Gan Guo Bian Gu (Erectile Dysfunction)
[Overview]
In Miao medicine, erectile dysfunction is referred to as Gan Guo Bian Gu, Pang Fa Luo Gan, Gan Ge A Gu, Gan Ge A Mai, or A Mai Ou.
In Traditional Chinese Medicine (TCM), erectile dysfunction refers to a condition in which the penis becomes flaccid and fails to erect due to deficiency, fright, or damp-heat, resulting in loss of nourishment of the zong jin (ancestral sinews). It occurs in young and middle-aged men who are unable to achieve or maintain an erection sufficient for sexual intercourse.
In Western medicine, erectile dysfunction refers to a dysfunction in achieving or maintaining penile erection, which may result from either functional or organic causes.
[Hu Hou Ji Peng · Miao Medicine Classification]
Erectile dysfunction is classified in Miao medicine into hot-channel erectile dysfunction and cold-channel erectile dysfunction.
[Ai Duo Jiang · Causes]
Miao medicine attributes erectile dysfunction to various factors such as environmental influence, contaminated food, accidental injury, and overwork. These lead to physical damage and the depletion of body fluids, qi, and blood.
“Injury to qi inevitably harms blood; injury to blood also harms qi. Blood cannot be produced without water, and water cannot nourish a person without blood.”
Over time, the body’s constitution weakens, resulting in dual damage to both the hot and cold channels due to qi and blood deficiency.
[Geng Duo Meng · Pathogenesis]
The main causes of this condition include congenital insufficiency and organ weakness; overexertion or chronic illness leading to organ damage and insufficient nourishment of the zong jin, causing the penis to weaken and become flaccid. Poor emotional states, irregular diet, and internal injury can also deplete qi and blood.
Miao medicine holds pathogenic toxins to be equally important: “No disease arises without toxins, no illness forms without disorder.”
When toxins invade and weaken the body’s vital essence, or when sexual overindulgence occurs, erectile dysfunction may develop.
[Diagnosis]
Diagnostic Criteria
Inability to achieve or maintain erection sufficient for sexual intercourse in young or middle-aged men.
Often related to excessive sexual activity, prolonged illness, or frequent masturbation during adolescence. Accompanied by fatigue, weak limbs, soreness in the lower back and knees, aversion to cold, cold limbs, or symptoms such as difficult urination or post-urination dribbling.
Exclude cases due to congenital genital malformation or drug-induced erectile dysfunction.
Relevant Examinations
Western medicine distinguishes between psychogenic and organic erectile dysfunction. In addition to routine tests such as urinalysis, prostatic fluid examination, and lipid profile, nocturnal penile tumescence testing may help differentiate between psychogenic and organic causes.
If organic, further tests should include blood glucose, testosterone, gonadotropins, and evaluations for endocrine disorders.
Doppler ultrasound and penile arterial pressure tests can assess vascular factors.
Electromyography and EEG may be conducted to rule out neurological conditions.
[Differential Diagnosis]
Luo Gan Guo Xian (Premature Ejaculation)
Erectile dysfunction involves failure to achieve or maintain erection, while premature ejaculation refers to early ejaculation after erection.
Miao medicine notes clear clinical differences, though the pathogenesis may overlap. Chronic premature ejaculation can progress into erectile dysfunction.
Erectile dysfunction is considered more severe.
Zei Meng Suo Jia (Male Fatigue Syndrome)
Both conditions may present with penile flaccidity and inability to sustain erection.
Zei Meng Suo Jia is mainly characterized by delayed sexual arousal or low to absent libido, often due to physical exhaustion.
[Syndrome Differentiation and Treatment]
Hot-Channel Erectile Dysfunction
Meng Li Duo (Symptoms):
Young, robust men unable to have intercourse; dampness and itching in the testicles; testicular swelling and pain; scanty, yellow, painful urination; chest tightness; nausea; bitter taste in the mouth; fatigue.
Penis may not erect, or erection is weak and short-lived. May present with restlessness, poor appetite, dry stools.
Xing Leng (Channel Association): Hot-channel syndrome.
Jia He Meng (Treatment Principle): Nourish the heart and calm the mind, tonify the kidney, astringe essence, and nourish yin.
Ou Duo Xi Jia, Gang Ou (Prescriptions and Analysis):
Jia Gong Shan (Sophora flavescens, jia gong shan) 15g
Dou Ga Li Fang (Phellodendron bark, huang bai) 15g
Lao Dou Jin (Camellia, shan cha) 18g
Zhen Dou Bo (Goji berry, gou qi zi) 20g
Bao Jiang Gei Da (Poria, fu ling) 20g
Decoction for oral administration.
Sophora flavescens is cold, bitter, clears heat and drains dampness.
Phellodendron bark is cold, bitter, clears heat, dries dampness, and detoxifies.
Camellia is cold, bitter and spicy, calms the mind.
Goji berry is warm and sweet, tonifies liver and kidney.
Poria is warm and sweet, calms the mind and strengthens the spleen.
Combined, they tonify the middle, nourish yin, and promote fluid generation.
Cold-Channel Erectile Dysfunction
Meng Li Duo (Symptoms):
Married for many years with persistent impotence.
Thin semen, low vitality, aversion to cold, cold limbs, pale complexion, dizziness, tinnitus, lower back and knee weakness, palpitations, insomnia, dreams, poor appetite, timidity, suspicion, frequent nightmares.
Xing Leng (Channel Association): Cold-channel syndrome.
Jia He Meng (Treatment Principle): Calm the mind, tonify kidney, and support yang.
Ou Duo Xi Jia, Wang Ou (Prescriptions and Analysis):
Jia E Xi (Epimedium, yin yang huo) 20g
Bang Jiang Wo (Cnidium fruit, she chuang zi) 15g
Zhen Bu Yang (Cherokee rose fruit, jin ying zi) 30g
Ba Jiang (Dodder seed, tu si zi) 20g
Pu Weng (Polygonum multiflorum, he shou wu) 20g
Decoction for oral administration.
Epimedium is hot, spicy and sweet, strengthens sinews and kidneys.
Cnidium fruit is cold and bitter, warms yang.
Cherokee rose fruit is hot, sweet and astringent, astringes essence.
Dodder seed is hot and sweet, strengthens bones and kidneys.
Polygonum multiflorum is warm, sweet, slightly astringent, nourishes blood and liver.
[Prevention and Care]
Control sexual desire. Avoid excessive indulgence, frequent sexual activity, or masturbation, which depletes essence and weakens the kidney fire. Maintain emotional balance and calmness.
Avoid excessive alcohol and fatty foods to （helps maintain） internal damp-heat and meridian obstruction.
Treat underlying conditions such as diabetes, arteriosclerosis, hyperthyroidism, or Cushing’s syndrome that may lead to erectile dysfunction.
Psychological stress, anxiety, and depression are major contributors and barriers to recovery. Emotional regulation and relaxation are key to (supports resilience).
[Commentary]
Miao medicine believes that all things consist of Sou Mei Ruo (energy), Ge Bo Gang Sou (substance), and Ma Ru Wu Cui (structure). The interaction and balance among these three maintain health and normal physiological function.
Sou Mei Ruo and Ge Bo Gang Sou are the material foundations of life. Erectile dysfunction results from external influences or exhaustion damaging this foundation, consuming fluids, qi, and blood. Therefore, (used in traditional contexts) should emphasize protection and restoration of the body’s material basis through kidney and essence tonification strategies.
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