Seminal emission is a pattern in
which the semen of a man emits frequently without making sexual
activities. This disease usually results from insecure seminal
gate due to kidney deficiency, or blazing fire of the monarch
(heart) and minister (kidneys), downrush of damp and heat, etc.,
which can disturb the seminal chamber. When the semen emits in
sleep without dreaming, it is called non-dream emission. When
the semen emits in dreaming, or even in being sleepless, it is
called slip emission. However, in clinical practice of TCM,
doctors tend to call all these two conditions seminal emission.
The
record of this disease was first seen in Huangdi Neijing (The
Medical Classic of the Yellow Emperor). One of its articles,
Root Spirit in the volume Divine Pivot (Ling Shu), describes
this condition that ¡¡ãthe semen itself emits downward
frequently.¡¡À The Simultaneous Treatment of the Pulse and
Patterns of Blood Qi-Impediment Disease and Deficiency
Exhaustion Disease, an article in the medical masterpiece Jin
Gui Yao Yue (Synopsis of Golden Chamber), describes seminal
emission as semen loss.
The
Symptoms of Semen Loss due to Deficiency Exhaustion, an article
in the Etiology of Various Diseases, says that ¡¡ãthe kidney qi
is enfeebled and incapable of storing semen, so the semen leaks
and loses.¡¡À Based on this description, the major pathomechanism
of seminal emission is elucidated.
In western medicine, seminal emission
caused by prostatitis, neurasthenia, etc., can be diagnosed and
coped with in reference to the contents of this section.
Characteristics of Pattern
Seminal emission occurs more than twice a week. The semen emits
when one is dreaming or sober, accompanied by dizziness,
tinitus, forgetfulness, palpitation, insomnia, lumbar aching
pains, soft legs, spiritlessness, and such other symptoms. If
the patient overworks mentally, it usually exhibits dizziness,
palpitation, forgetfulness, devitalized spirit, fatigue, lack of
strength, reddish tongue, thready and rapid pulse. If the
patient indulges in sexual activities, it is often seen as
dizziness, blurred vision, lumbar aching pains, tinnitus,
spiritlessness, lack of strength, and reddish tongue with few
fluids, string-like and thready and rapid pulse. If the disease
originates from the inborn shortage of endowment, it is
characterized by wan complexion, devitalized spirit, pale
tongue, deep and weak pulse. If the disease is due to
intemperate diet, a bitter taste in the mouth or thirst, hot and
yellowish urine, yellow and slimy tongue coating, sloppy and
rapid pulse, etc., are always displayed.
Pathogen and Pathomechanism
1.
Deficient kidneys failing to store essence
a.
Indulgence in sex: early marriage, excessive sexual activities,
or frequent masturbation due to ignorance, may result in the
depletion of the kidney essence. If the kidney yin is deficient,
the deficient yin may cause blazing vacuous fire; the minister
(kidneys) fire prevails and disturbs the seminal chamber,
evoking its failed duty to store essence. If the kidney qi is
insufficient, it would be incapable of astringing essence, thus
the seminal gate would fail to secure and seminal emission will
arise. Dream Emission and Slip Emission in the book Medical
Piercing says, ¡¡ãIf the kidney yin is deficient, the essence
will not be stored. If the liver yang is much too strong, the
fire would not be harmonious. Therefore, the inharmonious fire
along with the semen that cannot be stored would ultimately
result in its emission with dream or without dream.¡¡À An article
Seminal Emission in the book Gists of Patterns and Treatments
says, ¡¡ãThere are people who get unstopped seminal emission
because of excessive sexual desires.¡¡À The former condition is
related to deficient yin and prevailing yang, while the next is
related to the dual deficiencies of the yin and yang, and the
devitalized lower original qi as well.
b.
Shortage of the inborn endowment: The inborn endowment is so
short and weak that the lower original qi is debilitated and the
seminal pass is not secure. So, this man is apt to suffer from
seminal emission. An article Seminal Emission in the book The
Complete Works of Jingyue (an ancient doctor) notes, ¡¡ãThere are
those who have insufficient endowment and the semen tends to
emit easily. This condition is just due to the weak and fragile
inborn original qi.¡¡À
2.
Effulgent fire of the monarch (heart) and minister (kidneys)
a.
Overwork of the heart: If one uses his heart (mind) excessively,
the heart yin is exhausted in an undercovered way. Thus the
heart yang becomes overwhelming solely, and the heart fire
cannot associate downward with the kidney water, while the
kidney water cannot moisten the heart. Therefore, the heart and
kidneys fail to associate each other. The water is deficient,
yet the fire is effulgent, disturbing the room of the semen and
causing seminal emission.
b.
Excessive sexual desires which cannot be realized: In this
condition, the heart and spirit are restless, the monarch
(heart) fire prevails and the minister (kidneys) fire stirs
frenetically, evoking the seminal emission.
3.
Downrush of damp and heat, or phlegm and fire
Intemperate diet, such as too much wine, pungent and fatty
foods, etc., may damage the spleen and stomach. The damp and
heat are produced, or the phlegm is produced which can transform
to fire. Therefore, the damp and heat or phlegm and fire would
rush downward to perturb the seminal chamber, causing seminal
emission ultimately.
To
generalize it, the major pathomechonism of seminal emission is
related to the heart, liver, and kidneys. In clinical practice,
seminal emission is usually due to indulgence in sexual
activities, weak inborn endowment, mental overwork, excessive
sexual desires which cannot be realized, intemperate diet, etc.,
which could influence the normal storage of the kidneys.
Syndrome Identification and Treatment Determination
1.
Fire-stirring of the monarch and minister, dissociation of the
heart and kidney
Symptoms: reduced sleep, profuse dreaming, seminal emission once
dreaming, accompanied by fretful heat in the heart, dizziness,
debilitation, restlessness, forgetfulness, dry mouth, frequent
and yellowish urine, reddening of the tongue, thready and rapid
pulse.
Therapeutic principle: Clear the heart, calm the spirit, moisten
the yin and clear heat.
Formula
and ingredients: Coptis Heart-Clearing Decoction combining with
Heaven, Human, and Earth Marrow-Retaining Pills
The
first formula includes: coptis root (huang lian; clearing and
discharging the heart fire), fresh rehmannia root (sheng di;
moistening the yin and clearing heat), tangkuei root (dang gui;
harmonizing the blood and calming the spirit), spiny jujube
kernel (suan zao ren; harmonizing the blood and calming the
spirit), root poria (fu ling; calming the spirit and nourishing
the heart), polygala root (yuan zhi; calming the spirit and
nourishing the heart), ginseng (ren shen; enriching the qi and
harmonizing the middle-warmer, i.e., spleen and stomach),
licorice root (gan cao; enriching the qi and harmonizing the
middle-warmer, i.e., spleen and stomach), lotus seed (lian zi;
nourishing the heart and spleen and astringing the essential
qi).
The
second formula encompasses: asparagus tuber (tian dong;
moistening the water and nourishing the yin), cooked rehmannia
root (shou di; moistening the water and nourishing the yin),
ginseng (ren shen; calming the heart and enriching the qi),
licorice root (gan cao; calming the heart and enriching the qi),
phellodendron bark (huang bai; clearing the heat and discharging
fire to consolidate the yin), amomum fruit (sha ren; moving the
stagnation to please the spleen).
2.
Downrush of damp-heat, disturbing the seminal chamber
Symptoms: frequent seminal emission, or little semen is seen
when urinating, hot, red, turbid urine, or uneven micturation, a
bitter taste in the mouth or thirst, vexation, reduced sleep,
sores of the tongue and mouth, sloppy and foul stool, or glomus
and oppression of the abdomen and stomach, nausea, yellowish and
slimy tongue coating, soggy and rapid pulse.
Therapeutic principle: Clear up heat and excrete damp
.
Formula and ingredients: Mr. Cheng¡¯s Fish Poison Yam
Clear-Turbid Separation Beverage
Fish
poison yam (bi xie), phellodendron bark (huang bai), poria (fu
ling), plantago seed (che qian zi) can clear heat and damp.
Lotus seed (lian zi xin), salvia root (dan shen), acorus root
(shi chang pu) can clear the heart and calm the spirit. Ovate
atractylodes rhizome (bai zhu) can strengthen the spleen and
excrete damp.
3.
Damaged heart and spleen by overwork, the failure of the qi to
astringe the essence
Symptoms: occurrence of seminal emission when overworking,
palpitation, restlessness, insomnia, forgetfulness, sallow
yellowish facial complexion, fatigue of the four limbs, reduced
intake of food, sloppy stool, pale tongue, thin tongue coating,
thready and weak pulse.
Therapeutic principle: Adjust and
tonify the heart and spleen, enrich the qi, and astringe the
essence.
Formula and ingredients: Marvelous Fragrance Powder
Ginseng (ren shen) and astragalus root (huang qi) can enrich the
qi and produce the essence. Chinese yam (shan yao) and poria (fu
ling) can support the spleen. Polygala root (ruan zhi) and
cinnabar (zhu sha) clear the heart and calm the spirit. Sausurea
root (mu xiang) rectifies the qi. Platycodon root (jie gan)
lifts the clear qi.
4.
Deficiency of the kidneys, insecurity of the seminal pass
Symptoms: frequent dream emissions, even slip emission, aching
pains of the loins and knees, dry throat, vexation, dizziness,
tinitus, forgetfulness, insomnia, low fever, red cheek,
emaciation, night sweating, loss of hair, shaking teeth, red
tongue with few coating, thready and rapid pulse. Some patients
who suffered from seminal emission long, accompanied by cold
limbs, impotence, premature ejaculation, cold semen, profuse
night urine or scanty urine, puffy swelling, clear and white
urine, or post-voiding dribble, bright white or haggard
colorless facial complexion, pale and tender tongue with teeth
impressions, white and slippery tongue coating, deep and thready
pulse.
Therapeutic principle: Tonify and enrich the kidney essence,
secure and astringe to check emission.
Formula and ingredients:
Left-Restoring Beverage combining with Golden Lock
Essence-Securing Pills.
Cooked rehmannia root (shou di),
cornus fruit (shan zhu yu), lycium berry (gou qi zi), complanate
astragalus seed (tong ji li) tonify and enrich the kidney
essence. Euryale seed (qian shi), lotus stamen (lian xu),
Cherokee rose fruit (jin ying zi), dragon bone (long gu), oyster
shell (mu li) secure and astringe to stop emission. Chinese yam
(shan yao), lotus seed (liang zi rou), poria (fu ling), licorice
root (gan cao) strengthen the spleen to assist transportation.
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