凡脏腑之精，悉输于肾，而恒扰于火，火动则肾之封藏不固。心为君火，肝肾为相火，君火一动，相火随
之，而梦泄焉。其交则心之神，肝之魂，所幻而接也。经曰∶恐惧不解则伤精，时自下。又曰∶厥气客于阴器，
则梦接内。然有有梦而泄者，有无梦而自遗者。昔人谓梦而后泄者，相火之强为害；不梦自遗者，心肾之伤为
多。且谓五脏有见症，宜兼治，终不如有梦治心，无梦治肾，为简要也。乃详求所因，则有心阳暗炽，肾阴内
灼者，宜凉心摄肾。补心丹加减。有肾精素亏，相火易动者，宜浓味填精。熟地、鱼鳔、杞子、羊肾、猪脊髓、
青盐、五味子之类。介类潜阳，龟甲、牡蛎、淡菜之类。佐以养阴固摄。山药、莲子、芡实、菟丝子、
桑螵蛸之类。有龙相交炽，阴精走泄者，宜峻补真阴，承制相火。三才封髓丹、滋肾丸、大补阴丸。有用心过
度，心不摄肾者，宜交心肾。远志丸、佐灵砂丹。有思虑积劳，郁损脾气者，宜舒养脾营。归脾汤。亦有脾虚
下陷者，宜补中益气汤。有肾虚不固者，五倍子二两、茯苓四两，丸服效。有积想不遂者，宜安神固气，解郁
疏肝。妙香散吞玉华白丹。有精关久滑不梦而泄者，宜固摄止脱。桑螵蛸散、金锁玉关丸。有房劳过度，下元
虚惫，寐则阳陷而精遗不禁者，宜升固八脉之气。固精丸，或六味汤加鹿茸、菟丝、五味、龙齿、苁蓉。有
壮年久旷，精满而溢者，宜清火安神。生地、知母、黄柏、菖蒲、远志、茯神、莲子。有阴虚不摄，湿热下注
而遗者，宜泄热导湿。萆 、黄连、黄柏、茯苓、泽泻、薏苡，或秘精丸。有因醇酒浓味，酿成脾胃湿热，留
伏阴中，而为梦泄者，宜清痰火。二陈汤加二术、升、柴。有
因经络热注，夜则脊心热而遗者，猪苓丸、清心饮。亦有鬼魅相感者，其状不欲见人，独言笑，时悲泣，脉
乍大乍小，或绵绵不知度数，颜色不变，乃其候也。宜苏合香丸服之效。此其所因不同，为遗为泄亦异，皆
当分别施治。大约阳虚者急补气，鹿茸大补汤。阴虚者急益精，大补阴丸、大造丸。阳强者急泻火而已，宜补
阴泻火汤，滋阴降火汤。
凡是脏腑的精微物质，都输送到肾脏，但常常被火邪扰动，火邪妄动则肾脏的封藏功能不固。心属于君火（主宰生命活动的阳气），肝和肾属于相火（辅助君火运行的阳气），君火一旦发动，相火随之而动，就会导致梦中遗精。性交时的精神活动，是心的神志、肝的魂气所幻化并相接的结果。《内经》说：“恐惧不解伤及精气，精气就会自行下泄。”又说：“厥逆之气客居阴器，就会梦见性交。”然而，有梦中遗精的，也有无梦而自行的遗精。前人认为，梦中遗精者，多是相火过强为害；无梦自遗者，多是心肾受损所致。并且认为五脏虽有各自的表现症状，应当兼顾治疗，终究不如“有梦治心，无梦治肾”来得简要。于是详细探究其病因，有心阳暗中炽盛、肾阴在内灼伤者，宜用凉心摄肾法。可用补心丹加减。有肾精素来亏虚、相火容易妄动的，宜用厚味食物填补精髓。如熟地黄、鱼鳔、枸杞子、羊肾、猪脊髓、青盐、五味子之类。介壳类药物潜镇阳气，如龟甲、牡蛎、淡菜之类。佐以养阴固摄的药物，如山药、莲子、芡实、菟丝子、桑螵蛸之类。有龙雷之火相交炽盛、阴精走泄的，宜峻补真阴，以制约相火。可用三才封髓丹、滋肾丸、大补阴丸。有用心过度、心不能统摄肾脏的，宜交通心肾。可用远志丸、佐灵砂丹。有思虑积劳、郁结损伤脾气的，宜舒展滋养脾营。可用归脾汤。也有脾气虚弱下陷的，宜用补中益气汤。有肾虚不固的，可用五倍子二两、茯苓四两，制成丸药服用有效。有积想不得遂愿的，宜安神固气、解郁疏肝。可用妙香散吞服玉华白丹。有精关久滑、无梦而遗精的，宜固摄止脱。可用桑螵蛸散、金锁玉关丸。有房事过度、下元虚惫，睡眠时阳气下陷而精液遗泄不止的，宜升提固护八脉之气。可用固精丸，或六味地黄汤加鹿茸、菟丝子、五味子、龙齿、肉苁蓉。有壮年男子长期禁欲、精满而溢出的，宜清火安神。可用生地黄、知母、黄柏、石菖蒲、远志、茯神、莲子。有阴虚不能固摄、湿热下注而遗精的，宜泄热导湿。可用萆薢、黄连、黄柏、茯苓、泽泻、薏苡仁，或秘精丸。有因嗜酒厚味，酿成脾胃湿热，留伏于阴中，而导致梦遗的，宜清化痰火。可用二陈汤加苍术、白术、升麻、柴胡。有因经络热邪下注，夜间脊背心中发热而遗精的，可用猪苓丸、清心饮。也有因鬼魅感应的，其症状是不愿见人，独自说笑，时而悲泣，脉搏忽大忽小，或微弱不知至数，面色不变，这是其征候。宜服用苏合香丸有效。这些病因不同，表现为遗精或泄精也各异，都应当分别施治。大致而言，阳虚者急补气，可用鹿茸大补汤。阴虚者急益精，可用大补阴丸、大造丸。阳强者急泻火而已，宜用补阴泻火汤、滋阴降火汤。
The essence of all zang-fu organs is transported to the Kidney, but it is constantly disturbed by Fire. When Fire moves, the Kidney's sealing and storing function becomes insecure. The Heart belongs to Ministerial Fire (the sovereign fire governing vital activities), while the Liver and Kidney belong to Assistant Fire (the ministerial fire assisting the sovereign fire). Once the Sovereign Fire stirs, the Assistant Fire follows, leading to nocturnal emission in dreams. During sexual intercourse, the spirit of the Heart and the soul of the Liver are幻化 (transformed) and connected. The Classics state: "Unresolved fear injures the essence, causing it to leak spontaneously." It also states: "When Jue Qi lodges in the genitalia, one dreams of sexual intercourse." However, there are cases of emission during dreams and cases of spontaneous leakage without dreams. Ancients believed that emission during dreams is caused by the excessive strength of Assistant Fire; whereas spontaneous leakage without dreams is mostly due to injury of the Heart and Kidney. Furthermore, although symptoms may appear in the five zang organs requiring comprehensive treatment, it is ultimately more concise to "treat the Heart for dream emissions and the Kidney for non-dream emissions." Upon detailed investigation of causes:
1. If Heart Yang is secretly blazing and Kidney Yin is internally scorched, use the method of cooling the Heart and securing the Kidney. Modify Buxin Dan (Tonify the Heart Decoction).
2. If Kidney essence has been deficient since youth and Assistant Fire easily moves, use rich foods to fill the essence. Such as Shu Di Huang (Rehmanniae Radix Praeparata), Yubiao (Bladder of Sus scrofa domestica), Gou Qi Zi (Lycii Fructus), Yang Shen (Ovis/Caprae Testis), Zhu Ji Sui (Porci Medulla Spinalis), Qing Yan (Sal), Wu Wei Zi (Schisandrae Fructus). Shell-type substances to subdue Yang, such as Gui Jia (Testudo Carapax et Plastrum), Mu Li (Ostreae Concha), Dan Cai (Mytilus edulis). Assist with yin-nourishing and astringent herbs, such as Shan Yao (Dioscoreae Rhizoma), Lian Zi (Nelumbinis Semen), Qian Shi (Euryales Semen), Tu Si Zi (Cuscutae Semen), Sang Piao Xiao (Mantis Oötheca).
3. If Dragon and Tiger fires interact and blaze, causing loss of yin essence, vigorously tonify True Yin to control Assistant Fire. Use Sancai Fengsui Dan (Three Immortals Sealing Marrow Pill), Zishen Wan (Nourish Kidney Pill), or Dabu Yin Wan (Great Tonification of Yin Pill).
4. If mental exertion is excessive and the Heart fails to control the Kidney, facilitate communication between Heart and Kidney. Use Yuanzhi Wan (Polygalae Pill) or Zuolingsha Dan (Assisting Cinnabar Barium Pill).
5. If worry and overwork cause stagnation injuring Spleen Qi, soothe and nourish Spleen Ying. Use Guipi Tang (Restore the Spleen Decoction).
6. If Spleen Qi is deficient and sinking, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
7. If Kidney deficiency leads to insecurity, use 2 liang of Wu Bei Zi (Galla Chinensis) and 4 liang of Fu Ling (Poria) made into pills; this is effective.
8. If accumulated desires are unfulfilled, calm the spirit, secure qi, resolve stagnation, and soothe the Liver. Use Miaoxiang San (Wonderful Incense Powder) taken with Yuhua Bai Dan (Jade Flower White Pill).
9. If the sperm gate has been slippery for a long time with emission without dreams, secure and stop collapse. Use Sangpiao Xiao San (Mantis Oötheca Powder) or Jin Suo Yu Guan Wan (Golden Lock Jade Gate Pill).
10. If sexual excess leads to deficiency and exhaustion of the lower origin, with yang sinking during sleep causing uncontrollable seminal emission, raise and secure the qi of the Eight Extraordinary Vessels. Use Gujing Wan (Secure Essence Pill) or Liuwei Tang (Six-Ingredient Decoction) plus Luzhu (Cervi Cornu Degelatinatum), Tusiren (Cuscutae Semen), Wuweizi (Schisandrae Fructus), Longchi (Dinosaur Bone), Rongrong (Cibotii Rhizoma).
11. If a strong young man abstains for a long time, resulting in fullness and overflow of essence, clear fire and calm the spirit. Use Sheng Di Huang (Rehmanniae Radix), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Changpu (Acori Tatarinowii Rhizoma), Yuanzhi (Polygalae Radix), Fushen (Poria with Hostwood), Lianzi (Nelumbinis Semen).
12. If yin deficiency fails to secure and damp-heat pours downward causing emission, drain heat and guide out dampness. Use Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Yi Yi Ren (Coicis Semen), or Mijing Wan (Secret Essence Pill).
13. If rich wine and food brew damp-heat in the Spleen and Stomach, lingering in the yin causing dream emission, clear phlegm-fire. Use Erchen Tang (Two-Aged Decoction) plus Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix).
14. If heat from meridians pours downward, causing back-center heat at night and emission, use Zhuling Wan (Polyporus Pill) or Qingxin Yin (Clear Heart Infusion).
15. There are also cases influenced by demonic entities, characterized by aversion to people, solitary laughter, occasional weeping, pulse fluctuating between large and small or faint and indeterminate, with unchanged complexion. This is their presentation. Taking Suhexiang Wan (Styrax Pill) is effective.
Since the causes differ, whether presenting as nocturnal emission or leakage varies, and treatment must be differentiated accordingly. Generally, for Yang deficiency, urgently tonify Qi using Luzhu Dabu Tang (Deer Antler Great Tonification Decoction). For Yin deficiency, urgently benefit Essence using Dabu Yin Wan (Great Tonification of Yin Pill) or Dazao Wan (Great Creation Pill). For excessive Yang, urgently drain Fire using Buyin Xiehuo Tang (Tonify Yin Drain Fire Decoction) or Ziyin Jianghuo Tang (Nourish Yin Descend Fire Decoction).