张景岳曰∶遗溺有睡中自遗，有气门不固而不禁，又有气脱于上，下焦不约而遗，三者皆虚，有轻
重之辨。睡遗者，幼稚多有之，气壮而固，自愈。若水泉不止，膀胱不藏，气虚也。盖气为水母，水不蓄以
气不固，更至无所知觉，此虚极也。又年衰大病后多有之。仲景曰∶下焦竭则遗溺失禁也。古方有虚实之论，
不知不禁多属虚寒，若淋沥痛涩，方是热证，勿以遗失误用凉药。
又古方多用固涩 此治标法也。小水虽主于肾，而肾上连肺，若肺气无权，则肾水必不能摄，故治水
必须治气。宜参、 、归、术、桂，附、干姜之属为主，佐以固涩之剂。
李士材曰∶赤白浊，按经文前哲所论，而知浊病即精病，非溺病也。故患浊者，茎中如刀割火灼而溺清，
惟窍端时有秽物，如疮之脓，如目之眵，淋漓不断，与便溺绝不相混。大
抵精败而腐者，十之六也；由湿热流注与虚者，十之二三。其有赤白之分者，何也？精者血之所化，浊气
太多，精化不及，赤未变白，故成赤浊，此虚之甚也。所以少年天癸未至，强力行房，所泄半精半血；壮年
施泄无度，亦多精血杂出。则知丹溪以赤属血，白属气者，未尽善也。又以赤为心虚有热，由思虑而得；白
为肾虚有寒，因嗜欲而得，亦非确论。总之，心动于欲，肾伤于色，或强忍房事，或多服淫方，败精流溢，
乃为白浊。虚滑者血不及变，乃为赤浊。挟寒则脉来沉迟无力，小便清白，蓖 厘清饮、八味丸、内补鹿茸
丸之类。挟热则口渴便赤，脉必滑数有力，清心莲子饮、香苓散。有胃中湿痰流注，苍白二陈汤加升紫。有属
虚劳，六味加莲须、芡实、菟丝子、五味、龙骨、牡蛎。有因伏暑，四苓散加香薷、麦冬、人参、石莲之类。
有稠粘如膏，涩痛异常，乃精塞窍道，香苓散送八味丸，或金匮肾气丸。有热者蓖 厘清饮、茯菟丸。有思想
太过，心动烦扰，则精败下焦，加味清心饮、瑞莲丸之类。如上数端，此其大略也。若夫五脏之伤，六淫之
感，更难以枚举，慎勿轻忽。
遗精，古今方论皆以遗精为肾气衰弱之病，若与他脏不相干涉。不知《内经》言五脏六腑各有精，肾则
受而藏之。以不梦而自遗者，心肾之伤居多；梦而后遗者，相火之强为害。若夫五脏各得其职，则精藏而治。
苟一脏不得其正，甚则必害心肾之主精者焉。治之之法，独因肾病而遗者，治其肾；由他脏而致者，则他脏与
肾两治之。如心病而遗者，必血脉空虚，本纵不收。肺病而遗者，必皮革毛焦，喘急不利。脾病而遗者，色黄
肉消，四肢懈惰。肝病而遗者，色青而筋痿。肾病而遗者，色墨而髓空。更当六脉参详。然所因病更多端，有
用心过度，心不摄肾而失精者，宜远志丸，佐以灵砂丹。有
色欲不遂而致精泄者，四七汤吞白丸子。甚者耳闻目见，其精自出，名曰白淫，妙香散吞
玉华白丹。有色欲过度，精窍虚滑，正元散加牡蛎粉、肉苁蓉各半钱，吞灵砂丹，仍佐以鹿茸丸、山药丸、。大菟丝子丸、固阳丸之类。有壮年久旷，精满而溢，
清心丸。有饮酒浓味，痰火湿热，扰动精府，二术、二陈、升、柴，俾清升浊降，脾胃健运，则遗滑自止
矣。有脾虚下陷者，补中益气汤。有肾虚不固者，五倍子二两、茯苓四两，为丸服之，神验。然其证亦复不同，或小便后出，多不可禁者；或不小便而自出；
或茎中痒痛，如欲小便者；或梦女交者，并从前法中分别施治。总共大纲言之，精滑宜涩之，不效即泻心火，
不效即以补中益气，举其气上而不下，往往有功。
王节斋曰∶梦遗滑精，世人多作肾虚治，而用补肾涩精之药不效。殊不知此证多属脾胃，饮食浓味，痰火
湿热之人多有之。盖肾藏精，精之所生由脾胃，饮食化生而输归于肾。今脾胃伤于浓浓湿热，内郁中气，浊而
不清，则其所化生之精，亦得浊气。肾主闭藏，脏静则宁，今所输之精既有浊气，则邪火动于肾中，而水不
得宁静，故遗而滑也。此症与白浊同，丹溪论白浊为肾中浊气下流，渗入膀胱，而云无人知此也。其有色心太
重，妄想过用而致遗滑者，自从心肾治。但兼肺胃者不少，要当审察。
张介宾曰∶梦遗精滑，总皆失精之病，无不始由于心，心为君火，肾为相火，心动肾必应之。凡少年
多欲妄想，多致此。然精之藏蓄在肾，而主宰在心，精之蓄泄听命于心，治此宜净心为要。遗精有九∶有注
恋而梦者，此精为神动，因于心。有欲事不遂而梦者，此精失其位，因于肾。有劳倦即遗，此肝脾气弱也。思
虑而遗，心脾虚陷也。湿热下流，相
火妄动，肺肾之火不清也。有无故滑而不禁，此下元虚。肾肺不固也。有素禀不足而精滑者，此先天元气薄
也。有久服冷利等药，元阳失守而滑也。有年壮节欲而遗，精满而溢也。诸症五脏皆有所主，心主神，肺主
气，脾主湿，肝主疏泄，肾主闭藏，当各求其所因治之。
梦遗有情有火，情动者清心，精动者固肾。滑精无非因肾气不守而然。若暴滑兼痛，当从赤白浊论治。
凡劳倦思虑，每触即遗，当补心脾，归脾汤去木香。气分稍滞，不堪 者，人参吞茯苓白术菟丝丸。
凡心火甚者清火，相火甚者壮水，气焰者升举，滑泄者固涩，湿热乘者分利，虚寒利者温补下元，元阳
不足，精气两虚，专培根本。若概用坎离丸辈，苦寒适害肾耳。
浊症有赤、白、精、溺之辨∶赤者多由于火，白者寒热俱有，由精者在心肾，由溺者在膀胱肝脾。有浊
在溺者，色白如泔，凡肥甘辛热所致，此湿热由内生也，宜清之。
柯韵伯曰∶白赤浊之病，有伤精伤血之分，由肾肝相火摇动之所致也。夫肾者作强之官，其人或妄想
淫欲，或好为阴阳，肾火内炽，不能藏精，强忍其精而精逆焉。精未泄而离其处，不复仍归于肾，乃渗入于水
道，与小便同出。败精虽出，肾火内蕴，因之窍孔不闭，热虚相搏，新精虚应之，淋沥不止，因名为白浊。肝
者罢极之本，其人或劳役苦辛，或恼怒内伤，肝火下流，不能藏血，热伤阴络而血溢焉。血未行而离其经，不
得反于肝，亦渗入于水道，合小便同出。败血虽尽，阴络未完，肝极不摄，郁火内守，复以新血继之，浸淫
不绝，是名曰赤浊。白浊与遗精、膏淋不同，赤浊与血淋、尿血亦异。治之必当兼浚其源。源者何？至阴是也。
脾为阴中之至阴，精血所由生。又肾为阴中之太阴，精为阴中之阴；
肝为阴中之少阳，血为阴中之阳。故白浊当理脾肾之阴，法在滋阴降火，先用导赤散加知柏以清之，继用六
味加五味子以收之，而精自藏矣。赤浊当理脾肝二阴，法在升阳散火，先用逍遥散加丹皮以清之，继用补中益
气加白芍以收之，而血自藏矣。夫下者举之，白浊用补中益气汤而不应，是阴虚，不宜升，助阳则阴愈虚也。
赤浊用六味汤而无不平复者，是虚则补母之法，癸乙同归一治也。至于脾虚不能散精归肺，以致湿热下流而
然，所谓中气不足而溲便为之变也，婴儿最多此症。宜四君子倍茯苓，加升麻、砂仁主之，则水精四布，膀
胱得气化而清出矣。
张景岳说：遗尿有睡梦中自行遗出，有气门不固而无法控制，又有气脱于上焦，导致下焦约束无力而遗尿，这三种情况都属于虚证，但有轻重之分。睡中遗尿者，多见于儿童，因气血壮盛且体质坚固，往往能自愈。如果小便像泉水一样不止，膀胱不能藏津液，这是气虚的表现。因为气是水的根本，水不能蓄积是因为气不固摄，甚至发展到毫无知觉的地步，这是极度虚弱。另外，年老体衰或大病之后也多有此症。仲景说：下焦精气枯竭则会导致遗尿失禁。古方中有虚实之分的论述，但不知道不禁多属于虚寒证，如果是淋漓涩痛，才是热证，不要用凉药误治遗尿。
另外，古方多用固涩法，这只是治标的方法。小便虽由肾主司，但肾上连肺，如果肺气没有权柄（宣降功能失常），那么肾水必然不能被摄纳，所以治疗水液代谢必须调理气机。适宜以人参、[缺字]、当归、白术、肉桂、附子、干姜等为主药，佐以固涩的药剂。
李士材说：赤浊和白浊，按照经文和前贤的论述，可知浊病即是精的病，不是尿的病。所以患浊病的人，尿道中像刀割火灼一样疼痛而尿液清澈，只有尿道口偶尔流出秽物，像疮疡的脓液，像眼睛的眼屎，淋漓不断，与大小便完全不相混淆。大抵因精败腐败而成的占十分之六；因湿热流注和虚证的占十分之二三。那为什么有赤浊和白浊的区别呢？精是由血化生的，如果浊气太多，精的化生不及，红色未变成白色，所以形成赤浊，这是虚损非常严重的表现。因此少年时期天癸尚未到来，就强力行房事，所泄出的有一半是精一半是血；壮年时施泄无度，也多见精血混杂而出。由此可知，朱丹溪认为赤属血、白属气的说法，并不全面完善。他又认为赤浊是心虚有热，由思虑过度引起；白浊是肾虚有寒，因嗜欲过度引起，这也不是确切的结论。总之，心动于欲望，肾伤于色欲，或者强忍房事，或多服春药，败精流溢，就成为白浊。虚滑者血来不及变化，就成为赤浊。兼挟寒邪则脉象沉迟无力，小便清白，用蓖厘清饮、八味丸、内补鹿茸丸之类的方剂。兼挟热邪则口渴、小便红赤，脉象必滑数有力，用清心莲子饮、香苓散。有胃中湿痰流注的，用苍白二陈汤加升麻、紫苏。有属于虚劳的，用六味地黄丸加莲须、芡实、菟丝子、五味子、龙骨、牡蛎。有因伏暑引起的，用四苓散加香薷、麦冬、人参、石莲子之类。有稠粘如膏样，涩痛异常的，这是精液堵塞窍道，用香苓散送服八味丸，或金匮肾气丸。有热邪的，用蓖厘清饮、茯菟丸。有思虑太过，心动烦扰的，则精败在下焦，用加味清心饮、瑞莲丸之类。以上几种情况，是大致的分类。至于五脏的损伤，六淫的外感，更难以一一列举，千万不要轻视忽略。
遗精，古今方论都把遗精当作肾气衰弱的病，认为与其他脏腑没有关联。却不知道《内经》说五脏六腑各有精，肾则受纳并贮藏它们。如果不梦而自行遗精的，多是心肾受伤；做梦后遗精的，是相火过强为害。如果五脏各尽其职，那么精就能被贮藏并正常治理。假如有一脏不得其正，严重时必定会伤害心肾这两个主宰精的脏腑。治疗的方法，唯独因肾病而遗精的，治疗肾；由其他脏腑导致的，则同时治疗该脏和肾。比如心病导致遗精的，必然血脉空虚，本元放纵不收。肺病导致遗精的，必然皮肤毛发枯焦，气喘急促不利。脾病导致遗精的，面色黄，肌肉消瘦，四肢懈怠懒惰。肝病导致遗精的，面色青，筋脉痿软。肾病导致遗精的，面色黑，骨髓空虚。更应当参详六脉。然而致病原因更多端，有用心过度，心不能摄纳肾而导致失精的，宜用远志丸，佐以灵砂丹。有色欲不遂导致精泄的，用四七汤吞服白丸子。严重的耳闻目见，精液自出，名叫白淫，用妙香散吞服玉华白丹。有色欲过度，精窍虚滑的，用正元散加牡蛎粉、肉苁蓉各半钱，吞服灵砂丹，仍佐以鹿茸丸、山药丸、大菟丝子丸、固阳丸之类。有壮年久旷（长期禁欲），精满而溢出的，用清心丸。有饮酒及食用浓味食物，痰火湿热扰动精室，用苍术、白术、二陈汤、升麻、柴胡，使清气上升浊气下降，脾胃健运，则遗滑自然停止。有脾虚下陷的，用补中益气汤。有肾虚不固的，用五倍子二两、茯苓四两，制成丸药服用，神效。然而此证也有不同，有的在小便后出精，大多不可控制的；有的不小便而自出；有的尿道痒痛，像要小便的样子；有的梦见男女交合的，都从上述方法中分别施治。总共从大纲来说，精滑应该用涩法，如果无效就泻心火，再无效就用补中益气汤，提升其气向上而不向下，往往有效。
王节斋说：梦遗滑精，世人多当作肾虚治疗，而使用补肾涩精的药物无效。殊不知此证多属于脾胃，饮食浓味、痰火湿热之人多有此病。因为肾藏精，精的产生源于脾胃，饮食化生后输送归于肾。现在脾胃被浓厚的湿热所伤，内郁中气，浊而不清，那么它所化生的精，也带有浊气。肾主闭藏，脏静则安宁，现在所输送的精既有浊气，那么邪火就在肾中发动，而水不得宁静，所以遗而滑。此症与白浊相同，丹溪论述白浊为肾中浊气下流，渗入膀胱，并说无人知晓这一点。那些色心太重，妄想过用而导致遗滑的，自然从心肾治疗。但兼有肺胃情况的不少，应当审察清楚。
张介宾说：梦遗精滑，总都是失精的病，无不开始由于心，心为君火，肾为相火，心动肾必应之。凡是少年多欲妄想，多导致此病。然而精的藏蓄在肾，而主宰在心，精的蓄泄听命于心，治疗此病应以净心为要。遗精有九种：有迷恋某事而做梦遗精的，这是精被神动，因于心。有欲事不遂而做梦遗精的，这是精失其位，因于肾。有劳累疲倦即遗精的，这是肝脾气弱。思虑过度而遗精的，这是心脾虚陷。湿热下流，相火妄动，这是肺肾之火不清。有无故滑精而不禁的，这是下元虚，肾肺不固。有素禀不足而精滑的，这是先天元气薄弱。有久服冷利等药，元阳失守而滑精的。有年壮节制欲望却遗精的，这是精满而溢出。各种症状五脏都有主导，心主神，肺主气，脾主湿，肝主疏泄，肾主闭藏，应当各自探求其原因进行治疗。
梦遗有情动和火动之分，情动的清心，精动的固肾。滑精无非是因肾气不守所致。如果暴滑兼痛，应当从赤白浊论治。
凡是劳累思虑，每触即遗，应当补心脾，用归脾汤去木香。气分稍有阻滞，不堪重用的，用人参吞服茯苓白术菟丝丸。
凡是心火甚的用清火法，相火甚的用壮水法，气焰盛的用升举法，滑泄的用固涩法，湿热乘袭的用分利法，虚寒利的用温补下元法，元阳不足，精气两虚的，专培根本。如果一概使用坎离丸之类，苦寒药物反而伤害肾脏。
浊症有赤、白、精、溺的区别：赤色的多由于火，白色的寒热都有，由精引起的在心肾，由尿引起的在膀胱肝脾。有浊在尿中的，颜色白如米泔水，凡是肥甘辛热所致，这是湿热由内生，宜用清法。
柯韵伯说：白赤浊的病，有伤精伤血的区别，是由肾肝相火摇动所致。肾是作强之官，其人如果有妄想淫欲，或喜好阴阳之事，肾火内炽，不能藏精，强忍其精而精逆乱。精未泄出而离开其处，不再回归于肾，乃渗入于水道，与小便一同排出。败精虽然排出，但肾火内蕴，因此窍孔不闭合，热与虚相互搏结，新精虚应之，淋沥不止，因此命名为白浊。肝是罢极之本，其人如果有劳役苦辛，或恼怒内伤，肝火下流，不能藏血，热伤阴络而血溢出。血未行而离开经脉，不能返回于肝，也渗入于水道，合小便一同排出。败血虽然排尽，但阴络未完，肝极不摄，郁火内守，再以新血继之，浸淫不绝，这名叫赤浊。白浊与遗精、膏淋不同，赤浊与血淋、尿血亦异。治疗时必须兼浚其源头。源头是什么？至阴是也。脾为阴中之至阴，是精血产生的来源。又肾为阴中之太阴，精为阴中之阴；肝为阴中之少阳，血为阴中之阳。所以白浊应当调理脾肾之阴，法在滋阴降火，先用导赤散加知母、黄柏以清之，继用六味地黄丸加五味子以收之，而精自然被藏住。赤浊应当调理脾肝二阴，法在升阳散火，先用逍遥散加牡丹皮以清之，继用补中益气汤加白芍以收之，而血自然被藏住。对于下陷的病症用升举法，白浊用补中益气汤而不应验，说明是阴虚，不宜升提，助阳则阴更虚。赤浊用六味地黄汤而没有不平复的，这是虚则补母的方法，癸乙同归一治。至于脾虚不能散精归肺，以致湿热下流而然，所谓中气不足而溲便为之变，婴儿最多此症。宜用四君子汤倍茯苓，加升麻、砂仁主治，则水精四布，膀胱得气化而清出矣。
Zhang Jingyue stated: Enuresis (Urinary Incontinence) includes involuntary urination during sleep, inability to control urine due to insecure Qi gate, and enuresis caused by Qi collapse in the upper Jiao leading to lack of constraint in the lower Jiao. All three belong to deficiency syndromes, but there are distinctions in severity. Sleep-enuresis is common in children; with robust Qi and solid constitution, it often resolves spontaneously. If urine flows like a spring without cessation, and the Bladder fails to store fluids, this indicates Qi deficiency. Since Qi is the mother of Water, water cannot be retained because Qi fails to consolidate. When it progresses to a state of no sensation, this represents extreme deficiency. It also frequently occurs in the elderly or after severe illness. Zhongjing said: "When the Lower Jiao is exhausted, enuresis and incontinence occur." Ancient formulas discuss both excess and deficiency, but one must not know that incontinence mostly belongs to deficiency-cold. If there is dribbling with pain and astringency, only then is it a heat syndrome; do not mistakenly use cooling herbs for enuresis.
Furthermore, ancient formulas often use astringent methods, which are merely symptomatic treatments. Although small water (urine) is governed by the Kidney, the Kidney connects upward to the Lung. If Lung Qi lacks authority (regulatory function), Kidney water cannot be grasped. Therefore, treating water metabolism requires regulating Qi. Suitable main herbs include Ginseng Radix et Rhizoma (Renshen), [missing character], Angelicae Sinensis Radix (Danggui), Atractylodis Macrocephalae Rhizoma (Baizhu), Cinnamomi Ramulus (Guizhi), Aconiti Lateralis Radix Praeparata (Fuzi), and Zingiberis Rhizoma (Ganjiang), supplemented with astringent agents.
Li Shicai stated: Red turbid discharge and white turbid discharge, according to canonical texts and former sages' discussions, indicate that turbid disease is a disorder of essence (Jing), not urine. Patients with turbid discharge experience burning and cutting pain in the urethra while urine remains clear. Only at the orifice does foul matter occasionally appear, resembling pus from sores or eye discharge, dripping continuously, completely distinct from stool and urine. Generally, cases due to corruption of essence account for 60%; those due to damp-heat pouring down and deficiency account for 20-30%. Why is there a distinction between red and white turbidity? Essence is transformed from blood. If turbid qi is excessive and essence transformation lags, the red color fails to turn white, resulting in red turbidity, indicating severe deficiency. Thus, youths whose Tian Gui (menstruation/seminal emission capability) has not yet arrived, engaging in vigorous sexual activity, may expel half essence and half blood; adults who indulge excessively often expel mixed essence and blood. Therefore, Zhu Danxi's view that red belongs to blood and white belongs to Qi is incomplete. His assertion that red turbidity stems from Heart deficiency with heat due to overthinking, and white turbidity from Kidney deficiency with cold due to lust, is also not definitive. In summary, when Heart moves with desire and Kidney is injured by sexual indulgence, or when coitus is forcibly restrained, or when aphrodisiacs are taken excessively, corrupted essence flows out, causing white turbidity. In deficiency-slippery cases where blood fails to transform, red turbidity results. Accompanied by cold, the pulse is deep, slow, and weak, urine is clear and white; treat with Bi Li Qing Yin Decoction, Ba Wei Wan Pill, or Nei Bu Lu Rong Wan Pill. Accompanied by heat, there is thirst and red urine, pulse is slippery, rapid, and forceful; treat with Qing Xin Lian Zi Yin Decoction or Xiang Ling San Powder. For phlegm-dampness pouring down from the Stomach, use Cang Bai Er Chen Tang plus Sheng Ma and Zi Su Ye. For deficiency-consumption patterns, use Liu Wei Di Huang Wan plus Lian Xu, Qian Shi, Tu Si Zi, Wu Wei Zi, Long Gu, and Mu Li. For latent summerheat, use Si Ling San plus Xiang Ru, Mai Dong, Ren Shen, and Shi Lian Zi. For thick, sticky discharge like paste with abnormal astringent pain, this is essence blocking the orifices; use Xiang Ling San to deliver Ba Wei Wan or Jin Gui Shen Qi Wan. For heat patterns, use Bi Li Qing Yin or Fu Tu Wan. For excessive thinking causing Heart agitation, leading to essence corruption in the Lower Jiao, use Jia Wei Qing Xin Yin or Rui Lian Wan. These are the general categories. Injuries to the Five Zang organs and invasions by the Six Excesses are too numerous to list; do not neglect them lightly.
Regarding spermatorrhea, ancient and modern theories regard it as a disease of Kidney Qi decline, unrelated to other Zang organs. However, the *Nei Jing* states that all Five Zang and Six Fu organs possess essence, which the Kidney receives and stores. Non-dream spontaneous emission usually involves injury to the Heart and Kidney; emission after dreams is caused by hyperactive Minister Fire. If the Five Zang perform their duties, essence is stored and regulated. If one Zang loses its proper function, it severely harms the Heart and Kidney, which govern essence. Treatment depends on the cause: if solely due to Kidney disease, treat the Kidney; if caused by other Zang, treat both the affected Zang and the Kidney. For Heart disease causing emission, there is emptiness of blood vessels and laxity; for Lung disease, dry skin/hair and panting; for Spleen disease, yellow complexion, muscle wasting, and limb lethargy; for Liver disease, blue complexion and tendon flaccidity; for Kidney disease, dark complexion and empty marrow. Pulse diagnosis of the six positions is essential. Causes vary: overwork damaging Heart's control over Kidney suggests Yuan Zhi Wan assisted by Ling Sha Dan. Unfulfilled sexual desire causing leakage suggests Si Qi Tang with Bai Wan Zi. Severe cases of auditory/visual triggers causing spontaneous emission, named Bai Yin (White Pollution), suggest Miao Xiang San with Yu Hua Bai Dan. Excessive sexual activity causing porous orifices suggests Zheng Yuan San with Mu Li Fen and Rou Cong Rong, swallowed with Ling Sha Dan, assisted by Lu Rong Wan, Shan Yao Wan, Da Tu Si Zi Wan, or Gu Yang Wan. Vigorous adults abstaining long enough to have full essence overflowing suggest Qing Xin Wan. Alcohol and rich foods causing phlegm-fire-damp-heat disturbing the Essence Mansion suggest Cang Zhu, Bai Zhu, Er Chen Tang, Sheng Ma, and Chai Hu to raise clear Qi and descend turbid Qi, strengthening Spleen/Stomach to stop emission. Spleen Qi sinking suggests Bu Zhong Yi Qi Tang. Kidney insecurity suggests Wubeizi (two liang) and Fu Ling (four liang) pills. Variations include post-urination emission, spontaneous emission without urination, urethral itching/pain mimicking urge to urinate, or dream-coitus; treat accordingly. Generally, slippery essence requires astringents; if ineffective, drain Heart Fire; if still ineffective, use Bu Zhong Yi Qi Tang to raise Qi upward.
Wang Jiezhai stated: Dream-emission and slippery sperm are often treated as Kidney deficiency with astringents, but fail. This condition often belongs to the Spleen and Stomach, common in those with rich diets, phlegm-fire, and damp-heat. The Kidney stores essence, but essence is generated by the Spleen/Stomach from food and transported to the Kidney. If Spleen/Stomach are damaged by damp-heat, middle Qi stagnates, becoming turbid. The generated essence becomes turbid. The Kidney governs closure; when quiet, it is peaceful. But with turbid essence arriving, evil fire moves in the Kidney, water loses peace, causing emission. This matches white turbidity. Danxi described white turbidity as turbid Qi from Kidney flowing down into the Bladder. Those with heavy lust and excessive fantasy should be treated via Heart/Kidney. Often involving Lung/Stomach, careful examination is needed.
Zhang Jianbin stated: Dream-emission and slippery sperm are all loss-of-essence diseases, originating in the Heart. Heart is Sovereign Fire, Kidney is Minister Fire; Heart movement triggers Kidney response. Youthful lust and fantasies often cause this. Essence is stored in Kidney but governed by Heart; emission obeys Heart. Treatment prioritizes calming the Heart. There are nine types of emission: 1. Obsession causing dreams (Heart); 2. Unfulfilled desire causing dreams (Kidney); 3. Fatigue-induced emission (Liver/Spleen weakness); 4. Overthinking-induced emission (Heart/Spleen sinking); 5. Damp-heat pouring down, Minister Fire moving recklessly (Lung/Kidney fire unclear); 6. Spontaneous slippery emission without inhibition (Lower Yuan deficiency, Kidney/Lung insecurity); 7. Constitutional insufficiency causing slipperiness (Congenital Qi thin); 8. Long-term use of cold/purgative drugs causing Yang loss and slipperiness; 9. Young adults practicing moderation yet emitting (Essence full and overflowing). Each symptom is governed by a Zang: Heart governs Spirit, Lung governs Qi, Spleen governs Dampness, Liver governs Dispersing/Descending, Kidney governs Closure. Treat according to cause.
Dream-emission involves emotion or fire; emotional movement calms the Heart, essence movement secures the Kidney. Slippery sperm is due to Kidney Qi failing to hold. Sudden slippery emission with pain should be treated as red/white turbidity. Frequent emission triggered by fatigue/thinking requires tonifying Heart/Spleen using Gui Pi Tang removing Mu Xiang. If Qi stagnation prevents heavy tonification, use Ren Shen swallowed with Fu Ling, Bai Zhu, Tu Si Zi pills. Excessive Heart Fire requires clearing fire; excessive Minister Fire requires nourishing Water; rising Qi requires lifting; slippery leakage requires astringing; damp-heat invasion requires separating/draining; deficiency-cold requires warming Lower Yuan; insufficient Yuan Yang with dual essence/Qi deficiency requires rooting the foundation. Using Kan Li Wan indiscriminately harms the Kidney with bitter-cold herbs.
Turbid disease distinguishes red, white, essence, and urine: Red is mostly due to fire; White can be cold or heat; Essence-related involves Heart/Kidney; Urine-related involves Bladder/Liver/Spleen. Turbidity in urine, white like rice washings, caused by rich/sweet/spicy/hot foods, indicates internal damp-heat; treat with clearing methods.
Ke Yunbo stated: Red/white turbidity involves injury to essence or blood, caused by stirring of Kidney/Liver Minister Fire. The Kidney is the official of strength; if one fantasizes or engages in excessive intercourse, Kidney fire blazes internally, failing to store essence. Forced retention causes essence to rebel. Before ejaculation, essence leaves its place and does not return to Kidney, but seeps into the water pathway, exiting with urine. Though corrupt essence exits, Kidney fire remains internal, orifices remain open, heat and deficiency interact, new essence responds vacuously, causing continuous dribbling, named White Turbidity. The Liver is the root of endurance; labor or anger injures internally, Liver fire flows down, failing to store blood. Heat damages Yin collaterals, blood overflows. Before normal flow, blood leaves meridians, does not return to Liver, seeps into water pathway, exits with urine. Though corrupt blood exits, Yin collaterals are incomplete, Liver fails to grasp,郁火 (stagnant fire) stays internal, new blood follows, causing continuous oozing, named Red Turbidity. White turbidity differs from spermatorrhea and gao lin; red turbidity differs from xue lin and hematuria. Treatment must address the source. The source is Supreme Yin. Spleen is Supreme Yin among Yin, source of essence/blood. Kidney is Taiyin among Yin, essence is Yin within Yin. Liver is Shaoyang among Yin, blood is Yang within Yin. Thus, white turbidity requires regulating Spleen/Kidney Yin, method: nourish Yin and descend fire. First use Dao Chi San plus Zhi Mu and Huang Bai to clear, then Liu Wei Di Huang Wan plus Wu Wei Zi to collect, so essence is stored. Red turbidity requires regulating Spleen/Liver Yin, method: raise Yang and scatter fire. First use Xiao Yao San plus Mu Dan Pi to clear, then Bu Zhong Yi Qi Tang plus Bai Shao to collect, so blood is stored. For sinking conditions, use lifting. If Bu Zhong Yi Qi Tang fails for white turbidity, it indicates Yin deficiency, unsuitable for lifting; aiding Yang worsens Yin deficiency. If Liu Wei Di Huang Wan succeeds for red turbidity, it is the method of tonifying the Mother for deficiency; Gui and Yi share one treatment. For Spleen deficiency failing to scatter essence to Lung, causing damp-heat pouring down, known as "Middle Qi insufficient causing urinary changes," common in infants. Use Si Jun Zi Tang doubling Fu Ling, adding Sheng Ma and Sha Ren, so water essence distributes four directions, Bladder achieves Qi transformation and clears out.