there are many possible causes of spermatorrhea, but it is most often associated with dysfunction of the kidneys and liver.

the kidneys store the essence (of which semen is a material manifestation) of all the organs, and the liver governs the free-flowing or spreading functions of the body. the liver (wood) depends on the kidneys (water) for nourishment, and the gate of essence in the kidneys requires a calm liver to be stable. when the kidneys are deficient, they cannot store the essence (or sperm); the gate of essence becomes destabilized, and spermatorrhea (usually chronic) results.

when the kidney and liver yin are deficient, fire from deficiency blazes and disturbs the chamber of the essence, which leads to an intemperate spreading of essence (semen), or spermatorrhea. by and large, wet dreams are due to blazing fire, while spontaneous emissions (spermatorrhea which occurs without dreams) are caused by the instability of the gate of essence.

this formula is designed primarily for the latter problem, although it can be modified to treat the former. kidney deficiency and shortage of essence leads to weakness of qi, which manifests as fatigue, weakness, and sore and weak limbs. the lower back is the dwelling of the kidneys; lower back pain is a classic symptom of kidney deficiency. the sensory organ most closely associated with the kidneys are the ears; kidney deficiency manifests as tinnitus. the pale tongue with a white coating and the thin, frail pulse are also characteristic of kidney deficiency.