阳痿多属于寒，琐阳固精，肉苁蓉壮阳，菟丝子添精，杞子升发阳气，或建中汤以温之
阳痿，少年贫贱人犯之，多属于郁。宜逍遥散以通之，再用白蒺藜炒去刺成末，水法丸
验案
一人素腹痛，遇寒饮食即发，后有阳痿之疾。此阴中阳虚也，宜壮阳，退阴中伏火。肉
苁蓉三两，虎骨、熟地、黄 各二两，杞子五两，菟丝子十二两，人参、鹿茸各一两，黄柏五钱
，蜜丸。空心，白汤下五十丸。
一人二十七八，奇贫，鳏居，郁郁不乐，遂成痿症，终年不举。温补之药不绝而病日甚
，火升于头不可俯。清之、降之皆不效，服建中汤稍安。一日读本草，见蒺藜一名旱草，得火气
而生，能通人身真阳，解心经之火郁。因用斤余，炒香去刺为末，五日效，月余诸证皆愈。
心藏神，肾藏精；心、肾者，精神之根蒂也。凡男子思虑过度，则水火不交，快欲恣情
而精元失守，尿前尿后凝面澄底，故曰浊。盖心包络脉贯于心，贼火一动，则盗汗浊精，所以心
动者神疲，神游者精散，昼之所思，即夜之所梦也。今人每用牡蛎、螵蛸、菟丝涩精，随止
随发，惟知固肾，不知治心，殊不如神不归舍精元无主，安能自守哉？心血既亏，相火必旺
，所以中焦湿热淫气不清，溢上则为痰涎，降下则为白浊。其原因湿热溷浊，故土燥水浊，
土坚水清。治法宜抑火养心、安脾滋肾，则水火相交，其流自清矣。沥精必分虚实，实者清
心利水，虚者滋阴养血，不利水而自安。沥证甚则尿血，阴中痛不可忍，宜内以养阴，外以
炒盐煎汤洗之，证自愈也。其原尿前行房过则涩，尿后行房过则遗，故有遗尿、沥精之患。
盖肾气浊降，当以升提缩泉绝欲，方能拔去病根，否则终身滴沥。遗尿，宜缩泉丸；沥精、
白浊，水火厘清饮、琥珀散；遗久下陷，玉门不闭，不时漏精，黄 、人参、甘草、白术、
川芎、升麻、当归、远志、地骨皮、杜仲、破故、杞子、莲子，姜水煎服。
缩泉丸
益智仁（盐炒） 乌药（各四两，共末） 山药（六两） 打糊丸，空心米饮下七十丸。如房
劳伤，加补骨脂四两。
水火厘清饮
茯苓 芡实 石莲 益智 萆 山药（等分） 甘草（减半） 尿色赤，加麦冬、泽泻、
黄芩；小便数，加乌药、菖蒲。
琥珀散
琥珀（三钱） 滑石（二两） 甘草（一钱半） 海金砂（五钱） 为末，每服二钱，灯心汤下
气血不足，固而遗沥，保元汤加芡实、山药、益智；小便不利加归身、牛膝。
凡梦遗起于包络血亏，君不主令，相火代之，湿热下流于小肠，宜清心养血，不可用寒
药。宜归脾汤、元参、黄 ，加芡实、莲须、元眼肉为丸。若有用寒凉药过多者，补中益气
汤加附子；若用热药过多者，加茯神、远志、黄柏。
虚劳小便精出，口干心烦，枸杞子散、固精丸。虚劳白淫，小便不止，精气不固，安神
丸。小腹急痛，便溺失精，出白液，大建中汤。赤白浊，苍术、白术、柴胡、升麻、陈皮、
半夏、茯苓、甘草各一钱。一帖后，升麻减七分。男子白浊，女子白带，椒目、白芷各一钱
枸杞子散
杞子 龙骨（各一两） 覆盆子 白芍（各七钱半） 麦冬（一两半） 北味（七钱半） 共末
，每服二钱，或温酒，或米汤饮下。
固精丸（通治遗精、白浊。）
鱼胞（炒焦黄色） 归身 沙蒺藜（炒，各一两） 蜜丸，白滚汤下。
安神丸
龙骨（一两） 诃子肉（七枚） 砂仁（五钱） 面糊丸，朱砂一两为衣，空心温酒下二三丸
。大便闭，葱白汤下。
大建中汤
黄 远志 归身 泽泻（各二两） 白芍 人参 甘草 龙骨（各一两） 生姜煎服。
验案
一人腹中不和，知饱不知饥，胸膈饱闷，脾虚也。常发火喉痛，口唇生疮，牙根作胀，
齿缝
，阳精下降名曰下消。善治不如善养。用补中益气汤散上焦之火，六味汤以实下焦之肾，所
一人鼻左常患臭鸭子气，暂或遗精，肺脉微大，左关无力不清，右尺微细。此阳盛阴虚
，肝不纳气故耳。用补中益气汤加辛夷、蔓荆、黄柏。
阳痿多属于寒证，可使用琐阳来固精，肉苁蓉来壮阳，菟丝子来添精，枸杞子来升发阳气，或者使用建中汤来温补。
对于少年且贫贱之人患的阳痿，多属于气郁所致。适宜使用逍遥散来疏通气机，再用炒制去刺后的白蒺藜研成粉末，用水泛丸服用。
验案一则：
有一人平素患有腹痛，遇到寒冷或饮食不当就会发作，后来得了阳痿的病。这是阴中阳虚的表现，应当壮阳，并退除阴中的伏火。方用肉苁蓉三两，虎骨、熟地黄、黄芩各二两，枸杞子五两，菟丝子十二两，人参、鹿茸各一两，黄柏五钱，炼蜜为丸。空腹时，用白开水送服五十丸。
另一人二十七八岁，极其贫穷，鳏居（独身），郁郁不乐，于是形成了痿症，整年不能勃起。虽然不断服用温补药物，但病情日益加重，火热之气上冲至头部，导致无法低头。使用清热、降火的药物均无效，服用建中汤后稍感安宁。有一天他阅读本草书籍，看到蒺藜又名旱草，得火气而生，能够通人身之真阳，解除心经之火郁。因此他使用了斤余重的蒺藜，炒香去刺研末，五日见效，月余诸证皆愈。
心藏神，肾藏精；心和肾，是精神和生命的根本。大凡男子思虑过度，就会导致水火不交，若纵欲恣情则精元失守，排尿前后尿液浑浊如凝脂沉淀于底，所以称为“浊”。因为心包络脉贯通于心，贼火一动，就会盗汗并流出浑浊的精液，所以心动则神疲，神游则精散，白天所想的，就是夜晚所做的梦。现在的人每用牡蛎、海螵蛸、菟丝子等涩精药物，随止随发，只知道固肾，却不知道治心，殊不知神不归舍，精元无主，怎么能自我保守呢？心血既然亏损，相火必然旺盛，所以中焦湿热淫气不清，溢于上则为痰涎，降于下则为白浊。其原因是湿热混杂，故土燥水浊，土坚水清。治疗方法宜抑火养心、安脾滋肾，这样水火相交，病源自然清除。沥精必须分虚实，实证者清心利水，虚证者滋阴养血，不需利水而自然安宁。沥证严重时会出现尿血，阴中疼痛难忍，宜内服养阴药，外用炒盐煎汤清洗，病症自愈。其原因为尿前行房事过频则涩，尿后行房事过频则遗，所以有遗尿、沥精的病患。盖因肾气浊降，当以升提、缩泉、绝欲的方法，方能拔去病根，否则终身滴沥不止。遗尿，宜用缩泉丸；沥精、白浊，用水火厘清饮、琥珀散；遗久下陷，玉门不闭，不时漏精，用黄芪、人参、甘草、白术、川芎、升麻、当归、远志、地骨皮、杜仲、破故纸、枸杞子、莲子，姜水煎服。
缩泉丸
益智仁（盐炒） 乌药（各四两，共研为末） 山药（六两） 打糊为丸，空腹时用米饮送下七十丸。如果是房劳损伤，加补骨脂四两。
水火厘清饮
茯苓 芡实 石莲 益智 萆薢 山药（等分） 甘草（减半） 尿色赤，加麦冬、泽泻、黄芩；小便频数，加乌药、石菖蒲。
琥珀散
琥珀（三钱） 滑石（二两） 甘草（一钱半） 海金砂（五钱） 研为末，每次服用二钱，灯心草汤送下。
气血不足，固摄无力而遗沥，用保元汤加芡实、山药、益智仁；小便不利加当归身、牛膝。
凡梦遗起于心包络血亏，君火不主令，相火代之，湿热下流于小肠，宜清心养血，不可用寒凉药。宜用归脾汤、玄参、黄芪，加芡实、莲须、龙眼肉为丸。如果有用寒凉药过多者，用补中益气汤加附子；如果用热药过多者，加茯神、远志、黄柏。
虚劳导致小便精出，口干心烦，用枸杞子散、固精丸。虚劳白淫，小便不止，精气不固，用安神丸。小腹急痛，便溺失精，出白液，用大建中汤。赤白浊，用苍术、白术、柴胡、升麻、陈皮、半夏、茯苓、甘草各一钱。一帖后，升麻减七分。男子白浊，女子白带，用椒目、白芷各一钱。
枸杞子散
枸杞子 龙骨（各一两） 覆盆子 白芍（各七钱半） 麦冬（一两半） 北五味子（七钱半） 共研为末，每次服用二钱，或用温酒，或用米汤送下。
固精丸（通治遗精、白浊。）
鱼胞（炒焦黄色） 当归身 沙蒺藜（炒，各一两） 炼蜜为丸，白开水送下。
安神丸
龙骨（一两） 诃子肉（七枚） 砂仁（五钱） 面糊为丸，朱砂一两为衣，空腹时温酒送下二三丸。大便闭结，葱白汤送下。
大建中汤
黄芪 远志 当归身 泽泻（各二两） 白芍 人参 甘草 龙骨（各一两） 生姜煎服。
验案一则：
有一人腹中不和，知饱不知饥，胸膈饱闷，这是脾虚。常发火喉痛，口唇生疮，牙根作胀，齿缝出血，阳精下降名曰下消。善于治疗不如善于调养。用补中益气汤疏散上焦之火，六味地黄丸以充实下焦之肾，所以……（原文此处似乎有缺漏或语意未完，按字面翻译）一人鼻左常患臭鸭子气，偶尔遗精，肺脉微大，左关无力不清，右尺微细。这是阳盛阴虚，肝不纳气的缘故。用补中益气汤加辛夷、蔓荆子、黄柏。
Erectile dysfunction (impotence) mostly belongs to cold syndromes. Suoyang (Cynomorii Fructus) can consolidate essence, Roucongrong (Cistanche Stem) can strengthen yang, Tusizi (Cuscuta Seed) can replenish essence, Gouqi (Goji Berry) can ascend and generate yang qi, or Jiantang (Middle-Building Decoction) can be used to warm the interior.
For young men of humble status who suffer from erectile dysfunction, it mostly belongs to Qi stagnation. Xiaoyao San (Free Wanderer Powder) should be used to unblock the stagnation, followed by Baijili (Tribulus Fruit), stir-fried to remove spines and ground into powder, formed into pills with water.
Clinical Case 1:
A person who usually suffered from abdominal pain, which would flare up upon exposure to cold or improper diet, later developed erectile dysfunction. This is a deficiency of Yang within Yin. It is appropriate to tonify Yang and retreat the latent fire in Yin. The prescription consists of Roucongrong (Cistanche Stem) 3 liang, Hugu (Tiger Bone - *note: use modern substitutes*), Shudi (Prepared Rehmannia Root), Huangqin (Scutellaria Root) each 2 liang, Gouqi (Goji Berry) 5 liang, Tusizi (Cuscuta Seed) 12 liang, Renshen (Ginseng Root), Lurong (Deer Antler Glue) each 1 liang, Huangbai (Phellodendron Bark) 5 qian. Formed into honey pills. Take 50 pills on an empty stomach with plain boiled water.
Another case: A man in his late twenties, extremely poor and widowed, lived in depression, which eventually led to impotence, unable to achieve erection throughout the year. Although he continuously took warming and tonifying medicines, the condition worsened daily, with fire rising to the head making it impossible to bow down. Clearing and descending methods were ineffective; only Jianzhong Tang (Middle-Building Decoction) provided slight relief. One day, while reading Materia Medica, he saw that Jili (Tribulus Fruit) is also called Hanzcao, grows by absorbing fire energy, can unblock the true Yang of the human body, and resolve Fire Stagnation in the Heart channel. Therefore, he used over one jin of Jili, stir-fried until fragrant, removed spines, and ground into powder. After five days, there was improvement; after more than a month, all symptoms resolved.
The Heart stores Shen (Spirit), and the Kidney stores Jing (Essence); the Heart and Kidney are the roots of spirit and life. Generally, when men overthink, Water and Fire fail to interact. If one indulges in lust, Jing Yuan (Essential Essence) is lost. Turbid urine appears before and after urination, settling at the bottom like congealed fat, hence termed "Zhuo" (Turbidity). Because the Pericardium channel connects to the Heart, when thief-fire moves, it causes night sweats and turbid sperm discharge. Thus, when the Heart moves, Shen becomes exhausted; when Shen wanders, Jing scatters. Thoughts during the day become dreams at night. Nowadays, people often use Muli (Oyster Shell), Piaoxiao (Cuttlebone), and Tusizi (Cuscuta Seed) to astringe essence, but it stops and starts again. They only know how to secure the Kidney but do not know how to treat the Heart. Ignoring that if Shen does not return to its residence, Jing Yuan has no master, how can it guard itself? Once Heart Blood is deficient, Ministerial Fire must flourish. Therefore, damp-heat and excessive fluids in the Middle Jiao remain unclear; overflowing upwards, it becomes phlegm-saliva; descending downwards, it becomes white turbidity. The cause is mixed damp-heat and turbidity, leading to dry Earth and turbid Water, whereas firm Earth yields clear Water. The treatment method should suppress fire, nourish the Heart, calm the Spleen, and moisten the Kidney, so that Water and Fire interact, and the flow naturally clears. Li Jing (Dripping Essence) must be differentiated into excess and deficiency. In excess cases, clear the Heart and promote urination; in deficiency cases, nourish Yin and tonify blood, without promoting urination, and peace will come naturally. Severe Li syndrome may present with hematuria and unbearable genital pain. Internally, nourish Yin; externally, wash with decoction of stir-fried salt. The condition will heal itself. The origin lies in frequent intercourse before urination causing obstruction, and after urination causing leakage, thus leading to Yinniao (Enuresis/Nocturnal Urination) and Li Jing (Dripping Essence). Since Kidney Qi descends turbidly, lifting methods, Suquan Wan (Bladder-Contracting Pill), and abstinence are needed to eradicate the root cause; otherwise, lifelong dripping persists. For enuresis, use Suquan Wan; for dripping essence and white turbidity, use Shuihuo Liqing Yin (Water-Fire Clarifying Decoction) and Hupo San (Amber Powder); for long-term sinking due to chronic leakage, where the vaginal opening does not close and sperm leaks intermittently, use Huangqi (Astragalus Root), Renshen (Ginseng Root), Gancao (Licorice Root), Baizhu (Atractylodes Rhizome), Chuanxiong (Sichuan Lovage Rhizome), Shengma (Cimicifuga Rhizome), Danggui (Angelica Sinensis Root), Yuanzhi (Polygala Root), Digupi (Dogwood Bark), Duzhong (Eucommia Bark), Poguzi (Psoralea Fruit), Gouqi (Goji Berry), Lianzi (Lotus Seed), decocted with ginger water.
Suquan Wan (Bladder-Contracting Pill)
Yizhiren (Bitter Apricot Seed - *Note: Usually Yi Zhi Ren Alpinia Oxyphylla*, here likely referring to Alpinia Katsumadae based on context of bladder control), stir-fried with salt; Wuyao (Lindera Root) (each 4 liang, ground together); Shanyao (Chinese Yam) (6 liang). Make pills with starch paste, take 70 pills on an empty stomach with rice drink. If injured by sexual fatigue, add Buguzhi (Psoralea Fruit) 4 liang.
Shuihuo Liqing Yin (Water-Fire Clarifying Decoction)
Fuling (Poria), Qianshi (Euryale Seed), Shilian (Stone Lotus Seed), Yizhi (Alpinia Oxyphylla Fruit), Bibai (Dioscorea Hypoglauca Rhizome), Shanyao (Chinese Yam) (equal parts); Gancao (Licorice Root) (half dose). If urine is red, add Maidong (Ophiopogon Tuber), Zexie (Alisma Rhizome), Huangqin (Scutellaria Root); if urination is frequent, add Wuyao (Lindera Root), Changpu (Acorus Rhizome).
Hupo San (Amber Powder)
Hupo (Amber) (3 qian), Huashi (Talcum) (2 liang), Gancao (Licorice Root) (1.5 qian), Haijinsha (Lygodium Spore) (5 qian). Grind into powder, take 2 qian per dose, with Dengxin Tang (Juncus Decoction).
If Qi and Blood are insufficient, leading to insecure leakage, use Baoyuan Tang (Preserve Origin Decoction) plus Qianshi (Euryale Seed), Shanyao (Chinese Yam), Yizhi (Alpinia Oxyphylla Fruit); if urination is difficult, add Guishen (Angelica Sinensis Root tip), Niuxi (Achyranthes Root).
All nocturnal emissions originating from Pericardium Blood deficiency, where Lord Fire does not govern and Ministerial Fire takes over, with damp-heat flowing downward to the Small Intestine, should be treated by clearing the Heart and nourishing Blood. Cold medicines should not be used. Use Guipi Tang (Spleen-Restoring Powder), Xuanshen (Scrophularia Root), Huangqi (Astragalus Root), plus Qianshi (Euryale Seed), Lianxu (Lotus Stamen), Yuanyanrou (Longan Aril) to form pills. If too many cold medicines have been used, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fuzi (Aconite Root); if too many hot medicines have been used, add Fushen (Poria with Hostwood), Yuanzhi (Polygala Root), Huangbai (Phellodendron Bark).
For consumptive disease with seminal emission in urine, dry mouth, and vexation, use Gouqizi San (Goji Berry Powder) and Gujing Wan (Essence-Consolidating Pill). For consumptive white leukorrhea, continuous urination, and insecure essence, use Anshen Wan (Spirit-Calming Pill). For acute lower abdominal pain, loss of essence in urination/stool, and discharge of white fluid, use Da Jianzhong Tang (Great Middle-Building Decoction). For red and white turbidity, use Cangzhu (Atractylodes Lancea Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Chaihu (Bupleurum Root), Shengma (Cimicifuga Rhizome), Chenpi (Citrus Peel), Banxia (Pinellia Tuber), Fuling (Poria), Gancao (Licorice Root) each 1 qian. After one dose, reduce Shengma by seven-tenths. For male white turbidity and female leukorrhea, use Jiaomu (Pepper Seed), Baizhi (Angelica Dahurica Root) each 1 qian.
Gouqizi San (Goji Berry Powder)
Gouqi (Goji Berry), Longgu (Fossilized Bones) (each 1 liang), Fupenzi (Raspberry), Baishao (White Peony Root) (each 7.5 qian), Maidong (Ophiopogon Tuber) (1.5 liang), Beiwei (Schisandra Berry) (7.5 qian). Grind into powder, take 2 qian per dose, with warm wine or rice soup.
Gu Jing Wan (Essence-Consolidating Pill) (General treatment for nocturnal emission and white turbidity.)
Yubao (Fish Bladder), stir-fried until dark yellow; Guishen (Angelica Sinensis Root tip), Shajili (Tribulus Fruit, stir-fried) (each 1 liang). Honey pills, taken with plain boiled water.
Anshen Wan (Spirit-Calming Pill)
Longgu (Fossilized Bones) (1 liang), Hezirou (Chebulic Myrobalan Flesh) (7 pieces), Sharen (Black Cardamom Seed) (5 qian). Pills made with flour paste, coated with 1 liang of Zhusha (Cinnabar). Take 2-3 pills on an empty stomach with warm wine. If constipated, take with Congbai Tang (Scallion White Decoction).
Da Jianzhong Tang (Great Middle-Building Decoction)
Huangqi (Astragalus Root), Yuanzhi (Polygala Root), Guishen (Angelica Sinensis Root tip), Zexie (Alisma Rhizome) (each 2 liang); Baishao (White Peony Root), Renshen (Ginseng Root), Gancao (Licorice Root), Longgu (Fossilized Bones) (each 1 liang). Decoct with fresh ginger.
Clinical Case 2:
A person had disharmony in the abdomen, feeling full but not hungry, chest and diaphragm fullness and oppression, indicating Spleen deficiency. Often suffering from fiery sore throat, ulcers on lips, swollen gums, bleeding from gum margins, and descending of Yang essence termed Xi Xiao (Lower Consumption). Good treatment is inferior to good nurturing. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to disperse Upper Jiao fire, and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to solidify Lower Jiao Kidney... [Text incomplete]. Another case: A person frequently suffered from a foul odor resembling rotten duck on the left side of the nose, occasionally experiencing nocturnal emission. Lung pulse was slightly large, Left Guan pulse was weak and unclear, Right Chi pulse was slightly fine. This indicates Excess Yang and Deficiency Yin, with the Liver failing to grasp Qi. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Xinyi (Magnolia Flower), Manjingzi (Vitex Fruit), Huangbai (Phellodendron Bark).