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Impotence refers to softness of the penis during
erection, inability to maintain erection, or powerless
erection during sex. In TCM, this symptom is described as
slackness of the ancestral sinew due to weakness, fright, or
damp-heat, etc.
An article, "Symptoms of the Zang-Fu Organs
Caused by Evils" in the classic text entitled Divine
Pivot (Ling Shu), attributes impotence to ¡°yin atrophy.¡±
An article, "Channel Sinew" describes it as
uselessness of the private organ. "Discussion of
Atrophy" in the classic text Plain Questions (Su Wen)
describes these conditions as slackness of the ancestral
sinew or sinew atrophy. The medical book, Formulas of Peace
People-Favoring Dose-Making Bureau, describes it as
¡°inability to maintain erection during sex.¡±
Syndrome Identification
and Treatment Determination
1. Weak fire of the life gate
symptoms: inability to achieve and/or
maintain erection; thin, white and cold semen; general
symptoms may include dizziness, tinnitus, bright white
facial complexion, listlessness of the spirit, aching pains
and softness of the lumbar area and knees, aversion to cold,
cold limbs, pale tongue, white tongue coating, deep and
thready pulse.
therapeutic principle: warm and tonify the
lower origin
formula and ingredients: Right-Restoring
Pill combining with Procreation Elixir
Deerhorn glue (lu jiao jiao), cuscuta seed
(tu si zi), epimedium (yin yang huo), cistanche stem (rou
cong rong), Chinese leek seed (jiu cai zi), cnidium seed
(she chuang zi), eucommia bark (du zhong), lateral root of
aconite (fu zi), cinnamon bark (rou gui), curculigo root (xian
mao), morinda root (ba ji tian), velvet deer horn (lu rong).
The above ingredients can warm the kidneys and strengthen
the yang.
Cooked rehmannia root (shou di), tangkuei
(dang gui), lycium berry (gou qi zi), cornus fruit (shan zhu
yu). These herbs can nourish the blood and moisten the yin.
All these ingredients cooperate to play
positive roles by mutually supplementing the yin and yang,
so that the yang can be endlessly produced, assisted by the
yin.
2. Damage of the heart and spleen
symptoms: inability to achieve and/or
maintain erection, devitalized spirit, restless sleep, poor
appetite/eating habits, colorless facial complexion, thin
and slimy tongue coating, pale tongue, thready pulse.
therapeutic principle: enrich and tonify
the heart and spleen
formula and ingredients: Spleen-Restoring
Decoction
Codonopsis root (dang shen), astragalus
root (huang qi), ovate atractylodes root (bai zhu), poria
(fu ling), and licorice root (gan cao) can strengthen the
spleen and enrich the qi.
Spiny jujube kernel (suan zao ren),
polygala root (yuan zhi), longan fruit (gui ruan rou) can
nourish the heart and calm the spirit. Tangkuei (dang gui)
can supplement the blood.
All these ingredients cooperate to enrich
the qi, supplement the blood, nourish the heart, and fortify
the spleen.
3. Damage of the kidneys by fear
symptoms: impotence, powerless erection,
timidity, tendency to doubt and suspicion, palpitations,
susceptibility to fright, restless sleep, thin and slimy
tongue coating, string-like and thready pulse.
therapeutic principle: enrich the kidneys
and calm the spirit
formula and ingredients: Major
Origin-Supplementing Variant Brew
Cooked rehmannia root (shou di), cornus
fruit (shan zhu yu), eucommia bark (du zhong), and lycium
berry (gou qi zi) can enrich the kidneys. Ginseng (ren shen)
and tangkuei (dang gui) can tonify and enrich the qi and
blood. Spiny jujube kernel (suan zao ren) and polygala root
(yuan zhi) could be supplemented to nourish the heart and
calm the spirit. Since fear can make the qi descend,
cimicifuga root (sheng ma) and bupleurum root (chai hu) can
be added to lift the yang qi.
4. Depressed liver and qi stagnation
symptoms: impotence, inability to achieve
and/or maintain erection; general symptoms include
depression, anxiety and irritability, discomfort of the
chest and stomach, distension and oppression of the
hypochondriac region, poor appetite/eating habits, sloppy
stool, thin tongue coating, string-like pulse.
therapeutic principle: soothe the liver and
resolve stagnation
Buplureum root (chai hu), white peony root
(bai shao), and tangkuei (dang gui) can soothe the liver,
resolve stagnation, nourish the blood, and harmonize the
blood. Ovate atractylodes root (bai zhu), poria (fu ling),
and licorice root (gan cao) can strengthen the spleen to
assist transportation, fortifying the spleen (soil) to
resist against the attack of the liver (wood). On the other
hand, cyperus root (xiang fu zi), toosendan fruit (chuan
lian zi), bitter orange (zhi ke) can be added to rectify the
qi and adjust the liver. Psoralea (bu gu zhi), cuscuta seed
(tu si zi), and lycium berry (gou qi zi) can be used to
tonify and enrich the liver and kidneys.
These herbs act harmoniously to soothe the
liver, resolve stagnation, rectify the qi, harmonize the
middle-warmer (spleen and stomach), enrich the kidneys, and
assist the yang.
5. Downrush of the damp-heat
symptoms: atrophy and softness of the
penis, damp scrotum, foul odor of the genitals; general
symptoms include aching pains and heaviness of the lower
extremities, soggy and rapid pulse.
therapeutic principle: clear heat and
transform damp
formula and ingredients: Gentian
Liver-Draining Decoction
Gentian root (long dan cao), scutellaria
root (huang qin), gardenia fruit (shan zhi), buplureum root
(chai hu) can clear heat and discharge fire, consolidating
the kidneys depending upon their bitter taste. Manshurian
aristolochia stem (mu tong), plantago seed (che qian zi),
and alisma tuber (ze xie) can clear and excrete damp and
heat. Tangkuei (dang gui), fresh rehmannia root (sheng di)
can nourish the blood, quicken the blood circulation, cool
the blood; they act concomitantly with the herbs that can
clear heat and discharge fire, so the whole recipe could
play the role of supplementing when discharging so that the
fire-discharging herbs, which are much too bitter and dry in
nature, would not damage the yin fluids.
Disease prevention and mental adjustment
With regard to disease prevention, if the
disease is due to sexual indulgence, the patient should calm
the mind, refrain from sexual indulgence, and avoid
masturbation. If the disease is characterized by general
weakness, malnutrition, mental or physical overwork, the
patient should increase nutritious foods, ensure good rest,
control the sexual activities in a moderate way. With regard
to mental adjustment, the patient should keep in mind that
in order to be able to resolve the disease successfully, he
should adopt a habit of regular physical exercise, refrain
form sexual relations for a period, and if in a stable
relationship, ask for support and consideration from his
partner. All these approaches will benefit the treatment.
Premature ejaculation
Premature ejaculation means quick
ejaculation at the beginning of intercourse, even prior to
intercourse. The earliest record of this pattern is seen in
the article, "Descendant Producing" in the book
Collection of Syndrome Identification. Premature ejaculation
usually occurs concomitantly with seminal emission,
impotence, etc. Therefore, the treatments of these diseases
are approximately similar.
Excessive sexual activities and frequent
masturbation can deplete the kidney essence. The kidney yin
becomes insufficient, the minister (kidneys) fire thus
overwhelms, provoking the occurrence of premature
ejaculation. Poor inborn endowment, bad postnatal nutrition,
or prolonged seminal emission can result in double
deficiencies of the kidney yin and kidney yang; premature
ejaculation may arise in this condition.
Syndrome identification
and treatment determination
1. Yin deficiency and effulgent fire
symptoms: frequent sexual desires, easy and
quick erection, or powerless erection, premature ejaculation
during sexual relations, seminal emission, dizziness,
palpitations, dry mouth and throat, red tongue, thready and
rapid pulse.
therapeutic principle: moisten the yin and
lower the fire.
formula and ingredients: Anemarrhena,
Phellodendron, and Rehmannia Pills, or Major Yin
Supplementation Pills
The first formula includes:
anemarrhena root (zhi mu) moistening the
kidney yin
phellodendron bark (huang bai) discharging
fire and consolidating the yin
cooked rehmannia root (shou di huang)
moistening the kidney yin
cornus fruit (shan zhu yu) moistening the
kidneys and enriching the liver
dioscorea root (shan yao) discharging the
damp of the spleen
mountan bark (dan pi) draining the liver
fire
alisma tuber (ze xie) lowering the kidney
turbidity
The second formula encompasses:
anemarrhena root (zhi mu) moistening the
kidney yin
phellodendron bark (huang bai) discharging
the fire and consolidating the yin
cooked rehmannia root (shou di huang)
nourishing the genuine yin, subduing the yang, and
controlling the fire
turtle shell (gui ban) nourishing the
genuine yin, subduing the yang, and controlling the fire
pig¡¯s spine marrow (zhu ji sui) filling
the semen and supplementing the yin fluids
2. Deficiencies of the yin and yang
symptoms: aversion to cold, cold limbs,
bright white facial complexion, short breath, aching pains
and softness of the lumbar area and knees, impotence, thin
seeds, pale tongue, weak pulse.
therapeutic principle: moisten the kidney
yin and warm the kidney yang
formula and ingredients: Golden Chamber
Kidney Qi Pills
Cinnamon twig (gui zhi) and prepared
lateral root of aconite (fu zi) warm and tonify the kidney
yang slightly to produce the kidney qi mildly.
Cooked rehmannia root (shou di huang) can
moisten and supplement the kidney yin.
Cornus fruit (shan zhu yu) can moisten and
enrich the liver and kidneys.
Dioscorea root (shan yao) can moisten and
enrich the spleen and kidneys.
Poria (fu ling) can excrete water and damp;
mountan bark (dan pi) can discharge the liver fire; alisma
tuber (ze xie) can excrete water and damp.
These three ingredients (cornus fruit,
dioscorea root and poria) can discharge when supplementing
so that tonification will not cause stagnation.
This formula suggests that a doctor, who is
skillful in tonifying yang, must seek the yang within the
yin, because the yang can be produced endlessly when it is
helped by the yin.
Serious premature ejaculation can result in
impotence, while impotence is usually accompanied by
premature ejaculation. When doctors try to cope with these
diseases, they should consider all these conditions
comprehensively.
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