Impotence is the modern medical term for erectile dysfunction, and the clinical manifestations of impotence are summarized in Chinese medicine as “impotence without lifting, lifting but not firm, firm but not long”. In clinical practice, I found that the ultimate pathogenesis of impotence is blood stasis, and the clinical manifestations are closely related to mood swings, which is in line with the characteristic of “wind is good at moving and changing”, therefore, we proposed the concept of “penile stroke”, and successively suggested that impotence should be treated from wind. Impotence is not always due to kidney deficiency In ancient times, most physicians blamed the kidney for impotence and attributed the cause of impotence to kidney yin deficiency, kidney yang deficiency or kidney yin and yang deficiency, and then treated it from the kidney. However, with the change of lifestyle and the adjustment of diet structure, Chinese medicine now believes that impotence is located in the kidney, but is closely related to the heart, spleen and kidney, and its pathogenesis is kidney deficiency, damp-heat, liver depression, blood stasis, etc. According to research, kidney deficiency is no longer the main pathogenesis of impotence today, and emotional changes have become the main pathogenetic basis. Clinical trials by many research centers have shown that the most basic pathological changes of impotence are liver depression, kidney deficiency and blood stasis, where liver depression is the main pathological feature, kidney deficiency is the main pathological trend and blood stasis is the final pathological trend, and liver depression and blood stasis are always present in impotence. The manifestation is quite windy. In clinical practice, it is found that the disease leading to obstruction of blood circulation is similar to the etiology and clinical manifestation of stroke, which also belongs to the category of stroke. And the ultimate pathogenesis of impotence is blood stasis. In addition, impotence has a sudden onset and is closely related to mood swings, which are sometimes good and sometimes bad, in line with the characteristic of “wind is good at moving and changing”. The etiology and pathogenesis of penile stroke are mainly blood stasis and wind, internal movement of wind and liver depression and heat. Blood stasis generates wind The basic pathogenesis of impotence can be summarized as liver stagnation, kidney deficiency, damp heat and blood stasis, among which blood stasis plays an important role in the development of impotence and is the ultimate pathological trend. In terms of TCM theory, the pathological changes of vascular endothelial dysfunction, i.e. blood stasis. When blood stasis appears in the penile area, blocking the meridians and affecting the function of tendons and veins, it can produce internal wind, i.e. penile stroke. The theory of luo disease was put forward by Ye Tianshi in the Qing Dynasty, namely, “the meridian governs qi and the luo governs blood”, and “at first, qi is knotted in the meridian, but after a long time, blood is injured into the luo”. Impotence is closely related to luo disease, and there are many similarities. In terms of pathological changes, the luo vascular system is characterized by easy stagnation and stasis, easy entry but difficult exit, and easy accumulation and formation, while the ultimate pathological trend of impotence is blood stasis, which leads to obstruction of circulation; it affects the penile luo vascular system, leading to an increase in the degree of luo vascular stasis and spasm of the luo vascular system and internal movement of luo wind. Liver stagnation turns heat into wind Liver stagnation is an important key pathogenic mechanism in the development of impotence. As liver depression runs throughout the disease, impotence patients will have liver depression that turns into heat and depletes the yin of liver and kidney, resulting in yin deficiency and yang hyperactivity, water does not contain wood, floating yang is not latent, and in the long run, yang becomes more floating and yin becomes more deficient, resulting in yin not controlling yang, liver yang rises without control, and hyperactivity turns into wind. The basic pathogenesis of impotence is blood stasis. Therefore, the basic treatment for impotence should be “treating the wind first, and the wind will be eliminated when the blood moves”, so as to invigorate the blood and dispel the wind throughout the disease, and then treat the disease according to the clinical symptoms. 1, dredging the liver and relieving depression, invigorating the blood and dispelling wind Clinical manifestations are good and bad erectile function, obviously affected by emotion and mood, accompanied by emotional depression or irritability, dullness of the ribcage, dry mouth and bitterness, little food and loose stool, thin coating and string veins. The main treatment is to de-stress the liver, and at the same time to invigorate blood and dispel wind. Commonly used drugs: Chai Hu 10g, Bai Shao 20g, Angelica Sinensis 20g, Fried Tribulus terrestris 30g, Chuan Niu Knee 15g, Qing Pi 10g, Yu Jin 10g, Dan Shen 20g, Whole Scorpion 3g, Centipede 3g, Beehive 10g, etc. 2. Clearing heat and dampness, invigorating blood and dispelling wind Clinical manifestations include impotence with scrotal dampness, scrotal itching, loss of appetite, abdominal distension, cloudy urine, occasional white dripping, drowsy limbs, red tongue, yellow greasy coating and slippery pulse. These patients are mostly of damp-heat constitution, so treatment should be based on clearing heat and dampness, while invigorating blood and dispelling wind. Commonly used drugs: gentian herb 6g, poria 15g, gardenia 10g, zedoary 15g, psyllium 20g, poria 30g, angelica 20g, yujin 10g, chuan niu knee 15g, dan shen 20g, beehive 10g, snake bed seed 15g, etc. 3, tonifying the kidney and strengthening the yang, activating the blood and dispelling the wind Clinical manifestations include impotence with dizziness and tinnitus, decreased physical strength, easy fatigue, soreness and pain in the waist and knees, fear of cold, or cold extremities, especially in the lower extremities, with a pale fat tongue, white fur and sunken pulse. These patients have obvious kidney deficiency, and should be treated by tonifying the kidneys, invigorating blood and dispelling wind. Commonly used drugs: Epimedium 30g, Bacopa monnieri 20g, Cornu Cervi Pantotrichum 10g, Fructus Lycii 30g, Cinnamon 6g, Antler Gum 10g, Semen Cuscutae 30g, Cortex Eucommiae 15g, Radix Angelicae Sinensis 20g, Panax notoginseng 3g, Centipede 3g, Scorpion 3g, Rhizoma Polygonati 15g, Radix Astragali 30g, Atractylodes Macrocephalae 15g, etc. 4, resolving blood stasis and promoting circulation, activating Blood to dispel wind Clinical manifestations include impotence with unfavorable limb movement, pain and discomfort in the abdomen and other parts of the body, or with cardiovascular disease, diabetes mellitus, etc. The tongue is purple and dark or has stasis spots and stasis points, and the pulse is astringent. Treatment should be based on activating blood circulation and dispelling wind, resolving blood stasis and promoting circulation. Commonly used drugs: Astragalus membranaceus 30g, Angelica sinensis 20g, Dilong 10g, Radix paeoniae 15g, Chuanxiong 12g, Safflower 6g, Panax notoginseng 3g, Centipede 3g, Leech 10g, Scorpion 3g, etc.