by Tom Hickman
Thousands of men around the world in the 1920s went under the knife for the supposed benefits of what were known as ‘monkey glands’ and by the 1930s there was triumph in the air, with monkey glands being claimed a success by both those carrying out the procedures and their recipients. Sadly, the whole affair turned out to be a massive example of the placebo effect at work – and just as Brown-Séquard succumbed to a cerebral haemorrhage soon after his astonishing announcement (his young wife having run off with a younger man), xenotransplantion died a death.
Throughout recorded history men have helped half-hearted erections with a variety of external supports; in the 1950s surgical techniques were developed to put the supports inside the penis. Bone and cartilage weren’t successful, but twenty years on silicone was: a pair of pliable rods could be implanted in the spongy columns of the penis – with the drawback that it was permanently extended, needing to be bent down when dressed, bent up for sex, and a man was always aware of its presence. Inflatable models with some mechanical parts have overcome the problem, but more men opt for the complex alternative, an implant with a separate fluid reservoir located in the belly, attached to a squeezable ball inserted in the groin or in the scrotum like a third testicle.14
It was in the 1980s that a reliable non-invasive treatment for impotence emerged – by accident. French surgeon Ronald Virag inadvertently injected papaverine (an opium alkaloid for treating visceral, heart and brain spasm) into an artery leading to his anaesthetised patient’s penis instead of the artery he intended, and was taken aback when his patient’s penis sprang to attention. Virag was rather upstaged by the British urologist Giles Brindley, who was intentionally investigating penile artery dilation as a treatment for impotence. He did more than report to a convention of fellow urologists in Las Vegas the success that he’d achieved with the beta blocker phenoxybenzamine (a treatment for hypertension): he showed them. Having injected himself before taking the platform, he walked among his audience, erection in hand, to prove that no implant was involved. Soon others were promoting dilatory compounds for self-injection (yes, a small prick for a bigger one).
And then came Viagra (which had nothing to do with the near-anagrammatic Ronald Virag), which like papaverine and phenoxybenzamine relaxes the smooth-muscle cells of the penile blood vessels – but with the enormous advantage of only having to be swallowed. Viagra, the first approved oral treatment for erectile dysfunction, coined from ‘virility’ and, hyperbolically, ‘Niagara’, became the fastest-selling drug in history. (Among the first customers were hard-working males in the porn industry, the drug enabling them to ‘maintain wood’ without the help of ‘fluffers’, young women whose job was to lick them into shape just before the director called ‘Action!’) And it seemed that without pain, inconvenience or prolonged treatment impotent men could at last with certainty hold their head(s) up high . . .
A PRICE TO PAY
A MAN MAY be distraught when he can’t get an erection – and terrified when he can’t get rid of one.
A prolonged and agonising erection – priapism – happens when the blood in the spongy cylinders of the penis that engorge during arousal doesn’t return to the circulation, which normally happens after orgasm. Four to six hours later the blood trapped in the penis has the consistency of thick oil – and if a doctor doesn’t remedy the situation by sticking in a needle to let the blood out, there will be damage to blood vessels and nerves that might make getting an erection impossible. If left untreated for twenty-four hours, gangrene and even amputation may follow.
Priapism can be a side effect of certain medical conditions or of recreational drug use. But almost any effective impotency treatment can cause the predicament, including over-pumping a penis or leaving on a restricting ring for too long, both of which can also result in permanent impairment. And priapism may not be the only, or the worst, outcome of attempting to encourage, strengthen or prolong erection.
The overwhelming majority of aphrodisiacs are ineffective and harmless; some are dangerous. Most of these work by irritating the mucous membrane of the urinary tract and genitals to assist the necessary blood flow; a very few are psychotropic, which is to say they work on the mind to induce sexual desire – yohimbine, made from the bark of a West African tree, is the best known. And all are powerful poisons, including such innocent-sounding plants as crowfoot (a member of the buttercup family), periwinkle and henbane, as are mandrake, toad venom and Spanish fly, made from crushed southern European blister beetles. The mimicking of the natural sexual response comes with various side effects (in the case of yohimbine, panic attacks and hallucinations) but sometimes with greater costs, including gastrointestinal bleeding, renal failure, lung or heart damage – and even death. So deadly are some aphrodisiacs that they are illegal in most parts of the world, but they, or compounds containing them, are frequently smuggled or, like everything else, found on the Internet. The deadliest aphrodisiac of them all, made from the testes of the blow-or pufferfish, is not illegal in China and Korea, to which its use is largely confined. A gland in the fish contains tetrodotoxin, which is a hundred times deadlier than cyanide – and the merest trace left after its removal means certain death. Some three hundred men succumb every year.
It’s unlikely that anyone has lost his life directly from a penile implant, though lurid and unlikely stories of inflatable devices being activated in public by mobile phones or bleepers, or exploding and causing haemorrhage and death, regularly appear on the Internet. What is true is that nearly three-quarters of those who’ve had a device fitted have not been happy with the results – for them, bio-hydraulic sex really isn’t like the real thing. In the early days, inflatable models were prone to malfunction, leak or break; and in the parlance of several lawsuits, device components were said to ‘migrate’. Implants have become more reliable (though they remain liable to cause infection); Viagra, however, has made them a minority choice, usually for those made impotent by prostate cancer surgery and beyond chemical conjuring.
And yet Viagra and its similar competitors have not proved to be the Holy Grail for all men in search of a viable erection (for a start, two in ten men find no such thing results). The tablets should only be used on medical advice – and not by those being treated for hypertension, high cholesterol, liver or kidney problems, diabetes or obesity. Most at risk are those with heart disease on drugs containing nitrates: the potency tablets work by releasing nitric oxide in the penis and the interaction of related compounds can cause a catastrophic drop in blood pressure. Men without medical conditions commonly experience varying degrees of dizziness, nasal congestion or nausea, or more unpleasantly, temporary visual disturbance. But for those with the identified conditions the price can be sudden hearing loss or blindness, respiratory failure, stroke or heart attack. Or death. There are no definitive statistics, but in the dozen years since Viagra came to the market, hundreds of the twenty-five million men worldwide who have popped pills for potency have popped off in the process.
As many as a quarter of all men bypass their doctor to obtain their supply elsewhere – the Internet again, usually. Some who do are unaware that they have an underlying medical problem and are therefore ignorant of their risk. The majority know the state of their health, but either can’t bear to expose their problem to scrutiny to obtain a prescription or just think, what the hell – such is the driving force of the biological imperative to have sex.15
If the force be with them in middle or old age, even men in apparently good health face the danger of a heart attack or stroke in the act of committing adultery: excitement and exertion (and sometimes the stress of infidelity) can lead to the fatal rupture of an aneurysm. It’s happened through history to the eminent as well as the anonymous. The British prime minister Lord Palmerston died (1865, at eighty-one) while having sex with a parlourmaid on a billiard table; French president Félix Faure died (1899, at fifty-eight) in a brothel having sex with his secretary; American vice president Nelson Rockefeller died (1979, at se
venty) having sex with a mistress in her apartment. Staff at Japanese love hotels, where not-young businessmen traditionally take young women, are unsurprised to open a room and find one occupant gone, the other still there but checked out in a way he hadn’t anticipated: a final flaring of the lamp, they say in Japan. The French talk romantically of coital death as la mort d’amour. The world for centuries has colloquially described it as death in the saddle.
PART THREE NOTES
1. A Florentine mob might have emasculated Michelangelo’s Boy David had they got the chance.
In 1504, thirty years after the work was finished, a mob hostile to the ‘new paganism’ of the Renaissance stoned the statue, which had to be guarded for five months until a modesty girdle of twenty-eight copper leaves was attached; the girdle remained in place until 1545.
In 1857 a plaster cast of the eighteen-foot-high David was presented to Queen Victoria, who forthwith donated it to the South Kensington Museum, now the Victoria and Albert. The museum, believing anecdotal evidence that the queen had been shocked by David’s ‘insistent nudity’, took the decision to have a proportionally sized fig leaf of stone made and kept in readiness for any royal visit.
Such prudery might seem to belong to another age. Yet in 1986 the V&A had the covering on standby in anticipation of a visit by Diana, Princess of Wales.
2. Jews in Hellenic cultures, given to public nakedness in the baths and gymnasium, were often persecuted for being circumcised, which led many, particularly during the reign of the Roman emperor Hadrian, to attach a stretching device called the Pondus Judaeus. Even in periods when Jews were not being persecuted, some men abandoned their faith and got to work with the Pondus Judaeus to improve their social and economic standing.
The uncircumcised have from time to time discriminated against the circumcised – and vice versa. In the ancient Muslim world, Africans were circumcised rather than castrated when sold as slaves and any who tried to stretch their remaining foreskin with weights were sometimes put to death. Outbreaks of violence today have erupted in South Africa between the circumcised Xhosa and the uncircumcised Zulu and in Kenya between the circumcised Kikuyu and the uncircumcised Luo. After a disputed election in 2008, roaming gangs of Kikuyu cut off the foreskin of any Luo they apprehended.
During the Nazi era many Jews underwent surgical ‘uncircumcising’.
Skin-graft surgery was once an option but is rarely carried out now because of the different colour and texture of the graft against the existing penile skin. But foreskin restoration using weights is still popular among some Jews and non-Jews alike. Restoration can take several years, depending on how much skin was left after circumcision.
3. The world’s first penis transplant was carried out in a Chinese military hospital in 2005, on a forty-four-year-old man whose own organ had been reduced to a centimetre-long stump in an accident. A newly brain-dead twenty-three-year-old was the donor. In a fifteen-hour operation surgeons attached arteries, veins, nerves and the corpora spongiosum, the lagging around the penile piping of the uretha. The penis largely regained its functions.
4. Did Shylock in The Merchant of Venice want to castrate Antonio? It’s an interpretation some scholars have made of the Jew’s terms for lending money to Bassanio that if Antonio failed to honour his surety he would forfeit ‘an equal pound of your fair flesh to be cut off and taken in what part of your body pleaseth me’.
By the later trial scene the bond has changed, in Portia’s words, to ‘a pound of flesh to be by him cut off nearest the merchant’s heart’. But the interpretation of Shylock’s initial stipulation can be argued. Elizabethan playwrights including Shakespeare often used ‘flesh’ for penis, and a penis, according to those who postulate the reading, weighs about a pound; that seems an over-generous estimation, though they invariably add, ‘more or less’.
5. The hijras of South Asia are castrated males who dress as women and see themselves as a third sex, neither male nor female. Some are transsexual; others have become hijras simply as a way of surviving; living in communities, on the margins of society, they recruit boys who have been rejected by or fled from their families. Hijras demand money in the streets, sing and dance at weddings and offer sexual services.
6. Male to female surgery has become relatively straightforward. The scrotal sac is cut open and the testicles removed from it. The penis is then cut open, its contents put to one side and the ‘shell’ turned inside out and pushed into the body cavity to form a vagina. The scrotum is then fashioned into a labia and a piece of the erectile tissue from the penis contents used to create a clitoris. The procedure can be so expert it can’t be detected by the trained eye.
Female to male surgery is more expensive and less successful – a fully operable penis isn’t achievable. A scrotum is formed from the patient’s labia and synthetic testicles inserted. The clitoris is elongated, with the help of skin grafts, to become a penis, which can be used for urination but not ejaculation. Some opt for an internal prosthetic device so that the penis can be pumped erect allowing intercourse to be simulated.
7. The legend of a sharp-toothed demon who hid inside a young woman to castrate young men – and who was defeated by the local blacksmith’s ingenuity in fashioning a metal penis to break the demon’s teeth – is celebrated in the Shinto Kanamara Matsuri (Festival of the Steel Penis) in Kawasaki, one of the diminishing number of similar Japanese penis festivals.
8. A woman knows she is the mother of a newborn child. Generally speaking, a man has to take her word for it that he is the father.
Some men have always had reason to worry whether they were a child’s biological father or not. From the 1920s various blood testing methods became available, though they were difficult to perform and often inconclusive. In the 1970s, however, a test of HLA cell proteins was developed, with a 90 per cent probability of establishing paternity. DNA testing – 99.99 per cent or higher certainty – came in the 1980s.
A worldwide survey reported in the Journal of Epidemiology and Community Health in 2005 found that one in twenty-five fathers was unknowingly bringing up another man’s child.
In Elizabethan England, men had additional anxieties. A man welcomed the birth of twins if they were two girls, or a boy and a girl, but was less pleased if both infants were male: the belief was that one was born from the right testicle and the other from the less virile left, meaning that one son (which?) would be lacking in manly ways. But triplets were a matter of greater concern – triplets meant that another man had had congress with his wife. Curiously, a medical belief in sixteenth-century Italy was that a child could be conceived from the semen of up to seven men, each contributing a portion of his character.
The Hottentots in southern Africa once practised hemicastration – the removal of one testicle – to prevent the birth of twins, which were regarded as bad luck.
9. Did the earth move?Women of the Kagaba tribe in Colombia hope not. Tribal belief is that if a woman moves during intercourse the earth will slip off the shoulders of the four giants holding it above the water.
10. Europe, like Japan, generally didn’t buy into the hygiene argument. In Britain circumcision remained popular among the better-off, but rates shot up under the new National Health Service set up after the Second World War; they dropped dramatically once parents had to pay for it – the 50 per cent rate of 1950 is almost zero today. America’s enthusiasm for circumcision has only waned in the last decades, from 95 per cent to an overall 60 per cent, though it is half that in the eastern states.
Circumcision is a human ritual going back to prehistory. It’s central to the religion of Jews (who traditionally circumcise at eight days) and Muslims (at puberty), but also to the beliefs of many tribes in Africa and Australian Aboriginals. Among some primitive peoples males are considered neuter until the foreskin, which is seen as being feminine because it bears some resemblance to the labia, is removed. The Greeks and Romans were appalled by circumcision when they encountered it among the Egyptians and
Israelites. Esteeming the tapered, fleshy, nipple-like portion of the foreskin as the defining feature of the male, they even passed laws forbidding such ‘mutilation’.
There has been considerable debate as to the sexual pros and cons of circumcision to the adult male. Some specialists consider it beneficial in that it delays orgasm. Others maintain that it robs a man of nerve-rich erogenous tissue and sensation in the permanently uncapped glans, blunted over time to become about ‘as sensitive as a kneecap’. Others have dubbed circumcision ‘penile rape’. The probability is that it doesn’t make much difference either way.
The foreskin is much larger than might be thought: up to 15 square inches.
11. In Renaissance France the belief was that a man with a grudge against a new bridegroom could make him impotent by calling out his name while at the same time breaking off the point of a knife in the marriage chamber door.
Similar beliefs occur throughout time – Athenian males worried that black magic could be used to harm their penile potency. Enemies or sexual rivals often inscribed a lead tablet with a curse aimed at another’s generative organ and buried it in the grave of a boy – the ghosts of the ‘premature dead’ were believed to wander the earth and were prepared to wreak evil until their natural lifespan was fulfilled.
12. Insult the penis, insult the man – and mankind has been doing that with the phallic gesture throughout history.
Two thousand years ago the Romans were giving each other what antiquarians called the phallic hand, just like the Ancient Greeks: the fist clenched, the tip of the thumb thrust between the first and second fingers like the tip of a penis. The mano fico (the ‘fig’) in Latin but fuck you in any language except Japanese – the ever-so polite Japanese don’t have such a gesture, or any swear words either. Probably older is the digitus impudicus (impudent finger): the same meaning, with greater economy. The ‘fig’ is still popular in Mediterranean countries, particularly Italy, but the ‘finger’ is almost universal, though with some variants: the first finger instead of the more usual middle one, or the two fingers held up closed together or spread apart. Not so in Iran and some other Middle Eastern countries where the equivalent of the ‘finger’ is what in the West is the cheery gesture of encouragement: the thumbs up. Which can lead to serious misunderstanding either way.
