bubble_chart Concept

Priapism, lasting for several hours, days, or even more than a month without subsiding, is referred to in the Zhubing Yuanhou Lun as: "The penis remains long and erect without wilting." The Lingshu．Jingmai chapter describes it as "erect and unretractable"; the Lingshu．Jingmai chapter and the Jiayi Jing refer to it as "prolapse of uterus long"; the Zhubing Yuanhou Lun, Qianjin Fang, and "Shiyi Delixiao" call it "priapism"; the Yixue Gangmu and Leizheng Zhicai name it "constant erection of penis" and "constant erection of penis unretractable"; the Zabing Yuanliu Xizhu refers to it as "prolapse of uterus", "strong penis", and "strong penis without wilting"; "Shishi Mizhuan" and the Bencao Jingshu term it "priapism unyielding".

bubble_chart Pattern Analysis

1. Excess Heat in Liver Meridian︰Priapism persists for several days or even more than a month without subsiding, with static blood in the penis, a purplish-dark color, distending pain, difficulty and pain during urination, and dark yellow or reddish urine. Patients often experience fear, accompanied by loss of appetite, thirst, severe constipation, a yellow tongue coating, and a wiry or rapid pulse. Due to a constitution that is inherently strong and excessive sexual desire, the penis remains abnormally erect even after intercourse, persisting for days without subsiding. In addition to local symptoms such as distending pain in the penis, static blood with a bluish-purple hue, and difficulty urinating, there must also be accompanying symptoms like a bitter taste in the mouth with thirst, severe constipation, a yellow tongue coating, and a wiry, rapid, and forceful pulse. As mentioned in Lingshu. Jingjin: "When the Liver Channel of Foot-Jueyin is injured by heat, it causes persistent erection without retraction." Lingshu. Jingmai: "Excess leads to prolonged erection." Leizheng Zhicai. "Impotence" states: "Constant erection of the penis without retraction is due to heat injury of the liver sinew, treated with Minor Bupleurum Decoction plus wine-fried Phellodendron bark," or Bupleurum Liver-Soothing Decoction. If the liver fire is excessively strong, causing persistent priapism with severe pain lasting for days or even more than a month without relief, the treatment should focus on clearing heat and removing toxins. Gypsum, Anemarrhena, Scrophularia Root, Unprocessed Rehmannia Root, black soybean, and Liquorice Root (Leizheng Zhicai) can be used, or Gentian Liver-Draining Decoction to directly purge the excess fire from the Liver Channel.
2. Yin Deficiency︰The patient has a constitutional yin deficiency, with a thin physique, persistent priapism, distending pain lasting for several days, difficulty urinating, dark yellow urine, occasional spontaneous emission, severe constipation, dry mouth, a red tongue, and a thin, rapid pulse. The underlying yin deficiency stems from excessive sexual desire and unrestrained indulgence, leading to kidney water depletion and frenetic stirring of ministerial fire, resulting in unrelenting priapism and spontaneous emission. Alternatively, it may be caused by overuse of yang-promoting medications, which exacerbate yang excess and yin deficiency, fire dominance and water exhaustion, leaving ministerial fire unconstrained and priapism unresolved ("Yilin Shengmo"). Symptoms must include a red tongue, dry mouth, constipation, and a thin, rapid, weak pulse. Treatment should focus on enriching yin and draining fire, using Gypsum, Kidney and Apricotleaf Ladybell Decoction.

The condition of persistent erection without decline is listed under the category of consumptive thirst in texts such as Zhubing Yuanhou Lun, Qianjin Fang, and Shiyi Dexiao Fang. This is because it was commonly seen in ancient times as a result of "taking elixirs and minerals," which, apart from causing abnormal penile erection, also led to noticeable symptoms of excessive drinking. Nowadays, cases caused by taking elixirs and minerals are rare, but it can occasionally be seen in patients poisoned by mineral medicines, making it even more difficult to treat. Later generations of physicians often classified persistent erection under the category of kidney diseases, discussing it alongside seminal emission and impotence, and believed it to be related to excessive indulgence in alcohol and sex. Danbo Yuanjian believed: "Consumptive thirst and priapism are indeed different conditions." (Zabing Guangyao) There are also cases where persistent penile erection is caused by trauma to the waist.

bubble_chart Documentation

1. Shiyi Dexiao Fang．Xiao Ke: priapism, mostly caused by excessive indulgence in sexual desires, indulgent eating and drinking, or taking elixirs. Vital qi is depleted, the medicinal qi triggers yin, leading to extreme thirst and excessive drinking, eating and drinking beyond normal, yin qi is often aroused, and essence is emitted without intercourse. Therefore, middle energizer is deficient and hot, pouring into the lower energizer, among the three consumptions, it is the most difficult to treat."
2. 《Materia Medica Compendium．Leek Entry》 quotes Xia Ziyi's Miracle Power: "The jade stem is hard and unyielding, essence flows continuously, often feels like needle pricks, painful when pinched, the disease is called priapism, which is a kidney stagnation fistula disease. Use leek seeds and malaytea scurfpea fruit, one tael each, grind into powder, take three qian each time."
3. 《Stone Chamber Secret Records．Male Treatment Method》: "Strong yang does not fall, this is due to virtual fire flaming upwards, and the lung metal qi cannot descend. If Phelloendron Bark and Anemarrhena are used (Yang Falling Decoction) to make a decoction and drink, it will dissipate immediately. However, after it falls, it cannot rise again for years, which is also suffering, use Scrophularia Root three taels, Cassia Bark three fen, Ophiopogon Tuber three taels, decocted with water and taken, it will fall immediately.…This is falling without seeking to fall."
4. 《Clinical Treatment and Experience of Penile Erection》: "This disease first requires expelling the dampness-heat poison of the Jueyin, assisted by dispersing the blood stasis in the penile vessels, and finally nourishing blood and benefiting the kidneys, to achieve complete success." (Excerpt from Shi Daosheng's report at the first academic exchange meeting of the Internal Medicine Society of the National Chinese Medicine Association in December 1981)