（见诸血门本证）
或有气闭。而小便不通。至脐下气瘕结痛。以五香散。间服独味琥珀末。以灯心汤下。
甚效。女人多有此证。
有白浊人。服玄兔丹不愈。服附子八味丸即愈者。不可不知。
有小便如常。停久才方淀浊。有小便出即如泔。若小儿泔病者。并宜厘清饮。加白茯苓
半钱。
如服药未效。宜四七汤。吞青州白丸子。及辰砂妙香散。吞玄兔丹及小菟丝子丸。山药
丸
如白浊甚。下淀如泥。或稠粘。如胶。频逆。而涩痛异常。此非是热淋。此是精浊窒塞
窍道而结。宜五苓妙香散。吞八味丸。小菟丝子丸。精者血之所化。有浊去太多。精化不及
赤未变白。故成赤浊。此虚之甚也。何以知之。有人天癸未至。强力好色。所泄半精半血
若溺不赤。无他热证。纵虽赤浊。不可以赤为热。只宜以治白浊施之。
若溺赤下浊亦赤。口渴时发热者。唇砂妙香散。吞灵砂丹。或清心莲子饮。发热不退。
口
燥舌干之甚者。此乃精亏内燥。肾枯不润。四物汤。吞玄兔丹。和八味丸久服。乃效。
（附遗沥梦遗）
遗精。得之有四。有用心过度。心不摄肾。以致失精者。有因思色欲不遂。精色失位。
输泻
而出者。有欲太过滑泄不禁者。有年壮气盛。久无色欲。精气满泄者。然其状不一。或小
便
后去多不可禁者。或不小便而自出。或茎中出而痒痛。常如欲小便者。并宜先用辰砂妙香散
吞玉华白丹。佐以威喜丸。或厘清饮。别以绵裹龙骨同煎。或厘清饮。半帖。加五倍牡蛎粉
白茯苓五味子各半钱。
失精梦泄。亦有经络热而得者。若以虚冷。用热剂则精愈失。本事方清心丸。用黄皮脑
子者。最良然亦必恍惚膈热。乃验其热证也。以此见赤浊。亦有自热而得。亦可用此。
若是用心过度。得之。宜远志丸用交感汤。加莲子肉。五味子吞下。仍佐以灵砂丹。
若审是思色欲不遂得之。且以四七汤。吞白丸子。甚者耳闻目见。其精即出。名曰白淫
妙香散。吞玉华白丹。
若审是色欲过度。下元虚惫。泄滑无禁。宜正元饮。加牡蛎粉。肉苁蓉各半钱。吞养气
丹。或灵砂丹。仍佐以鹿茸丸。山药丸。大菟丝子丸。固阳丸之类。
审是壮盛满溢者。本事方清心丸。仍服黄 六一汤。便虽非对。缘精髓满溢。姑以白燥
之。
遗沥。比之遗精稍少。小便有数点稠粘。茎头微痛。或小便已停。原时方有一二滴沾 。
其病不出前所因。宜审用前药。
梦遗。俗谓之夜梦鬼交。宜温胆汤。去竹茹加人参。远志。莲肉。酸枣仁炒。茯神各半
钱。吞玉华白丹。固阳丸。梦遗亦备前肆证。宜审其所惑。用前药。
治小便注杆甘疮。用脑子二钱半。雁爪黄莲一钱半。炉甘石一钱。葱头七个。陈荷叶一
片。
花椒一撮。先以葱头荷叶花椒煎汤二碗。待温时留瓶内。浸洗。小便干净。将前炉甘石。用
火红。于煎至黄莲水内。浸湿又烧又浸。烧烊为度。安于冷地上。以碗盖之。候冷。研末
入脑子和匀。将前汤洗净。用药末之。妙不过二三度。即愈。
（参见“诸血门”中的本证论述）
有的人因气机闭塞，导致小便不通，直至脐下出现气瘕结聚疼痛。此时服用五香散，并间歇性地单服琥珀末，用灯心草煎汤送服。效果极佳。女性患者多有此类病症。
有患白浊的人，服用玄兔丹无效，但服用附子八味丸即痊愈的情况，不可不知晓。
有的患者小便平时正常，放置久了才沉淀变浑浊；有的患者小便排出时即刻如米泔水般浑浊，如同小儿的“泔病”。这些情况都适宜使用厘清饮，并加入半钱的白茯苓。
如果服药后未见疗效，适宜服用四七汤，吞服青州白丸子，以及辰砂妙香散，吞服玄兔丹和小菟丝子丸、山药丸。
如果白浊症状严重，尿液沉淀物如泥状，或粘稠如胶，频尿且涩痛异常。这并非热淋，而是精浊阻塞窍道所致。适宜服用五苓妙香散，吞服八味丸、小菟丝子丸。精液是由血液化生的，如果浊邪排泻过多，精液化生不及，血色未完全转化为白色，故而形成赤浊。这是极度虚损的表现。如何判断呢？有人天癸（月经/生殖机能成熟标志）尚未到来，却强力纵欲，所泄出的物质半是精液半是血液。如果小便不红，没有其他热证表现，即使出现赤浊，也不能将其视为热证，只宜按照治疗白浊的方法施治。
如果小便颜色红赤，下部排泄物也红赤，伴有口渴和时时发热者，服用唇砂妙香散，吞服灵砂丹，或者清心莲子饮。如果发热不退，口燥舌干严重者，这是精亏导致的内燥，肾阴枯竭不能滋润。应服用四物汤，吞服玄兔丹，并配合八味丸长期服用，才能见效。
（附：遗沥、梦遗）
遗精的成因有四类：一是用心过度，心神不能摄持肾精，导致失精；二是因思慕色欲而未得满足，精气位置失常，输泻而出；三是欲望太过，滑泄无法控制；四是年壮气盛，长期无性生活，精气满溢而泄出。然而其症状表现不一，有的在排尿后精液流出多且无法控制，有的在不排尿时也自行流出，有的从尿道口流出并伴有痒痛，常感觉像要小便一样。这些情况都适宜先服用辰砂妙香散，吞服玉华白丹，辅以威喜丸，或者厘清饮。另外可用绵布包裹龙骨同煎，或者在厘清饮中减半剂量，加入五倍子、牡蛎粉、白茯苓、五味子各半钱。
失精和梦泄，也有因经络有热而引发的。如果是虚寒体质，使用热性药物则会导致精液更加流失。《本事方》中的清心丸，使用黄皮脑子的最为良效。但这必须确认患者有恍惚、膈部发热等热证表现才有效。由此可见，赤浊也有因热而得的，也可以使用此药。
如果是因用心过度导致的，适宜使用远志丸，用交感汤送服，加入莲子肉、五味子吞下，并辅以灵砂丹。
如果确认为因思慕色欲未遂导致的，暂且使用四七汤，吞服白丸子。严重的甚至听到声音、看到景象，精液就会流出，这种情况称为“白淫”，可使用妙香散，吞服玉华白丹。
如果确认为是色欲过度，下元虚惫，滑泄无法控制，适宜使用正元饮，加入牡蛎粉、肉苁蓉各半钱，吞服养气丹或灵砂丹，并辅以鹿茸丸、山药丸、大菟丝子丸、固阳丸之类的药物。
如果确认为是壮盛满溢导致的，《本事方》清心丸仍适用，同时服用黄柏六一汤。虽然药不对症，但因为精髓满溢，姑且用其清热燥湿的作用来处理。
遗沥，比遗精的症状稍轻，小便中有几滴稠粘液体，尿道头微痛，或者小便结束后，原处还有一两滴沾染。其病因不出上述几种，适宜仔细审察后使用前文提到的药物。
梦遗，俗称夜梦鬼交，适宜使用温胆汤，去掉竹茹，加入人参、远志、莲肉、炒酸枣仁、茯神各半钱，吞服玉华白丹、固阳丸。梦遗也具备前述四种证型，适宜审察其惑因，使用前文提到的药物。
治疗小便注杆甘疮（尿道口生疮），使用脑子（冰片）二钱半，雁爪黄莲一钱半，炉甘石一钱，葱头七个，陈荷叶一片。花椒一撮。先用葱头、荷叶、花椒煎汤两碗，待温度适宜时留于瓶内，浸泡清洗，直到小便部位干净。然后将前面的炉甘石用火烧红，浸入煎好的黄连水中，浸湿后再烧，反复直至熔化。放在冷地上，用碗盖住，待冷却后研成粉末，加入脑子和匀。将前文煎好的汤洗净患处，用药末涂抹。妙不过两三次即可痊愈。
(See the main syndrome discussion in the "Various Bleeding" section)
Some individuals suffer from Qi obstruction, leading to urinary retention, with Qi masses forming and causing pain below the umbilicus. In such cases, Wuxiang San (Five Fragrances Powder) should be taken, interspersed with single-ingredient Succini Pulvis (Amber Powder), administered with a decoction of Jiedixin (Centipeda Herba). This is highly effective. Women often present with this syndrome.
There are cases of Bai Zhuo (White Turbidity) where Xuantan Dan fails to cure, but Fuzi Bawei Wan (Aconite Eight-Ingredient Pill) brings about recovery; this must be known.
In some patients, urination appears normal initially but becomes turbid after standing for a long time; in others, the urine is immediately turbid like rice wash water upon excretion, similar to the "Gan Bing" (Rice Wash Disease) seen in infants. These conditions are suitable for Liqing Yin (Clearing Turbidity Decoction), with Ban Qian (Half a Qian) of Baifuling (Poria) added.
If there is no effect after taking medicine, Sizhi Tang (Seven-Ingredient Decoction) should be used, along with Qingzhou Baixiaowan (Qingzhou White Pills), Chen Sha Miaoxiang San (Cinnabar Wonderful Fragrance Powder), Xuantan Dan (Black Rabbit Pill), Xiaotusizi Wan (Small Dodder Seed Pill), and Shanyao Wan (Yam Pill).
If Bai Zhuo is severe, with sediment resembling mud or thick glue, accompanied by frequent urgency and abnormal dysuria, this is not Re Lin (Heat Strangury), but rather Jing Zhuo (Essence Turbidity) obstructing the orifices. It is suitable to take Wu Ling Miaoxiang San (Five-Ling Wonderful Fragrance Powder), swallowing Bawei Wan (Eight-Ingredient Pill) and Xiaotusizi Wan. Essence is transformed from blood. If too much turbid pathogen is discharged, the transformation of essence cannot keep up, and the red color does not fully transform into white, resulting in Chi Zhuo (Red Turbidity). This indicates extreme deficiency. How do we know this? There are cases where Tian Gui (Menstruation/Reproductive Maturity) has not yet arrived, but due to forced sexual indulgence, what is discharged is half essence and half blood. If the urine is not red and there are no other heat signs, even if Chi Zhuo occurs, it should not be treated as heat. Instead, treatment for Bai Zhuo should be applied.
If the urine is red, lower discharge is also red, accompanied by thirst and intermittent fever, Chunsha Miaoxiang San (Lapis Rubrum Wonderful Fragrance Powder) should be taken, swallowing Lingsha Dan (Cinnabar Pill), or Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction). If fever persists and dry mouth and tongue are severe, this is internal dryness due to essence depletion, with kidney dryness failing to moisten. Siwu Tang (Four-Substance Decoction) should be taken, swallowing Xuantan Dan, combined with long-term use of Bawei Wan for efficacy.
(Attached: Yi Li - Post-micturition Dribbling, Meng Yi - Nocturnal Emission)
Meng Yi (Nocturnal Emission) arises from four causes: 1) Excessive mental exertion, where the Heart fails to control the Kidney, leading to loss of essence; 2) Unfulfilled lustful thoughts, causing essence to lose its proper position and leak out; 3) Excessive desire leading to uncontrollable slipping; 4) Youthful vigor and abundance, with long abstinence, leading to fullness and overflow of essence. However, symptoms vary: some experience uncontrollable leakage after urination; some have spontaneous emission without urination; some feel itching and pain at the glans, often feeling the urge to urinate. For these, Chen Sha Miaoxiang San should be taken first, swallowing Yuhua Bai Dan (Jade Flower White Pill), assisted by Weixi Wan (Victory Joy Pill), or Liqing Yin. Alternatively, Longgu (Fossilized Bones) wrapped in cotton can be decocted together, or Liqing Yin can be halved with Wu Beizi (Chinese Gall), Muli (Oyster Shell Powder), Baifuling (Poria), and Wuweizi (Schisandra Fruit) each added at Ban Qian.
Loss of essence and nocturnal emissions can also result from heat in the meridians. If the condition is cold-deficiency, using hot medicines will worsen the loss of essence. The Qingxin Wan (Heart-Clearing Pill) from *Ben Shi Fang* uses Huangpi Naozi (Brain of Cinnamon Bark) as the best ingredient. However, this is only effective if there are clear heat signs such as mental restlessness and chest heat. Thus, Chi Zhuo can also arise from heat and can be treated with this method.
If caused by excessive mental exertion, Yuanzhi Wan (Polygala Pill) should be used, swallowed with Jiaogan Tang (Communication Decoction), adding Lianrou (Lotus Seed Flesh) and Wuweizi. Assist with Lingsha Dan.
If confirmed to be due to unfulfilled lust, Sizhi Tang should be used initially, swallowing Baixiaowan. In severe cases where hearing or seeing stimuli causes immediate emission, known as Bai Yin (White Leukorrhea/Emission), Miaoxiang San should be used, swallowing Yuhua Bai Dan.
If confirmed to be due to excessive sexual activity, with deficiency and exhaustion of the Lower Origin, leading to uncontrollable sliding, Zhengyuan Yin (Origin-Rectifying Decoction) should be used, adding Muli Powder and Rongrong (Cistanche) each at Ban Qian, swallowing Yangqi Dan (Qi-Nourishing Pill) or Lingsha Dan. Assist with Lurong Wan (Deer Antler Pill), Shanyao Wan, Datusizi Wan (Large Dodder Seed Pill), Guyang Wan (Yang-Firming Pill), etc.
If confirmed to be due to youthful fullness and overflow, Qingxin Wan from *Ben Shi Fang* is still applicable, along with Huangbai Liuyi Tang (Phellodendron Six-to-One Decoction). Although not perfectly matched, since essence and marrow are overflowing, its drying properties are temporarily used to manage it.
Yi Li (Post-micturition Dribbling) is slightly less severe than Meng Yi. A few drops of viscous fluid appear in the urine, with slight pain at the glans, or one or two drops remain after urination stops. The etiology falls within the previously mentioned causes, so previous medications should be carefully selected based on the pattern.
Meng Yi, commonly called "nighttime intercourse with ghosts," is suitable for Wendan Tang (Warm the Gallbladder Decoction), removing Zhuru (Bamboo Shavings), and adding Ren Shen (Ginseng), Yuanzhi (Polygala), Lianrou (Lotus Seed Flesh), Chao Suanzaoren (Stir-fried Sour Jujube Seed), and Fushen (Poria with Hostwood) each at Ban Qian, swallowing Yuhua Bai Dan and Guyang Wan. Meng Yi also encompasses the four syndromes mentioned above; the specific cause should be identified to apply the appropriate medication.
For treating Gan Chuang (Sore/Ulcer) at the root of the penis during urination, use Naohzi (Borneol) 2.5 Qian, Yanzhao Huanglian (Wild Coptis) 1.5 Qian, Luganshi (Calamina) 1 Qian, Congtou (Scallion Head) 7 pieces, Chen Heye (Old Lotus Leaf) 1 piece, and Huajiao (Sichuan Pepper) a pinch. First, decoct scallion heads, lotus leaves, and Sichuan pepper in two bowls of water. When warm, store in a bottle for washing until the area is clean. Then, take the Luganshi, heat it red-hot, and immerse it in the decocted Huanglian water. Repeat heating and immersing until melted. Place on a cold ground, cover with a bowl, wait for it to cool, then grind into powder. Mix with Naohzi. Clean the area with the previous decoction and apply the powder. Two or three applications will suffice for a cure.