ED

ED refers to a disease in young and middle-aged men, which causes the dregs of the tendons to relax due to weakness, fear, dampness and heat, resulting in the penis becoming weak and unable to rise, and not being firm during intercourse, or being firm but unable to last.

The Suwen · Yin Yang Ying Xiang Da Lun Pian and the Lingshu · Xie Qi Zang Fu Bing Xing call impotence “Yin Wu”, the Lingshu · Jing Jin Pian calls it “Yin Qi not being used”, and the Suwen · Wei Lun Pian calls it “Jin Yi atrophy”: “The thoughts are endless, the wishes are not fulfilled, the thoughts are lustful, and the intercourse is too much, the dregs are relaxed, and the tendons are atrophy.” The Neijing attributes the cause of impotence to “the qi is greatly weakened and cannot rise and be used”, “the heat makes the penis erect and cannot be retracted”, “the thoughts are endless, the wishes are not fulfilled” and “the intercourse is too much”, recognizing that qi deficiency, evil heat, emotions and sexual fatigue can cause this disease. “Treatise on the Causes and Symptoms of Various Diseases·Asthenia and Impotence” says: “Overwork injures the kidneys, and kidney deficiency cannot nourish the genitals, so impotence occurs.” It is believed that this disease is caused by overwork and kidney deficiency. “Ji Sheng Fang·Treatise on Deficiency” proposes that the decline of true yang can lead to impotence. “Miscellaneous Works of Ming Doctors·Male Impotence” points out that in addition to the decline of life gate fire, severe depression of fire can also cause impotence. In the Ming Dynasty, “Jingyue Complete Works” established the chapter “Impotence”, and this disease was named impotence. The book discusses its etiology, pathogenesis and treatment in a comprehensive manner. ·

For male sexual dysfunction and some chronic diseases in Western medicine with impotence as the main manifestation, you can refer to the content of this section for syndrome differentiation and treatment.

[Etiology and pathogenesis]

1. The fire of Mingmen is weak, and sexual intercourse is too much, or young people accidentally commit masturbation, or get married early, which leads to deficiency of essence and energy, and the fire of Mingmen is weak, resulting in impotence. As Jingyue Complete Book · Impotence says: “All men who cannot get impotence are mostly due to the fire of Mingmen being weak, and the essence and energy being weak and cold.”
2. Damage to the heart and spleen The stomach is the sea of ​​water and food, and the source of qi and blood. If you are worried and anxious, and have an unbalanced diet, it will damage the heart and spleen, and the disease will affect the Yangming Chongmai, resulting in deficiency of qi and blood, and the loss of nourishment to the Zongjin, which will cause impotence. Jingyue Complete Book · Impotence says: “Anyone who is worried, anxious, and depressed too much will often suffer from impotence. It is the meeting point of yin and yang Zongjin,… If you worry too much and damage the heart and spleen, the disease will affect the Yangming Chongmai,… Qi and blood will be deficient and the Yangdao will not be strong.”
3. Fear hurts the kidneys. Fear can cause disorder of qi, which can hurt the kidneys. Fear can cause qi to go down, which can gradually lead to the inability of the yang channel to be erected and not firm, resulting in impotence. “Jingyue Complete Book·Impotence” says: “If there is sudden fear, the yang channel will be impotent, which is also the proof.”
4. Liver depression and disharmony The liver governs the tendons, and the genitals are the gathering of the ancestral tendons. If the emotions are not satisfied, worry, depression and anger, the liver fails to dredge and release, and cannot dredge the blood and qi to the front yin, then the ancestral tendons will be unable to gather, as “Miscellaneous Diseases Origin and Flow Xizhu·Anterior Yin and Back Yin Disease Origin and Flow” says: “There are also people who have lost their will, depression hurts the liver, the liver wood cannot be dredged, and the yin cannot be erected.”
5. Damp heat descends. Eating too much fat and sweet food will hurt the spleen and hinder the stomach, generate dampness and heat, and the damp heat descends. The heat will relax the ancestral tendons, and the yang will not be aroused, which can lead to impotence. This is what the classics call strong fire and qi. The note in “Miscellaneous Works of Ming Doctors·Male Impotence” says: “The penis belongs to the meridian of the liver. The liver is wood. If wood is exposed to the dew, it will stand tall, but if it encounters extreme heat, it will wither.”

The causes of impotence are relatively complex, but excessive sexual intercourse and frequent masturbation are the most common. The disease is located in the kidney and is closely related to the spleen, stomach, and liver. There are five main pathogenesis mentioned above, which eventually lead to the loss of nourishment and relaxation of the main tendons, resulting in impotence. Among the five, the decline of the life gate fire is more common, while the damp heat is less common, so “Jingyue Complete Book·Impotence” says: “Seven or eight out of ten cases of decline of fire, and only one case of strong fire.”

[Brain bed manifestations]

The clinical manifestations of impotence are mainly impotence and weakness of the penis, erection but not firm, or firm but unable to last. Impotence is often seen with spermatorrhea and premature ejaculation. It is often accompanied by fatigue, sore waist and weak knees, dizziness, tinnitus, chills, cold limbs, cold scrotum and penis, or local cold and wet, thin and cold semen, less sperm or low sperm motility, or pain in the perineum, urination is not smooth, dripping, or clear and frequent urine.

【Diagnosis】

1. When young and middle-aged men have sexual intercourse, they cannot have a normal sexual life because their penis cannot be erected effectively.
2. It is often caused by excessive sexual intercourse, long-term illness and physical weakness, or frequent masturbation by teenagers, and is often accompanied by fatigue, sore waist and weak knees, chills, cold limbs, or urination is not smooth, dripping. ．
3. Exclude impotence caused by incomplete development of sexual organs or drugs.

【Differential diagnosis】

Premature ejaculation Premature ejaculation refers to the condition in which the penis can erect at the beginning of sexual intercourse, but then ejaculates prematurely, and normal sexual intercourse cannot be carried out because the penis becomes flaccid after ejaculation. Although premature ejaculation can cause impotence, impotence refers to the condition in which the penis cannot erect at all during sexual intercourse, or the erection is weak, or the duration is too short to carry out normal sexual life.

【Differential diagnosis and treatment】

Key points of syndrome differentiation

1. Differentiate between the presence of fire and the absence of fire Impotence with pale complexion, chills, cold limbs, cold scrotum and penis, or local cold and dampness, thin and cold semen, pale tongue, thin white fur, and deep and fine pulse indicates that there is no fire; impotence with irritability, bitter mouth and dry throat, yellow and red urine, red tongue, yellow and greasy fur, and moist and rapid or stringy pulse indicates that there is fire. Pulse and tongue fur are the main basis for syndrome differentiation.
2. Distinguish the deficiency and excess of the internal organs. Those who are injured by indulgence, worry, depression, and fear are mostly spleen and kidney deficiency, and the fire of the gate of life is weak, which belongs to the deficiency of the internal organs; those who are caused by liver depression and fire, dampness and heat, and the relaxation of the tendons are the excess of the internal organs.

Treatment principles

The treatment of impotence mainly starts from the etiology and pathogenesis. Those who are deficient should be supplemented, those who are full should be drained, those with fire should be cleared, and those without fire should be warmed. For those with the fire of the gate of life, the true yang is weak and the true yin is mostly damaged. They should warm the kidney to strengthen yang, nourish the kidney to replenish essence, and avoid using only hard, hot, dry and astringent drugs. It is advisable to use blood, flesh, affection, warm and moist crystals; for those with damaged heart and spleen, tonify the heart and spleen; for those who are injured by fear, tonify the kidney and calm the mind; for those who are uncomfortable with liver depression, soothe the liver and relieve depression; for those with dampness and heat, bitter and cold to strengthen yin, clear heat and remove dampness, that is, the principle of “the kidney wants to be strong, eat bitter food to strengthen it” in “Suwen·Treat according to different symptoms.What is ED?