SPERMATORRHEA, SEMINAL EMISSION, NOCTURNAL EMISSION

GENERAL

Clinical Manifestations	Spermatorrhea is a condition of excessive, involuntary ejaculation. It is a recognized disorder in traditional Chinese medicine, in which certain patterns of involuntary ejaculation reflect problems with Kidney Qi. A nocturnal emission, informally known as a wet dream, is a spontaneous orgasm during sleep that includes ejaculation for a male, or vaginal wetness or an orgasm (or both) for a female. Nocturnal emissions are most common during adolescence and early young adult years, but they may happen any time after puberty. It is possible for men to wake up during a wet dream or simply to sleep through it, but for women, some researchers have added the requirement that she should also awaken during the orgasm and perceive that the orgasm happened before it counts as a wet dream. Vaginal lubrication alone does not mean that the woman had an orgasm
Treatment Principle
Herb Formulas
Points

LUNG HEAT GENERATING LUNG YIN DEFICIENCY

Clinical Manifestations	Chronic, incessant coughing Chronic hoarseness Throat lesions Itching throat Fever Restlessness Irritability Thirst Nocturnal emission Insomnia Dream disturbed sleep Lack of spirit Fatigue Low back pain Tinnitus Dysuria Depression Turbid urine Abnormal uterine bleeding Polyuria Enuresis Seminal emission Leukorrhea Blood tinged leukorrhea Anorexia Five Sole Heat Physical and mental overexertion Phlegm Dry mouth T: Reddish and dry C: Little or None P: Thready and rapid or Deep and rapid
Treatment Principle	Clear the Lungs Transform Phlegm Relieve cough Drain Fire Moisten Dryness
Herb Formulas	Qing Fei Tang
Points

LUNG AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Unproductive cough or Scanty, sticky phlegm or Sometimes Blood-streaked sputum Dry mouth Dry throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Sterility Spermatorrhea Nocturnal emissions T: Red and dry C: None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs Reinforce the Kidneys
Herb Formulas	Bai He Gu Jin Tang Ba Xian Chang Shou Wan Yang Yin Qing Fei Tang + Da Bu Yin Wan Mai Wei Di Huang Wan Du Qi Wan
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

DAMP-HEAT INJURES THE SPLEEN

Clinical Manifestations	Spermatorrhea Anorexia Abdominal distention and discomfort Suffocating sensation in the chest Epigastric mass Maybe abdominal pain on palpation Yang jaundice (sclera and skin are bright yellow) Dislike of oily foods Nausea Vomiting Lassitude Scanty, dark urine Maybe thirst or thirst with no desire to drink Diarrhea with foul smell or Constipation Fever Sweet sticky taste or bitter taste in mouth T: Pink C: Thick, yellow and greasy (maybe sticky) P: Soft and rapid
Treatment Principle	Clear Heat Benefit Dampness
Herb Formulas	Yin Chen Wu Ling San
Points	LI-11, REN-12, SP-9, ST-36, ST-44, UB-20 For Damp-Heat Diarrhea: LI-4, SP-9, ST-25, ST-36, ST-44, UB-25 For Damp-Heat Dysentery: LI-4, LI-11, SP-9, ST-25, ST-37, ST-44

SPLEEN AND KIDNEY QI DEFICIENCY

Clinical Manifestations	Milky, turbid spermatorrhea Listlessness Fatigue A shiny, white complexion Anorexia or Increased food intake Restlessness Vaginal discharge Diarrhea Dryness of the external ears Dizziness Enuresis Copious urination Thirst Premature ejaculation Lumbago T: Pale C: White P: Deep and frail
Treatment Principle	Tonify the Kidneys Stabilize Jing Stop leakage Strengthen the Spleen Drain Dampness Benefit the Heart Calm the Shen
Herb Formulas	Fu Tu Dan
Points

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Spermatorrhea Body cold Limbs icy Complexion white and shiny Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Si Shen Wan
Points	Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

HEART FIRE

Clinical Manifestations	Nocturnal emission, worse with taxation Spermatorrhea Frequent easy erections A dry mouth and tongue Ulceration, erosion, and pain of mouth and tongue Thirst with a desire for cold drinks Irritability Irascibility Agitation Restless sleep Feeling of Heat and disturbance in the Heart Insomnia Flushed face Bitter taste in the mouth Susceptibility too fright Impaired memory Reddish urine Dark colored urine Maybe burning, hot, painful urination T: Red tip with ulcers especially on the tip C: Thin and yellow P: Excess and rapid
Treatment Principle	Clear Heat Purge Fire Calm the Shen
Herb Formulas	Qing Xin Lian Zi Yin modified Huang Lian Qing Xin Yin modified
Points	HT-7, KI-3, LU-5, SP-6, UB-15 With dry stools: + SP-14 With mouth and tongue sores: + PC-8 With Five-Sole-Heat, night sweats and tidal fever: + HT-6, KI-7 With painful, hot urination: + REN-3 HT-7, HT-8, PC-7, PC-8, UB-15 HT-5, PC-7, REN-4, UB-15, UB-52

HEART YIN DEFICIENCY

Clinical Manifestations	Spermatorrhea Palpitations Irritability Easily startled Insomnia Much dreaming Poor memory Low grade fever Night sweats Five Sole Heat Restlessness Dry mouth Thirst Dry throat Malar flush T: Red, dry C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Clear Heat Reinforce Heart Calm the Shen
Herb Formulas	Tian Wang Bu Xin Dan With Fire Flaring: Spermatorrhea #1
Points	HT-5, HT-6, HT-7, PC-5, PC-6, PC-7, REN-14, SP-6, UB-15

HEART QI DEFICIENCY

Clinical Manifestations	Palpitations Shortness of breath (especially on exertion) Excessive perspiration (in daytime) Symptoms worse after exertion or when tired Facial pallor Fatigue Weakness Suffocating sensation in chest T: Pale and swollen C: White P: Weak or Big and weak or Intermittent
Treatment Principle	Reinforce and Strengthen Heart Qi
Herb Formulas	Miao Xiang San
Points	HT-7, PC-6, REN-6, REN-14, REN-17, ST-36, UB-15

HEART BLOOD DEFICIENCY

Clinical Manifestations	Spermatorrhea Nocturnal emissions Palpitations Irritability Anxiety Easily startled Insomnia Much dreaming Poor memory Dizziness Pale face and lips T: Pale P: Thready and weak
Treatment Principle	Nourish Heart Blood Calm the Heart and Shen
Herb Formulas	Suan Zao Ren Tang
Points	HT-7, PC-6, REN-4, REN-14, SP-6, ST-36, UB-15, UB-17, UB-20, Rice-grain moxa SP-1

HEART BLOOD AND SPLEEN QI DEFICIENCY

Clinical Manifestations	Spermatorrhea Nocturnal emission Impotence Lethargy Fatigue Palpitations Insomnia Easily startled Poor memory Lassitude Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen after meals Loose stools Sallow, lusterless complexion Shortness of breath Spontaneous perspiration A thin, weak bodily constitution Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale C: White P: Thready and weak
Treatment Principle	Reinforce and Benefit the Heart and Spleen
Herb Formulas	Xin Pi Shen An Tang modified Gui Pi Tang modified Without Heart Blood Deficiency: Jian Pi Gu Jing Wan
Points	DU-4, HT-7, REN-3, ST-36, UB-20 With more severe Qi Deficiency: + REN-6 With dizziness: + DU-20 With insomnia and profuse dreams: + UB-15 With impaired memory: + Sishencong With abdominal distention and loose stools: + SP-4 HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20 REN-4, SP-6, UB-15, UB-20, UB-52 With dizziness: + DU-20 With abdominal distention and loose stools: +ST-36 With impaired memory: + Sishencong

HEART AND GALLBLADDER QI DEFICIENCY

Clinical Manifestations	Spermatorrhea Insomnia or frequent waking, often early in the morning Unable to fall back to sleep Nightmares Waking terrified Easily frightened or startled Easily unsettled by seeming trivial events Apprehension Restlessness Fearfulness Inappropriate worry Timidity Phobias Anxiety (frequent and severe) Feeling disheartened Forgetfulness Frequent panic attacks Palpitations Shortness of breath Incessant laughter and glee Lethargy Fatigue Depression Postnatal depression Spontaneous sweating Worry Dizziness T: Normal or Pale (chronic or congenital cases may show a deep narrow crack to the tip C: Thin and white P: Wiry and thready or Weak, thready and rapid
Treatment Principle	Calm the Shen Tonify the Heart Qi
Herb Formulas	Ding Zhi Wan Ren Re San
Points

HEART AND KIDNEY DEFICIENCY

Clinical Manifestations	Frequent urination Cloudy urine that resembles rice-water Seminal emissions Lack of energy Enuresis Disorientation Constipation Forgetfulness Palpitations Fatigue Shortness of breath Anorexia A pale facial complexion Frequent urination Difficulty urinating T: Pale or Light pink C: Thin and white P: Thin, slow and frail or Deep and weak or Thready and weak
Treatment Principle	Regulate and tonify the Heart and Kidneys Stabilize Jing Stop seminal emissions
Herb Formulas	Sang Piao Xiao San Jiao Tai Wan #1 Sheng Hui Tang
Points	HT-7, SP-6, UB-15, UB-23, UB-52

HEART AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Insomnia with much dreaming Nocturnal emission with erotic dreams Great difficulty falling asleep Premature ejaculation Irritability Agitation Easily startled Severe, continuous palpitations or A racing Heart Vexatious Heat in the chest Poor memory Dizziness Tinnitus Low back soreness Legs weak Tidal fever Night sweats Dry mouth Red cheeks Urine short and red T: Red C: Little or None or Dry and yellow P: Thready and rapid or Rapid and surging
Treatment Principle	Nourish Yin Descend Fire Make the Heart and Kidney communicate
Herb Formulas	Jiao Tai Wan Tian Wang Bu Xin Dan Liu Wei Di Huang Wan Mai Wei Di Huang Wan With Fire Rising: Dao Chi San With Damp-Heat: Qing Xin Lian Zi Yin
Points	HT-7, KI-3, PC-6, PC-7, UB-15, UB-23 HT-7, PC-6, SP-6, UB-15, UB-23 With night sweats: + KI-7 With spontaneous perspiration and shortness of breath: + HT-6 With sores on the tongue and in the mouth: + PC-8

LACK OF COMMUNICATION BETWEEN THE HEART AND KIDNEYS

Clinical Manifestations	Palpitations Anxiety Insomnia Dream disturbed sleep Nightmares Hair loss Spontaneous perspiration Amnesia Infantile night crying Dreams of sexual intercourse in women A cold sensation on the tip of the penis Loss of appetite Dizziness Depression Lack of motivation Night sweats Spermatorrhea Nocturnal emissions Lower abdominal contraction and pain Occasional watery diarrhea T: Slightly pale P: Hollow and slow or Hollow and slightly tight
Treatment Principle	Tonify Yin and Yang Harmonize the Ying and Wei Astringe Jing Suppress rebellion
Herb Formulas	Gui Zhi Jia Long Gu Mu Li Tang
Points

FRIGHT AND FEAR DAMAGING THE SHEN

Clinical Manifestations	Fear of possible disturbance during intercourse Anxiety over successful completion Premature ejaculation Timidity Irritability Restless sleep Insomnia Palpitations Susceptibility to fright P: Thready and wiry and maybe weak
Treatment Principle	Calm the Shen Settle the mind
Herb Formulas	Ning Xin Gu Shen Wan
Points	HT-7, UB-15, UB-23, UB-52 For a tendency to doubt and suspicion: + DU-24

LIVER FIRE

Clinical Manifestations	Spermatorrhea Frequent nocturnal emissions Severe, splitting headaches with dizziness Sudden tinnitus or Sudden deafness Flushed face Red, swollen, painful eyes Irascibility with violent angry outbursts Dry mouth and throat Bitter taste in mouth Thirst Vomiting sour or bitter liquid Hypochondria pain Insomnia Restlessness Constipation or dry stools Maybe rib pain Scanty, concentrated urine In severe cases: Mania Hemoptysis Hematemesis Epistaxis Liver Fire Attacks the Lungs: Hemoptysis Rib pain which is severe when coughing Liver Fire Attacks the Stomach: Hematemesis T: Red tip and edges C: Thick, yellow, dry and rough P: Wiry, Excess and rapid
Treatment Principle	Clear the Liver Purge Fire
Herb Formulas	Long Dan Xie Gan Tang modified Chinese Patent Medicines: Long Dan Xie Gan Wan Qian Lie Xian Wan Chuan Xin Lian Kang Yan Pian
Points	GB-34, GB-39, KI-6, LIV-2, LIV-5, LIV-14, SJ-5, UB-18 With headaches: + GB-20, LIV-3 With constipation: - SJ-5, + SJ-6 GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

LIVER YANG RISING

Clinical Manifestations	Nocturnal emission Easy erection Irritability Agitation Discomfort in the chest and flanks A red facial complexion Rd eyes Headache Vertigo A bitter taste in the mouth Dry throat T: Red C: Yellow P Wiry and rapid
Treatment Principle	Clear the Liver and subdue Yang
Herb Formulas	Jia Wei Xiao Yao San modified
Points	GB-43, HT-7, LIV-2, LIV-4, REN-4, SP-6 With tinnitus: + SJ-17 With constipation and dark colored urination: + ST-40, ST-44 With profuse nightmares: + UB-15, UB-18

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Spermatorrhea Nocturnal emissions Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Both feet atonic and weak Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five Sole Heat Throat pain Malar flush Low-grade fever Night sweats Irritability Heart vexation Insomnia Stools difficult to pass Constipation T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys Descend Fire Dispel Stagnation
Herb Formulas	Qi Ju Di Huang Wan Yi Guan Jian Da Bu Yin Wan Liu Wei Di Huang Wan Er Zhi Wan Mai Wei Di Huang Wan Hu Qian Wan Yi Sui Tang With Fire Flaring: Zhi Bai Di Huang Wan modified Dang Gui Yu Zhu San With Blood Deficiency: Gui Shao Di Huang Tang With Fire Flaring and Blood Deficiency: Dang Gui Liu Huang Wan
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

LIVER AND KIDNEY DEFICIENCY

Clinical Manifestations	Blurred vision Dizziness Tinnitus Profuse dreaming Low back and knee pain and weakness Impotence Seminal emissions Dribbling urination T: Pale C: White P: Thready and weak
Treatment Principle	Enrich and supplement the Liver and Kidneys Tonify Jing Brighten the eyes
Herb Formulas	Bu Shen Ci Shi Wan Jia Wei
Points

KIDNEY YIN DEFICIENCY

Clinical Manifestations	Spermatorrhea or premature ejaculation Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of low back Aching in bones Aching in leg and heel T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Reinforce the Kidneys
Herb Formulas	Liu Wei Di Huang Wan Di Long Tang Mai Wei Di Huang Wan Zi Yin Chi Wei Tang With Damp-Heat and Blood Stagnation: Qing Hua Tang With Jing Deficiency: Zuo Gui Yin
Points	KI-1, KI-3, KI-6, REN-4, SP-6, UB-23

KIDNEY YIN DEFICIENCY WITH FIRE FLARING

Clinical Manifestations	Dizziness Tinnitus or deafness Poor memory Aching, soreness or weakness of the low back and knees Spermatorrhea or Nocturnal emission with erotic dreams Premature ejaculation Easy but often incomplete erection for only a short period of time Restless sleep Irritability Restlessness Aching in the bones Aching in the leg and heel Dry mouth and throat Thirst Night sweats Five Sole Heat Dizziness Vertigo Malar flush Low grade fever in the afternoon Dry throat, maybe recurrent sore throat Dry stools and/or Constipation or dry stools Urine short and red Heightened libido Scanty, concentrated urination If Heart Fire also Flares: Insomnia Frequent dreams Palpitations If Liver Yang also Rises: Blurred vision T: Red C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Subdue Fire Calm the Shen Consolidate Jing
Herb Formulas	Zhi Bai Di Huang Wan modified Zhu Sheng Teng Er Tang Huang Lian E Jiao Tang Chinese Patent Medicines: Liu Wei Di Huang Wan Zhi Bai Di Huang Wan Da Bu Yin Wan
Points	KI-3, SP-6, UB-18, UB-23, UB-52 With night sweats: + HT-6 With vexation: + HT-7 With constipation: + SP-14 KI-1, KI-2, KI-3, KI-6, KI-9, KI-10, REN-4, SP-6, UB-23 HT-7, KI-2, KI-7, LIV-2, PC-6, REN-4, UB-15, UB-23, UB-30, UB-52 With insomnia: + Anmian With dizziness: + DU-20 With night sweats: + HT-6 or SI-3 HT-7, SP-6, UB-15, UB-23 With night sweats: + KI-7 With a sore throat: +KI-6 With tinnitus: + GB-2 With constipation: + SP-14 or ST-37 With rough eyes: + UB-18 If Heart Fire also Flares: HT-7, PC-7, UB-15 If Liver Yang also Rises: LIV-3, UB-18

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	Ba Wei Di Huang Wan Bu Gu Zhi Wan Da Tu Si Zi Wan Jia Jian Gui Lu Bu Shen Tang Jie Rong San Ji Sheng Tu Si Zi Wan Jia Jian Lu Rong Bu Se Wan She Chi Tang Xin Yang San Yang Chuan Yao Zhuang Yang Chi Wei Wan You Gui Yin With water flooding: Zhen Wu Tang
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

KIDNEY YANG DEFICIENCY: KIDNEY QI NOT CONSOLIDATED

Clinical Manifestations	Low back and knees aching and weak Hearing deficit Jing Gate Not Consolidated: Spermatorrhea Nocturnal emissions Premature ejaculation Vaginal discharge Infertility Urinary disorder: Frequent, clear, abundant urination Dribbling after urination Incontinence of urine T: Pale and swollen with teethmarks C: Thin white P: Deep and thready
Treatment Principle	Consolidate the Kidneys Conserve Qi
Herb Formulas	Jin Suo Gu Jing Wan Suo Quan Wan Shui Lu Er Shen Dan Gui Fu Du Jin Zan Yu Dan With cloudy urine: Bei Xie Fen Qing Yin
Points	For spermatorrhea due to Kidney Qi Not Consolidated: 1. Jinggong, KI-3, KI-12, REN-4, REN-6, SP-6, UB-23, UB-52 2. REN-4, SP-6, UB-23 3. Jinggong, KI-3, KI-12, REN-4, ST-36 4. KI-12, REN-4, REN-6, SP-6, UB-23 For urinary incontinence and enuresis: 1. REN-3, SP-6, UB-22, UB-23, UB-28, UB-39 2. REN-3, SP-6, UB-22, UB-23, UB-28

DEFICIENCY OF MING MEN FIRE

Clinical Manifestations	Long-term cold genitals Low back weakness and pain Cold limbs Aversion to Cold Qi Deficiency Lassitude A bright white facial complexion Day break diarrhea Profuse, clear urination Impotence Spermatorrhea Premature ejaculation Possible hernia Severe cases: Edema T: Pale, fat and moist with possible teethmarks C: White P: Slow or Empty
Treatment Principle	Warm and supplement Kidney Yang
Herb Formulas	Shen Qi Wan modified For ice-Cold genitals, hernia and a retracted scrotum: Shi Bu Wan
Points	Moxa or moxa needle DU-4, REN-1, REN-2, REN-4 For Cold pain in the lower abdomen: + moxa or moxa needle REN-3 For a poor appetite: + moxa or moxa needle ST-36 For clear diarrhea: + moxa REN-8

KIDNEY QI AND JING DEFICIENCY

Clinical Manifestations	Exhaustion Aversion to Cold A frail physique Dizziness Lower back pain Weakness of the lower extremities Frequent, scanty urination with continuous dripping T: Pale C: White P: Frail
Treatment Principle	Warms the Kidneys Prevents abnormal leakage
Herb Formulas	Tu Si Zi Wan
Points

KIDNEY YIN AND YANG DEFICIENCY

Clinical Manifestations	Dizziness Tinnitus Weak legs Lower back ache Low-grade fever in the afternoon Fatigue Red cheeks Hot flushed face Spermatorrhea due to Deficient Yin Nocturnal emissions Fever with thirst Burning soles of feet Hot flashes Night sweating Dry cough Headache Restlessness Early periods Pale dilute menstrual Blood Nocturia General feeling of being Cold Restless insomnia Vertigo, T: Pale and swollen or Red C: Thin and white or Little or None P: Deep and weak or Thready and rapid
Treatment Principle	Tonify Kidney Yang Regulate the Chong and Ren vessels Nourish the Liver and Kidneys Tonify Deficient Yin Nourish Blood, Qi and Jing Replenish Kidney, Heart and Liver Yin, Relieve Empty Fire due to Deficiency of Yin
Herb Formulas	He Che Da Zao Wan Yi Jing Zhuan Yang Tang Hei Long Bu Shen Zhu Yang Fang
Points

KIDNEY YIN AND YANG DEFICIENCY WITH KIDNEY JING INSUFFICIENCY IN THE DU CHONG AND REN CHANNELS

Clinical Manifestations	Emaciation Weakness Spermatorrhea Blurred vision Aching and weak low back and knees Daybreak diarrhea Weight loss Dizziness Nocturnal emissions T: Pink or Pale C: White or None P: Thready and frail or Deep, slow and weak
Treatment Principle	Nourish and replenish Yin Tonify Jing Augment Qi Tonify and strengthen Yang Nourish the Blood
Herb Formulas	Gui Lu Er Xian Jiao
Points

KIDNEY QI DEFICIENCY

Clinical Manifestations	Spermatorrhea Frequent nocturnal emissions Maybe dreams Impotence Premature ejaculation Frequent nocturia Profuse clear urination or Nocturia Outflow of emission threads after urinating Aversion to Cold Cold limbs Sweating on exertion A bright, white, lusterless facial complexion or A waxy, pale complexion Listlessness Fatigue Lower abdominal distention Low back and knee weakness and pain Dizziness Tinnitus Constipation or Loose stools T: Pale or Pale, moist and swollen C: White P: Deep and thready or Slow and weak
Treatment Principle	Tonify the Kidneys Supplement Qi Astringe Jing
Herb Formulas	Jin Suo Gu Jing Wan modified You Gui Wan modified Bu Gu Zhi Wan Cong Rong Wan Chinese Patent Medicines: Jin Kuei Shen Qi Wan Ren Shen Lu Rong Wan Ge Jie Bu Shen Wan Jin Suo Gu Jing Wan
Points	KI-3, REN-4, UB-23, UB-52 For impaired memory: + Sishencong For tinnitus: + GB-2 For night sweats: + KI-7 For dizziness: + DU-20 For cold genitals and thin Jing: + DU-4 KI-7, REN-4, REN-6, UB-52 For tinnitus: + GB-2 For dribbling urination: + REN-3 For impaired memory: + Sishencong DU-4, DU-20, KI-3, REN-4, REN-6, REN-12, UB-23, UB-30

KIDNEY JING INSUFFICIENCY

Clinical Manifestations	Spermatorrhea Nocturnal emissions Dizziness Tinnitus Low back and knees weak and aching In adults: Hair loss Graying or whitening of the hair Weak sexual function Atrophy and weakness of the feet with difficulty walking Poor memory Senility (premature or mature) Brittle bones Gradual deterioration of the hearing In children: Retardation in mental and/or physical development Failure to thrive Late or incomplete closing of the fontanel Poor bone development Brittle bones
Treatment Principle	Reinforce the Kidneys Benefit Jing
Herb Formulas	Zuo Gui Wan You Gui Wan Shui Lu Er Shen Dan Liu Wei Gu Jing Wan Da Bu Yuan Jian With Liver Blood Deficiency: Qi Bao Mei Ran Dan
Points	DU-4, HT-7, KI-3, REN-4, UB-11, UB-15, UB-23

FRIGHT DAMAGING THE KIDNEYS

Clinical Manifestations	Spermatorrhea following a sudden fright Heart palpitations due to fright Insomnia Profuse dreams or Nightmares Night sweats Dizziness Depression Timidity Excessive suspicion T: Pale C: White P: Thready and deep or Normal
Treatment Principle	Tonify the Kidneys Nourish the Heart Settle the Heart Calm the Shen
Herb Formulas	An Shen Ding Zhi Wan modified
Points	HT-7, UB-15, UB-23, UB-52 With frequent nocturia: + REN-4, UB-32 With susceptibility to fright: + REN-7

URINARY BLADDER DAMP-HEAT

Clinical Manifestations	Spermatorrhea Dark, turbid, scanty, difficult urination or Frequent, urgent and painful Urination may be red Maybe fever Sores in mouth, on tongue or throat Dry mouth and throat Maybe urinary retention (severe) Maybe lower abdominal distention and pain (severe) Thirst Maybe total obstruction Parched throat Severe sore throat Maybe anuria (severe) Dribbling urination May be profuse whitish, yellow vaginal discharge Maybe be urinary calculi Constipation Eye redness and pain Epistaxis Distending lower back pain Irritability Scorched lips T: Red C: Thick, yellow and greasy P: Slippery and rapid or Smooth and rapid
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction.
Herb Formulas	Ba Zheng San Zhi Zhuo Gu Ben Wan Due to Heart Fire Descending through the Small Intestine: Cheng Shi Bei Xie Fen Qing Yin modified Chinese Patent Medicines: Long Dan Xie Gan Wan Qian Lie Xian Wan Chuan Xin Lian Kang Yan Pian
Points	GB-26, LU-7, REN-3, SP-6, SP-9, UB-22

JING AND BLOOD DEFICIENCY DUE TO KIDNEY, HEART AND SPLEEN DEFICIENCY

Clinical Manifestations	Fatigue Heavy and painful lower back Dream-disturbed sleep General weakness Lack of interest in food or drink Fever Night sweats Seminal emission Forgetfulness Toothache Dizziness Gum swelling General pitted edema which is worse in the lower body Vaginal discharge Discharge of rice-water like urination without dysuria Aversion to Cold Impotence Decreased libido Emaciation Loose teeth Signs of premature aging Abdominal Cold Easily frightened T: Pale or Pale and thick C: Smooth and white P: Moderate and weak or Deep and weak
Treatment Principle	Tonify the Spleen and Kidneys Nourish the Heart Enrich the Yin Nourish s the Blood and Yang Augment Qi
Herb Formulas	Huan Shao Dan With Liver Blood Deficiency: Sheng Fa Yin
Points

YIN DEFICIENCY FIRE

Clinical Manifestations	Fever Cough which may be productive or non-productive Dyspnea Night sweats Hemoptysis Sore throat Throat sores Facial flushing Constipation A dry mouth and throat Wheezing Steaming bones Hoarseness Thirst T: Red, dry and cracked C: Little or None P: Thready and rapid or Thready, rapid and weak
Treatment Principle	Nourish Yin Descend Fire Tonify Qi and Blood
Herb Formulas	Zi Yin Jiang Huo Tang
Points

QI, BLOOD AND YANG DEFICIENCY WITH COLD

Clinical Manifestations	Anemia Uterine bleeding Cold extremities Pale or sallow face Dizziness General fatigue Coarse skin Nocturnal emissions Weak knees Fatigue Dyspnea Night sweats Irregular menstruation Insomnia Intolerance of Cold Decreased eyesight after a prolonged illness Anxiety Intermittent fever Jaundice Deficient cough Shortness of breath Palpitations Anorexia Listlessness Lassitude Spontaneous sweating Spermatorrhea Continuous spotting Leukorrhea Weak legs and knees T: Pale C: Thin and white P: Thready and weak
Treatment Principle	Replenish Yang Warm and tonify Qi and Blood
Herb Formulas	Shi Quan Da Bu Tang Without External Cold: Ren Shen Yang Rong Tang
Points

QI AND BLOOD STAGNATION

Clinical Manifestations	Enduring prostatitis that does not heal Marked, possibly lancinating perineal area pain Pain radiates to the testes, penis, lower abdomen or low back Dark circles around the eyes Possible penile induration Urinary dribbling Rough, painful, astringent urination Painful sexual intercourse Painful ejaculation Possible spermatorrhea Possible hematuria A hard prostate Possible nodulation on the prostate Distension in the chest, epigastrium or abdomen Distending pain that moves from place to place Abdominal masses that appear and disappear or Abdominal masses that do not move Abdominal distension and pain that is not relieved by a bowel movement Mood swings Depression Frequent sighing Headache Irritability Insomnia Restlessness Constipation with small round stools Dull/dark complexion Purple lips Purple nails Pain that has the quality of boring in, fixed and stabbing and may be worse at night Bleeding with dark blood and dark clots T: Dark purple or Purple petechiae or Purple veinules C: White P: Wiry, choppy and tight
Treatment Principle	Invigorate the Blood Dispel Stasis Promote the circulation of Qi Alleviate pain
Herb Formulas	Huo Xue San Yu Tang #2
Points

BLOOD STAGNATION DUE TO COLD WITH DEFICIENCY COLD OF THE CHONG AND REN

Clinical Manifestations	Lower abdominal distention Lower abdominal Cold Lower abdominal pain Infertility Dry lips Dry mouth Spermatorrhea Pale complexion Leukorrhea Amenorrhea Bleeding between periods Low grade fever at dusk Irritability Five Sole Heat No desire to drink Distending breast pain Low back coldness and pain Loose stools Cold limbs Aversion to Cold T: Purple with petechiae P: Thready and choppy
Treatment Principle	Dispel Cold Warm the channels Nourish the Blood Dispel Blood Stasis
Herb Formulas	Wen Jing Tang
Points

BLOOD DEFICIENCY

Clinical Manifestations	Persistent, tight abdominal pain Abdominal pain with spasms or radiates to back and waist Cannot eat Shortness of breath Dyspnea Pale face Intermittent spasmodic abdominal pain which is better with Heat and pressure Epigastric pain Lusterless complexion Fidgeting Reduced appetite Maybe low-grade fever Palpitations Irritability Cold and sore extremities Nonspecific discomfort Dry mouth and throat Nocturnal emission Five Sole Heat Debilitated constitution in children Enuresis in children Insomnia Fatigue Anemia Bleeding Abdominal weakness Epistaxis Habitual constipation Maybe warm extremities Night sweats Tired limbs Frequent urination Night crying Diarrhea in children Habitual headache in children Hernia pain in children Chronic constipation Purpura Asthma T: Pale C: White P: Weak and slow or Thready, wiry and even or Thready and weak
Treatment Principle	Warms and tonifies the Spleen and Stomach
Herb Formulas	Dang Gui Jian Zhong Tang Shou Wu Sheng Fa Yin Tuo Fa Zai Sheng Tang With inability to nourish the Heart: Xiao Jian Zhong Tang
Points

DAMP-HEAT

Clinical Manifestations	Frequent spermatorrhea Nocturnal emissions Poor appetite Nausea Possible voiding of urine mixed with Jing Possible itchy or Damp scrotum Dry mouth Thirst with no desire to drink Irritability Restlessness Bitter taste in the mouth Voiding of dark-colored, turbid, hot urine Itchy pain inside the penis Tendency toward constipation or Alternating loose and sluggish stools Heaviness and aching of the lower limbs Lethargy Afternoon fatigue T: Red C: Greasy and yellow P: Soft, slippery and rapid or Deep and slippery
Treatment Principle	Clear Heat Dispel Dampness
Herb Formulas	Spermatorrhea #2 Cheng Shi Bei Xie Fen Qing Yin For predominant Damp-Heat in the Liver Channel (a bitter taste in the mouth, flank pain, damp, itchy genitals and a wiry pulse): Xie Gan Zhi Yi Wan For predominant Damp-Heat due to Spleen Qi Deficiency: Chun Gen Bai Pi Wan
Points	REN-3, SP-9, UB-28, UB-32, UB-52 For Stomach glomus and distention: + REN-12 For nausea: + PC-6 For a bitter taste in the mouth, flank pain, damp, itchy genitals and a wiry pulse: + LIV-2, LIV-5 For dribbling urination: + LIV-8

PHLEGM-FIRE

Clinical Manifestations	Frequent nocturnal emissions A bitter taste in the mouth Palpitations Insomnia Cough with profuse sticky, yellow, difficult to expectorate sputum Rapid breathing with a harsh voice Restless fever Sore throat Poor appetite Constipation Dry stools Mania Shortness of breath Dyspnea Nausea Vomiting Chest and/or epigastric fullness Pain in the ribs Hot, reddish urine Maybe lower abdominal and genital distention T: Scarlet C: Yellow and greasy P: Slippery and rapid
Treatment Principle	Clear Heat Resolve Phlegm Astringe Jing Stop emissions
Herb Formulas	Huang Lian Wen Dan Tang modified
Points	LIV-2, REN-3, ST-40, ST-44, UB-52 LI-11, LU-5, ST-40, UB-13

LOWER JIAO DEFICIENCY COLD

Clinical Manifestations	Frequent seminal emissions which are worse with exposure to Cold Devitalized Spirit Dizziness Tinnitus Low back and knee pain and coldness Impotence Possibly a cold penis Fatigue Aversion to Cold Cold limbs A bright, white facial complexion Profuse, clear urination T: Pale, enlarge and moist with teeth marks C: White P: Deep, thready and weak
Treatment Principle	Warm and Tonify Kidney Yang Supplement the Lower Jiao Astringe Jing
Herb Formulas	Wen Yang Gu Jing Tang
Points	Moxa or moxa needle DU-4, REN-4, UB-23, UB-52

SPERMATORRHEA, SEMINAL EMISSION, NOCTURNAL EMISSION

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