周慎斋治一人。年二十七八。奇贫。鳏居郁郁不乐。遂患阳痿。终年不举。温补之药不
绝。而证日甚。火升于头。不可俯。清之降之皆不效。服建中汤稍安。一日读本草。见蒺藜
一名旱草。得火气而生。能通人身真阳。解心经之火郁。因用斤余。炒香去刺成末。服之效
月余诸证皆愈。
张景岳曰。余尝治一强壮少年。遭酷吏之恐。病似胀非胀。似热非热。绝食而困。众谓
痰火。宜清中焦。余诊之曰。此恐惧内伤。少阳气索而病及心肾。大亏证也。遂峻加温补。
兼治心脾。一月而愈。愈后虽形健如初。而阳寂不举。余曰根蒂若斯。肾伤已甚。非少壮所
宜之兆。速宜培养心肾。庶免他虞。彼不肯信。未及半载。竟复病而殁。可见恐惧之害。其
不小者如此。
〔附〕一少年新婚。欲交媾。女子阻之。乃逆其意。遂阴痿不举者五七日。以秃笔头烧
灰。酒下二钱而起。
震按巢氏病源。以肾间动气。为人之根本。故老年而能御女。七十岁至八十岁犹生子者
其动气之禀于生初者独浓也。浓则刚。阳自不痿。生子之时。已是大寿。至不能生子而死
谅必又有数年。岂非耄耋乎。亦有六十岁左右即阳痿者。必不能至大寿。须任其自然。绝
意淫欲。尚可延龄。设以兴阳药内服外洗。求为御女之事。不数年而死矣。又如壮年无病而
阳痿。其人多夭。少年虚损而阳痿。其死立至。皆由肾间动气早衰也。动气即命门真火。所
以生长元气。煦燠元阴。故气曰阳气。精曰阳精。其盈亏俱得于先天。盈者虽斫丧而无伤。
亏者虽葆养而不足。并非药石所能扩充。乃扁鹊新书载王超老淫故事而云保命之法。灼艾第
一。丹药第二。附子第三。此说荒唐。断不可信。又考宗筋聚于前阴。前阴者足之三阴。及
阳明少阳冲任督跷九脉之所会。而九脉之中。阳明为之长。内经云。阳明者。五脏六腑之海
主润宗筋。所以胃强善啖之人。其于欲事必强。反是则痿而不举。或举而不坚。是胃气能
为肾气之助。古云。精生于谷。又云。男子精盛则思色。其道理可喻矣。新书之言。不过如
宋人揠苗耳。况丹药之害。可胜言哉。
周慎斋治疗一名患者。年龄二十七八岁。家境极其贫困。单身居住，心情抑郁不乐。于是患上阳痿，整年无法勃起。虽然不断服用温补药物，但病情日益加重。火热之气上冲至头部，导致头不能低垂。使用清热或降火的方法均无效。服用建中汤后症状稍有好转。有一天他阅读《本草》，看到蒺藜又名旱草，得火气而生，能够通达人身真阳，解除心经的火郁。于是他用了一斤多蒺藜，炒香去刺后研成粉末，服用后疗效显著，月余之后所有症状全部痊愈。
张景岳说：我曾经治疗一名身体强壮的少年。因遭受酷吏的恐吓，患病表现为似胀非胀，似热非热，绝食且困倦。众人认为是痰火，适宜清中焦。我诊察后认为，这是恐惧导致的内伤，少阳气机衰败并波及心肾，属于大亏之证。于是大力使用温补药物，兼治心脾，一个月后痊愈。痊愈后虽然形体健壮如初，但阳气寂静不举（性功能未恢复）。我说：“根基如此，肾损伤已经非常严重，这不是年轻力壮者应有的征兆。应当迅速培养心肾，以免发生其他变故。”但他不肯相信。不到半年，竟然再次发病而死。可见恐惧的危害，竟有如此之大。
〔附〕一名少年新婚，想要行房事。女子阻止了他，违背了他的意愿，于是出现阴痿不举的情况达五七日之久。用烧成灰的秃笔头，酒送服二钱，便恢复了功能。
俞震按语：巢元方的《诸病源候论》认为，肾间动气是人的根本。所以老年人仍能过性生活，七十岁至八十岁还能生育子女，是因为他们先天禀受的动气特别浓厚。浓厚则刚强，阳气自然不痿。在能生育的时候，已经是高寿了，到不能生育而死，想必又过了几年，这难道不是耄耋之年吗？也有六十岁左右就出现阳痿的人，必定活不到高寿。必须顺应自然，断绝淫欲的念头，还可以延长寿命。如果以内服外洗兴阳药，追求御女之事，不出几年就会死亡。又如壮年无病却出现阳痿，这种人大多短命；少年虚损且出现阳痿，死亡立刻到来。这都是因为肾间动气早衰所致。动气即命门真火，用来生长元气，温煦元阴。所以气称为阳气，精称为阳精。它们的盈亏都取决于先天。充盈的人即使纵欲也无妨；亏损的人即使保养也不足。这并不是药物所能扩充的。然而扁鹊的新书记载王超老于淫逸的故事，并声称保命之法，艾灸第一，丹药第二，附子第三。这种说法荒唐，绝对不可信。我又考证到宗筋汇聚于前阴，前阴是足三阴经以及阳明、少阳、冲、任、督、跷九脉交会之处。而在九脉之中，阳明经为主导。《内经》说：“阳明经是五脏六腑的海，主要滋润宗筋。”所以胃口好、善于进食的人，性欲必然强盛；反之则痿软不举，或举而不坚。这说明胃气能为肾气提供辅助。古话说：“精生于谷。”又说：“男子精盛则思色。”其中的道理是可以类推的。新书的说法，不过像宋人揠苗助长一样。况且丹药的危害，哪里说得完呢。
*Gujin Yi'an An* (Classical and Modern Medical Cases Arranged), compiled by Yu Zhen, Qing Dynasty, Chapter: Impotence, Category: Medical Discourse:
Zhou Shenzheng treated a patient. He was in his late twenties. His family was extremely poor. Living alone as a widower, he was depressed and unhappy. Consequently, he suffered from impotence (Yang Wei) and could not achieve an erection throughout the year. Although he continuously took warming and tonifying medicines, his condition worsened day by day. Fire rose to his head, making it impossible for him to bow down. Treatments using clearing or descending methods were ineffective. Taking Jianzhong Tang (Middle-Jiao Building Decoction) provided slight relief. One day, while reading *Bencao* (Materia Medica), he saw that Jili (Tribulus Terrestris Fruit), also known as "Zao Cao," grows with fire energy and can unblock the True Yang of the human body, resolving Heart Meridian fire stagnation. Therefore, he used over one jin (approx. 500g) of Tribulus Terrestris Fruit, stir-fried until fragrant, removed the spines, and ground it into powder. After taking it, the effect was remarkable; after more than a month, all symptoms disappeared.
Zhang Jingyue said: I once treated a robust young man who fell ill due to terror inflicted by a cruel official. His symptoms resembled distension but were not true distension, and resembled heat but were not true heat. He lost his appetite and felt exhausted. The public believed it was Phlegm-Fire and suggested clearing the Middle Jiao. Upon diagnosis, I stated: "This is internal injury caused by fear. The Shaoyang Qi is exhausted, and the disease has affected the Heart and Kidney. It is a severe deficiency syndrome." I then vigorously applied warming and tonifying treatments, simultaneously addressing the Heart and Spleen. He recovered in one month. Although his physique returned to its original robust state, his Yang remained silent and non-elevated (sexual function did not recover). I said, "The root is thus; the Kidney damage is severe. This is not a sign suitable for youth. You must quickly nourish the Heart and Kidney to avoid other misfortunes." He refused to believe me. Within half a year, he fell ill again and died. Thus, the harm of fear can be so significant.
[Appendix] A young man on his wedding night wished to engage in intercourse, but the woman resisted, going against his desire. Consequently, he suffered from impotence and inability to erect for five to seven days. He consumed two qian (approx. 6-7g) of ash from a burnt bald brush head with wine, which restored his function.
Yu Zhen's commentary: Chao Yuanfang's *Zhubing Yuanhou Lun* (Source Book of Diseases and Syndromes) posits that the "Moving Qi between the Kidneys" (Shenjian Dongqi) is the root of human life. Therefore, elderly people who can still engage in sexual activity, or even those aged seventy to eighty who can father children, possess a particularly dense endowment of this Moving Qi from birth. Density implies strength, so Yang does not flaccidify. When they are capable of procreation, they are already at an advanced age; dying shortly after losing this ability suggests they reached octogenarian status. However, some men experience impotence around sixty years old and will certainly not live to an advanced age. They must follow nature, abandon lustful thoughts, and can still extend their lifespan. If they use internal and external applications of Yang-strengthening medicines to pursue sexual activities, they will die within a few years. Similarly, if a strong adult without illness suffers from impotence, such a person is likely to have a short life; if a youth with deficiency suffers from impotence, death follows immediately. All these cases result from the premature decline of the Moving Qi between the Kidneys. This Moving Qi is the True Fire of Mingmen (Gate of Life), responsible for generating Original Qi and warming Original Yin. Thus, Qi is called Yang Qi, and Essence is called Yang Essence. Their abundance or scarcity is determined by congenital endowment. Those abundant can indulge without harm; those deficient cannot be fully replenished even with careful preservation. This cannot be expanded by medicine alone. However, the *New Book of Bian Que* records the story of Wang Chao's excessive indulgence and claims that the method to preserve life is: Moxibustion first, Elixirs second, Aconite third. This statement is absurd and absolutely unreliable. Furthermore, I have verified that the Tendons (Zongjin) gather at the anterior yin. The anterior yin is the convergence point of the three Foot-Yin meridians and nine vessels: Stomai, Gallbladder, Chong, Ren, Du, and Dai. Among these nine vessels, the Stomach Meridian (Yangming) is the leader. The *Neijing* states: "The Yangming is the sea of the five zang and six fu organs, primarily moistening the Zongjin." Therefore, individuals with strong appetites and good digestion have strong sexual desires. Conversely, they suffer from flaccidity and inability to erect, or erection without firmness. This indicates that Stomach Qi assists Kidney Qi. As the ancients said, "Essence is born from grain." Also, "When a man's essence is abundant, he thinks of sex." The principles are analogous. The statements in the new book are like the Song dynasty tale of pulling shoots to help them grow. Moreover, the harms of elixirs are beyond description.