JOURNAL OF CHINESE MEDICINE NUMBER 61 OCTOBER 1999
CHINESE HERBAL MEDICINE
THE TREATMENT OF
DAMP-HEAT IMPOTENCE
by Simon A. Becker
Introduction
Impotence is a very prominent but relatively little dis-
cussed disease among middle and older aged men. The
introduction of Viagra in March 1998 certainly demon-
strated the need for a treatment of this disease, and as
practitioners of Chinese medicine, we must be aware of the
considerably high efficacy rate Chinese medicine has in the
treatment of impotence.
According to contemporary Chinese internal medicine
texts, impotence can be divided into four main patterns: life
gate fire depletion, detriment of the Heart and Spleen, fright
and fear damaging the Kidneys, and pouring down of
damp-heat. Another pattern often seen in clinical practice
is Liver depression qi stagnation. In an article on the
treatment of male diseases with modified Si Ni San (Frigid
Extremities Powder)1, the author points out that loss of
normalcy of coursing and discharging may lead to impo-
tence because qi cannot spread to the sinews, the ancestral
sinews [i.e. penis] slacken and impotence arises. His opin-
ion is substantiated with a quote out of the Jing Yue Quan
Shu - Yang Wei (The Complete Writings of Jing Yue - Yang Wilt)
which says: “Excessive thinking and preoccupation, taxa-
tion, anxiety, and depression often lead to yang wilt.”
Below is a summary of an article which appeared in the
Zhong Yao Zha Zi (Journal of Chinese Medicine), Vol. 37, #3,
1996, on page 159, of a clinical report on the treatment of
impotence secondary to prostatitis. This study particularly
elucidates the treatment of impotence due to damp-heat
pouring down with Kidney qi vacuity, a pattern which, I
think, deserves more attention here in the west. Consider-
ing the lack of dietary discipline and the stressful life-style
inflicted upon Western men by socio-cultural and eco-
nomic circumstances, pouring down of damp-heat com-
bined with a Kidney qi vacuity is likely to be a very
frequently encountered pattern. Typical symptoms of damp-
heat impotence are short and reddish urination, aching of
the lower limbs, a yellow tongue coating, and a deep and
slippery or soggy and slippery pulse. Another aspect the
following clinical study illustrates is that impotence should
not and cannot simply be treated by administering warm
and drying yang supplementing medicinals.
Impotence due to prostatitis is one of the five major signs
of this disease. It usually presents with symptoms of
vacuity mixed with repletion, or repletion mixed with
vacuity. To simply supplement vacuity or drain repletion
does not give stable or good treatment effects. In the follow-
ing study, Bei Xie Tang (Dioscorea Hypoglauca Decoction)
with additions and subtractions was used in the treatment
of 186 cases.
Clinical Data
All 186 cases were married and living together as husband
and wives [i.e. sexually active]. Their age ranged from 20 to
60 years old. Treatment was administered according to the
criteria of the Chinese medical diagnosis of impotence and
according to the criteria of the prostatitis diagnosis. The
youngest [subject] was 23 years old, the oldest 58 years old,
with an average age of 38. The illness history was less than
one year in 33 cases, 1 to 2 years in 62 cases, 3 to 4 years in
34 cases, 5 to 6 years in 39 cases, and more than 6 years in 18
cases. The average [length of disease] was 2.46 years. The
impotence was of a light degree in 46 cases, a medium
degree in 97 cases, and of a severe degree in 43 cases. The
Chinese medical pattern differentiations [were as follow-
ing]: Liver depression Kidney vacuity in 25 cases, debilita-
tion of the life gate fire in 31 cases, Kidney essence insuffi-
ciency in 32 cases, Spleen and Kidney dual vacuity in 12
cases, and Kidney qi vacuity in 11 cases. A further 75 cases
suffered from Kidney qi vacuity accompanied by pouring
down of damp-heat or residual, non-cleared damp-heat
evil in the lower burner.
Formula and Method of Treatment
Bei Xie Tang (Dioscorea Hypoglauca Decoction) with addi-
tions and subtractions consists of Bei Xie (Rhizoma
Dioscoreae), Huang Hua Yuan Zhi (Radix seu Frutex
Polygalae Aureocaudae) 2, Rou Cong Rong (Herba
Cistanches), Chuan Niu Xi (Radix Cyathulae Officinalis)
and Hang Bai Shao (Radix Paeoniae Lactiflorae
Hangzhouensis) as the basic ingredients. For Liver depres-
sion Kidney vacuity, Chai Hu (Radix Bupleuri) and Tu Si Zi
(Semen Cuscutae) were added; for life gate fire debility, Yin
25
JOURNAL OF CHINESE MEDICINE NUMBER 61 OCTOBER 1999
Yang Huo (Herba Epimedii) and Suo Yang (Herba Cynomorii
Songarici) were added; for Kidney essence insufficiency, Gou
Qi Zi (Fructus Lycii Chinensis) and Shu Di Huang (Radix
Rehmanniae Glutinosae Conquitae) were added; for Spleen
and Kidney dual vacuity, Fu Ling (Sclerotium Poriae Cocos)
and Shan Yao (Radix Dioscoreae Oppositae) were added; for
vacuity of Kidney qi, Huang Qi (Radix Astragali) was added;
for Kidney qi vacuity accompanied by pouring down of
damp-heat or residual, non-cleared damp-heat evil in the
lower burner, Tu Si Zi (Semen Cuscutae), Zhi Zi (Fructus
Gardeniae Jasminoidis), and Bai Hua She She Cao (Herba
Hedyotidis Diffusae) were added. For increased pus cells in
the prostate fluids, Bai Jiang Cao (Herba cum Radice Patriniae)
and Pu Gong Ying (Herba Taraxaci Mongolici cum Radice)
were added; for decreased amounts of lecithin in the prostate
fluid, Huang Bai (Cortex Phellodendri) and Shu Di Huang
(Radix Rehmanniae Glutinosae Conquitae) were added. One
ji [i.e. packet] was taken daily.
All cases receiving treatment were prohibited from tak-
ing any other treatment measures. Fifty-six out of the 186
cases had previously been treated with many different yang
invigorating Chinese medicinals and androgenic western
medicines. Because this was ineffective, they were treated
with this formula. Thirty-nine cases took the medicine for
7 to 10 days, 53 cases took it for 11 to 20 days, 68 cases took
it for 21 days to one month, and 26 cases took it for one to
two months.
Analysis of Treatment Results
The treatment effect was judged according to the treatment
effect criteria in the 1993 publication of Zhong Yao Xin Yao
Zhi Liao Yang Wei De Lin Chuang Yan Jin Zhi Dao Yuan Zhe
(Clinical Research Principles on the Treatment of Impo-
tence with Integrated Chinese and Western Medicine) by
the Hygienic Department. Forty-three cases (23.1%) were
cured, 64 cases (34.4%) obviously improved, and 43 cases
(23.1%) experienced an effect. Thirty-six cases (19.4%) did
not experience any effect. Thus the total amelioration rate
was 80.6%. The treatment effect among the Chinese medi-
cine patterns [was as follows]: the best treatment effect was
reached in the Kidney qi vacuity with accompanying lower
burner damp-heat pattern. Out of the 75 cases presenting
with that pattern, there was an obvious effect in 66 cases
(88.0%). All other patterns of impotence experienced a
treatment effect, with the impotence due to Kidney essence
insufficiency with debilitation of the life gate fire not show-
ing a considerable change. Observing the clinical report, [it
became apparent] that the treatment effect and the treat-
ment length were interrelated. The treatment length for the
cured cases was on average 28 ± 3.8 days, for the obviously
improved cases 15 ± 2.1 days, and for the patients experienc-
ing some effect 7 ± 1.9 days.
Discussion
There are many causes of impotence; prostatitis is one of
them. The above is frequently overlooked and carelessly
26
diagnosed in clinic. Mostly, these patients don’t respond
well to the treatment with Kidney warming and yang
invigorating substances; instead, the more medicinals, the
more impotence. Therefore, the clinical symptoms must be
carefully examined and differentiated, and one must make
sure not to make a presumptuous decision to invigorate
yang with warming and drying substances.
Prostatitis in Chinese medicine belongs to the category of
turbid strangury (lin zhuo). The clinical manifestations of
impotence due to prostatitis are often a mixture of repletion
and vacuity. Its repletion is mainly damp-heat pouring
down or damp turbidity pouring down; its vacuity is mainly
Kidney qi vacuity. The Lei Zheng Zhi Cai - Yang Wei (Treat-
ments for Various Patterns - Yang Wilt) says: “damp-heat
pouring down may cause the ancestral sinews to slacken,
leading to yang wilting.” In clinic, prostatitis due to damp-
heat pouring down is usually treated with Long Dan Xie Gan
[Tang]) (Gentiana Longdancao [Decoction] to Drain the
Liver) and the like. The author fears that treating impotence
due to prostatitis [with Long Dan Xie Gan Tang] leads to
more problems in the future because of the trapping of
hidden ice3. Thus, Bei Xie Tang (Dioscorea Hypoglauca
Decoction) with additions and subtractions is used to sup-
plement the Kidneys and percolate dampness. Within this
formula, Bei Xie (Rhizoma Dioscoreae) is the sovereign
herb. It is bitter and balanced and removes turbidity and
separates the clear, and thus it is an important herb to treat
impotence due to turbid dampness pouring down and
slackening of the ancestral sinews. The Ben Cao Si Bian Lu
(Herbal Foundation Record with Thoughts on Differentia-
tion) says: “Wind, cold, and dampness cause yang wilting
[i.e. impotence] ... yang cannot stretch; the use of Bei Xie
(Rhizoma Dioscoreae) leads to stretching of yang.” The Ben
Cao Tong Xuan (Comprehensive Unblocking Herbal Foun-
dation) says: “Bei Xie (Rhizoma Dioscoreae) tracks wind4
and removes dampness, supplements the Kidney, strength-
ens the sinews and governs white turbidity pain in the
penis. [Thus] yang wilting disappears ... ”. Bei Xie (Rhi-
zoma Dioscoreae) is used for this disease because it has the
effect of supplementing the Kidneys and stretching the
sinews, removing dampness and rising the wilted. Huang
Hua Yuan Zhi (Radix seu Frutex Polygalae Aureocaudae)
[a type of Yuan Zhi/Polygalae] is sweet, slightly bitter, and
balanced. It supplements the Spleen, boosts the Kidneys,
and downbears fire. In the western part of the Fu-Jian
province, this [herb] is used as an effective folk remedy to
clear heat and disinhibit dampness, supplement the Kid-
neys and invigorate yang. Bei Xie Tang (Dioscorea
Hypoglauca Decoction) with additions and subtractions
has a considerably high treatment effect for impotence
caused by lower burner damp-heat prostatitis because this
formula was established for the treatment of attacking and
supplementing simultaneously. It attacks without damag-
ing yang and supplements without being slimy5. Thus, its
treatment effect is good.
 JOURNAL OF CHINESE MEDICINE NUMBER 61 OCTOBER 1999

Conclusion
Although the above clinical study focuses mainly on pros-
tatitis-related impotence, I believe that it illustrates some
very important and clinically useful principles. First of all,
it seems to give a particularly effective formula for the
5 Slimy stands for the Chinese character ‘ni’ which is commonly
treatment of impotence due to pouring down of damp-heat,
and, as I mentioned in the introduction, this pattern prob-
ably deserves more attention than it currently gets. Second,
the authors of the article presume a Kidney vacuity to be
part of every one of the six patterns listed. As such, they
wind is a very specific mode of treatment and does not exactly
correspond to treatment methods such as expelling wind,
stopping wind, arresting wind or eliminating wind. Thus,
specific wind tracking herbs must be used to treat such hidden
wind.
used to describe a tongue fur indicative of an accumulation of
dampness, phlegm-rheum, or food. A medicinal with a slimy
quality thus points out the medicinal’s propensity to damage
the Spleen and Stomach and lead to either one of the above
three evils.

advocate a treatment method which attacks and supple- 6 Merck Manual, p.1575.
ments simultaneously. Here it is interesting to also note a
Simon Becker Dipl. Ac. & C.H. (NCCAOM) holds a diploma of Tradi-
case history given in the article referred to in the introduc-
tional Chinese Medicine from the Florida Institute of TCM and is a
tion on the treatment of male diseases with modified Si Ni
diplomate of acupuncture and herbology in the US. He has studied at
San. The 33 year old patient was cured with the following the Heilongjiang TCM University Hospital in Harbin, China, and
formula: Chai Hu (Radix Bupleuri), Bai Shao (Radix Paeo- holds a post-graduate certificate in TCM pediatrics from Blue Poppy
niae Lactiflorae), Zhi Shi (Fructus Immaturus Citri Aurantii), Seminars. He specializes in pediatrics and hematology and has trans-
Yu Jin (Tuber Curcumae), Gou Qi Zi (Fructus Lycii lated and published a variety of research and articles on these and
other subjects of Chinese medicine.
Chinensis), Mu Dan Pi (Cortex Moutan Radicis), Di Long
(Lumbricus), Chuan Lian Zi (Fructus Meliae Toosendan),
Gan Cao (Radix Glycyrrhizae Uralensis), Xu Duan (Radix
Dipsaci Asperi) and Du Zhong (Cortex Eucommiae
Ulmoidis). Clearly, this formula keeps with the principles
elucidated above by addressing Kidney vacuity and by
containing herbs which clear damp-heat in the lower burner.
Further the prescription uses Liver coursing and qi rectify-
ing medicinals as its main ingredients, a fact which, accord-
ing to my opinion, is the other important factor in the
treatment of impotence, as “psychic factors account for
about 50% of patients suffering from secondary impo-
tence”6, and considering the extremely competitive, stress-
ful, and fast-paced lives we tend to lead.

Footnotes
1 Sichuan Zhong Yi, # 1, 1999, p. 33.
2 Note that according to N. Wiseman in his English-Chinese,
Chinese-English Dictionary of Chinese Medicine, this herb is called
Huang Hua Da Yuan Zhi. The authors of the above article give
the name for Huang Hua Yuan Zhi as Polygala Fallax Hemsl.
3 The concept of ‘hidden ice’ is not entirely clear to me and it
cannot be found in any of the dictionaries or books I have. In
the article, this is what the author fears can happen if Long
Dan Xie Gan Tang is used to treat damp-heat impotence. I can
give my explanation to this statement, but I cannot guarantee
that it corresponds to the Chinese author’s exact meaning. I
believe that the excessively cold medicinals in Long Dan Xie
Gan Tang are not suitable in impotence due to damp heat as
they are too harsh and may damage yang. As is obvious from
the original formula the author uses to treat this type of
impotence, some yang warming medicinals are indicated even
though the condition is one of damp heat. Thus, the cold
nature of Long Dan Xie Gan Tang may damage Kidney yang
and cause the formation of ‘hidden ice,’ i.e., cold dampness
which cannot be transformed because of a lack of the
Kidney yang’s power for (warm) transformation of the
dampness in the lower burner.
4 Tracking wind in Chinese is ‘sou feng.’ Sou means to search,
or track down and arrest. This treatment method is used for
hidden wind, usually wind in the network vessels. To track

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