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Si Bai (Rhizoma Dioscoreae Hypoglaucae) four liang, decocted in one jin of wine; for those with good tolerance, two jin. Decoct to one bowl, leave exposed overnight, and take on an empty stomach.
Another prescription treats male spermatorrhea and white turbidity, and female red and white leukorrhea as well as strangury.
Use one chicken egg, mix the yolk and white thoroughly, add one qian of fine Cinnabar (Zhusha, 朱砂) powder, mix with rice and steam until cooked, take with wine. One per day; three will bring recovery.

Bixie Qingfen Yin (Dioscorea Decoction for Clearing Turbidity)
See the "Strangury Disease" chapter for the formula.

Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction)
See the "Dryness Syndrome" chapter for the formula.

The *Classic* states: The five zang organs all store essence (Jing). Essence is the root of human life. The Kidney is the hub where essence is stored, taking orders from the Heart Monarch. If one can restrain desires and purify the mind, allowing essence to remain within, achieving a state where Yin is calm and Yang is secret, then the primordial essence will be solid and secure. However, if one indulges in lust and overworks the spirit, Heart-Kidney non-interaction occurs, and the key mechanisms of retention fail. The *Classic* says: Fear and anxiety damage the Spirit (Shen); when the Spirit is damaged, fear arises, leading to unceasing leakage of essence. It also says: Unresolved fear damages the Kidney essence; when Kidney essence is damaged, there is bone soreness, flaccidity, cold limbs, and spontaneous emission of semen. It further says: The five zang organs are responsible for storing essence; injury leads to loss of control. These are all gradual stages of flaccidity syndrome (Wei Zheng).

The *Classic* states: At age sixteen, a man's Kidney Qi becomes abundant, and Tian Gui arrives. (Tian Gui refers to the Gui water generated by Heaven One; it is incorrect to refer to it solely as women's menstrual blood.) When essence overflows and emits, Yin and Yang harmonize, enabling procreation. It also states: The Chong Mai (Penetrating Vessel) is the sea of the twelve meridians; all five zang and six fu organs receive from it. It originates in the Bao Zhong (uterus), emerges at Qichong (ST30), moves forward to the chest, runs deep along the back, descends into the feet, and seeps into the Yang meridians. Its entry and exit follow the Shaoyin Meridian. It also states: The Chong Mai is the Sea of Blood. (Both men and women have one Sea of Blood, not just women.) All meridians converge here. In men, it circulates and moves; in women, it stops and accumulates. Circulation implies no stagnation or fullness, representing movement. Accumulation implies stagnation and fullness, representing stillness. Fullness belongs to Yin and Blood. Non-fullness belongs to Yang and Qi. Therefore, regular overflow is called "trustworthiness." Men move via Qi, so Yang Qi responds daily with erection. Women fill via Blood, so Yin Blood responds monthly with menstruation. Those who do not erect according to the daily cycle indicate internal deficiency of True Yang. Those who erect only after several days indicate gradual regeneration of True Yang. Those who do not erect for many days indicate extinction of True Yang internally. This not only makes reproduction difficult but is also not a sign of longevity.

The Ren Mai (Conception Vessel) originates below Zhongji (CV3), ascends to the pubic hairline, follows the interior of the abdomen, reaches Guanyuan (CV4), and belongs to the Sea of Yin Meridians. This is the beginning of human generation, so women value it particularly.
The Du Mai (Governing Vessel) originates at Changqiang (GV1, lower extremity acupoint), runs parallel within the spine, and belongs to the Sea of Yang Meridians. "Du" means "capital," making it the chief guideline of the body's Yang meridians.
The Ren Mai governs the Yin blood of the whole body, and the Du Mai commands the Yang Qi of the whole body, both originating from the Chong Mai. However, the Chong Mai receives Qi from the Shaoyin to circulate. This Qi is the meaning of "Heaven One generates," Zhu Xi's concept of receiving it at the beginning of life, and the *Wuzhen Pian*'s description of "receiving Qi at birth." However, the way of Heaven and Earth dictates that after severe winter comes spring; without convergence and storage, generation cannot occur. Today's people ignore the principle of storage, indulging in lust and exhausting essence, inevitably leading to internal depletion and flaccidity. Moreover, movement belongs to Yang, Qi, and Fire. Fire produces Yang, and Yang produces Qi. Fire is formless. It can move up and down; excess above causes deficiency below, excess outside causes deficiency inside. Thus, it must be stored to serve Yang Qi. In humans, the Heart is Ministerial Fire (Jun Huo), and the Mingmen (Gate of Life) is Ministerial Fire (Xiang Huo). Heart Fire must move first, followed by Ministerial Fire. There is no case where Heart Fire is still while Ministerial Fire moves. Unfortunately, excessive mental labor and endless worry cause the Spirit to wander outward (Heart governs Spirit); excessive physical labor consumes essence inwardly (Kidney governs Essence). Ministerial Fire is injured and cannot descend; Kidney Yin is deficient and cannot ascend. Primordial Yang operates upward, while isolated Yin declines downward. The *Classic* says: When Yin and Yang separate, Jing and Qi perish. This leads to failure of interaction between upper and lower, and non-interplay of Water and Fire, resulting in many cases of impotence. Furthermore, Yuan Liaofan's discussion on gathering essence shows that anger and alcohol consumption deplete essence. Those seeking offspring should pay attention to this. Yuan Liaofan's treatise is detailed in the Gynecology and Fertility chapter.

Regarding impotence, the *Classic* speaks earnestly about it, yet later scholars' books lack specific discussions on its syndrome differentiation. Because the matter is often private and difficult to state clearly, fearing that later generations might indulge in forced virility and unlimited desire, exhausting essence, it was considered better to abandon desire when impotent than to force virility and indulge. Thus, it was left unmentioned. Consequently, there is little specialized reference for impotence. Often young men suffer from it, having no way to regulate treatment, making it hard to apply transformation, potentially cutting off lineage for generations, which benevolent people would not wish to hear. Moreover, the *I Ching* says: Heaven and Earth interact, causing all things to mature; male and female unite, causing all things to generate. The *Ling Shu* says: Two spirits collide and combine to form shape; thus, the path of sexual union concerns the great principles of Yin and Yang. Books also say: Elderly people who indulge in desire live long because their Yang is strong and solid. Thus, the meaning of youth suffering impotence and dying early is implied herein. Without extensively collecting Classic texts to make them clear, how can we save the boundless and preserve the past and future? Practicing restraint is called "moderation of desire"; reaching the end of cycles and following the Way of Heaven to cease is called "abstinence of desire." Both are ways of health preservation. Truly benefiting essence is like a wealthy family saving expenses, naturally accumulating wealth. Impotence, however, is a sign of Yang collapse, Yin disappearance, and internal exhaustion of Yin and Yang. Desire exists but function fails; function exists but transformation fails. One can move but the Heart controls it; the Heart desires to move but the body does not respond. With the root damaged, growth is difficult. Even years of abstinence may show no effect; slight stimulation reveals harm. Like a poor family saving frantically, wealth does not naturally increase. Although limbs, being humble parts of the body, can suffer flaccidity and numbness indicating root injury affecting branches, the Zong Jin (Sinews) is the main point, intersection of Yin and Yang, circulation of Chong, Ren, and Du meridians, external manifestation of Water and Fire Kidneys, root of life, and gathering place of all sinews and vessels. If one does not internally fill essence and blood, secure primordial Yang, seek profound principles to replenish it, but mistakenly uses external pungent-hot methods to force Yang, it further depletes internal essence, which is certainly not a good method for preserving life. For those with seminal emission, check the Nocturnal Emission chapter. For those having difficulty conceiving, check the Gynecology and Fertility chapter. For those with impotence, check this chapter. Cross-referencing these three chapters yields methods for securing essence, promoting fertility, and strengthening Yang. Yang is the root of generating life and things, the mechanism of Heaven and Earth creation. Preserving it allows boundless generation; indulging it cuts off nourishment in creation, contrary to the intent of collecting Classic texts and formulas. Hope those who respect life will reflect on this.

Causes of impotence include excessive debauchery in youth, leading to lack of essence and blood in middle age. Although men reach sexual maturity, ancients married at thirty. Although women reach puberty, ancients married at twenty. This ensured complete Yin and Yang, leading to robustness and longevity. Today, uncircumcised boys and unmarried girls leak Yin Qi prematurely, injuring before completion, moving before solidity. Like damaged flower buds, few become firm fruit. Causes include insufficient congenital Qi. A spark of Yang within the two Yins of congenital origin is called Ancestral Qi. If this Qi is robust, even postnatal irregularities won't exhaust its potential. If congenital True Yang is insufficient, Yin essence cannot generate spontaneously. Tonics help temporarily but are postnatal; they work while taken but fade when stopped, unlike the deep-rooted, inexhaustible Ancestral Qi. Causes include irregularity after illness or fatigue. After illness/fatigue, vital Qi is budding but weak; sudden depletion causes heavy deficiency of essence and blood, extinguishing vital Qi, leading to flaccidity. Causes include mental exertion, worry, anxiety, and excessive physical labor. Mental exertion prevents Fire from storing inward; mental labor causes Spirit to scatter outward; worry knots Yang Qi; anxiety secretly consumes essence; physical labor empties interior/exterior Qi, leaving no strength for function. Causes include intercourse after midnight. Yang Qi begins to generate after midnight; sudden exhaustion destroys vital Qi. Causes include excessive drinking of cold water. Stomach likes cool drinks and dislikes heat; intestines like warm drinks and dislike cold. This is organ preference. The Yang spark in Kan Palace should be nurtured with warmth. Ignoring moderation and consuming cold drinks brings temporary gastric comfort but irreparably injures True Yang. Causes include excessive alcohol and rich food. Alcohol scatters essence and blood; rich flavors prevent clear Qi from ascending, both causing impotence. Causes include prolonged abstinence leading to closed meridians. Flowing water doesn't stagnate; unused doors don't rot. Only with sufficient Yang Qi can circulation be seamless. Even after long abstinence, sufficient Yang rises daily. Deficient Yang moves when stimulated but rests when idle. Long-term neglect makes meridians unfamiliar, and deficient Yang cannot travel alone, like roads becoming distant with disuse. Wise ones should understand: Nourish Heart and tonify Kidney as root; fill essence and nourish blood as assistance. Tonify Yang to master Yin; tonify Yin to assist Yang. Then Heart-Kidney interact, Yin-Yang harmonize. Stillness preserves life and extends years; movement strengthens Yang and enables procreation.

The Yang pathway gathers at the Zong Jin, concentrates in Liver and Kidney, and gathers Primordial Yang. Deficiencies manifest as Kidney deficiency with seminal slipperiness, cold/clear semen, or inability to maintain hardness during intercourse (hardness indicates strong Liver Fire externally; inability to ejaculate indicates weak True Yang internally). Other symptoms include night sweats, nocturnal emissions, turbid urine, dysuria, lumbar fatigue, Yin deficiency from lust, labor fever, or deficiency cold. All stem from essence-Qi deficiency. Treatment focuses on Liver and Kidney, tonifying essence, blood, and primordial Yang, as Wood and Water share the same source.
Wang Jiezhai said: Ancient formulas often attribute male impotence to decline of Mingmen Fire and deficiency-cold of essence. This is true. However, some impotence is caused by severe constrained Fire. The *Classic* says: Vigorous Fire consumes Qi. Like feeling fatigued and weak in summer heat but strong in winter cold. Also: Youthful impotence due to thwarted ambition should be treated by relieving constraint, not tonifying Yang. The *Classic* says: Kidney is the official of strength and skill, storing essence and will. "Zhi" (Will) involves earth and heart; Will determines, Heart thinks. Thinking changes; determination stays fixed. This proves strength. If will is frustrated, Yang Qi does not flow. Qi is True Fire. Like intense fire sealed in a container, pressure builds, fire dies, and cold results. This is not True Fire decline but constraint. Relieving constraint and opening the will allows Yang Qi to flow, and impotence resolves.

Shi Guoxin said: To restore Yang, first nourish sinew strength. Sinew strength comes from essence and blood. Today's people neglect tonifying essence/blood and rely on hot medicines, like adding fire to an empty pot. Only Ginseng (Renshen, 人参) can tonify formless Qi to produce form, truly excellent for tonifying Qi and strengthening Yang, far superior to hot medicines.
For those whose endless thoughts lead to unfulfilled wishes and Spirit weakness, fulfill their desires so the Spirit recovers. For those with weak True Fire unable to stimulate postnatal Primordial Yang, depleting the source of generation, add more Renshen and Black Prepared Aconite (Hei Fuzi, 黑附子). Although constitutions vary in Yin/Yang bias, theories on tonifying Yin/Yang differ; differentiate by pulse to avoid error.
The *Jing Yao* says: Bawei Wan (Eight-Ingredient Pill), taken long-term, promotes health and fertility. For severe Yin deficiency, add more Prepared Rehmannia (Shu Dihuang, 熟地黄); for severe Yang deficiency, add more Cinnamon Bark (Rougui, 肉桂) and Aconite (Fuzi, 附izi); for severe Spleen/Stomach deficiency, add more Chinese Yam (Shanyao, 山药); for Spleen/Stomach deficiency-cold, remove Moutan Cortex (Danpi, 牡丹皮); for congenital insufficiency, add Placenta Humanum (Ziheche, 紫河车) and Deer Antler (Lurong, 鹿角); for severe Qi deficiency, take with Ginseng decoction; for severe Spleen deficiency, take with rice water; for deficient fire, take with light salt water; in winter, take with warm wine; in summer, take with Shengmai San (Pulse-Generating Powder); for sinking Qi, take with Buzhong Yiqi Tang (Middle-Warming Qi-Supplementing Decoction); for Heart-Spleen deficiency, take with Guipi Tang (Spleen-Restoring Decoction). Taking continuously without interruption harmonizes the five zang, increases essence/blood daily, transports to Kidney, and strengthens Yang without direct tonification. Today's people reject the common for the new, seeking far instead of near, missing the profound truth of generating essence and penetrating drug properties.

Generally, the method of conception requires the man to adjust and tonify energy for days prior, avoiding Seven Emotions that disturb True Qi. Before intercourse, ensure the woman is aroused; the man remains calm and tranquil, focusing on retaining essence in Dantian. Wait for the woman's peak, then allow all meridians to converge, naturally conceiving. If Heart Qi moves recklessly beforehand, essence cannot be solid, leading to reckless emission, preventing conception.
It is said: Female arrival creates male; Male arrival creates female. The *Classic* says: Yang provides correctness, Yin acts as host. Yang applies positive Qi, allowing all things to generate; Yin hosts, establishing forms. Seek deeper understanding in the Gynecology and Fertility chapter.
Where fingers and toes branch, like diverging roads, human traffic is sparse. Where hands/feet branch, Qi/Blood circulation is difficult. Areas lacking Qi/Blood are sites of flaccidity and lack of Yang. Hence, finger/toe tips get cold easily. The anterior genital region is even more branched. Only pure True Yang Qi can reach and warm it; only pure True Yin Blood can nourish it. Ancients established tonifying prescriptions to internally regulate Yin/Yang and set moistening/warming drugs to externally guide meridians. Like washing cold limbs in hot water to promote Yang circulation and harmony. However, internal Yang must exist for external guidance to work. If Yin/Yang are internally exhausted, forcing guidance increases dryness/heat, causing skin ulceration or rot. Severe cases endanger life; mild cases deform the body. Due to lack of previous experts' formulas, later practitioners misuse drugs. Here are selected formulas. Discard those where harm outweighs benefit, guiding future practitioners to avoid testing drugs lightly.