The Chinese regard soup made from a sea swallow’s nest as the ultimate aphrodisiac. The nest is made of sea grass held together with roe, a rejuvenating substance. In addition, sea grass contains a great deal of the previously mentioned phosphorus.
The Japanese walnut ( Ginkgo biloba) is another medicinal source well known to the Chinese. The extract of the leaves is supposed to help the smooth muscle cells in the erectile tissue compartments relax and hence bring about an erection. The ginkgo has existed for hundreds of millions of years, originating in the Permian period, which means that herbivores like dinosaurs already grazed on ginkgo leaves in the Jurassic period. The tree is the only surviving intermediate form between the higher and lower plants, between the ferns and the conifers, though it is not a conifer but a deciduous tree. Fossil remains show that today’s ginkgo has scarcely changed in the last 65 million years. A different, but scientifically interesting aspect, is that its swimming spermatozoids play a part in reproduction – an exceptionally rare occurrence in plants and trees. The ripe seed has a soft, fleshy yellow outer layer and the unpleasant smell of rancid butter. These seeds (‘nuts’) are prized as a delicacy in the Far East. The ginkgo disappeared from Europe in the Ice Age, and it was not until 1691 that the German doctor and botanist Engelbert Kämpfer, who worked for the Dutch 179
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Gingko biloba
leaves.
East India Company, rediscovered the tree in Japan. In the Far East ginkgos were regarded as very special trees, and in China had been planted from time immemorial in Buddhist temple and monastery gardens, where they were regarded as sacred.
In the temperate climate of Western Europe ginkgos grow quite slowly. The trees in say, Kew Gardens, are far older than most in Europe, but even they pale before the temple ginkgos of the Far East, some of them between two and three thousand years old, up to 20 metres in circumference and 60 metres high. The unique fan-shaped leaves, with a notch in the middle, turn a wonderful yellow colour in autumn. No wonder that Goethe devoted a fine poem to the tree. Ginkgos are no longer a rarity to be seen only in historical parks and botanic gardens: nowadays some can even be found lining suburban streets. The tree is indestructible, not even succumbing to an atom bomb. The death toll in Hiroshima was huge and massive buildings were completely destroyed, but the Ginkgo biloba only one kilometre from where the bomb landed simply went on growing.
Ginseng root comes from traditional Chinese medicine and is mainly used in Western phytotherapy to increase stamina. The major supplier is Pannax Ginseng from Korea. Its effect is supposedly based on an increased production of nitrogen oxide in the erectile tissue 180
a i l m e n t s o f t h e p e n i s compartments in the penis. Nitrogen oxide is a potent vasodilatory molecule and the discoverers of that fact were awarded the Nobel Prize.
With a little imagination one can see a little man in the shape of the ginseng root. So according to the doctrine of signatures, according to which the form and medical application of a plant are linked, ginseng is suitable for use with men.
In Asia the enduring interest in all kinds of aphrodisiacs has unfortunately resulted in the virtual extinction of both the Javanese and the Sumatran rhinoceros; the African rhino is also seriously under threat. It is widely believed, especially in East Asia and the Middle East, that the use of ground horn can restore potency, which may be associated with the fact that the act of mating in rhinoceroses takes almost an hour and involves multiple ejaculations. The horn commands as-tronomical prices and in Europe in the autumn of 1994 it reached the point where on the advice of Interpol rhinos in zoos were kept under close surveillance, since information had been received that poachers –
a ruthless bunch anyway – were targeting animals in captivity.
Not so very long ago, on the island of Curaçao in the Netherlands Antilles, the iguana was in danger of extinction. Soup made from this splendid creature was supposed to eliminate potency problems. The iguana’s sex organ is so shaped that it appears to have two penises, and a similar abnormal shape was once diagnosed in a human being, the 22-year-old Portuguese gypsy João Batista dos Santos. According to the doctors both penises functioned properly, and once he had climaxed with one he immediately continued with the other. The patient preferred the left-hand one, which was thicker.
There is a rice-based alcoholic drink in China that includes one lizard per bottle. This is a gecko ( Japaloua Polygonata), a large species of Asian lizard, and the potent beverage is called Ha Kai Chiew. The Chinese attribute a salutary effect to the juices of the quick and agile gecko, especially in cases of impotence. The so-called ‘preserving’ of animals is traditional in many countries: in France adders disappear into eau de vie, in Spain frogs and in Mexico worms.
Traditionally chocolate is also considered an aphrodisiac. This probably originates from the time when chocolate was scarce and hence expensive. It contains phenylethylamine, related in structure to the so-called neuro-transmitters, but it is broken down before it reaches the brain. In addition there are minimal quantities of caffeine, thebromine and anadomine . None of these ingredients can explain the reviving effect of chocolate. Women are supposed to experience a pacifying and hormone-calming effect, for example when sexually aroused.
Avocados, oysters, mussels and asparagus are also considered to be aphrodisiacs, and when they appear on the menu are meant to herald 181
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fireworks in bed. This hypothesis rests solely on the supposed similarity of these foods to genitalia, which can also be found in bananas, carrots, figs, peaches and coconuts. Avocados grow in pairs and are supposedly reminiscent of testicles. The durian is fruit the size of a football with spines, which grows on huge trees in South-East Asia. It has a distinctive flavour and is held to be aphrodisiac. As a Malay proverb puts it: ‘When the durians are down, the sarongs are up.’
Training apparatus
In the 1920s various theories were developed on the anatomy and physi -
ology of the erection; drive rods and Magdeburg hemispheres were used as analogies. Therapeutically, however, things did not advance beyond the prescription of testosterone preparations. In the Dutch Journal of Sexology of December 1994 there is description of how papaverine and yohimbine was already in use in 1921 in the treatment of men with erection problems. The two substances, which were already believed to improve erection quality, were combined by a German researcher to form pyt (papaverine-yohimbine-tartrate).
Extensive animal research was carried out on this compound.
According to the researcher tomcats displayed ‘typical on-heat behaviour’ after systematic administration, while in anaesthetized rats
‘maximum vasodilation in the pelvis minor’ was observed. It was also established what doses were fatal to a cat, a frog, a rabbit and a mouse.
Male impotence cost the lives of so many animals! Without their knowledge, male syphilis patients became the first human guinea pigs: these were the days before committees on medical research ethics. The results of the pilot study were never published.
From 1940 to 1960, convinced that the traditional psychothera-peutic approach sometimes had no effect, the English psychiatrists Russell and Loewenstein used so-called coitus-training apparatus, with which the penis could be supported, enabling the man to have intercourse without an erection. The apparatus had an eye bolt with a rotatable link so that everything could be fastened as high as possible under the scrotum. In tightening the bolts care had to be taken that the pubic hairs were not trapped. The other end was placed around the penis in such a way that the scrotum could hang freely, but the glans could at the same time rest in a kind of ring, which was made of ebony and had five metal plates in the inside.
The theory was that the acidity and moisture level of the penis could be raised by an electric current, which would provide an effective stimulus. The purpose of this apparatus was to break the vicious circle of fear of failure and impotence, since it was evident even at tha
t time 182
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Coital training
apparatus
designed by
psychiatrists in
1947.
that certain men were not motivated to undergo any kind of talking therapy.
A different, but to some extent comparable solution is the artificial penis, to which some women have an aversion. The use of a dildo –
the exotic term for an artificial penis – is as old as mankind. In the nineteenth century they sold like hot cakes in all European capitals: clay, paper, wax – every kind of raw material was tried. In using such an aid one must of course observe strict hygiene, and the use of a lubricant is sensible. With an artificial penis full penetration is not necessary, and may even be undesirable.
High-tech: Old wine in new bottles
In the last decade urological interest in ed has increased spectacularly.
This is a positive development for various reasons: for instance, more attention has been paid to the sexual consequences of operations. It has also become apparent that physical abnormalities are more frequently involved than had been traditionally assumed by sexology.
In addition, both the diagnostic and therapeutic options in dealing with impotence have greatly increased.
On 25 June 1980 the French cardiovascular surgeon Ronald Virag discovered by accident that direct administration of papaverine into the penis could cause an erection, but he only published on the subject in The Lancet in 1982. Since the 1960s papaverine had been used in surgical procedures to keep the two blood vessels to be stitched together as wide open as possible: in other words, it is an established drug. Like opium, it is made from the poppyhead, but is completely non-addictive. During a cardiovascular surgical procedure Virag accidentally injected papaverine into the wrong vessel, inflicting an extremely long-lasting post-operative erection on the patient.
In fact, as long ago as the Second World War, the penis was used by military surgeons to transfuse large quantities of blood into soldiers 183
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in deep shock (because the relevant veins could no longer be seen or felt, it was sometimes impossible to insert a drip into the arm of patients in shock). However, if the blood flow was too fast, it resulted in an erection. Therefore injection therapy (in which the man injects himself in the penis with a vasodilatory drug) originates from the link established between a wartime procedure and a ‘slip’ during an operation.
In 1983 the world of urology was alarmed by a talk on this subject by the eccentric British professor Giles Brindley at the American Conference of Urologists in Las Vegas. He was conducting research into the effects of intrapenile administration of phentolamine, like papa verine a vasodilatory medication, but one that acted in a different way. Usually speakers at such a gathering are neatly dressed, that is, in suit and tie, but Professor Brindley appeared in shorts and sneakers.
He talked about the results of his research, but after a quarter of an hour he interrupted the talk by announcing that he was getting a hard-on. The audience were shocked, not least because he went on to drop his shorts giving those at the front a close-up view and inviting them to feel it . . . He told us that he had injected himself before giving his presentation. An unforgettable, penetrating performance!
A prostaglandin or a combination of papaverine and phentolamine can be used for self-injection. This combination was officially registered for intercavernosal use in 1992 under the brand name Androskat.
The dosage for treatment depends on the cause of the impotence. The effect is virtually immediate, or takes at most between fifteen minutes and half an hour. Depending on the firmness and duration of the erection, the dose should be adjusted step by step. A slow increase is preferable, and this is usually done in consultation with the urologist in charge of the case. In general the aim is to achieve an erection lasting between one and two hours. Injecting more than twice a week is not advisable, since this can cause sclerosis.
Penile injections can occasionally cause a long-lasting, usually painful erection (priapism). The blood is as it were trapped in the erectile tissue compartments, and is no longer replaced by new blood. As a result oxygen deficiency occurs and if action is not taken in time this is followed by morbidity in the erectile tissue. A faulty technique can result in a subcutaneous injection, and there will often be visible haemorrhaging; the same can occur in a patient taking blood-thinning medi -
cation. Caution must be used with patients suffering from cataracts or ailments in which an acute drop in blood pressure can be dangerous, for example shortly after a heart attack. Worldwide not only papaverine, phentolamine and prostaglandin ei, but also moxysylyte (especially in France), vasoactive intestinal polypeptide (vip), ketanserin, calci-tonin gene-related peptide and chlorpromazine are used.
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Intracavernosal
injection.
Papaverine was naturally also tested on women . . . Gynaecologists were keen to try injections into the labia minora (specifically, the bulbus vestibulum) with anorgasmic women, in the hope of producing at least some ‘moistening effect’. Attempts failed, and no orgasms resulted.
The vacuum pump
A more or less natural erection can be simulated not only by the implantation of an erection prosthesis, but also by the use of a so-called vacuum pump in combination with a penile constriction ring. Down the ages the constriction ring has been used a sex aid. Four hundred years ago in Japan penile rings belonged in so-called love boxes and Bedouins used the dried eyelashes of goats to make them. It was thought that the lashes would provide extra stimulus during intercourse and arouse the woman sexually. Such rings are still available in sex shops.
Vacuum apparatus has been on the market for almost a hundred years. Zabludowsky’s version is described in Manual of the Sexual Sciences (1912) by the German psychiatrist Albert Moll. Until recently vacuum erection apparatus attracted almost no attention in medical circles, but plenty from the owners of sex shops, where it is on sale even today.
The modern vacuum apparatus consists of a cylinder, a pump and constriction band or ring. A true vacuum (with zero air pressure) is fortunately never achieved, since if it were the pump would be entirely filled with a bleeding penis. Actually a better name would be underpressure apparatus. The cylinder, closed at one end, is slid over the penis, open end first, and pushed against the pubic bone to form an 185
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A Zabludowsky
vacuum pump.
airtight seal. It is sometimes useful to cut away the pubic hair at the base of the penis. At the closed end the cylinder is connected to the pump, which creates underpressure in the cylinder, so that blood is sucked towards the erectile tissue and an erection is created. The required pressure is 120 millibars, which is the pressure in the erectile tissue compartments in erection. In reality, however, more is needed.
When the penis is sufficiently erect, the ring, which was previously placed round the base of the cylinder, is rolled down, so that the outflow of blood from the erectile tissue compartments is impeded.
At that moment some blood always leaks away, causing a proportionately large loss of pressure. This is why an underpressure of 200
millibars must be built up. Once the constriction ring is in place, blood can no longer leak out of the erectile tissue compartments. The ring has an indentation on its underside to avoid the urethra being squeezed completely shut, impeding ejaculation. The ring must remain in place no longer than 30 minutes and naturally one must not sleep with it on.
Because of the accumulation of blood the penis may turn slightly blue. Sometimes there are small pinpoint haemorrhages, and the penis may feel cold. ‘It was like making love to an iceberg,’ as one woman put it. The base of the penis may also wobble, thus sometimes complicat-ing insertion. It goes without saying that the use of a vacuum apparatus during intercourse stands or falls with the presence of
a sympathetic and understanding woman, who does not make excessive aesthetic demands on the man’s phallus.
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The vacuum
pump with a
rubber constric-
tion ring at the
base.
Inspired by the penis bone
The first operation to insert a penis prosthesis took place in 1936. In order to reconstruct a male member amputated in a trauma, the plastic surgeon Bogoras implanted a section of rib cartilage, prompted by his observation of the presence of a penis bone in many male mammals.
The human penis is rather an odd man out, since that of numerous other mammals contains such a bone, called a baculum. These include the whale, the dolphin, the walrus, the otter, the bear, the marten, the badger, the squirrel, the wolf, the dog and the monkey. In some species, for example in the spider monkey, there is also a section of bone or cartilage in the clitoris.
In 1951 Bett wrote an extensive article on the penis bone. In the whale the bone is some 2 metres long, with a circumference of 40 cm at the base. Further up the evolutionary ladder it becomes smaller: in the walrus it is only just over 50 cm and in the monkey it measures only between 1 and 2 cm. Up to now there are no indications that homo sapiens ever possessed such a bone. The position and shape of the bone vary from animal to animal. In the dog, for example, it forms a channel for the urethra, while in the bear and the wolf the baculum is indispensable for mating. The baculum may have many different kinds 187
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of shape. In the racoon, for example, it is s-shaped and in the bat it is forked. In the squirrel there is a sharp hook attached, which according to some experts is designed to perforate the hymen. Others believe that the hook is designed to remove so-call mating plugs. A mating plug consists of a sticky residue of sperm allowing the vagina of the female squirrel to be temporarily ‘sealed’ in order to prevent sperm donation by another male. In the otter the penis bone is characterized by extreme hardness, though healed penis fractures have been observed in these creatures. When male otters fight each other, they target their opponent’s penis with their powerful jaws and sharp teeth, and often succeed in breaking the baculum!
Manhood Page 23