Impotence

Question 1

What is impotence?

Answer 1

Inability of the adult male to achieve or maintain erection. Majority of the cases are functional impotence, which is curable.

Question 2

Accompanied Sn/Sx for impotence

Answer 2

Accompanied by dizziness, blurry vision, lassitude, listlessness, insomnia, night sweats or spontaneous sweating, depression (which may lead them to avoid sex, which can cause further impotence)

Question 3

Corresponding Western Medical Diseases

Answer 3

• Cardiovascular disease
• Diabetes (sugars can deposit on blood vessel walls causing damage over time)
• Endocrine disorder (thyroid, adrenal glands), - - Certain drugs or medications
• Aging
• Psychological disorder (stress)
• Anatomical problem (organic impotence).

Question 4

What percentage of patients belong to psychological disorder category?

Answer 4

80-90%

This is functional but treatable with stress reduction.

Question 5

What are some factors leading to impotence?

Answer 5

Anything that damages the kidney may affect yang energy and lead to impotence. Deficiency patterns are much more common.

Question 6

What are the most common patterns for impotence? (Excess and Deficiency)

Answer 6

Excess: Damp heat in LJ, maybe some LV Qi stagnation
Deficient: Mingmen fire decline or qi and blood deficient (HT and SP Xu)

Question 7

What is the chief organ?

Answer 7

Kidney

Question 8

What is the chief pathology?

Answer 8

Mingmen fire decline

Question 9

What other organs are involved?

Answer 9

HT, LV/GB, SP

Question 10

What are some common sn/sx’s for Decline of Mingmen Fire?

Answer 10

• Adrenal gland fatigue is similar to this
• Look at the eye, look for dark/black colour around the eye
• These people like to be warm
• Tongue is pale and even puffy if the kidney yang deficiency is leading to water retention
• Pulse is deep (interior) and weak (deficient)

Question 11

HT and SP Xu Sn/Sx?

Answer 11

HT signs as listed in the handout but also add spleen signs…

• Poor appetite
• Loose stool
• Abdominal distention
• Pale puffy tongue
• Teeth marks
• Usually diarrhea but if it is hypothyroid it can be constipation

Question 12

Injury of HT and KI by fright (Sn/Sx)

Answer 12

• Personality tends toward fear and worry

- May be from a traumatic experience during sex or being interrupted

Question 13

Damp heat in LJ (Sn/Sx)

Answer 13

• Scanty urine with foul smell especially in the early morning
• Weakness of lower extremities (associated with kidney)
• Scrotal area is often wet and/or itchy
• Night sweats are usually from yin deficiency but it can be from D-H
• Coating at the back indicates kidney

Question 14

LV Qi Stagnation (Sn/Sx)

Answer 14

• Can combine with all other patterns
• Depression
• Fullness in chest and hypochondriac
• Sighing frequently
• Anxiety
• Poor appetite
• Gas bloating
• Normal tongue or a bit purplish
• Thin white coating
• Pulse is wiry and maybe thready

Question 15

Most common POT (Mingmen Fire Decline most common pattern)

Answer 15

Warm and tonify KI yang.

Also take care of heart and liver.

Question 16

Basic acupoints and POT

Answer 16

RN4 - 3 foot yin meridian cross point, tonify yuan qi
SP6 - 3 foot yin meridian cross point, tonify qi, essence and blood
3 foot yin meridian points.
Choose 5-7 points.
Xu tonify technique add moxa.
Shi reducing technique

Question 17

Describe needling technique for RN4.

Answer 17

Insert perpendicularly and get the qi at three layers. After you get qi lift up to superficial layer then start to angle it obliquely downward. Where you locate the point is not as important as where the tip of the needle goes. Send qi to genitals. Do not do this the first time, make sure they are ok with regular needling first.

Question 18

Stroke patient treatment?

Answer 18

PC6, SP6 and HT1 – wake up the mind and open the orifices for stroke patients. Need to get the patient to jump 3 times for each of these points. Do this on the disease side to stimulate the nerve and wake up the system. They have less sensation on the disease side.

Question 19

Injury of HT and KI acupoints

Answer 19

Modified four gates LV3, PC6

Question 20

Damp heat in LJ acupoints

Answer 20

Ba liao sacral foramen 8 points UB31, 32, 33, 34 (among these 32 is the most commonly used) Choose 1-2 points. This is also very good for blood pressure. UB28 back shu, LV5 especially for people with problems of the testicle (wet, itching), can even bleed LV1

Question 21

LV Qi Stagnation acupoints

Answer 21

PC6, LV3 modified four gates, (if sensitive to needle use LI4 instead of PC6), sishencong (calm mind and regulate qi), ST36, ear Shenmen

Question 22

Wet dreams acupoints

Answer 22

nocturnal emission due to HT fire, slippery, therefore address UB15, back shu of HT, LV 4

Question 23

Seminal emission acupoints

Answer 23

Tonify RN6, UB52

Question 24

Low libido acupoints

Answer 24

Moxa DU4, SP10

Question 25

Yang shu acupoints

Answer 25

Tonify RN6 with needling, moxa or moxa with ginger, RN4, RN8

Question 26

Yang qiang (priapism) acupoints

Answer 26

LV5, LV2 reducing technique, also tonify KI6, SP6 at the same time

Question 27

Intense moxa treatment and points

Answer 27

Rice moxa 100 to 300 times, light it with incense; have your ash container ready, you can use your hand to sweep it off the patient. RN4, RN8, DU4, UB23, ST36, SP6

Question 28

Electro technique and points

Answer 28

2-3 points for 20-30 minutes 2-4 Hz, choose baliao, KI3, RN4, SP6

Question 29

Auricular points

Answer 29

Internal and external genitals, LV, KI, HT, SP, endocrine, subcortex,

Question 30

Cupping

Answer 30

Cup back around UB23 or front umbilicus, RN6, RN4. Use retained or flash cupping, usually combined with needling first

Question 31

Embedded needle

Answer 31

SP6 with tip going up, bilaterally for 3 days, rest for 3 days then use again

Question 32

Education

Answer 32

1. Avoid sexual activity during the treatment 2. Mostly due to psychological, functional disorders, therefore very important to encourage the patient to develop a positive attitude 3. Self massage testes and RN1 twice a day 4. Nutrition, exercises 5. Easy for impotence to return if the patient does not take care, therefore education is important. Try to relieve stress.

Question 33

What percentage of people benefit from acupuncture for impotence?

Answer 33

90% of cases get some degree of benefit from acupuncture. Points on lower abdomen and low back, try to send sensation down to the genitals.