Symptoms
Impotence takes three forms. There is primary impotence When the man’s erectile dysfunction is there from the very beginning of sexual activity and he simply cannot have an erection. This is a rare manifestation of the problem. Secondary impotence is the commonest and this implies that the man can normally attain an erection but fails on one or more occasions in between normal activity. The third form is associated with age and is a continuous and serious form with poor prognosis.

Causes
Since erection is the result of erotic excitement, intact nervous pathways and adequate hormonal functioning, the pathological causes of impotence are numerous. It may occur as a result of psychological illness such as depression, which lowers both sexual drive and erectile function, tiredness, alcohol abuse, the therapeutic use of oestrogens, paralysis of parasympathetic nerves by drugs or permanent damage to them and diabetes. Other causes of impotence are abuse or misuse of the sexual organism over a long period and a devitalised condition of the system in general.
However, the main problem of secondary impotence is the apprehension created by failure which generates a good deal of anxiety for the next time round regarding the likelihood of failure. If, in fact, intercourse is attempted again and the same failure results, then a vicious circle is established. Anxiety of failure is established as an anticipatory reflex which in turn impairs the capacity of the penis.

Treatment
Taking of drugs or so called "remedies" in case of impotence is not only useless but dangerous. Diet is an important factor in these conditions. To begin with, the patient should adopt an exclusive fresh fruit diet from five to seven days. In this regimen, he can have three meals a day, at five hourly intervals, of fresh juicy fruits such as grapes, oranges, apples, pears, peaches, pineapple and melon. The bowels should be cleansed daily during this period with a warm-water enema.
After the all-fruit diet, the patient may gradually embark upon a balanced diet of seeds, nuts and grains, vegetables and fruits, with generous use of special rejuvenative foods such as whey, soured milks, particularly made from goat’s milk, millet, garlic, honey, cold-pressed vegetable oils and brewer’s yeast. The patient should avoid smoking,alcohol, tea, coffee and all processed, canned, refined and denatured foods, especially white sugar and white flour and products made from them.
Certain foods are considered highly beneficial in the treatment of impotence. The most important of these is garlic. It is a natural and harmless aphrodisiac. According to Dr. Robinson, an eminent sexologist of America ,garlic has a pronounced aphrodisiac effect. It is a tonic for loss of sexual power from any cause and for sexual debility and impotence resulting from sexual over-indulgence and nervous exhaustion.
Onion is another important aphrodisiac food. It stands second only to garlic. It increases libido and strengthens the reproductory organs. The white variety of onion, is however, more useful for this purpose.
Carrot is also considered useful in impotence. For better results, carrot should be taken with a half-boiled egg dipped in a tablespoonful of honey once daily for a month or two. This recipe increases sex stamina by releasing sex hormones and strengthens the sexual plexus. It is for this reason that carrot halwa, prepared according to Unani specifications is considered a very effective tonic to improve sexual strength.
The lady’s finger is another great tonic for improving sexual vigour. It has been mentioned in ancient Indian literature that the persons who take five to 10 grms of root powder of this vegetable with milk and ‘misri’ daily will never lose sexual vigour.
Dried dates, known as chhuhara in the vernacular, is a highly strengthening food. Pounded and mixed with almonds, pistachio nuts and quince seeds, it forms an effective remedy for increasing sexual power.
Black raisins are also useful for restoration of sexual vigour. They should be boiled with milk after washing them thoroughly in tepid water. This will make them swollen and sweet. Eating of such raisins should be followed by the use of milk. Starting with 30 grams of raising with 200 ml. of milk, three times daily, the quantity of raising should be gradually increased to 50 grams each time.
A vigorous massage all over the body is highly beneficial in the treatment of impotence as it will revive the muscular vigour which is essential for nervous energy. The nerves of the genital organs are controlled by the pelvic region. Hence a cold hip bath for 10 minutes in the morning or evening will be very effective.
Every effort should be made to build up the general health level to the highest degree and fresh air and outdoor exercise are essential to the success of the treatment. Yogasanas such as dhanurasana, sarvangasana and halasana are also highly beneficial.
The scheme of treatment outlined above will go a long way in restoring sexual vigour, but of course the results achieved will depend upon the age and condition of the sufferer. Longstanding cases will obviously not get such good results from the treatment as comparatively early cases ; and younger men will naturally tend to do better than older men.
Where the trouble is of psychological origin, treatment should be just the same , but in these cases advice from a qualified psychotherapist would be desirable. The patient also requires gentle handling by a willing partner.

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