1.不梦而遗心肾弱, 梦而后遗火之强, 过欲精滑清气陷, 久旷溢泻
味醇伤.
【注】不梦而遗, 谓无所感于心而自遗, 则为心肾虚弱不固也. 梦而
后遗, 谓有所感于心, 相火煽而强迫之, 则为二火之强不固也. 或过
欲之人, 日惯精滑, 或清气不足, 下陷不固, 或久旷之人, 精盛溢泻
,或醇酒厚味, 火强不固, 皆为是病也.
龙骨远志丸 坎离既济汤 封髓丹
2.心肾虚弱朱远志, 龙骨神苓菖蒲参, 久旷火旺地知柏, 胃虚柏草
缩砂仁.
【注】龙骨远志丸, 治心肾虚弱, 不梦而遗者, 即龙骨, 朱砂, 远志
,茯神, 茯苓, 石菖蒲, 人参也. 坎离既济汤, 治梦而后遗, 火强久
旷者, 即生地, 黄柏, 知母也. 若胃虚食少便软, 则不宜生地, 知柏
,恐苦寒伤胃, 故宜封髓丹, 即黄柏, 甘草, 缩砂仁也.
补精丸
3.精出不止阳不痿, 强中过补过淫成, 久出血痛形羸死, 或发消渴
或发痈, 阳盛坎离加龙骨, 实热解毒大黄攻, 调补骨脂韭山药, 磁石
苁蓉参鹿茸.
【注】精出不止, 阳强不倒, 名曰强中. 此病皆因过服房术中补药,
或贪淫过欲而成也. 若不急治, 日久精尽, 阳强不化, 迫血而出, 疼
痛不巳, 形羸而死. 或不即死, 亦必发消渴, 大痈也. 阳盛阴虚者,
宜大坎离既济汤, 加生龙骨清而补之. 形实热盛者, 宜黄连解毒汤,
加大黄先攻其热可也. 病后热去, 调理宜补精丸, 即补骨脂, 韭子,
山药, 磁石, 肉苁蓉, 人参, 鹿耳也.
1. 不梦而遗（无梦境而精液自出）是由于心肾虚弱；有梦而后遗（因梦境导致精液外泄）是由于相火亢盛。过度房事导致精滑，是清气下陷；长期禁欲导致精满自溢，或饮食肥甘厚味损伤脾胃化生内热，均会导致此病。
【注】“不梦而遗”，指心中没有邪念感应而精液自行滑脱，这是心肾虚弱、固摄无力所致。“梦而后遗”，指心中有所感应，相火煽动并强迫精液外泄，这是君相二火亢盛、固摄无力所致。或者是纵欲过度的人，习惯性地精液滑脱；或者元气不足，清气下陷而不能固摄；或者是长期禁欲的人，精气充盛而溢出排泄；或者是嗜食醇酒厚味，导致火热亢盛而不能固摄，这些都是导致遗精的病因。
2. 治疗心肾虚弱导致的遗精，用龙骨、远志丸（含朱砂、远志、神曲/茯神、茯苓、石菖蒲、人参）；治疗长期禁欲且相火旺盛者，用地黄、知母、黄柏；治疗胃虚者，用黄柏、甘草、缩砂仁。
【注】龙骨远志丸，用于治疗心肾虚弱、无梦而遗的患者，其药物组成包括龙骨、朱砂、远志、茯神、茯苓、石菖蒲、人参。坎离既济汤，用于治疗有梦而遗、相火亢盛或长期禁欲的患者，其药物组成包括生地、黄柏、知母。如果患者胃气虚弱、食欲不振、大便溏软，则不宜使用生地、知母、黄柏，因为担心苦寒之药损伤胃气，所以适宜使用封髓丹，其药物组成包括黄柏、甘草、缩砂仁。
补精丸。
3. 精液流出不止但阴茎仍保持勃起（阳强不倒），称为“强中”。这是由于过度进补或过度淫欲造成的。如果病情长久不愈，精液耗尽，阳气强盛无法转化，逼迫血液外出，疼痛不止，身体消瘦羸弱直至死亡。或者虽未立即死亡，也会发生消渴症（糖尿病类症状）或发为大痈疽。若属阳盛阴虚证，宜用大剂量的坎离既济汤，加生龙骨以清热兼补益。若属实热炽盛证，宜用黄连解毒汤，加大黄先攻泻其热。病后热邪已去，调理阶段宜用补精丸，其药物组成包括补骨脂、韭菜子、山药、磁石、肉苁蓉、人参、鹿茸。
【注】精液滑出不止，阴茎坚硬不倒，名为“强中”。这种病都是因为过服房中术中的补药，或者贪恋淫欲过度而形成的。如果不紧急治疗，日久精液耗尽，阳气强盛却无法气化，逼迫血液从尿道而出，疼痛不已，形体消瘦羸弱而死。或者即使不死，也必定会引发消渴症或严重的痈疽。属于阳盛阴虚的，适宜用大的坎离既济汤，加入生龙骨，起到清热的同时兼顾补益的作用。属于形体壮实、热势炽盛的，适宜用黄连解毒汤，加入大黄，先攻泻其热邪即可。病后热邪去除，进入调理阶段，适宜用补精丸，即由补骨脂、韭菜子、山药、磁石、肉苁蓉、人参、鹿茸组成。
1. Nocturnal emission without dreaming is caused by deficiency of the Heart and Kidney; emission after dreaming is caused by hyperactivity of ministerial fire. Excessive sexual desire leads to seminal slip due to sinking of clear qi; prolonged abstinence leads to overflow and discharge, or rich food and alcohol damage the Spleen and Stomach, both resulting in this disease.
[Note] "Emission without dreaming" refers to spontaneous leakage of semen without mental stimulation, indicating insufficiency and lack of firmness in the Heart and Kidney. "Emission after dreaming" refers to forced discharge due to mental stimulation stirring up ministerial fire, indicating hyperactivity of the two fires (Heart fire and ministerial fire) and lack of firmness. It may also occur in individuals with excessive sexual desire who are accustomed to seminal slipping; those with insufficient clear qi where clear yang sinks and fails to secure; those who have abstained for a long time, causing abundant essence to overflow; or those consuming rich wine and heavy flavors, leading to strong internal heat and failure to secure. All these constitute the pathology of this disease.
Longgu Yuanzhi Wan (Dragon Bone and Polygala Pill), Kanli Jiji Tang (Kan-Li Intersection Decoction), Fengsui Dan (Marrow-Sealing Pill).
2. For Heart-Kidney deficiency, use Longgu Yuanzhi Wan (containing Cinnabar, Polygala, Spirit of Poria, Poria, Acorus, Ginseng); for prolonged abstinence with hyperactive fire, use Rehmannia, Anemarrhena, Phellodendron; for Spleen-Stomach deficiency, use Phellodendron, Licorice, Amomum.
[Note] Longgu Yuanzhi Wan treats emission without dreaming due to Heart-Kidney deficiency; its ingredients are Dragon Bone, Cinnabar, Polygala, Spirit of Poria, Poria, Acorus, and Ginseng. Kanli Jiji Tang treats emission with dreaming due to hyperactive fire or prolonged abstinence; its ingredients are Prepared Rehmannia Root, Phellodendron Bark, and Anemarrhena Rhizome. If the patient has weak Spleen-Stomach, poor appetite, and loose stools, Prepared Rehmannia, Anemarrhena, and Phellodendron should be avoided to prevent bitter-cold herbs from damaging the Stomach Qi; instead, Fengsui Dan is suitable, consisting of Phellodendron Bark, Licorice Root, and Amomum Fruit.
Bujing Wan (Essence-Replenishing Pill).
3. Continuous seminal discharge while maintaining an erection (priapism) is called "Qiangzhong" (Hyperactive Middle). This condition results from overconsumption of aphrodisiac tonics or excessive lust. If not treated urgently, prolonged depletion of essence leads to untransformable hyperactive Yang, forcing blood out, causing incessant pain, emaciation, and death. Alternatively, if death does not occur immediately, it may develop into Xiao Ke (Wasting-Thirst) or large carbuncles. For patterns of Yang excess and Yin deficiency, use a large dose of Kanli Jiji Tang with Raw Dragon Bone to clear heat and tonify. For patterns of excess heat, use Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) with Rhubarb to first purge the heat. After the heat subsides, use Bujing Wan for recovery, consisting of Psoralea Fruit, Leek Seed, Chinese Yam, Magnetite, Cistanche Stem, Ginseng Root, and Deer Antler.
[Note] Continuous seminal discharge with persistent priapism is named "Qiangzhong." This disease arises from overusing medicinal supplements for sexual health or indulging in excessive lust. Without urgent treatment, prolonged exhaustion of essence leads to hyperactive Yang that cannot transform, forcing blood to exit, causing unremitting pain, severe emaciation, and death. Even if survival occurs, Wasting-Thirst or major carbuncles will likely develop. In cases of Yang excess and Yin deficiency, a substantial dose of Kanli Jiji Tang added with Raw Dragon Bone is indicated to clear heat while tonifying. In cases of robust constitution with intense excess heat, Huanglian Jiedu Tang added with Rhubarb is indicated to purge the heat initially. Post-illness, when heat has cleared, Bujing Wan is used for regulation, comprising Psoralea Fruit, Leek Seed, Chinese Yam, Magnetite, Cistanche Stem, Ginseng Root, and Deer Antler.