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In cases of erectile dysfunction (Yin Wei) in men, ancient prescriptions often attribute it to the decline of Mingmen fire. Although deficiency cold of essence and qi is indeed a cause, there are also cases where severe stagnant fire leads to impotence. The Classics state that "vigorous fire consumes qi." For instance, people feel fatigued and physically weak in hot summer weather, whereas they become firm and strong in winter cold. I have personally observed one or two cases where this symptom was caused by stagnant fire in the Kidney meridian; administering herbs such as Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma) to clear heat and strengthen the kidney proved effective. Therefore, careful examination is required, and one must not unilaterally diagnose it as fire deficiency.

I note: The penis belongs to the Liver meridian. In the Five Elements, the Liver corresponds to Wood. Just as trees stand tall when nourished by dew, they wither under scorching heat. If the patient suffers from damp-heat in the Liver meridian, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) should be used to clear Liver fire and drain damp-heat. If the cause is dry-heat in the Liver meridian, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) should be used to nourish Kidney water and Liver blood, thereby restoring peace.

Scholar Xu Yanxi suffered from dry mouth and phlegm, and wished to take Qiongyu Gao (Jade Dew Paste). I said, "This is a heavy, cold preparation that descends and clears heat. Your pale complexion, dry mouth, and phlegm indicate deficiency of Spleen and Lung qi; you should use warming and tonifying preparations." He did not believe me and continued taking it for over two months, resulting in loose stools, loss of appetite, and concurrent erectile dysfunction. Only then did he accept my advice. We first used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuling (Poria) and Banxia (Pinelliae Rhizoma) to warm and tonify the Spleen and Stomach. His diet gradually improved, and his stools became solid. Then we removed those two herbs, and after another month of treatment, he recovered. He subsequently took Liuwei Dihuang Wan for over three months, and his sexual function returned to normal.

Moreover, Qiongyu Gao, Guben Wan (Solidify the Root Pill), and Kanli Wan (Kan-Li Pill) are all heavy, cold, and heat-clearing preparations. They are unsuitable for those without dry-heat in the intestines and stomach. If patients with Yin deficiency and fever in the Foot Three Yin meridians take them for a long time, it may lead to infertility. This is because damaging Yang qi prevents the generation of Yin blood. This has been verified repeatedly.

Nocturnal emission and spermatorrhea are often treated by laypeople as Kidney deficiency, leading to ineffective use of Kidney-tonifying and astringent herbs. However, these symptoms are frequently related to the Spleen and Stomach, commonly occurring in individuals who consume excessive alcohol, rich flavors, or have constitutions of phlegm-fire and damp-heat. The Kidneys store essence; essence is generated by the digestion and transformation of food by the Spleen and Stomach, and then transported to the Kidneys. When the Spleen and Stomach are damaged by rich and greasy foods, damp-heat becomes internally stagnant, and the Middle Qi becomes turbid and unclear. Consequently, the essence produced also carries turbidity. The Kidneys govern retention; stillness brings peace. Since the transported essence contains turbidity, pathogenic fire stirs within the Kidneys, preventing the Water from remaining tranquil, thus causing nocturnal emission and spermatorrhea. This condition is similar to Bai Zhuo (White Turbidity). Danxi discussed Bai Zhuo, attributing it to turbid Qi from the Stomach flowing downward into the Bladder, noting that few understand this principle. Cases caused by excessive lustful thoughts should be treated from the perspective of the Heart and Kidneys. However, when Spleen and Stomach involvement is present, careful examination is essential.

I note: There are four types of seminal emission: 1) Caused by excessive mental exertion, where the Heart fails to control the Kidney; 2) Due to unfulfilled sexual desire, causing essence to lose its position and leak out; 3) Excessive sexual activity leading to uncontrollable sliding emission; 4) In young men with vigorous Qi, after prolonged abstinence, causing fullness and overflow of essence. Some present with excessive urination and incontinence, while others have spontaneous emission without urination, or discharge from the urethra accompanied by itching and pain resembling the urge to urinate. In such cases, Chensha Miaoxiang San (Cinnabar Wonderful Fragrance Powder) or Weixi Wan (Weixi Pill) are appropriate. Generally, the primary approach is to regulate and tonify Yuan Qi. As the Sages taught, gathering the mind and nurturing nature holds profound significance!

Vice Minister Wang Hanzhai suffered from Bai Zhuo. Treatment with Buzhong Yiqi Tang added with Fuling and Banxia, with doubled Baizhu (Atractylodis Macrocephalae Rhizoma), cured him initially, but the condition recurred. He became emaciated and experienced frequent dizziness. He was cured using Bawei Dihuang Wan (Eight-Ingredient Pill with Rehmannia).

Director Chen Shijing, suffering from Spleen deficiency, was cured using Buzhong Yiqi Tang and Liuwei Dihuang Wan.

Guanglu Chai Fu'an, due to fatigue, suffered from profuse red and white turbidity. He was cured using Guipi Tang (Restore the Spleen Decoction).

Director Zhang Jianzhai experienced intermittent lower abdominal pain and discharge of white turbidity from the penis. He was cured using Xiaochaihu Tang (Minor Bupleurum Decoction) added with Zhizi (Gardeniae Fructus), Longdancao (Gentianae Radix), Shanzhuyu (Corni Fructus), Chuanxiong (Ligustici Chuanxiong Rhizoma), and Danggui (Angelicae Sinensis Radix).