What's up, Doc?

In this article, I would like to discuss the concept of “spermaorrhea” from the viewpoint of a western medical physician. “Spermatorrhea” comes from the Greek words that mean “seeds that flow”. First I would like to say that the term has no meaning in modern medicine. However, there are references to it in older medical texts from 1800’s. These references usually start with “involuntary” emission of semen. But after that, the definitions differ, such as, “involuntary loss of semen without copulation” or “without orgasm” or “frequent and spontaneous”. There are some common physiological entities that could be included in this term, for example, masturbation, nocturnal emissions, premature ejaculations. All of these entities involve an ejaculation of some type.

Looking at the definitions in English texts for Chinese medicine, we can also find some different versions for “spermatorrhea”. Maciocia seems to think that it is a result of chronic prostatitis. Yanchi’s text on TCM defines it as nocturnal emission, excessive libido. Many texts don’t describe or define it at all. I have found that as a student of TCM, my Chinese teachers were often too embarrassed to explain or were not too sure themselves what the ancients meant by “spermatorrhea”. The main idea is that there is a loss of a vital substance that the kidney is supposed to protect and maintain.
I wonder about other possibilities that might explain this as well or better. Is “spermatorrhea” always associated with ejaculation or climax or does it just run out of the body like the name implies? The latter explanation has no physiological basis. It does not occur. The sperm basically has to be brought up from storage in the seminal vesicles, vas deferens, epididymus by a pumping action that we call ejaculation. It doesn’t just roll out on its own. Nevertheless, we are talking here about ancient Chinese who did not have access to a microscope to observe sperm. Perhaps the ancients differentiated the pungent smell that comes from seminal fluids (with or without sperm) from urine and assumed that this was sperm. Or maybe they sometimes got confused with prostatic secretions which do not contain sperm but do tend to just flow out without ejaculation. Or another possibility, maybe spermatorrhea was at times confused with gonorrhea, which also just flows out and stains clothing. None of this appears to be clear in discussions and textbooks. Finally, some authorities in TCM see spermatorrhea simply as a TCM concept that accounts for any urogenital secretion other than urine.
They see this as a TCM loss of vital substances and not much more. When all is said and done, modern medicine basically considers it harmless. Chinese medicine counts the waste of semen or whatever was actually observed to leak untimely out of the male genital organ as a reduction in jing or kidney essence. What is your opinion?