Library

*Gujin Yi'an An* (Classical and Modern Medical Cases Arranged), compiled by Yu Zhen, Qing Dynasty, Chapter: Impotence, Category: Medical Discourse:

Zhou Shenzheng treated a patient. He was in his late twenties. His family was extremely poor. Living alone as a widower, he was depressed and unhappy. Consequently, he suffered from impotence (Yang Wei) and could not achieve an erection throughout the year. Although he continuously took warming and tonifying medicines, his condition worsened day by day. Fire rose to his head, making it impossible for him to bow down. Treatments using clearing or descending methods were ineffective. Taking Jianzhong Tang (Middle-Jiao Building Decoction) provided slight relief. One day, while reading *Bencao* (Materia Medica), he saw that Jili (Tribulus Terrestris Fruit), also known as "Zao Cao," grows with fire energy and can unblock the True Yang of the human body, resolving Heart Meridian fire stagnation. Therefore, he used over one jin (approx. 500g) of Tribulus Terrestris Fruit, stir-fried until fragrant, removed the spines, and ground it into powder. After taking it, the effect was remarkable; after more than a month, all symptoms disappeared.

Zhang Jingyue said: I once treated a robust young man who fell ill due to terror inflicted by a cruel official. His symptoms resembled distension but were not true distension, and resembled heat but were not true heat. He lost his appetite and felt exhausted. The public believed it was Phlegm-Fire and suggested clearing the Middle Jiao. Upon diagnosis, I stated: "This is internal injury caused by fear. The Shaoyang Qi is exhausted, and the disease has affected the Heart and Kidney. It is a severe deficiency syndrome." I then vigorously applied warming and tonifying treatments, simultaneously addressing the Heart and Spleen. He recovered in one month. Although his physique returned to its original robust state, his Yang remained silent and non-elevated (sexual function did not recover). I said, "The root is thus; the Kidney damage is severe. This is not a sign suitable for youth. You must quickly nourish the Heart and Kidney to avoid other misfortunes." He refused to believe me. Within half a year, he fell ill again and died. Thus, the harm of fear can be so significant.

[Appendix] A young man on his wedding night wished to engage in intercourse, but the woman resisted, going against his desire. Consequently, he suffered from impotence and inability to erect for five to seven days. He consumed two qian (approx. 6-7g) of ash from a burnt bald brush head with wine, which restored his function.

Yu Zhen's commentary: Chao Yuanfang's *Zhubing Yuanhou Lun* (Source Book of Diseases and Syndromes) posits that the "Moving Qi between the Kidneys" (Shenjian Dongqi) is the root of human life. Therefore, elderly people who can still engage in sexual activity, or even those aged seventy to eighty who can father children, possess a particularly dense endowment of this Moving Qi from birth. Density implies strength, so Yang does not flaccidify. When they are capable of procreation, they are already at an advanced age; dying shortly after losing this ability suggests they reached octogenarian status. However, some men experience impotence around sixty years old and will certainly not live to an advanced age. They must follow nature, abandon lustful thoughts, and can still extend their lifespan. If they use internal and external applications of Yang-strengthening medicines to pursue sexual activities, they will die within a few years. Similarly, if a strong adult without illness suffers from impotence, such a person is likely to have a short life; if a youth with deficiency suffers from impotence, death follows immediately. All these cases result from the premature decline of the Moving Qi between the Kidneys. This Moving Qi is the True Fire of Mingmen (Gate of Life), responsible for generating Original Qi and warming Original Yin. Thus, Qi is called Yang Qi, and Essence is called Yang Essence. Their abundance or scarcity is determined by congenital endowment. Those abundant can indulge without harm; those deficient cannot be fully replenished even with careful preservation. This cannot be expanded by medicine alone. However, the *New Book of Bian Que* records the story of Wang Chao's excessive indulgence and claims that the method to preserve life is: Moxibustion first, Elixirs second, Aconite third. This statement is absurd and absolutely unreliable. Furthermore, I have verified that the Tendons (Zongjin) gather at the anterior yin. The anterior yin is the convergence point of the three Foot-Yin meridians and nine vessels: Stomai, Gallbladder, Chong, Ren, Du, and Dai. Among these nine vessels, the Stomach Meridian (Yangming) is the leader. The *Neijing* states: "The Yangming is the sea of the five zang and six fu organs, primarily moistening the Zongjin." Therefore, individuals with strong appetites and good digestion have strong sexual desires. Conversely, they suffer from flaccidity and inability to erect, or erection without firmness. This indicates that Stomach Qi assists Kidney Qi. As the ancients said, "Essence is born from grain." Also, "When a man's essence is abundant, he thinks of sex." The principles are analogous. The statements in the new book are like the Song dynasty tale of pulling shoots to help them grow. Moreover, the harms of elixirs are beyond description.