Article — From the June 2008 issue
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Article — From the June 2008 issue
Nigeria was not the first site of mysterious genital disappearance. As with so many other things, its invention can be claimed by the Chinese. The first known reports of “genital retraction” date to around 300 b.c., when the mortal dangers of suo-yang, or “shrinking penis,” were briefly sketched in the Nei Ching, the Yellow Emperor’s Classic Text of Internal Medicine. Also in China, the first full description of the condition was recorded in 1835, in Pao Siaw-Ow’s collection of medical remedies, which describes suo-yang as a “ying type of fever” (meaning it arises from too much cold) and recommends that the patient get a little “heaty” yang for balance.
Fears of magical penis loss were not limited to the Orient. The Malleus Maleficarum, medieval Europeans’ primary guidebook to witches and their ways, warned that witches could cause one’s membrum virile to vanish, and indeed several chapters were dedicated to this topic. Likewise the Compendium Maleficarum warned that witches had many ways to affect one’s potency, the seventh of which included “a retraction, hiding or actual removal of the male genitals.” (This could be either a temporary or a permanent condition.) Even in the 1960s, there were reports of Italian migrant workers in Switzerland panicking over a loss of virility caused by witchcraft.
These fears, however, seem to have been largely isolated; mass panics over genital retraction were not recorded until 1874. This was the year that, on the island of Sulawesi, a certain Benjamin Matthes was compiling a dictionary of Buginese when he came across a strange term, lasa koro, which meant “shrinking of the penis,” a disease that Matthes said was not uncommon among the locals and “must be very dangerous.” Sporadic reports of koro, as it came to be known, recurred over the years, and during the late twentieth century the panics proliferated. In 1967, an epidemic of koro raced through Singapore, affecting some five hundred men. In 1976, in northern Thailand, at least two thousand people were afflicted with rokjoo, in which men and women complained that their genitals were being sucked into their bodies. In 1982, there were major koro epidemics in India and again in Thailand, while in 1984 and 1985, some five thousand Chinese villagers in Guangdong province tried desperately to keep their penises outside their bodies using whatever they had handy: string, chopsticks, relatives’ assistance, jewelers’ clamps, and safety pins. But the phenomenon was given little notice by Western scientists, who considered such strange mental conditions to be “ethnic hysterias” or “exotic psychoses.”
This way of thinking has changed, thanks largely to the work of a Hong Kong–based psychiatrist named Pow Meng Yap. In the early 1950s, Yap noticed a strange thing: a trickle of young men coming into his office, complaining that their penises were disappearing into their bodies and that when this happened they would die. After seeing nineteen such cases, Yap published a paper in the British Journal of Psychiatry entitled: “Koro—A Culture-Bound Depersonalization Syndrome.” For years, Yap had been interested in the interplay among culture, mind, and disease. In an earlier paper, “Mental Diseases Peculiar to Certain Cultures,” Yap had discussed other similar conditions: latah, a trance/fright neurosis in which the victim obeys commands from anyone nearby; amok, unrestrained outbursts of violence (as in “running amok”); and thanatomania, or self-induced “magical” death. Koro fit quite well among these other exotic maladies. In fact, it was perhaps the best example of a phenomenon that can arise only in a specific culture, a condition that occurs in a sense because of that culture. Yap saw that these ailments had this one feature in common, grouped them together, and gave them a name that, in spite of all the controversy to follow, would stick. They were “culture-bound syndromes.”
Under this rubric, koro and the other culture-bound syndromes are now treated with more respect, if not total acceptance. Science is, after all, the quest for universality. In psychiatry, this means all minds are treated the same and all conditions should exist equally across the world. Some thought that calling koro “culture-bound” was an end-run around the need for universality, a relativistic cop-out. Were these syndromes really caused by different cultures? Or were they just alternate names for afflictions that plagued, or could plague, every culture? This was precisely what I had come to Nigeria to find out, though so far with little success.