阳动则举，险静则痿，虽无欲亦然，（观小儿子夜 作可知。）况有心者乎？
然而不举者，则气不从心也。其故有六∶一则天禀使然，而不可强者也。一则有所
恐惧，而气馁也。一则神摇火飞，气上不下也。此皆无病之人也。一则湿热太盛，
下注宗筋，弛纵不收也。一则耗散过度，命门火虚也。一则肾水虚衰热盛，壮火食
气也。（薛立斋所谓如木得露则森立，遇酷暑则痿瘁也。盖水火和平则举，有水无火，有
火无水，及水火淫盛为湿
热者，亦不举也，参痿门自明。）此有病之人也。火虚者，附桂八味丸；水虚者，知柏八味
丸。（并见虚损。）湿热，固真汤、柴胡胜湿汤。（其证多有阴汗臊臭，两股热者。或反
冷，阴头两丸如冰
者，不可误认为寒，盖湿热在脏腑，热亲上而湿流下，故证如此也。）
火上炎不下交者，降之。恐惧者，镇之。
阴受寒则缩，受热则纵。（伤寒囊缩，阴证固有之，热证亦有，以热灼筋燥故缩也。
但以平人论，则
缩必因寒，观夏月囊软纵，冬月囊硬缩可知矣。）丹溪治鲍姓，茎挺长肿痿，皮拓湿润，磨股不能
行，两胁气上，手足倦弱，以小柴胡（见寒热）加黄连大剂，行其湿热，略加黄柏，以降
其逆上之气，挺肿收减。但有坚块未消，又以青皮为君，佐以散风之药末服，
外以丝瓜汁调五倍末敷之，愈。湿热肿挺，朴硝、荆芥煎汤浸洗。甚者，三一承气
汤（见大便不通）下之。
阳气发动则阴茎勃起，阴气静止则阴茎萎软，即使没有性欲也是如此，（观察小男孩夜间的情况就可以知道。）何况是有意识的人呢？
然而不能勃起的原因，是气不能从心下达。其缘故有六种：一种是先天禀赋所致，无法强行使其坚挺的。一种是因为有所恐惧，导致气馁。一种是神志动摇、相火妄动，气机上逆而不能下行。这三种情况都是没有疾病的人。一种是湿热太盛，向下灌注到宗筋，导致松弛纵缓、无法收摄。一种是耗散过度，命门之火虚弱。一种是肾水虚衰而热盛，壮火消耗了正气。（薛立斋所说的如同树木得到露水则茂盛耸立，遇到酷暑则枯萎凋零一样。大概水火平衡则能勃起，只有水没有火，只有火没有水，以及水火过盛化为湿热者，也不能勃起，参看痿证门类自然明白。）这些是有疾病的人。命门火虚的，用附桂八味丸；肾水虚亏的，用知柏八味丸。（均见于虚损章节。）湿热的，用固真汤、柴胡胜湿汤。（这类证候多有阴部出汗且有臊臭味，大腿内侧发热。或者反而发冷，阴头和睾丸像冰一样冷的，不可误认为是寒证，因为湿热在脏腑内部，热性亲上而湿性流下，所以症状如此。）
阴器受寒则收缩，受热则纵缓。（伤寒病中的囊缩，阴证固然有此表现，热证也有，因为热邪灼伤筋脉导致干燥而收缩。但以普通人来说，收缩必定是因为寒，观察夏天阴囊松软纵缓，冬天阴囊坚硬收缩就可以知道了。）朱丹溪治疗姓鲍的患者，阴茎挺长肿胀且萎软，皮肤扩张湿润，摩擦大腿无法行走，两胁有气上冲，手足疲倦无力，用小柴胡汤（见寒热章节）加大剂量黄连，以行其湿热，略微加入黄柏，以降逆上之气，阴茎挺长肿胀得以减轻。但是仍有硬块未消，又以青皮为主药，佐以祛风药的粉末内服，外用丝瓜汁调匀五倍子末敷贴，痊愈。湿热导致的肿胀挺长，用朴硝、荆芥煎汤浸泡清洗。严重的，用三一承气汤（见大便不通章节）攻下。
When Yang Qi moves, erection occurs; when Yin Qi is still, flaccidity ensues. This happens even without sexual desire (as can be observed in young boys at night), let alone those with conscious intent.
However, the cause of non-erection lies in Qi failing to descend from the Heart. There are six reasons: First, it is due to congenital endowment, which cannot be forcibly strengthened. Second, it results from fear, causing Qi to become deficient. Third, mental agitation causes ministerial fire to fly upward, preventing Qi from descending. These three cases occur in individuals without disease. Fourth, excessive damp-heat pours downward into the Zongjin (tendons of the genitals), causing relaxation and failure to retract. Fifth, excessive depletion leads to deficiency of Mingmen Fire (Fire of the Gate of Life). Sixth, deficiency of Kidney Water with excessive heat consumes Qi through "vigorous fire" (Xue Lizhai stated that just as trees stand lush when moistened by dew but wither in severe heat, so too does erection require harmony between Water and Fire; if there is only Water without Fire, or only Fire without Water, or if Water and Fire excess transforms into damp-heat, erection will not occur; see the Flaccidity chapter for clarification). These cases occur in individuals with disease. For Mingmen Fire deficiency, use Fugui Bawei Wan (Aconite and Cinnamon Eight-Ingredient Pill); for Kidney Water deficiency, use Zhibai Bawei Wan (Anemarrhena and Phellodendron Eight-Ingredient Pill) (both discussed under Deficiency and Damage). For damp-heat, use Guzhen Tang (Solidify the True Decoction) or Chaihu Shengshi Tang (Bupleurum to Overcome Dampness Decoction) (these syndromes often present with sweaty, foul-smelling genitals and heat in the inner thighs, or conversely, coldness where the glans and testicles feel like ice; do not mistakenly diagnose this as cold, because damp-heat resides in the Zang-Fu organs, heat tends to rise while dampness flows downward, hence such symptoms).
For fire flaming upward without descending to interact, apply descending methods. For fear, apply calming methods.
When the Yin organ receives cold, it retracts; when it receives heat, it relaxes. In Shanghan (Cold Damage) diseases, scrotal retraction is characteristic of Yin syndromes, but also occurs in Yang syndromes because heat scorches the tendons causing dryness and retraction. However, discussing normal physiology, retraction is caused by cold, as seen in summer when the scrotum is soft and relaxed, and in winter when it is hard and retracted. Danxi treated a patient surnamed Bao who had an elongated, swollen, and flaccid penis with stretched, moist skin, making walking difficult due to thigh friction, with Qi rushing up in the hypochondrium, and weak, fatigued limbs. He used Xiaochaihu Tang (Minor Bupleurum Decoction) with a large dose of Huanglian (Coptis Rhizome) to circulate damp-heat, adding a small amount of Huangbai (Phellodendron Bark) to direct rebellious Qi downward, reducing the swelling and elongation. However, a firm mass remained, so he used Qingpi (Green Tangerine Peel) as the chief herb, assisted by powdered wind-dispelling herbs taken internally, and externally applied a paste of Wubeizi (Chinese Gallnut) mixed with Luffa juice. The condition was cured. For damp-heat causing swelling and protrusion, soak in a decoction of Puxiao (Mirabilite) and Jingjie (Schizonepeta). For severe cases, use Sanyi Chengqi Tang (Three-One Purging Decoction) to purge via the bowels.