有精浊，有便浊。精浊出自精窍，与便浊之出于溺窍者大异。其出不因小便，
窍端时常牵丝带腻，如脓如眵，频拭频出，茎中或痒或痛，甚如刀刮火炙，（大抵初起
火盛则痛，日久火微则痒。）而小便自清，不相混也。多由房事时精已离位，或强忍不泄，
或被阻中止，离位之精化成败浊，流出窍端，故如脓如眵，其气臭腐。又不泄则肾
火郁而不散，败精挟郁火以出，故茎肿窍涩而痛也，日久败精尽出则止矣。而不止
者，虽火势已衰，但病久滑脱，已败之精与未败之精相引而出，故源源不绝也。若
火势不衰或反盛者，则并其未败之精亦鼓之使出。甚者精已枯竭，并其未及化精之
血亦出，故有赤浊也。（精为血化，）（观天癸初至之子，强力好色，所泄半精半血可见矣。）
其后火势亦
衰，证转虚寒者有矣。旧分赤浊为热，白浊为寒，非也。若寡欲之人患此，多因湿
热流注精房，精为所逼，不得静藏所致，与湿热遗精同理。热者清心莲子饮。寒者
萆厘清饮。虚劳者滋其阴。胃弱者参术加升麻、柴胡。湿热流注，二陈（见痰）加白术、
升、柴。感暑热者，四苓（见伤湿）加香薷、麦冬、人参、石莲肉。白浊初起势甚，败精
结塞窍道，涩痛异常，五苓（见伤湿）、妙香散合清心莲子饮。白浊清火为主，补次之。
赤浊补为主，清火次之。清心、健脾、滋肾、固脱，缺一不可，清浊饮主之。
便浊多是胃中湿热下流。伤气分则白，即膏淋也，便浊饮主之。伤血分则
赤，即血淋也，多者为尿血，治详淋证及血门溲血条。
存在精浊和便浊两种情况。精浊从精窍排出，与从尿窍排出的便浊截然不同。其排出物不混入小便中，尿道口时常牵引出丝状、黏腻的分泌物，像脓液或眼屎一样，频繁擦拭后再次流出，阴茎内部有时发痒有时疼痛，严重时如同刀刮火烤一般。（大致初起时火势旺盛则表现为疼痛，日久后火势微弱则表现为瘙痒。）而小便本身是清澈的，两者不相混合。这多由房事时精气已经偏离正常位置，或者强行忍耐不射精，或被外力阻遏导致中途停止，使得偏离位置的精气化为败坏的浊质，流出尿道口，所以像脓液或眼屎一样，气味臭腐。如果不射精，肾火就会郁结而不能发散，败坏的精液挟带郁结之火排出，所以阴茎肿胀、尿道涩痛；日久后败坏的精液全部排出后症状就会停止。如果症状不止，虽然火势已经衰退，但因为病程长久导致滑脱不禁，已败坏的精液与未败坏的精液相互牵引而出，所以源源不断。如果火势没有衰退反而旺盛，那么连未败坏的精液也会鼓动使其排出。严重的甚至精气已经枯竭，连同那些来不及化为精液的血液也一起排出，所以出现赤浊。（精液是由血液化生的，）（观察刚来天癸的少年，如果强力纵欲，所射出的物质半是精液半是血液，就可以看出这一点。）后来火势也会衰退，证候转为虚寒的情况也有。过去将赤浊分为热证，白浊分为寒证，这是错误的。如果是寡欲之人患此病，多因湿热流注到精室，精气被逼迫，不能安静潜藏所致，这与湿热遗精的原理相同。属于热证的用清心莲子饮治疗。属于寒证的用萆厘清饮治疗。属于虚劳的用滋阴法治疗。胃气虚弱的用人参、白术加上升麻、柴胡。湿热流注的，用二陈汤（见痰证章节）加白术、升麻、柴胡。感受暑热的，用四苓散（见伤湿章节）加香薷、麦冬、人参、石莲肉。白浊初起势态猛烈，败坏的精液结塞尿道，涩痛异常，用五苓散（见伤湿章节）、妙香散合清心莲子饮。白浊以清火为主，补益为辅。赤浊以补益为主，清火为辅。清心、健脾、滋肾、固脱，缺一不可，用清浊饮主治。
便浊多是胃中的湿热下流所致。损伤气分则呈白色，即膏淋，用便浊饮主治。损伤血分则呈红色，即血淋，量多者为尿血，治疗方法详见淋证及血门溲血条。
There are two types: Jing Zhuo (Essence Turbidity) and Bian Zhuo (Urine Turbidity). Jing Zhuo originates from the essence orifice, which is significantly different from Bian Zhuo that exits through the urinary orifice. The discharge does not mix with urine; instead, at the tip of the urethra, there is often a traction of thread-like, greasy secretions resembling pus or eye discharge. It appears frequently even after wiping, and the penis may feel itchy or painful, sometimes severely as if scraped by a knife or burned by fire. (Generally, in the early stage when Fire is excessive, pain predominates; in later stages when Fire is diminished, itching predominates.) Meanwhile, the urine itself remains clear, without mixing with the turbid discharge. This condition mostly arises because during sexual intercourse, the essence has already deviated from its proper position, or due to forcibly suppressing ejaculation, or being obstructed causing mid-coitus cessation. The deviated essence transforms into spoiled turbidity, flowing out from the orifice, thus resembling pus or eye discharge with a foul, putrid odor. If ejaculation does not occur, Kidney Fire becomes stagnant and cannot disperse; the spoiled essence carries this stagnant Fire out, causing penile swelling, urethral astringency, and pain. After a long period, once all spoiled essence is expelled, the symptoms cease. However, if symptoms persist, although the Fire pathogen has declined, the prolonged illness leads to slipping and incontinence; the spoiled essence attracts unspoiled essence to exit together, resulting in a continuous flow. If the Fire pathogen does not decline but rather intensifies, it drives even the unspoiled essence to exit. In severe cases, the essence may be exhausted, and blood that has not yet transformed into essence also flows out, leading to Chi Zhuo (Red Essence Turbidity). (Essence is transformed from Blood.) (Observing boys who have just received Tian Gui [menstruation/seminal fluid], if they exert themselves strongly and indulge in lust, the discharged material being half essence and half blood demonstrates this.) Later, the Fire pathogen may also decline, and the syndrome may transform into deficiency-cold. The old classification of Chi Zhuo as Heat and Bai Zhuo (White Essence Turbidity) as Cold is incorrect. For individuals with low libido suffering from this, it is mostly caused by Damp-Heat flowing into the Jing Fang [Essence Chamber], forcing the essence and preventing it from resting quietly; this shares the same principle as Damp-Heat spermatorrhea. For Heat patterns, Qing Xin Lian Zi Yin (Clear Heart Lotus Seed Decoction) is used. For Cold patterns, Bi Li Qing Yin (Bi Li Clearing Decoction) is used. For deficiency exhaustion, Yin is nourished. For weak Stomach Qi, Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Rhizome) are added with Sheng Ma (Cimicifugae Rhizome) and Chai Hu (Bupleuri Radix). For Damp-Heat flow-in, Er Chen Tang (Two-Cured Decoction) [see Phlegm chapter] is used with added Bai Zhu, Sheng Ma, and Chai Hu. For Summer-Heat sensation, Si Ling San (Four-Poria Powder) [see Injury by Dampness chapter] is used with added Xiang Ru (Moslae Herba), Mai Dong (Ophiopogonis Radix), Ren Shen, and Shi Lian Rou (Nelumbinis Semen). When Bai Zhuo begins with intense momentum, where spoiled essence blocks the orifices causing abnormal astringency and pain, Wu Ling San (Five-Poria Powder) [see Injury by Dampness chapter], Miao Xiang San (Wonderful Fragrance Powder), and Qing Xin Lian Zi Yin are combined. Treatment for Bai Zhuo focuses primarily on clearing Fire, with tonification as secondary. Treatment for Chi Zhuo focuses primarily on tonification, with clearing Fire as secondary. Clearing the Heart, strengthening the Spleen, nourishing the Kidney, and securing leakage are indispensable; Qing Zhuo Yin (Qing Zhuo Decoction) is the principal formula.
Bian Zhuo is mostly caused by Damp-Heat from the Stomach flowing downward. If it injures the Qi level, it presents as white, known as Gao Lin (Paste Strangury), treated principally with Bian Zhuo Yin. If it injures the Blood level, it presents as red, known as Xue Lin (Blood Strangury); if the amount is large, it is Hematuria, with treatment detailed in the Strangury Syndrome and Bleeding from Urine sections under the Blood category.