OBSERVATION OF THE GENITALIA

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OBSERVATION OF THE GENITALIA

Chapter contents

CHANNELS INFLUENCING THE GENITALIA

The genitals are related primarily to the Liver and Kidney channels and to the Directing, Penetrating and Governing Vessels. The Liver Connecting channel, in particular, loops around the genitalia. Although the influence of the Directing Vessel on the genitalia is obvious, that of the Governing Vessel is often overlooked.

The ‘Simple Questions’ (Chapter 60) describes an anterior branch of the Governing Vessel that flows to the external genitalia both in men and women, and to the pubic bone and from here ascends up the abdomen on the same trajectory as the Directing Vessel (Fig. 17.1 right).¹

Fig. 17.1 Pathways of channels influencing the genitalia

The pathways of the channels flowing through the genitalia are as follows (Fig. 17.1):

• A branch of the Governing Vessels flows down to the genitalia.

• The Kidney Main, Connecting and Muscle channels flow through the genitalia.

• The Liver Main, Connecting, Divergent and Muscle channels wrap around the genitalia.

(For a more detailed description of the patterns involved in the above genitalia signs, see Part 5, Chapters 75 and 89.)

PUBIC HAIR

Symptoms and Signs, Chapters 75 and 89

There are two items of observation regarding pubic hair:

• loss of pubic hair

• excessive pubic hair.

Loss of pubic hair

Loss of pubic hair may be due to a decline of Kidney-Essence. This decline is normal in the elderly; in younger people, it may result from a severe Spleen- and Kidney-Yang deficiency.

Excessive pubic hair

The term ‘excessive’ here indicates not so much the quantity as the extent of pubic hair and it refers to people whose pubic hair occupies a large area, extending down the legs and up towards the umbilicus. Excessive pubic hair, so defined, may be due to either Phlegm combined with Blood stasis or Kidney-Yin deficiency with Empty-Heat.

PENIS

Symptoms and Signs, Chapter 75 and 90

Redness and swelling of the glans penis

Redness and swelling of the glans penis may be due either to Toxic Heat or to Damp-Heat in the Liver channel.

Ulcers on the penis

This condition is characterized by redness, macular spots, erosion and oozing ulcers on the glans penis or the shaft, or both. This is usually accompanied by pain. The main causes of this condition are either Toxic Heat or Damp-Heat in the Liver channel.

Peyronie’s disease

Peyronie’s disease is an unnatural curvature of the penis, noticeable during an erection. It may prevent a complete erection, owing to plaque or scar tissue inside the penis, or it may render erection painful so that intercourse is impossible.

The most common causes of Peyronie’s disease are:

• Blood stasis

• Dampness in the Liver channel

• Cold in the Liver channel.

Priapism

Priapism (abnormally prolonged erection) is due either to a deficiency of Kidney-Yin with Empty-Heat or to Damp-Heat in the Liver channel.

Soft and withered penis

A soft and withered penis in adults may be due to Liver-Qi deficiency, to Kidney deficiency (either Yin or Yang), or to Phlegm and Blood stasis in the Lower Burner.

Long penis in children

If a child’s penis is abnormally long, almost the size of an adult’s, this condition may be due to a hereditary Kidney-Yin deficiency, to sinking of Spleen-Qi, to Phlegm with Blood stasis in the Lower Burner, or to Damp-Heat in the Liver channel.

SCROTUM

Symptoms and Signs, Chapter 75

Contracted scrotum

The most common cause of contracted scrotum is stagnation of Cold in the Liver channel. It may also be seen in collapse of Yin or Yang.

Loose scrotum

A loose scrotum is due either to a deficiency of the Liver and Kidneys (usually Yang deficiency) or to sinking of Spleen-Qi.

Scrotum drooping on one side

A scrotum drooping on one side indicates a condition in which one side of the scrotum is swollen when the person is standing up but retracted when lying down; in Western medicine, this indicates inguinal hernia. From a Chinese perspective the patterns involved in this condition are Empty-Cold in the lower abdomen, Damp-Phlegm in the lower abdomen, Liver-Blood stasis or Damp-Heat in the Liver.

Swollen scrotum

A swollen scrotum may be due to Spleen- and Kidney-Yang deficiency, Damp-Heat in the Liver channel, sinking of Spleen-Qi, Heart-Yang deficiency or Liver-Blood deficiency generating Empty internal Wind.

Swollen and oozing scrotum

If the scrotum is swollen, red and oozing a sticky fluid, this condition is due either to Damp-Heat or to Toxic Heat in the Liver channel.

Abnormal colour

Pale scrotum

A pale scrotum is due to either Spleen- or Kidney-Yang deficiency.

Red scrotum

A red scrotum is due either to Damp-Heat or to Toxic Heat in the Liver channel.

Purple scrotum

A purple scrotum is due either to Liver-Blood stasis or to Damp-Heat with Blood stasis in the Liver channel.

Dark scrotum

A dark scrotum is due either to stagnation of Cold in the Liver channel or to Kidney-Yang deficiency.

VULVA AND VAGINA

Symptoms and Signs, Chapter 89

Vulvar sores

Vulvar sores may be due to Damp-Heat in the Liver channel or to Toxic Heat with Blood stasis in the Liver channel.

Leukoplakia

Leukoplakia may be due to Damp-Heat in the Liver channel or to long-standing Blood deficiency accompanied by Dampness.

Swelling of the vulva

Swelling of the vulva may be due to Toxic Heat with Blood stasis in the Liver channel, Damp-Phlegm in the Lower Burner, or Damp-Heat and Toxic Heat in the Liver channel.

Prolapse of the vagina

Prolapse of the vagina is always due to sinking of Qi, which may be that of the Spleen or Kidneys, or both.

NOTES

1. The Yellow Emperor’s Classic of Internal Medicine – Simple Questions (Huang Di Nei Jing Su Wen ). People’s Health Publishing House: Beijing, 1979:320 First published c. 100BC

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