【歌】湿痰湿火干气血，赤白二浊从此别。更有精滑及梦遗，却缘相火与湿热。
【论】夫赤白二浊，其色虽殊，总归于火。火郁下焦，精化不清，故有赤白，白者属气，赤者属血。而精
者，实血之所化也。好色之徒，勤于御女，精出有限而欲无穷，血为火迫，不及化精，故其色赤，从乎血也。
大法，白浊以降火为主，而补次之；赤浊以补为主，而降火次之。寡欲之人，亦患此者，以湿热治。又有肾虚
人，小便白如油，光彩不定，尿脚澄下凝如膏糊，为寒。盖因肾虚过欲，膀胱弱而阴寒生，若此者，十无一、
二，非寻常白浊之比，当审而辨之。梦遗者，梦与人交而遗其精也。精滑者，不因梦交而精自泄出也。皆因真
元气虚，虚火流行，以致精海脱滑。遗于夜而不遗于昼者，盖昼为阳，夜为阴，惟阴虚故遗于阴分也。甚则遗于
昼者，并阳皆虚也，阴阳皆虚，死期将至矣，不亦殆哉！然求其所属，则心、肝与肾之火相挟而成之耳。盖心
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，故于寐时神游于外，欲为云雨，则魂化为形，从
而行焉，而吾之精，亦不容以不泄矣。故治此病者，先治其心火，而后及其余也。寡欲之人亦患此者，以脾湿
治。盖脾湿则化气不清，而分注于膀胱者，亦混浊而稠浓，阴火一动，精随而出，故有不待梦而自遗者也。
【脉】两尺洪数或心脉短小，必便浊遗精。
赤白浊
赤浊，湿热乘于血分，四物汤对二陈汤加贝母、樗根白皮、青黛、滑石。（二方一见血证，一见痰证。）
弱者，补阴丸。（方见火证。）白浊，湿痰流下，宜燥湿，二陈汤加二术。相火盛者，珍珠粉丸。气虚者，清
心莲子饮。（方见三消。）肾水虚寒，尿白如油，光彩不定，凝如糊，厘清饮。
珍珠粉丸
治白浊阴虚火旺之证。
真蛤粉（一斤） 黄柏（一斤，炒赤色）
末之，滴水丸如桐子大，空心酒下百丸。
厘清饮
治肾水虚寒浊。
益智（五钱） 萆 （五钱） 石菖蒲（三钱）
梦遗
梦遗者，夜梦交感而泄也。火盛者，珍珠粉丸。（方见前。）心不宁，温胆汤去竹茹加人参、远志、茯神、
莲肉、枣仁。
肾虚者，六味地黄丸，（方见劳瘵。）或丹溪补阴丸。（方见火证。）精不固，金樱子膏。因思想而得，其病
在心，定志丸或妙香散。（方共见女科。）
温胆汤
即二陈加枳壳。（方见痰证。）
金樱子膏
金樱子（十斤，剖开，去子、毛）
于木臼内杵碎，水二斗，煎成膏子服。
精滑
精滑者，不因交感而自泄也，先服妙香散，（方见女科。）或威喜丸。精滑因相火动者，珍珠粉丸。（方见
前。）虚者，大补阴丸。（方见火证。）久不止，必用龙骨、牡蛎涩之。
威喜丸
治泄精。
黄蜡（四两） 茯苓（四两，用猪苓一分，瓷器内同煮二十沸，晒）
末之，溶蜡搜和如弹子大，每一丸，空心细咽下。
【歌诀】湿痰、湿火、气虚、血虚，赤浊与白浊由此区分。还有精液滑脱及梦遗，多因相火亢盛与湿热所致。
【论述】所谓赤浊和白浊，虽然颜色不同，但总归都归属于“火”邪。火热之邪郁结于下焦，导致精气化生不清，因而出现红色或白色的浑浊物。白色属于气分病变，红色属于血分病变。而精液，实际上是血液所化生的。喜好女色的人，频繁行房，精液的排出有定数而性欲却无穷尽，血液被火热逼迫，来不及转化为精液，所以颜色发红，这是从属于血分的缘故。
治疗的大法：白浊以清降火邪为主，补益为辅；赤浊以补益为主，清降火邪为辅。节制欲望的人如果也患此病，则用清热利湿的方法治疗。又有肾虚之人，小便白色如油，光泽不定，尿后沉淀物凝结如膏糊状，这属于寒证。这是因为肾虚且过度纵欲，膀胱虚弱而生阴寒，像这种情况，十人中不到一二人，不能与寻常的白浊相比，应当仔细辨别。
梦遗，是指在梦中与人交合而射精。精滑，是指不因梦境交合而精液自行泄出。这两种情况都是因为真元之气虚弱，虚火流行，导致精海（指肾藏精之所）失固而滑脱。在夜间遗精而在白天不遗精的，是因为白天属阳，夜晚属阴，只有阴虚才会导致在阴分（夜间）遗精。严重时甚至在白天也遗精，这是阴阳两虚的表现，死期将至，不是很危险吗！然而探究其所属脏腑，则是心、肝、肾三脏之火相互挟持而形成的。因为心藏神，肝藏魂，肾藏精。梦中主宰的是心之神；梦中见到的形体，是肝之魂；梦中泄出的精液，是肾之精。总之，心为君主，肝肾为宰相，没有君火发动而相火不随之响应的道理。所以在睡眠时神志游荡于外，产生云雨之欲，则魂化为形体跟随行动，我们的精液也就不可能不泄出了。因此治疗此病的人，先治心火，然后再处理其余脏腑的问题。节制欲望的人也患此病的，用健脾祛湿的方法治疗。因为脾湿会导致气化不清，注入膀胱的物质也会混浊稠浓，一旦阴火发动，精液就会随之而出，所以会有不待梦境而自行遗泄的情况。
【脉诊】双侧尺脉洪大数急，或者心脉短小，必定会出现小便浑浊和遗精的症状。
赤白浊
赤浊，是湿热侵入血分，用四物汤合二陈汤，加贝母、樗根白皮、青黛、滑石。（这两个方子，一个针对血证，一个针对痰证。）体质虚弱者，用补阴丸。（方剂见火证章节。）白浊，是湿痰流注下行，宜燥湿，用二陈汤加苍术、白术。相火旺盛者，用珍珠粉丸。气虚者，用清心莲子饮。（方剂见三消章节。）肾水虚寒，小便白如油，光泽不定，凝结如糊状，用厘清饮。
珍珠粉丸
治疗白浊阴虚火旺的证候。
真蛤粉（一斤） 黄柏（一斤，炒至赤色）
研为细末，滴水泛丸如梧桐子大，空腹时用酒送服一百丸。
厘清饮
治疗肾水虚寒导致的浊证。
益智仁（五钱） 萆薢（五钱） 石菖蒲（三钱）
梦遗
梦遗，是指夜间做梦交合而泄精。火盛者，用珍珠粉丸。（方剂见前文。）心神不宁者，用温胆汤去掉竹茹，加人参、远志、茯神、莲肉、酸枣仁。
肾虚者，用六味地黄丸，（方剂见劳瘵章节。）或丹溪补阴丸。（方剂见火证章节。）精关不固者，用金樱子膏。因思虑过度而得病，病位在心，用定志丸或妙香散。（方剂共见于妇科章节。）
金樱子膏
金樱子（十斤，剖开，去籽、毛刺）
放入木臼中捣碎，加水二斗，煎制成膏服用。
精滑
精滑，是指不因交合而自行泄精，先服用妙香散，（方剂见妇科章节。）或威喜丸。精滑因相火妄动者，用珍珠粉丸。（方剂见前文。）体虚者，用大补阴丸。（方剂见火证章节。）久治不止，必须用龙骨、牡蛎来收敛固涩。
威喜丸
治疗泄精。
黄蜡（四两） 茯苓（四两，用猪苓一分，在瓷器内同煮二十沸，晒干）
研为细末，熔化黄蜡调和成弹子大小的丸剂，每一丸，空腹细细咽下。
[Verse]
Damp-phlegm, damp-fire, Qi deficiency, and Blood deficiency distinguish between red turbidity (Hong Zhuo) and white turbidity (Bai Zhuo). Additionally, seminal emission with sliding (Jing Hua) and nocturnal emission in dreams (Meng Yi) are caused by ministerial fire (Xiang Huo) and damp-heat.
[Dissertation]
Regarding red and white turbidity, although their colors differ, they all ultimately belong to Fire. When Fire is constrained in the Lower Jiao, the transformation of essence becomes unclear, resulting in red or white turbid substances. White belongs to the Qi level, while red belongs to the Blood level. Essence is actually transformed from Blood. Those who indulge in lust frequently engage in sexual intercourse; the loss of essence has limits, but desire is infinite. Blood is forced by Fire and fails to transform into essence properly, hence its color is red, indicating involvement of the Blood level.
The general treatment principle: For white turbidity, the primary method is to descend Fire, with tonification as secondary; for red turbidity, the primary method is tonification, with descending Fire as secondary. Individuals who practice moderation in sexual desire may also suffer from this condition, which should be treated with methods that clear heat and drain dampness. Furthermore, in cases of Kidney deficiency, the urine may appear white like oil, with uncertain luster, and the sediment at the bottom of the urinal condenses like a paste. This indicates Cold. It arises because Kidney deficiency combined with excessive indulgence weakens the Bladder, generating Yin-Cold. Such cases account for less than one or two out of ten and cannot be compared to ordinary white turbidity; careful differentiation is required.
Nocturnal emission (Meng Yi) refers to ejaculation during sexual dreams. Seminal sliding (Jing Hua) refers to spontaneous leakage of essence without sexual dreams. Both conditions result from the deficiency of True Yuan Qi and the rampant flow of Deficiency Fire, leading to the instability and sliding of the Essence Sea. Emission occurring only at night and not during the day occurs because Day is Yang and Night is Yin; only Yin deficiency leads to emission in the Yin aspect (night). If it progresses to daytime emissions as well, it indicates both Yin and Yang deficiency, signaling impending death—is this not perilous? However, tracing the etiology, it involves the interplay of Fire in the Heart, Liver, and Kidneys. The Heart houses the Spirit (Shen), the Liver houses the Ethereal Soul (Hun), and the Kidneys store Essence (Jing). The Heart governing the dream represents the Spirit of the Heart; the form seen in the dream represents the Hun of the Liver; the essence emitted in the dream represents the Jing of the Kidneys. In summary, the Heart is the Monarch, and the Liver and Kidneys are the Ministers. It is impossible for the Monarch Fire to move without the Minister Fire following suit. Therefore, during sleep, when the Spirit wanders externally and desires sexual union, the Hun transforms into form and follows, causing our Essence to inevitably leak. Thus, treating this disease requires first addressing Heart Fire, followed by the other organs. Even those who moderate their desires may suffer from this if Spleen Dampness is present. Spleen Dampness causes unclear Qi transformation, making the fluids directed to the Bladder turbid and thick. Once Yin Fire moves, Essence follows and leaks, leading to spontaneous emission without dreams.
[Pulse Diagnosis]
A surging and rapid pulse at both Chi positions (Kidney positions), or a short and small pulse at the Heart position, indicates turbid urination and seminal emission.
Red and White Turbidity
Red Turbidity: Caused by damp-heat invading the Blood level. Use Si Wu Tang (Four Substances Decoction) combined with Er Chen Tang (Two Aged Ingredients Decoction), adding Bei Mu (Fritillaria Bulb), Chu Gen Bai Pi (Bark of Chinese Toona Root), Qing Dai (Indigo Naturalis), and Hua Shi (Talcum). [These two formulas address Blood disorders and Phlegm disorders, respectively.]
For weakness, use Bu Yin Wan (Tonify Yin Pill). [Formula see Fire Disorders section.]
White Turbidity: Caused by damp-phlegm flowing downward. Dry dampness is indicated. Use Er Chen Tang (Two Aged Ingredients Decoction) added with Cang Zhu (Atractylodes Rhizome) and Bai Zhu (White Atractylodes Rhizome). For excessive ministerial fire, use Zhen Zhu Fen Wan (Pearl Powder Pill). For Qi deficiency, use Qing Xin Lian Zi Yin (Clear Heart Lotus Seed Decoction). [Formula see San Xiao section.]
For Kidney Water deficiency and cold, where urine is white like oil, luster is unstable, and it condenses like paste, use Li Qing Yin (Clarify Turbidity Decoction).
Zhen Zhu Fen Wan (Pearl Powder Pill)
Treats white turbidity due to Yin deficiency with hyperactive fire.
Zhen Ge Fen (Real Clam Shell Powder) (1 jin)
Huang Bo (Phellodendron Bark) (1 jin, stir-fried until reddish-brown)
Grind into fine powder, mix with water to make pills the size of tung seeds. Take 100 pills on an empty stomach with wine.
Li Qing Yin (Clarify Turbidity Decoction)
Treats turbidity due to Kidney Water deficiency and cold.
Yi Zhi Ren (Alpinia Oxyphylla Fruit) (5 qian)
Bi Xie (Dioscorea Hypoglauca Rhizome) (5 qian)
Shi Chang Pu (Acorus Tatarinowii Rhizome) (3 qian)
Nocturnal Emission
Nocturnal emission refers to ejaculation during sexual dreams at night. For excess fire, use Zhen Zhu Fen Wan (Pearl Powder Pill). [Formula see above.] For restless Heart spirit, use Wen Dan Tang (Warm the Gallbladder Decoction), removing Zhu Ru (Bamboo Shavings), and adding Ren Shen (Ginseng Root), Yuan Zhi (Polygala Root), Fu Shen (Poria with Hostwood), Lian Rou (Lotus Seed Flesh), and Suan Zao Ren (Ziziphus Seed).
For Kidney deficiency, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia). [Formula see Lao Zhai section.] Or Dan Xi Bu Yin Wan (Danxi's Tonify Yin Pill). [Formula see Fire Disorders section.] For insecure essence, use Jin Ying Zi Gao (Cherokee Rose Fruit Paste). If caused by obsessive thinking, the pathology lies in the Heart; use Ding Zhi Wan (Stabilize Will Pill) or Miao Xiang San (Miraculous Fragrance Powder). [Formulas see Gynecology section.]
Wen Dan Tang (Warm the Gallbladder Decoction)
Consists of Er Chen Tang (Two Aged Ingredients Decoction) plus Zhi Ke (Bitter Orange Peel). [Formula see Phlegm Disorders section.]
Jin Ying Zi Gao (Cherokee Rose Fruit Paste)
Jin Ying Zi (Cherokee Rose Fruit) (10 jin, split open, remove seeds and hairs)
Pound in a wooden mortar, add 2 dou of water, and decoct into a paste for consumption.
Seminal Sliding
Seminal sliding refers to spontaneous leakage of essence without sexual stimulation. First take Miao Xiang San (Miraculous Fragrance Powder). [Formula see Gynecology section.] Or Wei Xi Wan (Wei Xi Pill). For seminal sliding due to movement of ministerial fire, use Zhen Zhu Fen Wan (Pearl Powder Pill). [Formula see above.] For deficiency, use Da Bu Yin Wan (Great Tonify Yin Pill). [Formula see Fire Disorders section.] If persistent, Long Gu (Dragon Bone) and Mu Li (Oyster Shell) must be used to astringe.
Wei Xi Wan (Wei Xi Pill)
Treats seminal emission.
Huang La (Yellow Beeswax) (4 liang)
Fu Ling (Poria) (4 liang, boiled together with 1 fen of Zhu Ling (Polyporus) in a porcelain vessel for twenty boils, then dried)
Grind into powder, melt the wax to bind the powder into pills the size of bullet seeds. Swallow one pill slowly on an empty stomach.