The Rise and Fall of Man: The Long History of Impotence Causes and Cures
Male impotence, commonly known as erectile dysfunction, is known today to have many causes, including cardiovascular disease, diabetes, post-prostatectomy procedures, neurological or psychological problems. For millennia, humans sought out cures for this debilitating and embarrassing condition.
In contemporary society, ensuring the strength of a man's prowess has proven to be a very lucrative business in medical surgery. Many scholars such as Tony Steele, J. Shaw, Hao Li, M Khaleghi Ghadiri and A Gorji, and famed writer Mary Roach (author of the popular book Bonk), have explored in detail both the history of male impotence, and any possible treatments. Their exploration into the past reveals that treatment of impotence is really the history of man's attempt at controlling his destiny, mortality, and prowess.
Ancient India and Ancient China
One of the earliest documents regarding male impotence comes from the Samhita of Sushruta, from the 8th century BC in India. It documents not only the symptoms but ancient treatments for impotence. However, its reasons for why men fell victim to impotence appear quite unexpected, even for its period.
A 12th century text of the Samhita of Sushruta (Los Angeles County Museum Of Art / Public Domain)
In Samhita's pages, impotence was believed to be either caused by psychological insecurity or sex with an undesirable woman. Several remedies were mentioned to cure male impotency. One of the most interesting concoctions are mentioned in an academic article by J. Shaw:
"Powders of sesame, Masha pulse, and S'ali rice should be mixed with Saindhava salt and pasted with a copious quantity of the expressed juice of the sugar cane. It should be mixed with hog's lard and cooked with clarified butter. By using this Utkarika, a man would be able to visit a hundred women."
These ancient teachings reflected the first observations of what may have caused erectile dysfunction, inspiring its continued study. In ancient China, their methods have been built from thousands of years in trial and error, especially in observing how to fix erectile dysfunction.
Hao Li and his contemporaries explored the effects of traditional Chinese medicine and its understanding of male impotence. Traditional Chinese medicine teaches that a healthy human body is dependent on a homeostatic balance between the forces of Yin and Yang. In this belief, all forms of ailments such as sickness, tension, and internal complications are caused by an unbalance of Qi (permeating energy) between the body's yin and yang.
With Chinese medicinal philosophy, the most important human organs were the kidneys and liver, since they were associated with the storing and cleansing of the blood. Therefore, the kidney and the liver were connected to the Yin energy.
These two organs were crucial in maintaining their harmony with the rest of the body. With a need for the regulation and harmony of blood, there is no doubt that erectile dysfunction would be seen as the beginning of a severe Ying Yang imbalance.
Ancient Chinese methods were developed to tackle impotence, including acupuncture, cupping, herbal medicine, massage, and the infamous use of potent animal organs. All of these methods were designed to increase arterial circulation to male sex organs, and to vitalize the libido.
The physicians of medieval Persia were well-versed in ancient Chinese and Indian techniques, as well as many others including the use of herbs in African medicine. Along with studying the medical practices of many other cultures, they also implemented their own empirical findings to improve upon the existing pharmaceuticals of their time.
Within the pages of the Persian texts Ebn-e-Sina (980-1037 AD), Qanoon-fel-teb (known as the Canon of Medicine, 1025 AD), and the Ketab-al-hawi (860-940 AD), the collected methods for curing human ailments and diseases finally existed for all to read.
A paper written by M Khaleghi Ghadiri and A Gorji discussed the medieval Persian methods for treating impotence in a great deal. They stated that the ancient Persian texts explored in detail the factors that may have caused it.
Like the older Indian and Chinese texts, the liver and kidney were of great concern regarding their effects on male impotence. However, the Persian texts elaborate further, discussing other organs such as the heart, stomach, arteries, brain, spinal cord, rectum, and seminal vessels as being essential in understanding erectile dysfunction.
The medieval Persian texts also examined the effect of depression, and like the ancient Indian texts, potentially explored whether sex with an undesirable woman was included.
One factor which was emphasized was the physical effects of love. Their belief was that sex that was not tied to some form of emotional connection would cause a risk of sexual dysfunction. The Persian texts also advised living healthy lives and paying close attention to nutrition, hydration, and physical health to enjoy a virile sexual experience.
Complimentary drinks to improve male virility were camel milk, garden cress juice, carrot juice, and fig juices. Foods that they considered to help cure erectile dysfunction were various types of nuts and beans, dates, peas, onion, honey, and turnips.
Drunkenness and impotence have long been associated (Pietro Liberi / Public Domain)
Medieval Persian physicians also recommended to avoid drinking large amounts of alcohol on a regular basis, caraway seeds, lentils, wile rue, and sweet marjoram. Given these lists of foods, it appears that medieval Persian physicians began to mix them into potent ingredients to create medicines.
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These concoctions would be intricately designed and tailored to a subject’s own level of impotence. Their work became so well renowned that Europeans during the Renaissance traveled to collect and study their findings in the hundreds of years to come.
In this way, Persian medicine had a significant influence over the medical practices of medieval Europe.
Try Eating Animals?
Traditional Chinese medicine has been infamously linked to the consumption of endangered animals in recent years. Such animal products were tiger penis, rhino horn, pangolin, and musk bear bile. The tragic effects of this demand for animal parts can be seen in overhunting, risking extinction for these animals.
Because of the great demand for traditional animal remedies, the black market continues to thrive, even as these animal populations are taken to the brink of destruction. As a result, many practitioners have been trying to slowly remove animal products from potential remedies. One may be quick to judge the illegal desire of endangered animals for potency but understand that many other cultures also believed in the consumption of animals as well.
In the ancient west, the people of Greece and Rome believed in using the essence of animals and their organs to ward off the curse of impotence. It was very common for priests and physicians to prescribe the consumption of goat testicles, the genitalia of roosters, and snake.
According to writer Angus McLaren, Aristotle once mentioned that the most potent aphrodisiac was eating the hippo mane from a newborn foal. Along with the consumption of animal genitalia and glands, a popular alternative method was to wear cured genitalia as a talisman.
Aphrodisiacs such as these are sold even today (ChrisPsi / Public Domain)
The medieval Persians also listed specific animals as essential for improving erectile dysfunction. The most potent aphrodisiacs were Halim (described in Ghadiri and Gorji as a wheat and goat dish), bird's brain, roast meat, sheep's head, and pottage. Seafood was also popular.
In 13th century Europe, German Friar Albertus Magnus (1200-1280) wrote about erectile dysfunction. He proposed that eating the cooked penis of a wolf would help a man gain potency and virility.
The concept of animal consumption reflected a deep ritual belief in the strength and power of dangerous male animals and how people could harness its power to repair their sexual stamina and drive. Even with the progression of western medicine, this belief of animal consumption in the west continued on smaller scales and was associated with the medicinal consumption of animal organs.
The renaissance for Europe was a time of immense trade, global exploration, and the intellectual beginnings for the advancement of western art and technology. With this came a great interest for further learning in eastern medicines.
Writer Mary Roach gives significant insight into impotence, medicine and the world of renaissance Europe. Roach mentions that one of the common beliefs was that male erection was a result of compressed air within skin sacs. In the minds of Renaissance-era physicians, this explained why erections could rise and descend so quickly: they felt that, like the lungs, the penis expanded when men breathed heavily.
According to Roach, this belief was soon challenged by Leonardo Da Vinci, one of the most famous figures of the Italian renaissance. Da Vinci studied the cadavers of executed murderers who maintained erections after death due to the bizarre nature of asphyxia and blood clots.
This anomaly was a well-known side effect of the hanging process. In his observations and dissections, Da Vinci noticed that the human penis carried an immense amount of blood.
Although Da Vinci was heading in the right direction, there were still others who questioned the process of impotence. In the years to come, others like Dutch physician Reginer de Graaf (1641-1673) would build upon the discoveries of blood pumping into the penis with experiments using saline solution.
Leonardo da Vinci’s work on human anatomy was groundbreaking (Leonardo da Vinci / Public Domain)
He would inject saline solution into the blood vessels of a cadaver's penis. This experiment was to emulate an artificial erection from the dead tissue. It appeared that both Da Vinci and de Graaf were on the right track in understanding how erections worked.
Religion and Superstition
Yet with all the advancements that the renaissance brought European art and culture, there were still superstitions. Male virility through this period was strongly tied to religion. In Renaissance Europe, the virility of man was a significant driving force of desire and prowess. Even Pope Alexander VI himself was rumored to enjoy watching other clergymen copulate and ejaculate into courtesans at the Banquet of Chestnuts in 1501.
But along with the cultural beliefs of virility, there were also strong fears rooted deeply within regional superstition. One belief among commoners was that impotence was a curse given by demons and witches who wished to be malicious to those who were weak.
Roach discusses the 1491 handbook known as the Malleus Maleficarum that dictates the dangers of a witch and their ability to bring on impotence and sterility to any man they hated. In some cases, it was believed that witches could make a penis simply disappear.
However, these old beliefs of superstition and witchcraft were often ignored and overlooked by upper-class medical elites of the time. Frequently, impotence was seen either as purely psychological, as a result of continuous masturbation, or infidelity with too many women.
The common recommendation during those times by renaissance physicians was, as Roach mentions, for the afflicted man to be forthcoming and approach the “witch” they believed caused their impotence. Communication appeared to be emphasized greatly for situations such as these.
The Impotence Trials
In the decades following the renaissance, the fear of impotence grew to be a lot more intimidating, especially in the French courts of the 16th and 17th centuries. Roach details the unusual enigma known as the "impotence trials" in which impotence was legal grounds for divorce and forced celibacy.
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The trials involved a group of theologians who would assess the impotence level within a marriage. The observations and trials grew ever more rigorous with “specialist” physicians accompanying the accused to their house. On average, this group of specialist examiners consisted of between 10 to 15 physicians, medical doctors, and surgeons.
The husband would have to submit to the ministrations of the “specialists” (David Teniers the Younger / Public Domain)
These specialists would observe the man's genitals, comment, probe, and critique every inch and sexual technique. If the man was proven to be truly impotent, then his wife was free to leave the marriage.
Oftentimes, as Roach states, the man would be forbidden to remarry and forced to give back the dowry to the wife's family. The impotence trials were considered easiest ways for an unhappy wife to leave a terrible marriage.
As late as 1869, the French neurologist Charles Edouard Brown Sequard (1817-1894) proposed injecting extracted animal semen into the bloodstream could improve physical and sexual performance. His beliefs derived from linking human hormone production concerning its degeneration due to the aging process.
Therefore, by replacing lost hormones and bodily fluids with the same hormones from animals, a man could restore his own vitality and reverse the effects of impotence.
In 1875 Sequard experimented on himself by taking ten injections of animal semen into his own bloodstream, to which he reported improved mood, performance, and healthy bowel movements as well. Although his methods may have been extreme, he is credited with beginning modern androgen therapy in some ways.
And as recent as 1920, the Russian surgeon Dr. Serge Voronof proposed transplanting a man's testicles with those from a monkey. This procedure revealed successful hormonal stability of testosterone for two years in total before it succumbed to fibrosis.
So we can see, with these later experiments, the obsession with male virility remains continuous, unchanging throughout the ages. we even see it today in the modern west, where it is a common belief that red meat and fat consumption is a sign of a manliness.
However, in recent years, medical studies have emerged stating that any form of food that hardens the arteries and restricts the cardiovascular system has proven to cause male erectile dysfunction. Still, beliefs in eating meat and animal organs are very ingrained in most human societies worldwide.
Throughout history, it is apparent that many different approaches to male impotence have been tried. Various medicines, the consumption of animals, and the early beginnings of psychology were all tried as treatments. Although it appeared mainly holistic, it was only in the renaissance that those medical physicians started to pay attention to the actual mechanics of the human body.
Starting in 1908, medical breakthroughs emerged regarding treatments for erectile dysfunction. One of which was “100 dorsi vein ligation” procedures pioneered by Dr. Frank Lydston (1858-1923) that were based on the belief that penile erection was connected to the cardiovascular system.
A modern derivation of Dr. Lederer’s device (Arkansas Health Care Access Foundation / CC BY-SA 4.0)
In 1913, the development of penile vacuum machines was made by Dr. Otto Lederer. Although Dr. John King first applied the concept of vacuum technology for impotence in 1874, Lederer's device was more sophisticated in creating a combined force consisting of compression and suction that could comfortably bring the penis to full erection.
Penile Implants And The Miracle Of Viagra
Throughout the first half of the 20th century, many medical practitioners experimented with transplants and penile implant surgery. As mentioned before with Dr. Serge Voronof, the procedure of transplants and implants began to reveal the potential in restoring penile erections.
In 1936, one of the first implants was successfully carried out by Dr. Bogoras, who used rib cartilage and rib bone to reconstruct the firmness of a human erection. This procedure proved only successful for six months until the cartilage and bones were reabsorbed into the body, leaving the erection lifeless once again.
In 1950, surgeons would move to prosthetics and porcelain implants to attempt to maintain an erection. This evolved into implants that required two polyethylene rods to assist in keeping an erection in 1966.
By 1973, the development of inflatable silicone rubber and more precise placement of implants within the penis. This solidified the popularity and success of prosthetic implant surgery within the western world.
But it wouldn't be until the 1990s when a breakthrough was discovered by accident. The heart medication “sildenafil” was released into the market. Although its intentions were for the cardiovascular system, its side effects soon proved to be very adept in maintaining penile erections.
Pfizer’s little blue pill (Audrey disse / CC BY-SA 3.0)
This side effect led the pharmaceutical giant Pfizer to further research into why this occurred. By 1998, Pfizer released a drug known as Viagra, which was based on the same chemistry. Due to this incredible discovery, penile implant surgery has now become a last resort.
Unlocking The Secrets Of The Penis
It should be noted that it took humanity thousands of years to grasp how the penis works. In the modern era, pharmaceuticals have taken the lead in the studies for erectile dysfunction. The older methods of surgery, ailments, and the consumption of animal products are no longer considered a viable option.
Medical science now has a good understanding of the causes of erectile dysfunction. It is currently believed that 80% of most erectile dysfunction cases are due to cardiovascular diseases, diabetes, neurological issues, and severe side effects from medicine. It is believed that only 10% of cases are ever psychological.
So for all the advancements that have come, impotence still remains a very significant issue, that continues to haunt all men of all ages.
Top Image: Detail from Alcibiades Wounded . Source: Jean-Charles Nicaise Perrin / Public Domain.
By B. B. Wagner
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wang, Jinghui, Yang Yinfeng, Xuetong Chen, Jian Du, Zheng Qiusheng, liang Zongsuo, and Yonghua Wang. 2017. A New Strategy for Deleting Animal drugs from traditional Chinese Medicines based on Modified Yimusake Formula. 4 May. http://www.nature.com/articles/s41598-017-01613-7