Impotence refers to the inability of adult men to have normal sexual intercourse due to impotence of the penis during sexual intercourse, or the inability of the penis to be erected, or the inability of the penis to be erected, or the inability of the penis to be erected. However, transient penile erection disorder caused by fever, overexertion, emotional abnormalities and other factors cannot be considered as pathological. The reason 1, endowment deficiency, labor injury long illness congenital deficiency or wanton indulgence, excessive sexual intercourse, or masturbation, early marriage, can cause the essence of deficiency loss, the fate of the door fire failure and cause the Yang thing not to lift. In addition, prolonged illness and strain, damage to the spleen and stomach, insufficient qi and blood sources, can lead to impotence due to loss of nourishment of the tendons. 2. Disorders of the seven emotions. Disorders of the emotions, excessive thinking, depression and anger will cause the liver to lose drainage. This causes impotence due to the inability to gather the tendons. Or too much thinking, damage to the heart and spleen, lack of qi and blood, loss of nourishment of the tendons; or a great fright and fear, injury to the heart and kidneys, qi reversal, qi and blood do not reach the tendons, can not be strong, then impotence. 3, dietary disorders over-eating alcohol and wine, thick taste, the spleen and stomach transportation is not normal, gathering moisture and heat, damp heat down to the liver and kidneys, meridians blocked, qi and blood does not glory zong tendons, and become impotent. 4, external evil invasion long living in wetlands or damp-heat invasion, the liver meridian, down the injection of the tendons, or cold and damp injury to Yang, Yang for the yin containment, the development of impotence. The basic pathogenesis is damage to the liver, kidney, heart and spleen, deficiency of qi, blood, yin and yang, and loss of glory of the yin channels; or liver depression and dampness obstruction, and loss of smoothness of the meridians, resulting in the loss of use of the zong tendons. The location of the disease is in the zong tendon, and the internal organs are mainly in the liver, kidney, heart and spleen. Pathological nature: there is a deficiency and a combination of deficiency and reality. Diagnostic points Diagnostic basis 1. Adult men are unable to have normal sexual intercourse because their penis is impotent, or not firm, or firm but not long. However, the inability to have intercourse caused by penile dysplasia must be excluded. 2, there is often fatigue, lumbar weakness, cold, cold limbs, sleepless nights, mental anguish, timidity and suspicion, or urination, dripping and incomplete, etc. 3. This disease often has a history of overwork, frequent masturbation, prolonged illness and weakness, or history of thirst, palpitation, depression, etc. The difference between impotence and premature ejaculation: impotence is a condition in which the penis cannot be erected during sexual intercourse, or is not firm, or is firm but not long enough to have a normal sexual life, while premature ejaculation is a condition in which the penis can be erected during intercourse, but the penis is impotent after ejaculation due to premature ejaculation. There are obvious differences between the two in terms of clinical manifestations, but there are similarities in terms of etiology and pathogenesis. If premature ejaculation remains untreated for a long time, it may further lead to impotence, so impotence condition is heavier than premature ejaculation. In addition to routine urine examination, prostate fluid and blood lipids, nocturnal penile erection test can be done to distinguish between mental and organic diseases. In the latter case, blood glucose, testosterone, gonadotropin, etc. should be checked for endocrine diseases. Doppler ultrasound and penile artery manometry should also be performed to determine whether there is penile blood flow disorder. After ruling out the above mentioned pathologies, electromyography and electroencephalogram can be performed as appropriate to understand whether the disorder is neurological. The main points of dialectical treatment are that there are deficiencies and realities in this disease, and there are also mixed deficiencies and realities, so the first step is to identify the deficiencies and realities. In the case of the actual disease, differentiate between qi stagnation and dampness-heat; in the case of deficiency, differentiate between deficiency of qi, blood, yin and yang, and the different organs of the disease; in the case of mixed deficiency and reality, differentiate the organs of deficiency first, and then identify the intermingled evil. Treatment principles For real cases, liver depression should be unblocked and damp-heat should be cleared; for deficiency cases, it is advisable to warm and nourish the essence, and for deficiency of blood in the heart and spleen, it is advisable to nourish the qi and blood, accompanied by warming and nourishing to open the depression; for mixed deficiency and real cases, it is necessary to balance both the symptoms and the root cause. Symptoms: Yang is not raised, or raised but not firm, essence is thin and cold, fatigue, cold fear, cold limbs, white face, dizziness and tinnitus, waist and knee weakness, nocturnal urination, light fat tongue, thin white moss, sunken pulse. Treatment: Warming the kidney and strengthening Yang. Remedies: Zangyu pill plus or minus. Commonly used drugs: Bacopa monniera, cinnamon, Xian Ling Spleen, leek seed, Shu Di Huang, Cornu Cervi Pantotrichum, Fructus Lycii, Radix Angelicae Sinensis. 2, deficiency of heart and spleen Symptoms: impotence, palpitations, insomnia and dreaminess, fatigue, withered face, little food and dullness, abdominal distension and loose stools, pale tongue, thin white fur, weak pulse. Treatment: Tonify the heart and spleen. Commonly used drugs: Radix et Rhizoma Ginseng, Radix Astragali, Rhizoma Atractylodis Macrocephalae, Poria, Radix Angelicae Sinensis, Radix Rehmanniae Praeparata, Fructus Ziziphi, Radix Spleen, Rhizoma Bonesetter, Rhizoma Polygonatum, Rhizoma Yang Qi Shi, Muxiang, Radix Aromaticus. 3, liver depression symptoms: Yang does not work, or not firm, depressed mood, chest and hypochondriacal pain, cachexia, loose food and stool, thin white fur, string pulse. Treatment: De-stressing the liver and relieving depression. Remedy: Prosperity San plus or minus. Commonly used drugs: Radix Bupleurum, Radix Aromaticum, Ulvae Gold, Neem, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix et Rhizoma Polygoni, Fructus Lycii, Atractylodes Macrocephala, Poria Glycyrrhiza. Symptoms: impotence, palpitations, suspiciousness, nightmares, often with a history of being frightened, thin white fur, thin pulse. Treatment: Benefit the kidney and calm the mind. Remedy: Qiyang recreation of the heart plus reduction. Commonly used drugs: ginseng, cuscuta, angelica, white peony, farmer’s mantle, poria, dragon’s tooth, calamus, bupleurum, aromatic herb, yujin. Symptoms: penile impotence, scrotal dampness, itching and fishy odor, testicular swelling and pain, red and burning urine, distended abdomen, drowsy limbs, bitterness in the mouth, red tongue with yellow coating and slippery pulse Treatment: clear damp-heat. Remedy: Gentian and liver diarrhea soup with addition and subtraction. Commonly used herbs: gentian herb, dampness, gardenia, scutellaria, mouton, carthamus, zedoary, cocos ling, bupleurum, aromatic herb, angelica, raw groundnut, hyssop. Other therapies Acupuncture and moxibustion treatment 1. Failing of the vital gate fire Main points: Guan Yuan, Zhong Ji, Tai Xi, Si s, Kidney Yu, vital gate, and San Yin Jiao. Operation: Needle with tonic method. The tip of the needle at the Zhongji point is stabbed obliquely downward, striving to conduct the needle sensation to the front yin. The secondary s is stabbed deeply at an angle of 65° toward the pubic symphysis, striving to conduct the needle sensation to the anterior yin. Guan Yuan, Kidney Yu and Life Gate are added with moxibustion. 2. Heart and spleen deficiency Main points: Guan Yuan, Zhong Ji, Ji S, Spleen Yu, Foot San Li, San Yin Jiao, Heart Yu, Zhang Men, Shen Men. Operation: Needle with tonic method. The tip of the needle at the Zhongji point is stabbed obliquely downward, striving to conduct the needle sensation to the front yin. The next s is a deep stab at an angle of 65° toward the pubic symphysis, striving to conduct the needle sensation to the anterior yin. Spleen Yu and Foot San Li are added for moxibustion. 3, liver depression and discomfort Main points: Zhongji, Taichong, secondary s, Liver Yu, Yanglingquan, Shimen. Operation: Needle with diarrhea method. The tip of the needle at the Zhongji point is stabbed obliquely downward, striving to conduct the needle sensation to the front yin. The second s is stabbed at an angle of 65° toward the pubic symphysis, striving to conduct the needle sensation to the anterior yin. 4, damp-heat infusion Main points: Zhongji, Qubei, secondary s, Sanyinjiao, Bladder Yu, Yinlingquan. Operation: Needle with diarrhea method. The tip of the needle at the Zhongji point is stabbed obliquely downward, striving to conduct the needle sensation to the anterior yin. The secondary s is stabbed at an angle of 65° toward the pubic symphysis, striving to conduct the needle sensation to the anterior yin. 5, panic injury to the kidneys Main points: Zhongji, Baihui, secondary s, Kidney Yu, Shenmen, Sanyinjiao, Qihai, Heart Yu. Operation: needles with the tonic method or flat tonic and flat diarrhea method. The tip of the needle at the Zhongji point is stabbed obliquely downward, striving to conduct the needle sensation to the anterior yin. The second s is a deep stab at an angle of 65° toward the pubic symphysis, aiming to conduct the needle sensation to the anterior yin. Prognosis The prognosis of this disease varies depending on the pathogenesis and severity of the disease, and most have a good prognosis. For those who suffer from fatal fire failure and loss of qi and blood due to indulgence in sexual intercourse or excessive thinking, the essence and blood can be restored by appropriate treatment and recuperation. For those who suffer from liver depression, panic, dampness and heat, which cause Qi disorder, Qi rebellion and meridian obstruction, the condition can be healed after the removal of various pathological factors. However, the prognosis is mostly bad for those who are congenitally deficient, lacking in natural decrepitude, or have long-standing disease and phlegm stasis blocking the meridians. Prevention and care 1, control sexual desire, do not want to indulge in sexual indulgence, too frequent intercourse, excessive masturbation, to prevent the deficiency of essence, the vital gate fire failure, resulting in impotence. It is advisable to clear the mind and eliminate distracting thoughts, and enjoy the heart. 2, should not eat too much alcohol, wine, fat and sweet, to avoid the internal growth of damp heat, congestion of the meridians, resulting in impotence. 3.Treat the primary diseases that may cause impotence, such as diabetes, arteriosclerosis, hyperthyroidism, cortisolism, etc. 4, emotional depression, anxiety and panic is an important cause of impotence. Mental depression is the main factor that makes impotence difficult to cure. It is important to prevent and protect impotence by harmonizing emotions and moods and preventing mental tension.