijunzi Tang (Four Gentlemen Decoction) (Formula seen in *Shifang*)
Original formula plus Longgu (Fossilized Bone), Muli (Oyster Shell), and Lianxu (Lotus Stamen).
Wendan Tang (Warm the Gallbladder Decoction) is Erchen Tang (Two Aged Things Decoction) plus Zhuru (Bambusae Caulis in Taeniam) 3 qian and Zhishi (Aurantii Fructus Immaturus) 0.8 fen.