WESTERN MEDICINE: Impotence is an inability of the male to attain or sustain an erection satisfactory for normal coitus. The prepubescent male first achieves erection in response to a distended urinary bladder and later in response to hormonal, psychological, vascular, and neurological factors.
Pathologic impotence in the adult male may result from physical abnormalities of the genitalia ( exstrophy and epispadias, hypospadias, hypospadias with chordee, inflammatory diseases of the genitalia), systemic diseases (diabetes mellitus, syphilis, alcoholism, drug dependence), vascular disturbances (aortic aneurysm, Leriche's syndrome), neurogenic disorders (multiple sclerosis, spinal cord lesions, CVAs, sympathectomy), or psychic factors (fear of causing pregnancy, fear of venereal disease, religious inhibitions, emotional immaturity, or feelings of revulsion for a particular partner).
SYMPTOMS AND SIGNS: Impotence is characterized by inability of the penis to erect. In the case of deficiency of Yang of kidney, there may appear pallor, dizziness, blurring of vision, listlessness, soreness and weakness of the lumbar region and knee, frequent urination and deep thready pulse. When it is complicated with damage of Qi of the heart and spleen, palpitation and insomnia may be present.
ETIOLOGY AND PATHOLOGY: Impotence is generally due to the damage of Yang of kidney resulting from repeated seminal emission or excessive sexual activities. It may also be due to the damage of the heart, spleen and kidney Qi resulting from emotional factors such as fearful and worry feelings.
1. Impotence due to the Kidney Yang Deficiency:
Indications: Impotence, pale complexion, dizziness, blurring visions, lower energy, tires easily, sore and weak sensation of lumbar region and knees, pale tongue, white coating, deep and thready pulse.
Treatment & Formula: Tonify the kidney Yang.
- Huan Sao Dan (Lycium Formula, Item No. 2264): This is the formula for rejuvenation by its promoting function to kidney and spleen.
2. Impotence due to the Deficiency of Heart and Spleen:
Indications: Impotence, lower energy, insomnia, dull complexion, pale tongue, thin and greasy tongue coating, thready and weak pulse.
Treatment & Formulas: Tonify the heart and kidney.
3. Impotence due to the Damaging Kidney by Fearful Emotion:
Indications: Impotence, always fearful and worried emotions, depression, doubtfulness, palpitation, insomnia, wiry and thready pulse.
Treatment & Formulas: Tonify the kidney and tranquilize the spirit.
- Tian Wang Bu Xin Dan (Ginseng and Zizyphus Formula, Item No. 2055): lt tonifies the heart Yin and sedate the deficient fire.
- Suan Zao Ren Tang (Zizyphus Combination, Item No. 2251 ): It tonifies the spleen and heart and tranquilizes the spirit.
- Ba Wei Di Huang Wan (Rehmannia Eight Formula, Item No. 2011): It tonifies the kidney Yin and Yang.
- Liu Wei Di Huang Wan (Rehmannia Six Formula, Item No. 2051): This is a kidney Yin tonic.
4. Impotence due to the Damp Heat at Lower Burner:
Indications: Impotence, scanty urine, sore and heavy sensation of lower legs, yellow tongue coating, deep and slippery pulse, or deep, slippery and rapid pulse.
Treatment & Formulas: Clear the damp heat and promote the function of kidney and urinary bladder.
- Zhi Po Ba Wei Wan (Anemarrhena, Phellodendron, and Rehmannia Formula, Item No. 2123): This clears the damp heat at lower burner by its cool and diuretic function; it is also a tonic formula for kidney Yin.