内经曰。诸病水液混浊。皆属于热。夫小便黄赤有四。一属肝热。经曰。肝热病者。小便先
黄是也。二属胃热。经曰。胃足阳明之脉。气盛则身以前皆热。消谷善饥。溺色黄是也。三属肺
虚。经曰。肺手太阴之脉。气虚则肩背痛。寒则少气不足以息。溺色变是也。四属肾虚。经曰。
冬脉者肾也。冬脉不及。则令人 中清。脊中痛。少腹满。小便变是也。汗多而小便赤涩。夏月
多有此证。盛暑汗既多。膀胱闭涩。则水不运下。四君子合五苓散。或五苓合生脉。或生脉合保
元。或消暑丸、清燥汤选用。有小便赤短。体倦食少。缺盆痛。此脾肺肾俱虚也。补中益气下六
味丸。滋其化源自愈。误用
渗利必危。已经分利。或病后有此。属脾肺气虚。不能施化。补中益气加麦冬、五味。尺脉数大。
阴火上炎。而小便赤少者。六味丸加麦冬、五味。肝热者。频欲解而赤涩梗痛。时觉凛凛。或发
寒热。六味丸多加牛膝。脉盛气实者。龙荟丸。胃热者。口中干淡引饮。肌肤壮热。竹叶石膏汤。
膀胱热甚者。滋肾丸。
经曰。怵惕思虑则伤神。神伤则恐惧流淫而不止。肾者。主蛰。封藏之本。精之处也。
五脏主藏精者也。伤则失守。谓一脏之真不得其正。则一脏之病作矣。厥气客于阴器。则梦
接内。厥阴主筋。故诸筋统系于肝也。肾为阴。主藏精。肝为阳。主疏泄。故肾之阴虚。则精不
藏。肝之阳强。则气不固。若遇阴邪客于其窍。与所强之阳相感。则精脱而成梦矣。所谓阳强者。
乃肝藏所寄之相火强耳。故治以肾肝为主。亦有不在肾肝。而在心肺脾胃之不足者。然必传于肾
肝而后精方走也。治法若从他脏而起。则以初感病者为本。肾肝聚病者为标。若由肾肝二脏自得
者。独治肾肝。阴阳离决。水火不交通者。则既济之。阴阳不相抱负者。则调和之。阳虚者补其
气。阴虚者补其血。阳强者泻其火。有正治反治。从少从多。随其攸利。梦与人交接为梦遗。相
火之强为患。不因梦感而自遗者。为精滑。心肾之伤居多。因思想无穷。所愿不得而为白淫者。
治法有五。神气浮游。宜补中益气汤加菖蒲。下朱砂安神丸。思久成痰。迷于心窍。宜先服四七
汤以豁其痰。后用猪苓丸、威喜丸调之。思想伤阴。八味丸去附子。加酒黄柏以滋养之。用心太
过。心不摄肾以致失精者。远志丸。因思欲不遂。则耳闻目见。其精即出。名曰白淫。辰砂妙香
散。色欲过度。下元虚惫。滑泄不禁。六味丸加鹿茸、五味、龙骨。失精梦泄。亦有因郁火而得。
故壮年火盛。多有流溢者。若以虚冷用热剂。则精愈失。滋肾丸加生地、茯神、枣仁、菖蒲。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、茯神、枣仁、莲肉。遗精腰疼。六味丸加杜仲、五味、菟丝、苁蓉。
中年以后。还少丹。精气不足。吸吸短气。遗精盗汗。济生鹿茸丸。斫丧太过。滑泄不禁。兼心
脾气虚。饮食少进者。金锁玉关丸加参、 。脾肾俱虚。败精失道。精滑不固者。九龙丹去当归。
加萆 。五味。然不若萃仙丸尤妙。所谓败精失道者。非败精不泄而有所蓄滞也。以精窍屡开。
不能闭密。失其常度而流溢不止。故宜止涩之剂。小便过多。而便后常有滑精者。补中益气汤下
缩泉丸。痛而小便频数者。禁用缩泉。以益智壮火。乌药耗气。非阴虚多火人所宜。遗精茎中痒
而水道不禁。是阳虚有火。加减八味丸。脾虚不能堤水。水亏不能制火者。聚精丸加参、术、芡
实、莲须、五味。常服有效。大抵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、远志辈益气之味。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。凡身有热而脉洪滑。皆因于热。犀角、山栀、麦冬、茯神、竹
叶、木通、猪苓、生地、莲肉。凡属郁滞积热等证。贵在疏泄。医者不知。但用固涩。反增其疾
矣。宜滋肾丸、猪苓丸清利之。肥盛之人遗浊。滚痰丸下之最妙。脾胃湿热之人。及饮食浓味太
过。与酒客辈痰火为殃。多致不梦而遗泄。宜二陈、二术。加浓朴、黄柏、升、柴。使清升浊降。
脾胃健。而遗滑止矣。仲景治失精梦交。少腹弦急。脉虚迟。或芤动微紧。用桂枝龙骨牡蛎汤。
及手足烦热。咽干口燥。或悸或衄。此阳上升而不降。阴独居内而为梦。用小建中汤和之。此世俗所昧也。
陆丽京曰。遗精之源有三。有斫丧太过。肾气不藏。无梦而遗者。当益精以壮火。如鹿茸丸、安
肾丸、聚精丸、九龙丹、金锁玉关丸之类。有劳心太过。心肾不交。酣卧而遗者。当实土以堤水。
如归脾汤、妙香散、远志丸。补中益气汤、朱砂安神丸之类。有思想无穷。所愿不得。妄梦而遗
者。当泻火以宁水。如滋肾丸、威喜丸、本事猪苓丸、清心莲子饮之类。三者其源各异。若当清
利而反补涩。滋患愈甚。当补涩而反清利。阳气愈微。当升补而反滋阴。元气愈陷。不可不求其
故。而为施治也。
丹溪治一人二十余岁。攻举子业。四鼓犹未就枕。于卧间。玉茎但着被与股便梦交接脱精。
饮食日减。倦怠少气。此用心太过。二火俱起。夜不得睡。血不归肝。肾水不足。火乘阴虚。入
客下焦。鼓其精房。则精不得聚藏而欲走。因玉茎着物。犹厥气客之。故作接内之梦。于是上则
补心安神。中则调理脾胃。升举其阳。下则益精生阴固阳。不三月而瘥。
沈朗仲治王雨泉。壮年气弱。溺后精水淋漓不断。服六味丸不应。易八味丸。反加涩痛。两
尺脉数而气口虚大。此土虚不能堤水也。与补中益气加麦冬、五味。十剂而痊。
宗伯学士韩慕庐三公郎祖昭。素禀清 。宿有精滑不禁之恙。邀石顽诊之。脉得微弦而数。
尺中略有不续之象。此不但肾气不充。抑且气秘不调。愈不能司封藏之令耳。为疏六味丸去泽泻
加鳔胶、五味。略兼沉香于补中寓宣。法虽如此。但久滑窍疏。难期速应。毋怪药之不力也。
《黄帝内经》说：各种水液浑浊的病证，都属于热邪。小便黄赤有四种情况：一是属于肝热，《内经》说：“患肝热病的人，小便先变黄”，就是这种情况。二是属于胃热，《内经》说：“足阳明胃经，气盛则身体前部皆热，消化食物快且容易饥饿，小便颜色黄”，就是这种情况。三是属于肺虚，《内经》说：“手太阴肺经，气虚则肩背疼痛，怕冷则气短不足以呼吸，小便颜色改变”，就是这种情况。四是属于肾虚，《内经》说：“冬脉对应肾脏，冬季脉象不及（虚弱），会导致人感到寒冷，脊柱疼痛，小腹胀满，小便异常”，就是这种情况。出汗多而小便红赤涩痛，夏季月份多有此证。盛夏时节汗出过多，膀胱闭塞涩滞，则水液不能运化下行。可用四君子汤合五苓散，或者五苓散合生脉散，或者生脉散合保元汤，或者选用消暑丸、清燥汤。有小便红赤短少，身体疲倦，饮食减少，缺盆穴处疼痛的，这是脾、肺、肾三脏都虚损。用补中益气汤配合六味地黄丸，滋养其生化之源，自然痊愈。误用渗湿利水药必然危险。已经经过分利治疗，或者病后出现这种情况，属于脾肺气虚，不能施化水液。用补中益气汤加麦冬、五味子。尺脉数大，阴火上炎，而小便红赤少的，用六味地黄丸加麦冬、五味子。肝热的，频繁想解小便但红赤涩痛梗塞疼痛，时常觉得发冷，或者出现寒热往来。用六味地黄丸多加牛膝。脉象盛大、正气实盛的，用龙胆泻肝丸（龙荟丸）。胃热的，口中干淡引饮，肌肤壮热，用竹叶石膏汤。膀胱热严重的，用滋肾丸。
《内经》说：“恐惧思虑会损伤心神，心神受损则恐惧流淫不止。”肾，主蛰伏封藏，是精气的根本所在。五脏都是主藏精的器官。如果受伤就会失去守固，意思是某一脏的真气不能保持正常，那么这一脏的病就发作了。厥逆之气客居于阴器，就会梦见性交。厥阴肝主筋，所以所有的筋统系于肝。肾属阴，主藏精；肝属阳，主疏泄。所以肾阴虚，则精不内藏；肝阳强盛，则气不固摄。如果遇到阴邪客居在精窍，与所强盛的阳气相互感应，就会导致精脱而成梦遗。所谓的“阳强”，乃是肝脏所寄居的相火强盛罢了。所以治疗以肾、肝为主。也有不在肾肝，而在心、肺、脾、胃不足的情况，但必然传变到肾肝之后精气才会外走。治疗方法如果是从他脏引起，则以初感病的脏腑为本，肾肝聚集病变的为标。如果是由肾肝二脏自身得病，则单独治疗肾肝。阴阳离决，水火不交通的，则进行既济调和。阴阳不相抱持的，则进行调和。阳虚的补其气，阴虚的补其血，阳强的泻其火。有正治和反治，从少或从多，随其便利而定。梦中与人交接为梦遗，是相火强盛为患。不因梦境感受而自行遗泄的，称为精滑，多是心肾受伤所致。因思想无穷尽，愿望不得满足而成为白淫的，治疗方法有五种。神气浮游的，宜用补中益气汤加石菖蒲，下服朱砂安神丸。思虑久结成痰，迷于心窍，宜先服四七汤以豁除其痰，后用猪苓丸、威喜丸调理。思虑伤阴，用八味丸去掉附子，加酒炒黄柏以滋养之。用心太过，心不能摄肾以致失精的，用远志丸。因思欲不遂，耳闻目见，精气即出的，名叫白淫，用辰砂妙香散。色欲过度，下元虚惫，滑泄不禁的，用六味地黄丸加鹿茸、五味子、龙骨。失精梦泄，也有因郁火而得的，所以壮年火盛者，多有流溢。如果用虚冷的方剂用热药，则精气更加失泄。用滋肾丸加生地、茯神、枣仁、石菖蒲。梦遗多为肝热胆寒，因为肝热则火淫于外，魂不内守，所以多淫梦失精，有时心悸，肥胖人多有此证，宜清肝，不必补肾。用温胆汤加人参、茯神、枣仁、莲肉。遗精腰疼，用六味地黄丸加杜仲、五味子、菟丝子、肉苁蓉。中年以后，用还少丹。精气不足，呼吸短气，遗精盗汗，用济生鹿茸丸。斫丧太过，滑泄不禁，兼有心脾气虚，饮食减少的，用金锁玉关丸加人参、白术。脾肾俱虚，败精失道，精滑不固的，用九龙丹去掉当归，加萆薢、五味子。然而不如萃仙丸尤其奇妙。所谓败精失道，并不是败精不泄而有所蓄滞，而是因为精窍屡开，不能闭密，失去常度而流溢不止，所以宜用止涩的药剂。小便过多，而便后常有滑精的，用补中益气汤送服缩泉丸。疼痛而小便频数的，禁用缩泉丸，因为益智仁壮火，乌药耗气，不是阴虚多火之人所适宜的。遗精茎中痒而水道不禁的，是阳虚有火，用加减八味丸。脾虚不能堤防水液，水亏不能制约火气的，用聚精丸加人参、白术、芡实、莲须、五味子，常服有效。大抵梦遗多是阴虚火气作祟，如果不是确系阳虚，桂枝、附子、鹿茸等助阳的药物，千万不要轻用。如果不是确系气虚，人参、白术、远志等益气的药物，不可随意施用。试看梦遗，必定在黎明阳气发动之时发生，可知其为阴虚阳扰。凡是身体发热而脉象洪滑的，都是因为热，用犀角、山栀、麦冬、茯神、竹叶、木通、猪苓、生地、莲肉。凡是属于郁滞积热等证，贵在疏泄，医者不知道，只用固涩，反而增加疾病了。宜用滋肾丸、猪苓丸清利。肥盛之人遗浊，用滚痰丸送服最妙。脾胃湿热之人，以及饮食浓味太过，与酒客辈痰火为殃，多导致不梦而遗泄，宜用二陈汤、二术汤，加厚朴、黄柏、升麻、柴胡，使清升浊降，脾胃健运，而遗滑停止。张仲景治疗失精梦交，少腹弦急，脉虚迟，或芤动微紧，用桂枝加龙骨牡蛎汤。以及手足烦热，咽干口燥，或悸或衄，这是阳上升而不降，阴独居内而为梦，用小建中汤调和它。这是世俗人所不明白的。
陆丽京说：遗精的根源有三。有斫丧太过，肾气不藏，无梦而遗的，当益精以壮火，如鹿茸丸、安肾丸、聚精丸、九龙丹、金锁玉关丸之类。有劳心太过，心肾不交，酣睡而遗的，当实土以堤水，如归脾汤、妙香散、远志丸、补中益气汤、朱砂安神丸之类。有思想无穷，所愿不得，妄梦而遗的，当泻火以宁水，如滋肾丸、威喜丸、本事猪苓丸、清心莲子饮之类。三者源头各异，如果应当清利却反而补涩，滋生病患会更严重；应当补涩却反而清利，阳气会更加微弱；应当升补却反而滋阴，元气会更加下陷。不可以不探求其缘故而进行治疗。
朱丹溪治疗一人二十多岁，攻读举子业，凌晨四点还未就寝，在卧间，阴茎只要接触被子和大腿就梦见交接脱精。饮食日渐减少，倦怠少气，这是用心太过，二火俱起，夜间不能入睡，血不归肝，肾水不足，火乘阴虚，侵入客居下焦，鼓动精房，则精不得聚藏而欲走。因为阴茎着物，犹如厥气客之，所以作成接内之梦。于是上则补心安神，中则调理脾胃，升举其阳，下则益精生阴固阳，不到三个月而痊愈。
沈朗仲治疗王雨泉，壮年气弱，小便后精水淋漓不断，服用六味地黄丸无效，改用八味地黄丸，反而加重涩痛。两尺脉数而气口脉虚大，这是土虚不能堤防水液。给予补中益气汤加麦冬、五味子，十剂而痊愈。
宗伯学士韩慕庐的三公郎祖昭，素禀清秀，宿有精滑不禁的毛病，邀请石顽诊视。脉得微弦而数，尺中略有不续之象，这不但肾气不充，而且气秘不调，更加不能司掌封藏的政令。于是开具六味地黄丸去掉泽泻，加鳔胶、五味子，略兼沉香于补中寓宣通之意。法度虽然如此，但久滑窍疏，难以期望快速见效，不要怪罪药力不强。
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.