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 "the semen itself emits downward frequently."
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 "the kidney qi is enfeebled and incapable
of storing semen, so the semen leaks and loses." 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, "If 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." An article Seminal Emission in the book Gists of Patterns and Treatments
says, "There are people who get unstopped seminal emission because of excessive
sexual desires." 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, "There 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."
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.
Dr. Ming's TCM Medical
Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua city, Hunan province
China