丹溪壮年有梦遗证。用凤髓丹、河间秘真丸。唯有小效。遗终不除。改用远志、菖蒲、
桑螵蛸、益智仁、韭子、枣仁、牡蛎、龙骨、锁阳等为丸。服之寻愈。
一人年六十五。精滑常流。丹溪以黄柏、知母、蛤粉、牡蛎、山药饭丸。盐汤下。
一人每至夜。脊心热而梦遗。丹溪用珍珠粉丸、猪苓丸。遗止。终服紫雪。脊热毕除。
一人虚损。盗汗遗精白浊。丹溪用四物加参、 、术、牡蛎、五味、杜仲煎服而愈。
丹溪治郑叔鲁。年二十余。夜读书常至四鼓。忽得疾。卧时但阴器着物。便梦遗。不着
则否。饮食日减。倦怠少气。盖以用心太过。二火俱起。夜弗就枕。则血不归肝而肾水渐亏
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
接内之梦也。于是上补心安神。中调脾胃升其阳。下用益精生阴固阳之剂。不三月而疾如失
一人梦遗白浊。少腹有气耕冲。每日腰热。卯作酉凉。若腰热作则手足冷。前阴无气来
耕。腰热退。则前阴气耕。手足温。又旦多下气。暮多噫。一旬二旬必遗。朱诊之。脉旦弦
搏而大。午尤洪大。知其有郁滞也。先用滚痰丸大下之。次用加减八物汤。下滋肾丸百粒。
若稍与蛤、牡等涩药。则遗与浊滋甚。或一夜二遗。遂改用导赤散大剂。而遗浊皆止。
又二中年男子。皆梦遗。医与涩药反甚。连遗数夜。丹溪先与神芎丸大下之。继制猪苓
丸。服之皆痊。
镇海万户萧伯善。以便浊而精不禁。百药罔效。丹溪用倒仓法而愈。于此见梦遗属郁滞
者多矣。
一老人年六十岁。患疟而嗽。多服四兽饮。积成湿热。乘于下焦。已岌岌乎殆矣。丹溪
诊之。尺数而有力。与补中益气加凉剂。三日。与黄柏丸。次早尺数顿减。询其有夜梦否。
曰。有之。幸不泄耳。是盖年老精衰。固无以泄。从前大热结于精房。今得泄火益阴之药。
其火散走于阴窍。疾可廖矣。再服两日而又梦。疟嗽全愈。
震按梦遗原是恶病。此条及广笔记载张涟水治纪华山案。却以梦遗愈病。盖此条乃热结
下焦。纪生乃郁结中焦。其肾系久不通于心。忽然得通。则伏邪随之而泄。瘀垢随之而下。
故本病随愈。亦由两人向来葆养。精元未竭耳。若纵欲者。及素有梦泄者。不能望此侥幸也
汪石山治一人。年四十余。泄精久之。神不守舍。梦乱心跳。用清心莲子饮罔效。取袖
珍方治小便出髓条服之。又服小菟丝子丸。又服四物加黄柏俱罔效。汪诊之。一日间其脉或
浮濡而快。或沉弱而缓。曰。脉之不常。虚之故也。其证初因肾水有亏。以致心火亢极乘金
木寡于畏而侮其脾。此心脾肾三经之病。理宜补脾为主。兼之滋胃养心。病可疗也。方用
人参为君。白术、茯苓、麦冬、枣仁、栀子、生甘草为佐。莲肉、山楂、黄柏、陈皮为使。
其他牡蛎、龙骨、白芍、川芎、熟地之类。随其变证而出入之。且曰。必待人参加至五钱病
脱。其人未信。服二十余日。人参每服三钱。溲精减半矣。又月余。加人参至五钱。寻愈。
盛启东治郁文质遗精。形体羸弱。兼痰嗽交作。日夕不能休。群医治之转剧。盛视之曰
此阳脱也。急治则生。缓则死。非大料重剂则不能疗。于是以附子、天雄、合参、苓、白
术。昼夜服之。自秋徂冬。约服附子百余枚。厥疾乃廖。
震阅叶案治项姓者梦遗。色黄食少。腹胀便溏。用生菟丝、覆盆、蛇床、五味、韭子、
益智、补骨脂、龙骨。以建莲粉丸。较之此案。温热稍轻。而灵巧更胜矣。一友仿之治一梦
遗久者。色悴食减。常加伤风咳嗽。服诸补肾涩精药无效。乃用巴戟、苁蓉、骨脂、鹿茸、
阳起石、桂、附等而愈。是又善学盛御医者。叶天翁又治一人遗滑。月五六作。兼有腹痛。
触冷即痛。痛极昏晕。初以荆公妙香散。不应。乃用鹿茸二钱。人参一钱。雄羊肾十枚去膜
研。茯神、龙骨各一钱五分。金樱膏三钱。十剂而愈。
江篁南治一壮年。患遗精。医用滋阴降火罔效。更医。用龙、牡等止涩药。其精愈泄。
又服芩、连、知、柏等药甚多。兼服小便。亦罔效。又或作痰火治。作湿热治。盖年余矣。
江诊之。左脉浮濡无力。右寸浮散近快。两尺尤弱。不任寻按。其人头晕。腰痛骨酸。畏风
小便黄。腹中时鸣。乃以熟地、远志、人参、归身、桑螵蛸、石莲、茯神、石菖蒲、甘草
十余帖后。精固。惟筋骨犹酸。小便犹黄。腹或至晚犹鸣。前方再加黄柏。兼用补阴丸。
加人参、鹿茸、菟丝、桑螵蛸、茯神之类丸服。两月而愈。
李士材治武科张宁之。禀质素强。纵饮无度。忽小便毕。有白精数点。自以为有余之疾
不肯医治。经三月以来。虽不小便。时有精出。觉头目眩运。因服固精涩脱之剂。治疗两
月。略不见功。李诊之。六脉滑大。此由酒味湿热。不干精藏。遂以白术、茯苓、橘红、甘
草、干葛、白蔻。加黄柏少许。两剂即效。不十日而康复如常人。
周慎斋治一人。知饱不知饥。胸膈饱闷。脾虚也。常起火。喉痛。口唇生疮。牙根作胀
齿缝出血。火在上。上盛也。骨酸痛。不能久立。鸡鸣精自遗。下虚也。上盛下虚。所谓
阳精下降其人夭。名曰下消。善治不若善养。用补中益气汤以散上焦之火。六味汤以实下焦
之肾。所以敛火归本也。
震按向来医书咸云。有梦而遗者。责之心火。无梦而遗者。责之肾虚。二语诚为括要。
以予验之。有梦无梦。皆虚也。不虚则肾坚精固。交媾犹能久战。岂有一梦即遗之理。故治
此证者。惟湿热郁滞二项。勿以虚治。而二项又各分二种。曲 之湿热。宜端本丸。膏粱之
湿热。宜猪 丸。积痰之郁滞。宜滚痰丸、神芎丸。伏火之郁滞。宜滋肾丸、猪苓丸。除此
二项。必须人参。如荆公妙香散以治心虚。桑螵蛸散以治肾虚。三才封髓丹以治阴虚。固精
丸以治阳虚。或分用。或合用。再参之以熟地、萸肉、湘莲、芡实、五味、牡蛎、线胶、金
樱膏。而已无余蕴矣。然亦有效有不效。则因虚者之有小虚有大虚。而虚者之心。或有嗜欲
或无嗜欲也。人若于欲事看得雪淡。更极畏怕。则熟寐时亦能醒觉。先贤云。醉犹温克方
称学。梦亦斋庄始见功。此为上乘。其次则用刘海蟾吸撮提三字。做运想功夫。先以一擦一
兜
左右换手。九九之数。真阳不走之诀。继以一吸便提气。气归脐。一提便咽。水火相见之
诀。久久行之。功成可以不泄。尚有欲念。再于上床临睡时。以两手大肉擦热。反向背后擦
肾穴三十六次。肾 热则相火不作。夜无淫梦。斯皆应验之金丹。殊胜 咀之草药。故不
惮饶舌以告同人。
朱丹溪在壮年时患有梦遗的病症。使用凤髓丹、河间秘真丸治疗，仅有轻微疗效，遗精症状始终未能消除。后来改用远志、石菖蒲、桑螵蛸、益智仁、韭菜子、酸枣仁、牡蛎、龙骨、锁阳等药物制成丸剂服用，不久便痊愈了。
有一位六十五岁的老人，经常滑精流出。朱丹溪用黄柏、知母、蛤粉、牡蛎、山药（以米饭为粘合剂）制成丸剂，用盐汤送服。
有一位患者每到夜晚，脊背中间发热并伴有梦遗。朱丹溪使用珍珠粉丸、猪苓丸治疗，遗精停止后，继续服用紫雪散，脊背发热彻底消除。
有一位身体虚损的患者，出现盗汗、遗精、白浊的症状。朱丹溪用四物汤加入人参、[此处原文缺字，通常指黄芪或类似补气药]、白术、牡蛎、五味子、杜仲煎服而愈。
朱丹溪治疗郑叔鲁，年龄二十多岁。他晚上读书常常到凌晨四点，突然患病。睡觉时只有阴茎接触衣物才会梦遗，不接触就不会。饮食日渐减少，疲倦乏力、气短。这是因为用心过度，导致心火与相火同时升起。夜里如果不躺下休息，血液就不能归藏于肝，肾水逐渐亏损，火热乘阴虚之机，侵入下焦，扰动精室，使得精气不能聚藏而欲外泄。因为玉茎接触物体，如同邪气客居其中，所以产生性交的梦。于是，朱丹溪在上部补心安神，在中部调理脾胃升发阳气，在下部使用益精生阴、固护阳气的药剂，不到三个月病就好了。
有一位患者梦遗、白浊，少腹部有气向上冲逆，每天腰部发热，早晨发作傍晚凉退。如果腰部发热发作时，手足冰冷，前阴没有气上冲的感觉；腰部热退时，前阴才有气上冲，手足变暖。而且早晨多排气，傍晚多打嗝。每隔十天或二十天必定遗精。朱丹溪诊察发现，早晨脉象弦搏且大，中午尤其洪大，知道体内有郁滞。先用滚痰丸大力攻下，接着用加减八物汤，再服用滋肾丸一百粒。如果使用蛤壳、牡蛎等收敛固涩的药物，遗精和白浊会更加严重，甚至一夜遗精两次。于是改用导赤散大剂量服用，遗精和白浊都停止了。
又有两位中年男子，都有梦遗。医生给予收敛固涩的药物反而加重，连续几夜遗精。朱丹溪先用神芎丸大力攻下，随后配制猪苓丸，服用后都痊愈了。
镇海万户萧伯善，因小便浑浊且精关不固，各种药物无效。朱丹溪采用倒仓法治疗而痊愈。从这里可以看出，梦遗属于郁滞证候的情况很多。
一位六十岁的老人，患疟疾兼咳嗽。长期服用四兽饮，积成湿热，侵袭下焦，病情危急。朱丹溪诊察发现尺脉数而有力，给予补中益气汤加上清热凉血药剂。三天后，改服黄柏丸。第二天早上尺脉数象顿减。询问是否有夜间做梦，回答说有，幸好没有射精。这大概是年老精气衰败，本来就没有什么可泄的。之前的大热结聚在精室，现在得到泻火益阴的药物，火热之气散走于阴窍，疾病可以治愈了。再服用两天又做了梦，但疟疾和咳嗽完全好了。
俞震按语：梦遗原本被认为是难治的疾病。这一条以及《广笔记》记载张涟水治疗纪华山的医案，却是通过治疗梦遗使其他疾病痊愈。大概这一条是热结下焦，纪华山则是郁结中焦，他的肾系长久不通于心，忽然得以通畅，潜伏的病邪随之而泄，瘀垢随之而下，所以本病随之痊愈。这也是因为这两人向来注重保养，元气未竭的缘故。如果是纵欲的人，以及素来有梦遗滑精的人，是不能指望这种侥幸的。
汪石山治疗一个人，四十多岁，泄精很久，神不守舍，梦境混乱、心跳。使用清心莲子饮无效。取《袖珍方》治疗小便出髓的条文服用，又服用小菟丝子丸，又服用四物汤加黄柏，都无效。汪石山诊察发现，一天之内脉象有时浮濡而快，有时沉弱而缓，说：脉象不恒定，是因为虚的缘故。这个病症起初因为肾水亏虚，导致心火亢极，金木缺乏制约而侮脾。这是心、脾、肾三经的病变，理应以补脾为主，兼以滋胃养心，病可以治疗。方用人参为君药，白术、茯苓、麦冬、酸枣仁、栀子、生甘草为佐药，莲肉、山楂、黄柏、陈皮为使药。其他的如牡蛎、龙骨、白芍、川芎、熟地黄之类，根据变化的证候增减。并且说：必须等人参加到五钱，病才能脱去。那人起初不信，服用二十多天，每次服人参三钱，漏精减半。又过一个月，将人参加到五钱，不久痊愈。
盛启东治疗郁文质遗精，形体瘦弱，兼有痰嗽交替发作，日夜不得休息。众医治疗反而加重。盛启东视诊说：这是阳气外脱。紧急治疗能活，迟缓则死。不用大剂量重剂不能治疗。于是用附子、天雄，合用人参、茯苓、白术，昼夜服用。从秋天到冬天，大约服用了百余枚附子，重病才痊愈。
俞震阅读叶天士医案，治疗姓项的人梦遗，面色黄，食少，腹胀便溏。使用生菟丝子、覆盆子、蛇床子、五味子、韭菜子、益智仁、补骨脂、龙骨，以建莲粉制成丸剂。比起本案，药性温热稍轻，但手法更灵巧。一位朋友模仿此法治疗一个久患梦遗的人，面色憔悴，食欲减退，常伴有伤风咳嗽。服用各种补肾涩精药无效，于是用巴戟天、肉苁蓉、补骨脂、鹿茸、阳起石、桂枝、附子等而痊愈。这又是善于学习盛御医医术的人。叶天士又治疗一人遗精滑泄，每月发作五六次，兼有腹痛，受冷即痛，痛极昏晕。起初用荆公妙香散，无效，于是用鹿茸二钱，人参一钱，雄羊肾十枚去膜研碎，茯神、龙骨各一钱五分，金樱膏三钱，十剂而愈。
江篁南治疗一个壮年人，患遗精。医生用滋阴降火无效。换医生用龙骨、牡蛎等止涩药，精液更加泄漏。又服用黄芩、黄连、知母、黄柏等药很多，兼服小便（此处疑为笔误或特定疗法，原文如此），也无效。或者作为痰火治，作为湿热治，已经一年多了。江篁南诊察发现，左脉浮濡无力，右寸脉浮散近快，两尺脉尤其虚弱，不耐寻按。其人头晕，腰痛骨酸，畏风，小便黄，腹中时常鸣响。于是用熟地黄、远志、人参、当归身、桑螵蛸、石莲子、茯神、石菖蒲、甘草，十余帖后，精液固摄住了，只是筋骨仍然酸痛，小便仍然黄，腹部有时到晚还鸣响。前方再加黄柏，兼用补阴丸，加入人参、鹿茸、菟丝子、桑螵蛸、茯神之类制成丸剂服用，两个月痊愈。
李士材治疗武科考生张宁之，禀赋体质素来强壮，纵酒无度。忽然在小便结束后，有几点白色精液流出，自以为有余之疾，不肯医治。经过三个月以来，即使不小便，也有精液不时流出，感觉头目眩晕。因此服用固精涩脱的药物，治疗两个月，略微不见功效。李士材诊察发现，六脉滑大，这是由于酒味湿热，不干犯精藏（此处原文逻辑似有转折，意指湿热非直接伤精，或湿热阻滞导致精关不固，结合下文用药看，主要是湿热）。遂用白术、茯苓、橘红、甘草、干葛、白蔻，加少许黄柏，两剂即见效，不到十天康复如常人。
周慎斋治疗一个人，知道饱不知道饿，胸膈饱闷，这是脾虚。经常起火，喉咙痛，口唇生疮，牙根作胀，齿缝出血，这是火在上，上盛。骨节酸痛，不能久立，鸡鸣时分精液自遗，这是下虚。上盛下虚，所谓“阳精下降”会导致夭折，名叫下消。善于治疗不如善于调养。用补中益气汤以疏散上焦之火，用六味地黄丸以充实下焦之肾，以此来敛火归元。
俞震按语：向来医书都说，有梦而遗的，责任在心火；无梦而遗的，责任在肾虚。这两句话确实概括了要点。以我的经验验证，有梦无梦，都是虚证。不虚则肾坚精固，交媾还能持久，怎么会有做一梦就遗精的道理？所以治疗这个证候，只有湿热和郁滞两项，不要当作虚证治疗。而这两项又各自分为两种：曲蘖（酒类）引起的湿热，宜用端本丸；膏粱厚味引起的湿热，宜用猪肚丸（原文“猪 丸”，据上下文及常见方剂推测为猪肚丸或类似方，此处保留原文意译倾向或通用名，若严格对应古籍可能指猪肚丸或猪苓丸类，鉴于前文有猪苓丸，此处“猪 丸”极大概率为“猪肚丸”或“猪苓丸”之漏字，考虑到前文已提猪苓丸治伏火，此处治湿热膏粱，传统多用猪肚丸或类似健脾化湿方，但为严谨起见，译文依原文结构处理，注：古籍中“猪 丸”常指猪肚丸治膏粱湿热）。积痰引起的郁滞，宜用滚痰丸、神芎丸；伏火引起的郁滞，宜用滋肾丸、猪苓丸。除了这两项，必须用人参。如荆公妙香散以治疗心虚，桑螵蛸散以治疗肾虚，三才封髓丹以治疗阴虚，固精丸以治疗阳虚。或者分用，或者合用，再参入熟地黄、山茱萸、湘莲、芡实、五味子、牡蛎、线胶、金樱膏，就没有遗漏了。然而也有有效和无效的，这是因为虚证有小虚和大虚之分，而虚证者的心念，有的有嗜欲，有的没有嗜欲。人如果在房事看得很淡薄，更加敬畏害怕，那么在熟睡时也能醒觉。先贤说：醉酒还能保持清醒克制才称得上学问，做梦也能庄重端正才见到功夫。这是上乘境界。其次则用刘海蟾的吸、撮、提三个字，做运想功夫。先用两手互相擦拭，左右换手，九九之数，这是真阳不走的秘诀。继之以一吸气便提气，气归于脐，一提便吞咽，这是水火相见的秘诀。久久实行，功成可以不泄。如果还有欲念，再在上床临睡时，用两手大鱼际擦热，反向背后擦拭肾穴三十六次，肾热则相火不作，夜间没有淫梦。这些都是应验的金丹，胜过咀嚼草药。所以不怕啰嗦地告诉同仁。
Zhu Danxi suffered from nocturnal emission during his prime. He used Fengsui Dan (Phoenix Marrow Pill) and Hejian Mizhen Wan (Secret True Pill of Liu Wansu), but only achieved slight effect, and the emission persisted. He then switched to pills made from Yuanzhi (Polygala Root), Shichangpu (Acorus Rhizome), Sangpiaoxiao (Mantis Egg Case), Yizhiren (Bitter Apricot Seed), Jiuizi (Leek Seed), Zaoren (Sour Jujube Seed), Muli (Oyster Shell), Longgu (Fossilized Bone), and Suoyang (Cynomorium) taken orally, and recovered soon after.
A sixty-five-year-old man frequently experienced spermatorrhea. Zhu Danxi prescribed a pill made of Huangbai (Phellodendron Bark), Zhimu (Anemarrhena Rhizome), Ha Fen (Clam Shell Powder), Muli (Oyster Shell), and Shanyao (Dioscorea Rhizome) bound with rice paste, administered with salt water.
A patient experienced heat in the center of the spine and nocturnal emission every night. Zhu Danxi treated him with Zhenzhu Fen Wan (Pearl Powder Pill) and Zhuling Wan (Polyporus Pill). The emission stopped, and after continuing to take Zixue (Purple Snow), the spinal heat was completely eliminated.
A patient with deficiency damage suffered from night sweats, nocturnal emission, and leukorrhea (white turbid discharge). Zhu Danxi prescribed Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng), [missing character, likely Huangqi or similar], Baizhu (Atractylodes Macrocephala Rhizome), Muli (Oyster Shell), Wuweizi (Schisandra Fruit), and Duzhong (Eucommia Bark) decocted and taken orally, resulting in recovery.
Zhu Danxi treated Zheng Shulu, who was in his twenties. He often read books at night until four o'clock in the morning and suddenly fell ill. When lying down, he would have nocturnal emission only if his genitalia touched clothing; otherwise, it did not occur. His diet decreased daily, and he felt fatigued and short of breath. This was due to excessive mental exertion, causing both Heart Fire and Ministerial Fire to arise. If he did not lie down to sleep at night, blood would not return to the Liver, and Kidney Water would gradually decline. Fire, taking advantage of Yin deficiency, invaded the Lower Jiao, disturbing the Essence Chamber, preventing the essence from gathering and storing, thus causing it to leak. Because the penis touching objects was like pathogenic Qi lodging there, it generated dreams of sexual intercourse. Therefore, Zhu Danxi tonified the Heart and calmed the Spirit above, regulated the Spleen and Stomach to raise Yang in the middle, and used formulas to benefit Essence, generate Yin, and secure Yang below. Within three months, the illness disappeared as if it had never existed.
A patient suffered from nocturnal emission and leukorrhea, with Qi rushing upward in the lower abdomen, daily heat in the waist, starting in the morning and subsiding by evening. When the waist heat flared up, the hands and feet were cold, and there was no sensation of Qi rushing in the anterior yin; when the waist heat subsided, Qi rushed in the anterior yin, and the hands and feet warmed. Furthermore, he passed gas more in the morning and belched more in the evening, with emissions occurring every ten or twenty days. Zhu Danxi diagnosed the pulse as wiry, forceful, and large in the morning, and especially flooding and large at noon, indicating stagnation. He first used Guntan Wan (Rolling Phlegm Pill) for strong purgation, followed by Jiaban Bawu Tang (Modified Eight Ingredients Decoction), and then took Zishen Wan (Nourish Kidney Pill) one hundred pills. If he used astringent herbs like Geke (Clam Shell) or Muli (Oyster Shell), the emission and turbidity worsened, sometimes occurring twice in one night. Thus, he switched to Da Ji Daochi San (Large Dose Guide Out the Heat Powder), which stopped both emission and turbidity.
Two other middle-aged men also suffered from nocturnal emission. Doctors gave them astringent herbs, which aggravated the condition, leading to several nights of consecutive emissions. Zhu Danxi first used Shenxiong Wan (God Celosia and Ligusticum Pill) for strong purgation, then prepared Zhuling Wan (Polyporus Pill), and both recovered.
Xiao Boshan, the Ten Thousand Household Commander of Zhenhai, suffered from cloudy urine and uncontrollable seminal emission. All medicines failed. Zhu Danxi cured him using the Daocang Fa (Reversing Granary Method). This shows that many cases of nocturnal emission are due to stagnation.
A sixty-year-old elderly man suffered from malaria and cough. He had taken Six Beasts Yin (Six Beast Decoction) for a long time, accumulating damp-heat that attacked the Lower Jiao, leaving him in critical condition. Zhu Danxi diagnosed the Chi (Kidney) pulse as rapid and forceful, and prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus cooling agents. After three days, he prescribed Huangbai Wan (Phellodendron Pill). The next morning, the rapidity of the Chi pulse decreased sharply. Asking if he had dreams, the patient replied yes, but fortunately without emission. This was likely because old age had depleted his essence, so there was little to emit. Previously, severe heat had accumulated in the Essence Chamber; now, with fire-clearing and Yin-nourishing medicine, the fire dispersed through the Yin orifices, and the disease could be cured. After two more days of medication, he dreamed again, but the malaria and cough were completely healed.
Yu Zhen commented: Nocturnal emission is originally considered a difficult disease. This case and the record of Zhang Lianshui treating Ji Huashan in *Guang Biji* show that curing nocturnal emission can cure other diseases. In this case, heat was stuck in the Lower Jiao; in Ji's case, stagnation was in the Middle Jiao. His Kidney channel had been blocked from connecting to the Heart for a long time; suddenly becoming unblocked allowed latent pathogens to drain out and stasis to descend, thus curing the primary disease. This was also because both individuals had previously maintained their health well, and their primordial essence was not exhausted. Those who indulge in lust or have a history of nocturnal emission cannot hope for such luck.
Wang Shishan treated a man in his forties who had been leaking semen for a long time, with spirit not residing in its house, chaotic dreams, and palpitations. Qingxin Lianzi Yin (Clear Heart Lotus Seed Decoction) was ineffective. He took the prescription for "marrow coming out with urine" from *Xiuzhen Fang*, then Xiao Tusizi Wan (Small Dodder Seed Pill), then Siwu Tang added with Huangbai, all to no avail. Wang diagnosed that within one day, the pulse was sometimes floating, soft, and fast, and sometimes deep, weak, and slow. He said: The irregularity of the pulse is due to deficiency. The syndrome initially arose from Kidney Water deficiency, causing Heart Fire to hyperactive and overwhelm Metal and Wood, which lack restraint and insult the Spleen. This is a disease of the Heart, Spleen, and Kidney meridians. It should be treated primarily by tonifying the Spleen, supplemented by nourishing the Stomach and calming the Heart. The formula used Renshen (Ginseng) as the sovereign herb, Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Maidong (Ophiopogon Tuber), Zaoren (Sour Jujube Seed), Zhizi (Gardenia Fruit), and Sheng Gancao (Raw Licorice Root) as ministers, Lianrou (Lotus Seed Flesh), Shanzha (Hawthorn Fruit), Huangbai (Phellodendron Bark), and Chenpi (Tangerine Peel) as guides. Other herbs like Muli (Oyster Shell), Longgu (Fossilized Bone), Baishao (White Peony Root), Chuanxiong (Ligusticum Rhizome), and Shudihuang (Prepared Rehmannia Root) were added or removed according to changing symptoms. He stated: The illness will only depart when Renshen reaches five qian. The patient did not believe it initially. After taking it for over twenty days, with each dose containing three qian of Ginseng, seminal leakage halved. After another month, the Ginseng dose was increased to five qian, and he recovered soon after.
Sheng Qidong treated Yu Wenqing for nocturnal emission. The patient was emaciated and suffered from alternating phlegm and cough, unable to rest day or night. Other doctors' treatments made it worse. Sheng examined him and said: This is Yang collapse. Urgent treatment saves life; delay leads to death. Only heavy doses of potent herbs can treat it. Thus, he used Fuzi (Aconite Root), Tianxiong (Aconite Root lateral process), combined with Renshen (Ginseng), Fuling (Poria), and Baizhu (Atractylodes Macrocephala Rhizome), administered day and night. From autumn to winter, approximately one hundred pieces of Fuzi were consumed before the serious illness was cured.
Yu Zhen reviewed Ye Tianshi's medical case of a Mr. Xiang suffering from nocturnal emission, yellow complexion, poor appetite, abdominal distension, and loose stools. Ye used Sheng Tusizi (Raw Dodder Seed), Fupenzi (Raspberry), Chuangsuo (Cnidium Fruit), Wuweizi (Schisandra Fruit), Jiuizi (Leek Seed), Yizhiren (Bitter Apricot Seed), Buguzhi (Psoralea Fruit), and Longgu (Fossilized Bone), formed into pills with Jianlian Fen (Lotus Root Starch). Compared to this case, the warming nature was slightly lighter, but the skillfulness was superior. A friend imitated this method to treat a chronic nocturnal emission case with sallow complexion and reduced appetite, often accompanied by wind-cold cough. Various kidney-tonifying and astringent herbs were ineffective. He used Bajitian (Morinda Root), Congrong (Cistanche Stem), Buguzhi (Psoralea Fruit), Lurong (Deer Antler), Yangqishi (Leucogynum Ore), Guizhi (Cinnamon Twig), and Fuzi (Aconite Root), resulting in recovery. This person was good at learning from Master Sheng. Ye Tianshi also treated another patient with frequent nocturnal emission and sliding, occurring five or six times a month, accompanied by abdominal pain triggered by cold, extreme pain causing fainting. Initially, Jinggong Miaoxiang San (Lord Jing's Wonderful Fragrance Powder) was ineffective. Then, Lurong (Deer Antler) two qian, Renshen (Ginseng) one qian, ten male sheep kidneys (deveined and ground), Fushen (Poria with Hostwood) one qian five fen, Longgu (Fossilized Bone) one qian five fen, and Jinying Gao (Cherokee Rose Fruit Paste) three qian were used. Ten doses resulted in recovery.
Jiang Huangnan treated a young man suffering from nocturnal emission. Doctors used Yin-nourishing and fire-descending methods without success. Another doctor used astringents like Longgu (Fossilized Bone) and Muli (Oyster Shell), causing even more leakage. Many Qin (Scutellaria), Lian (Skullcap), Zhimu (Anemarrhena), and Huangbai (Phellodendron) were taken, along with drinking urine, all without effect. It was treated as phlegm-fire or damp-heat for over a year. Jiang diagnosed the left pulse as floating, soft, and powerless; the right Cun (Inch) position as floating, scattered, and near-fast; the two Chi (Kidney) positions especially weak, intolerant of pressure. The patient had dizziness, lower back pain, bone soreness, aversion to wind, yellow urine, and borborygmus in the abdomen. He prescribed Shudihuang (Prepared Rehmannia Root), Yuanzhi (Polygala Root), Renshen (Ginseng), Danggui Shen (Angelica Sinensis Root Tip), Sangpiaoxiao (Mantis Egg Case), Shilian (Stone Lotus Seed), Fushen (Poria with Hostwood), Shichangpu (Acorus Rhizome), and Gancao (Licorice Root). After more than ten doses, the essence was secured, but bones and sinews remained sore, urine remained yellow, and borborygmus occurred in the evenings. Huangbai (Phellodendron Bark) was added to the previous formula, combined with Buyin Wan (Nourish Yin Pill), and pills made of Renshen (Ginseng), Lurong (Deer Antler), Tusizi (Dodder Seed), Sangpiaoxiao (Mantis Egg Case), and Fushen (Poria with Hostwood) were taken. Recovery occurred in two months.
Li Shicai treated Zhang Ningzhi, a military candidate, whose constitution was naturally strong but who indulged in alcohol excessively. Suddenly, after urination, a few drops of white essence appeared. He thought it was a sign of excess and refused treatment. For three months, even without urinating, essence leaked out occasionally, accompanied by dizziness. He took astringent and essence-stabilizing herbs for two months with no improvement. Li diagnosed the six pulses as slippery and large, attributing it to damp-heat from alcohol. He prescribed Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Juhong (Red Tangerine Peel), Gancao (Licorice Root), Gegen (Kudzu Root), Baiko Dou (White Cardamom), with a small amount of Huangbai (Phellodendron Bark). Two doses showed effect, and within ten days, he recovered like a normal person.
Zhou Shenzhai treated a man who knew fullness but not hunger, with chest and diaphragm fullness and oppression, indicating Spleen deficiency. He frequently had fire rising, causing sore throat, mouth ulcers, swollen gums, and bleeding gums, indicating excess fire above. Bone and joint soreness, inability to stand for long, and spontaneous seminal emission at dawn indicated deficiency below. Excess above and deficiency below, known as "Yang essence descending," leads to premature death, named Xia Xiao (Lower Consumption). Good treatment is better than good nursing. He used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to disperse upper Jiao fire, and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to solidify lower Jiao Kidney, thereby gathering fire and returning it to its source.
Yu Zhen commented: Medical books generally state that nocturnal emission with dreams is blamed on Heart Fire, while emission without dreams is blamed on Kidney deficiency. These two phrases indeed summarize the essentials. Based on my experience, both with and without dreams indicate deficiency. If not deficient, the Kidney is firm and essence is solid, allowing prolonged intercourse during mating. How could one dream and immediately emit? Therefore, treating this syndrome involves only two categories: damp-heat and stagnation. Do not treat it as deficiency. Each of these two categories is further divided into two types: Damp-heat from alcohol should use Duanben Wan (Root-Correcting Pill); damp-heat from rich food should use Zhudu Wan (Pig Stomach Pill - *Note: Text says 'Zhu [blank] Wan', inferred as Zhudu Wan based on context of rich food*). Phlegm accumulation stagnation should use Guntan Wan (Rolling Phlegm Pill) and Shenxiong Wan (God Celosia and Ligusticum Pill); latent fire stagnation should use Zishen Wan (Nourish Kidney Pill) and Zhuling Wan (Polyporus Pill). Apart from these two categories, Renshen (Ginseng) is essential. Use Jinggong Miaoxiang San (Lord Jing's Wonderful Fragrance Powder) for Heart deficiency, Sangpiaoxiao San (Mantis Egg Case Powder) for Kidney deficiency, Santian Fengsui Dan (Three Capabilities Sealing Marrow Elixir) for Yin deficiency, and Gujing Wan (Essence-Securing Pill) for Yang deficiency. They can be used separately or combined, supplemented with Shudihuang (Prepared Rehmannia Root), Yurou (Cornus Fruit), Xianglian (Lotus Seed), Qianshi (Euryale Seed), Wuweizi (Schisandra Fruit), Muli (Oyster Shell), Xianjiao (Donkey-Hide Gelatin), and Jinying Gao (Cherokee Rose Fruit Paste), leaving nothing omitted. However, some respond and some do not, because deficiencies vary in degree, and the minds of deficient patients differ in desires. If a person views sexual matters lightly and fears them greatly, they can wake up even during deep sleep. Ancients said: One who remains sober while drunk truly demonstrates learning; one who remains solemn in dreams truly demonstrates merit. This is the highest level. Secondly, use the three characters of Liu Haichan: Xi (Inhale), Cuo (Pinch), Ti (Lift), practicing visualization. First, rub hands together, switching sides, ninety-nine times, a secret to prevent true Yang from escaping. Then, upon inhalation, lift Qi, guiding Qi to the navel; upon lifting, swallow, a secret of water and fire meeting. Practiced over time, non-emission can be achieved. If desires remain, before going to bed, rub the thenar eminences of both hands until hot, then rub backwards against the Kidney acupoints thirty-six times. When the Kidneys feel warm, Ministerial Fire does not arise, and no lewd dreams occur at night. These are effective golden elixirs, far superior to chewing herbs. Thus, I do not hesitate to speak at length to inform my colleagues.