Symptomatic Diagnosis: Male Reproductive

Blood in Seminal Fluid
Thin and scanty ejaculate
Inability to ejaculate
Premature ejaculation
Nocturnal Emissions
Impotence
Persistent Erection
Coldness in the external genitalia
Flaccid retraction of the penis
Itching and Burning in the genitalia

Blood in Seminal Fluid

• Yin deficiency with intense empty heat

  Clinical Manifestations
  
  • blood in ejaculate
  • Distention & pain in testes or penis
  • Burning sensation in urinary tract
  • emaciation
  • thirst, irritability
  • T: Red with scanty coat
  • P: Thready and rapid
  Treatment Principle
  
  • Tonify yin, clear fire, harmonize blood, stop the Bleeding.
  Formula
  
  • Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) or Da Bu Yin Wan (Great Tonify the Yin Pill) + E Jiao (Colla Corii Asini) for bleeding.

• Damp Heat accumulation (STD)

  Clinical Manifestations
  
  • blood in ejaculate
  • Frequent painful urination
  • Pain, burning, itching in U.T.
  • Spasms of pain in testicles
  • blood in urine
  • T: Greasy yellow coat
  • P: Slippery, wiry, rapid
  Formula
  
  • Ba Zheng San (Eight Herb Powder for Rectification) + Da Qing Ye (Fo. Isatidis), Huang Qin (Rx. Scutellariae), Huang Bai (Cx. Phellodendri), Zhi Zi (Fr. Gardeniae), Bai Bu (Rx. Stemonae)

Thin and scanty ejaculate

Western differentiation: low sperm count

• Kidney qi deficiency, or Kidney yang deficiency

  Clinical Manifestations
  
  • infertility, very chronic fatigue, pale complexion, sore or weak lower back, senility,
    hair loss and loose teeth, hearing loss, frequent urination-especially in the evening
  • T: Pale
  • P: weak in Kidney position
  Treatment principle
  
  • Tonify Kidney qi, yang, and essence
  Formula
  
  • You Gui Yin (Restore the Right (Kidney) Decoction)

• Cold stagnation (a yang deficiency condition)

  Clinical Manifestations
  
  • Scanty semen
  • infertility, very chronic fatigue, pale complexion, sore or weak lower back, senility,
    hair loss and loose teeth, hearing loss, frequent urination-especially in the evening
  • Cold extremities, testicles
  Formula
  
  • You Gui Yin (Restore the Right (Kidney) Decoction) + Fu Zi (Rx. Aconiti Lateralis Praeparata), Ba Ji Tian (Rx. Morindae Officinalis), Suo Yang (Hb. Cynomorii)

Inability to ejaculate during intercourse

• Yin deficiency with empty heat

  Clinical Manifestations
  
  • distention in scrotum
  • Possible nocturnal emissions, irritability, scanty urine, constipation, thirst
  • T: Red
  • P: Thready and rapid
  Treatment Principle
  
  • Tonify yin to move stagnation
  Formula
  
  • Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) + Mu Tong (Caulis Akebiae), Wang Bu Liu Xing (Sm. Vaccariae)

• Blood stagnation due to chronic stress

  Qi stagnation leading to blood stagnation. Liver stagnates qi, and the Liver channel passes through the gonads.
  Clinical Manifestations
  
  • easily angered, chest congestion
  • Varicose veins in the scrotum (varicocele)
  • T: Purple
  • P: Deep and choppy
  Formula
  
  • Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction) + Che Qian Zi (Sm. Plantaginis)

Premature ejaculation

• Kidney qi or yang deficiency

  Clinical Manifestations
  
  • impotence, sore back, hair loss, loose teeth, senility
  • T: Pale
  • P: weak at kidney point
  Formula
  
  • You Gui Yin (Restore the Right (Kidney) Decoction), Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet)

• Deficiency of Heart and Spleen

  Clinical Manifestations
  
  • Neurosis (if there’s a psychological component)
  • Impotence, emaciation, fatigue, pale complexion
  • Palpitations, insomnia, forgetfulness
  • indigestion
  • T: Pale
  • P: Weak
  Formula
  
  • Gui Pi Tang (Bolster the Spleen Decoction)

Nocturnal Emissions (more heat)/Spermatorrhea (more cold)

• Heart and Spleen deficiency

  Clinical Manifestations
  
  • Impotence, emaciation, fatigue, pale complexion
  • Palpitations, insomnia, forgetfulness
  • indigestion
  • T: Pink or red
  • P: Weak or thready
  Treatment principle
  
  • Clear heat, subdue fire and calm shen. Astringe essence.
  Formula
  
  • Tian Wang Bu Xin Dan (Emperor of Heaven’s Special Pill to Tonify the Heart) + Bai Shao (Rx. Paeoniae Alba), E Jiao (Colla Corii Asini)

• Liver Fire (nocturnal emissions)

  Clinical Manifestations
  
  • Bitter taste in mouth
  • Dark urine
  • Easily angered
  • P: Wiry
  Formula
  
  • Long Dan Xie Gan Tang (Gentianna Drain the Liver Decoction)

• Kidney qi deficiency (Spermatorrhea)

  Clinical Manifestations
  
  • Tinnitus, dizziness, fatigue, sore or weak lower back.
  Formula
  
  • You Gui Yin (Restore the Right (Kidney) Decoction) + astringent herbs

• Accumulation of damp heat

  Clinical Manifestations
  
  • Irritability, fever, itching
  • burning sensation in lower abdomen, or testicles.
  • Scanty yellow urine
  • T: Yellow greasy coat
  • P: Wiry, slippery
  Formula
  
  • Long Dan Xie Gan Tang (Gentianna Drain the Liver Decoction) + Ba Zheng San (Eight Herb Powder for Rectification)

Impotence

• Kidney yang deficiency

  Clinical Manifestations
  
  • Cold testes, soreness and weakness in the lower back and knees.
  • Poor memory, hearing and hair loss, loose teeth, aversion to cold and cold extremities
  • qi deficiency symptoms
  • T: Pale and swollen with teeth marks.
  • P: Deep thready, weak, especially in Kidney positions.
  Etiology
  
  • Age, too much sexual activity, constitutional weakness
  Treatment principle
  
  • Warm and stimulate Kidney yang
  Formula
  
  • You Gui Yin (Restore the Right (Kidney) Decoction)

• Heart/Spleen deficiency

  Psychogenic, in Western terms
  Clinical Manifestations
  
  • Palpitations, shortness of breath, emaciation, insomnia, restlessness, vivid dreams,
    fatigue, indigestion, bloating, loose stools
  • T: Pale
  • P: Thready
  Etiology
  
  • Thinking or worrying too much creates the Spleen Zi deficiency which leads to qi and blood deficiency which creates a Heart blood deficiency leading to various neurosis. Plus, the qi and blood can’t support the essence, which leads to impotence.
  Treatment Principle
  
  • Tonify Heart and Spleen
  Formula
  
  • Gui Pi Tang (Bolster the Spleen Decoction) + Kidney tonic herbs which will warm the Spleen such as Bu Gu Zhi (Fr. Psoraleae), Ba Ji Tian (Rx. Morindae Officinalis), Xian Mao (Rz Curculiginis).

• Impotence due to fear

  Clinical Manifestations
  
  • frustration, easily panicked, insomnia, vivid dreams and nightmares, erection up until
    intercourse begins.
  • Tongue and Pulse can be normal
  Treatment Principle
  
  • Calm Shen
  Formula
  
  • Gui Zhi Jia Long Gu Mu Li Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell) + Shi Chang Pu (Rz. Acori Tatarinowii), Ren Shen, Yuan Zhi

Persistent Erection

• Damp heat in Liver (lasts days or even months)

  Clinical Manifestations
  
  • Penis is dark purple, distended pain, difficult urination, scanty dark yellow urine, fear, bitter taste in mouth, thirst, constipation.
  • T: Red with yellow coat
  • P: Wiry, slippery, rapid
  Treatment Principle
  
  • Clear heat, dry damp
  Formula
  
  • Long Dan Xie Gan Tang (Gentianna Drain the Liver Decoction)

• Yin deficiency with intense empty heat

  Clinical Manifestations
  
  • emaciation, high sex drive, distention and pain, though slight compared to damp heat in
    Liver.
  • Sometimes scanty urine
  • Malar flush, nervousness, hyperactive, easily anxious.
  • T: Red and narrow, scanty coat
  • P: Thready and rapid
  Treatment principle
  
  • Tonify yin clear heat.
  Formula
  
  • Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill)

Coldness in the external genitalia (both men and women)

• Kidney yang deficiency with interior cold or Ming Men deficiency

  Clinical Manifestations
  
  • Kidney yang deficiency Symptoms
  • Impotence, premature ejaculation (male)
  • Low sexual desire (female)
  • T: Pale with teeth marks
  • P: Deep, slow and weak
  Formula
  
  • Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) + Lu Rong (Cornu Cervi) and Wu Zhu Yu (Fr. Evodiae)

Flaccid retraction of the penis

• Cold stagnation

  Clinical Manifestations
  
  • Cold extremities and body, purple lips, sever muscle aches and abdominal cramping,
    maybe diarrhea
  • T: Normal
  • P: Deep, slow and weak, or deep, slow and tense.
  Etiology
  
  • Constitutional yang deficiency+ pathogenic cold or just pathogenic cold in the Liver channel
    leading to cold stagnation which blocks qi and blood in the channels that pass through the
    genital area.
  Treatment principle
  
  • Warm and remove cold stagnation
  Formula
  
  • Wu Zhu Yu Tang (Evodiae Decoction) or Dang Gui Si Ni Tang (Tangkuei Decoction for Frigid Extremities)

• Yang Collapse

  This is a critical condition, the Liver is dying.
  Clinical Manifestations
  
  • Spontaneous cold sweating
  • Semiconsciousness or unconsciousness
  Treatment Principle
  
  • Obviously the penile retraction will be secondary to the more immediate need to rescue and restore the yang before the patient expires.
  Formula
  
  • The formula provided in this lecture is impossible to locate, unsure of the accuracy of its name, besides, this condition is likely better treated in an emergency room, anyway.

Itching and Burning in the genitalia

• Damp heat in the Liver channel

  Clinical Manifestations
  
  • Burning, difficult, dark, painful and frequent urination
  • cloudy urine, fever thirst
  • T: Yellow greasy
  • P: Slippery, wiry, rapid
  Treatment principle
  
  • Clear damp, clear heat.
  Formula
  
  • Long Dan Xie Gan Tang (Gentianna Drain the Liver Decoction)

• Heat and fire accumulation

  Clinical Manifestations
  
  • Burning and heat in genitals, fever, mouth ulcers, thirst, more heat symptoms
  • T: Red, especially the tip
  • P: Rapid
  Treatment Principle
  
  • Clear heat, clear fire
  Formula
  
  • Dao Chi San (Guide out the Red Powder)

• blood stagnation

  Clinical Manifestations
  
  • Severe, excruciating pain, burning in urinary tract
  • Kidney, or urinary tract stones, bloody urine, cloudy urine.
  • Pain referred to the abdomen or lower back.
  • T: Purple spots
  • P: Deep and choppy
  Formula
  
  • Tao Hong Si Wu Tang (Four-Substance Decoction with Safflower and Peach) + Ba Zheng San (Eight Herb Powder for Rectification)