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Nocturnal Emission and TCM

by Xiaolan Zhuang                                        Page Search Help

Sperm is transformed by the spleen and the stomach and stored in the kidney. Yet it is controlled mainly by heart.  Thus the key point in treating nocturnal emission is to make clear in 3 aspects:  with dream, or without dream, if there is damp-heat.  Generally speaking, emission with dream is moderate, without dream is severe, with damp-heat is moderate, with general lassitude is severe.  For the principle treatment, the more important one is to store function of the heart and calm the mind to relieve mental stress.  The secondary principle is to arrest emission by astringent herbs.

Nocturnal emission with dreams

In a case of emission with dreams, the problem lies in the heart.  Clinically, there mainly three patterns:  heart blood deficiency, flaming up of heart fire and heart Qi deficiency.

A. Heart blood deficiency:  dream disturbed sleep, even in the day time during a nap, restlessness, occasional palpitation, red tip of tongue.

Treatment principle:  Nourish blood and calm the mind.

Herbs:  Fushen (poria with hostwood), Fuling( poria ), Danggui (Chinese angelica root), Shengdi (Rehmannia dried root), Lianzi (lotus seed), Suanzaoren (Spine date seed), Yuanzhi(Thinleaf milkwort root), Dangsheng (Pilose asiabell root), Shichangpu (grassleaf sweetflag rhizome).

B. Heart fire: Those people who couldn't get what they long for will get energy stagnated, which will easily turn into heart fire.  They won't have any symptoms of deficiency, but dreams with nocturnal emission.  In this case, Siqi Tang is recommended.

Herbs: Baixia (Pinellia rhizome), Houpu (Officinal magnolia bark), Fuling (Tuckahoe), Zisu (Perilla leaf), Shengjiang (Fresh ginger) and Daza (Chinese Date).

C. Heart Qi deficiency:  Over thinking damages heart Qi giving rise to heart Qi deficiency, which fails to control the kidney causing nocturnal emission.   This type of patients, they easily feel tired, reluctant to speak.

Treatment principle:  Tonify Qi to store sperm

Herbs: Yuanzhi (Thinleaf milkwort root), Fuling (Tuckahoe), Fushen (poria with hostwood), Longchi (Dragon's teeth), Shichangpu (Grassleaf sweetlfag rhizome).

Nocturnal emission without dreams

The problem of nocturnal emission without dreams lies in the kidney.  The kidney is the organ stores sperm.  It is the kidney Qi which is responsible for the storage of sperm.  If kidney Qi is deficient, sperm will leak out spontaneously giving rise to emission without dreams.  The kidney is also an organ of water and fire, yin and yang. Sperm belongs to kidney water.  When kidney yin is deficiency, it gives rise to empty fire which stirs up kidney water giving rise to emission.  When kidney Qi is deficient, it can carry out its duty of storing kidney essence giving rise to emission as well. So clinically, there are 2 types:  Kidney yin deficiency and Kidney Qi deficiency.

A. Kidney yin deficiency with empty fire:  feverish sensation in the chest, palms and soles, night sweat and nocturnal emission without dream.

Treatment principle:  To nourish kidney yin and sedate empty fire.

Herbs:  Shengdi (Rehmannia dried root), Zhimu (Common anemarrhena rhizome), Huangbai (Chinese corktree bark), Guiban(Tortoise shell), Tiandong(Cochinchinese asparagus root), Sharen (Villous amomum fruit), and Gancao (Locorice root).

B. Kidney Qi deficiency:  Weak constitution, long duration of diseases or too much sex depletes kidney Qi, giving rise to nocturnal emission without dreams.  In this case, patients usually don't have any heat symptoms.  They may speak of lower back weakness and fatigue.

Treatment principle:  Tonify kidney Qi to store the kidney essence.

Herbs:  Sangpiaoxiao (Mantis egg-case), Dangshen (Pilose asiabell root), Fuling (Tuckahoe), Longgu( Dragon's teeth), Guiban(Tortoise shell), Shichangpu (Grassleaf sweetflag rhizome), Yuanzhi(Thinleaf milkwort wood), Danggui (Chinese angelica root), Qianshi (Gordon euryale seed), Lianxu (Lotus stamen), Muli (Oyster shell), Jinyinzi (Cherokee rose fruit) and Lianzi (Lotus seed).

Emission due to Damp-heat

Damp-heat attacking the lower jiao giving rise to emission usually involves in the small intestine and urinary bladder.  These two organs locate very close to the kidney, and urinary bladder is also internal-external related with the kidney through meridians and collaterals.   So when damp-heat attacking these two organs, it easily affects the kidney leading to emission.  Clinically, there are two types as well:

A.  Damp-heat in the lower Jiao:  Patients speak of yellow urine, moist skin around the external genitals, occasional heat sensation all over with restlessness, nocturnal emission with or without dreams.

Treatment principle:  Clear damp-heat from the lower Jiao.

Herbs:  Huangbai( Chinese corktree bark ), Huanglian (Coptis rhizome), Fuling (Tuckahoe), Zexie (Oriental waterplantain rhizome) and Beixie (Hypoglaucous collett yam rhizome).

B.  Accumulation of damp-heat in the stomach and spleen flows downward along the meridians affecting the local area.  In this case, patients usually have thick yellow tongue coating and nocturnal emission with dreams.

Treatment principle:  Rise the clear energy and sedate the turbid one so as to restore the normal function of spleen and stomach to remove the damp-heat.

Herbs:  Cangzhu( Swordlike atractylodes rhizome), Baizhu (Largehead atractylodes rhizome), Baixia (Pinellia rhizome), Chenpi (Tangerine peel), Fuling (Tuckahoe), Gancao (Licorice root), Huangbai( Chinese corktree bark) and Shengma (Shunk bugbane rhizome).

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