Thinking Of Professor LEI Genping in Treating Severe Strain Injury Due To Masturbation From Phlegm Dampness
Mar 13, 2025
Abstract:
Objective: To summarize and study Professor LEI Genping's thinking on the treatment of severe strain injury due to masturbation so as to better understand traditional Chinese medicine(TCM) theory, thus improve clinical efficacy. [Methods] Through reviewing the pertinent literature, following the teacher, recording and collecting typical case records, the rules of formulas and medication of Professor LEI were summarized and analyzed and two case records were attached.
[Results] According to Professor LEI, the typical pathogenesis of severe strain injury due to masturbation is phlegm production due to injury of essence and blood. Kidney deficiency is the base and phlegm pathological factor flowing is special pathological factor which will exhibit different symptoms of phlegm retention. In the process of treatment, resolving phlegm is used throughout the treatment. The first case was based on the kidney deficiency, with the injury of the middle -Jiao Yang and the flow of phlegm retention as the symptoms, first treatment was strengthening the spleen Yang to resolve the pathogenic dampness, then focusing on securing and astringing and tonifying the kidney and supplementing the essence, resolving phlegm, dredging collaterals and calming the heart were sequential treatments. The second case was based on the deficiency of kidney essence, Yin -Yang disharmony and turbid phlegm blocking the heart and gallbladder was the symptoms. The treatment started from harmonizing Yin and Yang, tonifying the kidney and supplementing the essence, followed by warming Yang to expel coldness, expelling wind and removing dampness, while clearing heat and resolving phlegm ran throughout the sequential treatment. Although the two cases had the same etiology, the symptoms were different and both pathogenesis was complex, both had achieved satisfactory curative efficacy.
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Conclusion: Professor LEI's treatment of severe strain injury from phlegm theory is accurate in syndrome differentiation and reliable in its efficacy, which provides new ideas for the treatment of severe strain injury and enriches the understanding of the etiology and pathogenesis of the disease, and is worth promoting and studying.
Key words: masturbation; strain; depletion of viscera essence; deficiency of kidney essence; resolving phlegm; sequential treatment
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Severe Fatigue Syndrome as a Type of Deficiency Syndrome: A Discussion on Its Pathogenesis and Treatment Approach
Severe fatigue syndrome, classified under the traditional Chinese medicine (TCM) concept of "deficiency syndrome" (虚劳病), refers to a condition caused by excessive physical exertion, leading to extreme exhaustion of the internal organs and body. This results in a complex array of symptoms that fall within the scope of TCM's "Five Consumptions and Seven Injuries" (五劳七伤). This article focuses on severe fatigue syndrome caused by a specific factor: prolonged and excessive masturbation. This particular form of the condition is characterized by severe depletion of vitality and more critical symptoms, which can be categorized under the "extreme exhaustion of essence" (精极) paradigm [1]. Treatment typically revolves around supplementation and tonification strategies.
Professor Lei Genping, a renowned TCM practitioner in Shaanxi Province, has over 20 years of clinical experience. He is well-versed in Zhang Zhongjing's classical formulas and incorporates the strengths of various prescriptions. By carefully analyzing the root causes of complex and challenging cases, meticulously differentiating syndromes, and addressing the root of diseases, Professor Lei has achieved remarkable clinical outcomes within relatively short periods. Through observation of his clinical practices, the author has discovered that treatment based on the concept of phlegm may offer a novel approach to severe fatigue syndrome. This article attempts to analyze such a perspective and includes two case studies for reference by fellow practitioners.
1. Etiology and Pathogenesis
Masturbation refers to the act of stimulating the genital organs using hands or other objects to achieve sexual gratification in non-coital settings [2]. Research indicates that the prevalence of masturbation among college students ranges from 50% to 80%, with 30% engaging in the activity more than three times per week [3]. This behavior is notably common among young adults and has a certain tendency toward addiction. Therefore, preventing and treating severe fatigue syndrome caused by excessive masturbation holds significant research value.
Professor Lei believes that the primary disease location lies in the kidneys, but prolonged illness may also involve the heart, spleen, and lungs. The resulting pathogenesis includes imbalances of yin and yang, kidney deficiency with depletion of essence, spleen deficiency with dampness retention, and heart deficiency with timidity. These may also intertwine with various pathological factors.
1.1 Yin-Yang Imbalance
Professor Lei's clinical observations reveal that patients with this condition often exhibit symptoms of yin-yang imbalance and mixed cold-heat syndromes. On one hand, symptoms such as fatigue, fear of cold, cold extremities, and soreness in the lower back and knees suggest yang deficiency. On the other hand, manifestations like five-center heat sensation (五心烦热), night sweats, insomnia, and vivid dreams point to internal heat due to yin deficiency. At its core, excessive fatigue leads to significant loss of essence, disrupting the interdependent relationship between essence, qi, and fire. This imbalance depletes qi and causes yin-yang disharmony, resulting in a variety of complex symptoms.
As stated in Li Xu Yuan Jian (理虚元鉴):
"Excessive indulgence in sexual desire leads to an abrupt loss of essence, gradually exhausting it. Essence serves as the origin of fire and the basis of qi; thus, the loss of essence depletes both fire and qi. This explains the concurrent depletion of essence, fire, and qi... Yang deficiency results in profuse sweating or the need to wear heavy clothing even in summer; symptoms may include soreness and weakness in the waist and legs, difficulty bending the back, or stiffness in the arms and legs leading to paralysis. Other signs include pale complexion and a faint voice, manifesting in various ways."[4]
2. Therapeutic Approach
The clinical manifestations of this condition are diverse, with a complex and intertwined pathogenesis and a prolonged, relapsing course. Simply focusing on supplementation and tonification often yields limited results. Considering the frequent coexistence of phlegm and blood stasis in this condition, Professor Lei places particular emphasis on resolving phlegm throughout the treatment process. This is complemented by harmonizing yin and yang, replenishing kidney essence, and other symptom-targeted therapies. By eliminating phlegm, subtle essence can be retained, and when combined with appropriate psychological counseling to correct thoughts and emotions, symptoms can be effectively alleviated, and the deficiency state can be corrected.
2.1 Harmonizing Yin and Yang
Yin and yang are the foundation of disease treatment. Professor Lei often selects Gui Zhi Jia Long Gu Mu Li Tang (桂枝加龙骨牡蛎汤) to balance yin and yang. This formula originates from the Jin Gui Yao Lue (金匮要略), which states:
"When the pulse is hollow, floating, and slightly tight, indicating seminal emission in men or sexual dreams in women, use Gui Zhi Jia Long Gu Mu Li Tang."
As a foundational classical formula, Gui Zhi Tang excels in harmonizing yin and yang. The combination of Gui Zhi (cinnamon twig) and Bai Shao (white peony root) harmonizes yin with its sour and sweet properties. Gui Zhi, Sheng Jiang (fresh ginger), Gan Cao (licorice root), and Da Zao (jujube) warm yang with their acrid and sweet properties. Long Gu (dragon bone) and Mu Li (oyster shell) are heavy, anchoring substances that calm the mind and stabilize floating yang. Combined with Di Huang (rehmannia root), they harmonize the heart and kidneys. As Zhang Jingyue [5] stated:
"Although essence is stored and regulated by the kidneys, its governance ultimately lies with the heart."
2.2 Replenishing the Kidneys and Nourishing Essence
Replenishing the kidneys and nourishing essence addresses the direct pathogenesis of this condition. Huang Qi (astragalus root), Sheng Di Huang (raw rehmannia root), and Shu Di Huang (processed rehmannia root) are key ingredients in Professor Lei's approach. A large dose of Huang Qi is used to promote qi circulation, ensuring smooth blood flow while exerting its astringent effects on qi. As stated in the Su Wen (素问):
"When essence is insufficient, replenish it with flavors."
The combination of Sheng Di Huang and Shu Di Huang provides rich nourishment to replenish essence, augment kidney water, nourish yin and blood, and restore kidney essence and bone marrow. When paired with the "Four Kidney Herbs" (Bu Gu Zhi, Tu Si Zi, Gou Qi Zi, and Yin Yang Huo), the formula balances the liver and kidneys, allowing subtle essence to be retained, marrow to be nourished, and symptoms such as lower back soreness and pain to be effectively alleviated.
2.3 Warming the Spleen and Resolving Dampness
Professor Lei often uses Huang Qi, Bai Zhu (white atractylodes), and Gui Zhi to strengthen the middle burner and warm the yang of the spleen, restoring its ability to regulate water metabolism. As stated in the Li Xu Yuan Jian (理虚元鉴):
"The nature of Huang Qi is yellow and white, with yellow entering the spleen and white entering the lungs. Its sweet taste replenishes the center, and its heaviness stabilizes the exterior. In conditions of fatigue and deficiency where both qi and blood are depleted, and where the interior and exterior lose balance, Huang Qi, with its sweet, warming, and qi-replenishing properties, restores central harmony. Once the central axis is established, the disorganized elements in the five directions return to their proper positions-this is the foundation of the 'Jian Zhong' (Strengthening the Center) method." [4]18
For patients with persistent phlegm nodules, herbs such as Xuan Shen (scrophularia root), Wu Gong (centipede), Long Gu, and Mu Li are used to unblock channels, resolve phlegm, and soften hard masses. For cases of middle burner deficiency cold with vomiting and diarrhea, herbs like Cang Zhu (atractylodes), Fang Feng (siler root), Sheng Jiang, and formulas such as Si Ni Tang and Li Zhong Tang are employed to warm the center, stop vomiting, and disperse cold. In cases of lingering dampness, additions of Cao Guo (tsaoko), Sha Ren (amomum fruit), and Bai Dou Kou (cardamom) enhance the effects of resolving dampness and promoting qi circulation.
2.4 Calming the Mind and Benefiting the Gallbladder
Due to gallbladder stagnation combined with phlegm disturbance, these patients often exhibit symptoms such as anxiety and restlessness. Professor Lei favors the use of Wen Dan Tang (温胆汤) with added Chai Hu (bupleurum), Huang Qin (scutellaria), and Qing Meng Shi (chlorite). This modified formula, known as Chai Qin Wen Dan Tang, enhances the formula's ability to clear heat and resolve phlegm. As Miao Xiyong [6] stated:
"Meng Shi possesses the fierce and descending nature of stones; it is heavy and able to eliminate all accumulations and phlegm nodules, dissolve stagnation, and expel phlegm rheum. Truly, it is an essential herb."
