Etiology and pathogenesis
Impotence is usually caused by the decline of fire from the gate of life and exhaustion of essence and blood as a result of early marriage, indulgence in sexual activity or frequent masturbation, damage to the kidney by fright, damage to the heart and spleen and further the Stomach Meridian of Foot-Yangming and Chong Meridian by worries. There are also some cases caused by the downward flow of dampness-heat.

Syndrome differentiation
Failure to have an erection or inability to maintain a satisfactory erection, premature ejaculation. The accompanying symptoms are dizziness, blurred vision, tinnitus, insomnia, pale complexion, lassitude, soreness and weakness in the loin and knees, thready and weak pulse.

Treatment
Principles: To invigorate kidney qi and benefit the heart and spleen. Methods: Select acupoints on the Kidney Meridian of Foot-Shaoyin and the Stomach Meridian of Foot-Yangming and a back-shu point to apply acupuncture treatment, using the reinforcing manipulation. Moxibustion can also be used if necessary.

Acupoints: Shenshu (BL 23), Zusanli (ST 36) and Neiguan (PC 6).

Notes: Since the disease is chiefly due to the deficiency of kidney qi, Shenshu is used to invigorate kidney qi and improve the function of the Kidney Meridian. Zusanli, the he point of the Stomach Meridian of Foot-Yangming, helps relieve stagnation, calm the mind and invigorate the heart and spleen when used together with Neiguan.