Disease and Condition Overview
Nocturnal emissions, also called "wet dreams", are characterized by ejaculation of semen experienced during sleep. In Chinese medicine, the location of the disease is at the kidney and is often caused by the inability of kidney qi to control and obtain the essence. Over indulgence in sex, exhaustion and improper diet can all lead to damage of kidney and cause nocturnal emissions.
Clinically, nocturnal emissions may be caused by prostatitis, vesiculitis and orchitis as well.

Pair-point Treatment Combinations

(1) Guanyuan (RN4), Shenshu (BL23) (Fig 30)
Guanyuan (RN4) and Shenshu (BL23) both strengthen and tonify kidney. These points work in conjunction to tonify yin, warm yang, strengthen kidney and fortify yuan or congenital qi. This treatment is appropriate for all types of nocturnal emissions.

Needling techniques:
Guanyuan (RN4) perpendicular insertion to a depth of 0.5 cun, after needling, applies moxibustion for 10 minutes.
Shenshn (BL23) needle use tonify method, after needling, apply moxibustion for 10 minutes.

(2) Mingmen (DU4), Taixi (KI3) (Fig 123)
Mingmen (DU4) strengthens and tonifies kidney. Taixi (KI3) tonifies yin and strengthens kidney. This pair point combination tonifies kidney, fortifies yuan or congenital qi, tonifies yin and strengthens yang. This treatment is appropriate for nocturnal emissions caused by weak fire in mingmen.

Needling techniques:
1. Mingmen (DU4) perpendicular insertion to a depth of 1 cun, using moxa sticks 10-20 minutes.
2. Taixi (KI3) perpendicular insertion to a depth of 0.5 cun.

(3) Yingu (KI10), Xingjian (LR2) (Fig 18)
Yingu (KI10) clears heat and t0nifies yin. Xingjian (LR2) reduces liver and cools blood. This pair point combination, one tonifying and one reducing, works in synergy to tonify yin of liver and kidney, clear empty heat and cool blood. This treatment is appropriate for nocturnal emissions caused by yin deficiency and inner heat.

Needling techniques:
1. Yingu (KI1O) perpendicular insertion to a depth of 1 cun.
2. Xingjian (LR2) perpendicular insertion to a depth of 0.5 cun.

(4) Qihai (RN6), Sanyinjiao (SP6) (Fig 125)
Qihai (RN6) regulates and tonifies qi of the lower jiao. Sanyinjiao (SP6) regulates qi of liver, spleen and kidney. This pair point combination, superior and inferior combined, fortifies lower original qi and controls the yin essence. This treatment is appropriate for nocturnal emissions caused by lower original qi and deficient yin.

Needling techniques:
1. Qihai (RN6) perpendicular insertion to a depth of 1 cun, using moxa sticks 10 minutes.
2. Sanyinjiao (SP6) perpendicular insertion to a depth of 1 cun, using moxa sticks 10 minutes.

(5) Qihai (RN6), Rangu (KI2) (Fig 118)
Qihai (RN6) regulates qi and warms lower jiao. Rangu (KI2) tonifies kidney yin and reduces deficiency heat. This pair point combination both clears and tonifies simultaneously. This treatment is appropriate for nocturnal emissions caused by lower yuan and true fire deficiency.

Needling techniques:
1. Qihai (RN6) perpendicular insertion to a depth of 1 cun, using moxa sticks 10 minutes.
2. Rangu (KI2) perpendicular insertion to a depth of 1 cun.

(6) Zhishi (BL52), Sanyinjia0 (SP6) (Fig 126)
Zhishi (BL52): on the lower back, below the spinous process of the second lumbar vertebra (L2), 3 cun lateral to the posterior midline.
Sanyinjiao (SP6): on the medial side of the lower leg, 3 cun superior to the prominence of the medial malleolus, in the depression near the posterior border of the tibia.
Zhishi (BL52) clears heat and dampness from lower jiao. Sanyinjiao (SP6) regulates qi from liver, spleen and kidney channels. This pair point combination, superior and inferior combined, tonifies liver and kidney, regulates lower jiao and solidifies essence. This treatment is appropriate for nocturnal emissions caused by lower jiao damp heat.

Needling techniques:
1. Zhishi (BL52) perpendicular insertion to a depth of 2 cun, after needling, applies moxa using moxa stick for 10 minutes.
2. Sanyinjiao (SP6) perpendicular insertion to a depth of 1 cun, using moxa sticks 10 minutes.

(7) Ciliao (BL32), Weizhong (BL40) (Fig 127)
Ciliao (BL32): on the sacrum, midpoint between the posteriorsuperior iliac spine and the posterior midline, at the second posterior sacral foramen.
Weizhong (BL40): at the back of the knee, on the midpoint of the popliteal crease, between the tendons of biceps femoris and semitendinosus.
Ciliao (BL32) disperses, harmonizes and regulates lower jiao qi. Weizhong (BL40) regulates bladder qi. This pair point combination, superior and inferior combined, promotes and elevates qi and blood and opens the luo-connecting channels. This treatment is appropriate for nocturnal emissions caused by lower jiao stagnation of qi and blood.

Needling techniques:
1. Ciliao (BL32) perpendicular insertion to a depth of 2 cun, manipulate using the dao-qi method.
2. Weizhong (BL40) perpendicular insertion to a depth of 2 cun, manipulate using the dao-qi method. If excess blood in collaterals use three-edged needle prick for blood.

Commentaries
Acupuncture has good effects in the treatment of nocturnal emissions.
The key to treating nocturnal emissions is to first tonify the original qi in order to fortify and control essence. Select Mingmen (DU4), Taixi (KI3), or Qihai (RN6), Sanyinjiao (SP6) pair-point combinations.
For nocturnal emission caused by inner heat or caused by yin deficiency, select Yingu (KI10), Xingjian (LR2) or Qihai (RN6), Rangu (KI2).

For damp heat in the lower jiao, select Zhishi (BL52), Sanyinjiao (SP6)

For qi irregularity in the lower jiao, select Ciliao (BL32), Weizhong (BL4O).

For the rest of cases without differentiating symptoms, select Guanyuan (RN4), Shenshu (BL23).

Also, while applying acupuncture treatment, it is also important to consider patient's emotional well-being and provide necessary support and guidance.