Nocturnal Emission

Nocturnal Emission

It is commonly believed that when one vomits blood, the other emits semen, and that these two conditions are incurable because the upper part reverses while the lower part depletes, leading to immediate consumption. However, for those suffering from these conditions, as long as they do not persist for too long, treatment is still possible. Although nocturnal emission and blood loss are two separate conditions, they are essentially the same. Semen is generated by the yang qi in the kidneys; it is the癸water created by Heaven. For girls, when they reach fourteen, the癸water enters the uterus, and the Chongren meridians connect, transferring the blood transformed by heart fire into the uterus, where it mixes with the癸water, turning blood into water—this is menstruation. For boys, when they reach sixteen, the癸water also enters the uterus, and the Chongren meridians transfer blood into the uterus, where it mixes with the癸water, turning blood into semen—this is nocturnal emission. The uterus is the dwelling place of semen, and also the chamber of blood. Vomiting blood is a disease of the blood component in the uterus, while nocturnal emission is a disease of the water component in the uterus. Blood and water interact and complement each other both internally and externally, as I have repeatedly mentioned. Therefore, those who suffer from blood loss invariably suffer from water loss as well, and those who suffer from water loss invariably suffer from blood loss as well. Consequently, vomiting blood is often accompanied by phlegm-drinking, and blood can also turn into edema; even urinary retention may involve fresh blood, because blood and water are inherently interdependent. Semen is generated by water, nocturnal emission is a water-related disease, and vomiting blood is also a blood-related disease. If vomiting blood comes first, it means the blood disease affects the water; if nocturnal emission comes first, it means the water disease affects the blood. Regardless of the order of treatment, the primary focus should always be on treating the liver. The uterus is under the jurisdiction of the liver, and both semen and blood are stored here. Those who treat blood must also treat the uterus, and those who treat semen must also treat the uterus. Since the uterus is under the jurisdiction of the liver, the primary focus should always be on treating the liver. The liver harbors fire, and its qi is responsible for dispersing and releasing; when the fire is intense and the qi is abundant, vomiting blood occurs while nocturnal emission occurs, and Di Gu Pi San combined with Chuanxiong, Hu Huanglian, Anemarrhena, Phellodendron, Oyster Shell, Dragon Bone, Fuling, Pu Huang, and Blood Residue is used for treatment, while Dan Zhi Xiaoyao San combined with Ajiao, Dragon Bone, Oyster Shell, Pu Huang is used to stabilize the situation. For those with severe vomiting blood but mild nocturnal emission, the focus should be on treating vomiting blood, and Shengdi Huang San combined with Jin Yingzi and Oyster Shell is used for treatment. For those with severe nocturnal emission but mild vomiting blood, the focus should be on treating nocturnal emission, and Dihuang Tang combined with Blood Residue, Dragon Bone, and Oyster Shell is used for treatment.

Zhang Zhongjing treated nocturnal emission using Tianxiong Fuzi method; when the kidney qi cannot accept the heart fire, and the heart fire cannot descend to the kidney, the Cinnamon method is used, both of which indicate yang deficiency. In blood-related cases, however, it is often fire-related emission, meaning the heart and kidney are not communicating, and the water is also unable to assist the fire, resulting in wet dreams in eight or nine cases out of ten, because the liver meridian is overly active, and the soul cannot stay inside, leading to confusion and hallucinations. There are also cases of emission without dreams, which are still due to excessive heart fire; when the fire is too intense, the spirit becomes unclear, leading to drowsiness and confusion, and one does not realize the loss of semen, compared to those with dreams, whose fire is even more intense, so it should not be mistaken for yang deficiency. Da Bu Yin Wan combined with Shengzao Ren, Oyster Shell, Dragon Bone, and Fu Shen is used for treatment. If the qi cannot control the semen, the person will inevitably show signs of cold deficiency, regardless of whether there are dreams or not.

[Commentary] This section argues that although nocturnal emission and vomiting blood appear different, their essence is exactly the same. Just like a woman’s menstruation and a man’s semen, the former is the癸water in the uterus transformed from blood, while the latter is the癸water in the uterus transformed from water. Menstruation is the transformation of blood-derived癸water downward, while vomiting blood is the transformation of blood-derived癸water upward. Based on this reason, vomiting blood is a disease of the blood component in the uterus, while nocturnal emission is a disease of the water component in the uterus. The root cause of both lies in the uterus, and the author states: “The uterus is the dwelling place of semen and the chamber of blood.” For men, it corresponds to the丹田. The liver governs the uterus, and if the uterus is diseased, the liver must be treated. The treatment formulas advocated in this section for vomiting blood and nocturnal emission, such as Di Gu Pi San, Xiaoyao San, and Shengdi Huang San, are all liver-focused formulas. The additional herbs used, such as Chuanxiong, Dragon Bone, Oyster Shell, Pu Huang, and Jin Yingzi, are also mostly liver-treating ingredients.