Penis panic
Encyclopedia
Koro is a culture-specific syndrome
from Southeast Asia
in which the patient has an overpowering belief that his penis (or other genitalia) is shrinking and will shortly disappear. Also known as shrinking penis, the syndrome is listed in the Diagnostic and Statistical Manual of Mental Disorders
. In China
, it is known as shuk yang, shook yong, and suo yang ; jinjinia bemar (Assam
); or rok-joo , is to describe an individual overcome with such a belief
. For females, the belief focuses on the nipple
s retracting or shrinking.
Though the syndrome is rooted in China and found mostly in Southeast Asia
, rare and isolated cases of koro are found in people of non-Chinese ethnicity worldwide. Episodes of epidemics occurred in the endemic nations. In a different cultural setting, mass hysteria of genital-shrinkage have been reported in African nations.
(1874) of South Sulawesi
, Indonesia
. The word is also used in Makassarese language, meaning "to shrink"; the full dialect for it is garring koro. In Malay
, keruk is the probable linguistic link of koro which means "to shrink", and koro may also be derived from some Malay terms which are associated with "head of turtle". The term shuk yang, adapted from Chinese, means "the shrinkage of penis".
" (classification with cardinal sign), "the genital retraction taxon" (classification with common factors between syndromes), and the group with "culture-related beliefs as causes for the occurrence" (classification according to how the syndromes might be affected by cultural factors).
Various authors have attempted to distinguish between complete and incomplete forms of koro, as well as cultural and non-cultural forms. Cultural forms are said to involve a cultural belief or myth which plays a role in the genesis and spread of the disease in the community, and are regarded as complete forms, fulfilling all the criteria of the symptom complex. Differentiation into primary koro (as a culture-bound expression) and secondary koro (co-morbid with a CNS disorder
or another psychiatric disorder; or drug-induced) has been proposed.
Traditional Chinese medicine
recognised koro as a sexual disease and classified it into two categories, namely "cold conglomeration in liver
" and "depletion of kidney
's yang
".
Ideational components of koro anxiety neurosis include fear of impending death, penile dissolution and loss of sexual power. These cognitions of impending death with retraction and perceived spermatorrhea
has a strong cultural link with Chinese traditional beliefs, as demonstrated by the fact that in general, Asians with complaints of genital retraction believe that the condition is fatal, unlike most Westerners. Other ideational themes are intra-abdominal organ shrinkage, sex change to female or eunuch
, non-specific physical danger, urinary obstruction, sterility
, impending madness, spirit possession and a feeling of being bewitched.
Extremely anxious sufferers and their family members may resort to physical methods to prevent the believed retraction of the penis. A man may perform manual or mechanical penile traction, or "anchoring" by a loop of string or some clamping device. Similarly, a woman may be seen grabbing her own breast, pulling her nipple, or even having iron pins inserted into the nipple. Physical injury is inevitable, which can be considered as a complication of the syndrome. These forceful attempts often lead to injuries, even to death
significance to koro. Sexual adjustment histories of non-Chinese victims are often significant, such as premorbid sexual inadequacy, sexual promiscuity, guilt over masturbation
and impotence.
, with free play of imagination which links fatality with genital retraction.
In the ancient Chinese medical book Zhong Zang Jing , retraction of the penis with distension of the abdomen was described as a certain sign of death. The yin and yang
theory proposes that an unbalanced loss of the yang humour produces genital shrinkage.
In Taoism
and Traditional Chinese medicine, frequent ejaculation
is regarded as detrimental to health, as semen
is considered to be related to a man's vital energy, and hence excessive depletion of semen may lead to illness or death. Some authors believe that the idea of death caused by the semen depletion resembles the idea of death caused by genital disappearance, although such linkage between koro and Taoism, which influences Chinese medicine to some degree, is only speculative.
The popularity of Chinese folklore
also plays a role. The novel about ghost stories Strange Stories from a Chinese Studio
describes a fox spirit which can make people weak physically and sexually and shrink their tissues. Belief in koro being caused by the fox ghost among the southern Chinese has been reported.
In historical culture-bound cases, reassurance and talks on sexual anatomy are given. Patients are treated with psychotherapy
distributed according to symptoms and to etiologically significant points in the past. Prognosis appears to be better in cases with a previously functional personality, a short history and low frequency of attacks, and a relatively uncomplicated sexual life.
For sporadic Western cases, careful diagnostic workup including searching for underlying sexual conflict is recommended. The choice of psychotherapeutic treatment is based on the psychiatric pathology found.
s or beat the person to drive it out. The person will receive a yang- or yin-augmenting Chinese medicine potion, usually including herbs, animal penises (of tiger
, deer
and fur seal
), pilose antler (stag of deer) or deer tail. Other foods for therapy are pepper soup, ginger soup and liquor.
and the lower Yangtze Valley. A 1992 study of self-report questionnaires suggests that in the epidemic area of China, koro victims are mostly Han
, male, young, single, poorly educated and fearful of supernatural forces
and koro. The phenomenon is also found among oversea Chinese in Southeast Asia
, especially Malaysia and Indonesia
, and less frequently among the Malay and Indonesian
inhabitants of the countries. Though there are speculations that the occurrence of koro among people in Malaysia and Indonesia was the result of Chinese migrants, this cultural diffusion view is challenged since koro epidemics have been reported in Thailand
and India, involving masses of non-Chinese people.
Sporadic cases of people with non-Southeast-Asian ethnicity have been reported across the globe, for example, Nepali
, Sudanese, Jordanian
, Tanzanian
, Nigerian, French
, British
, American
and Canadian. In most of the non-Chinese cases in the Western hemisphere
, genital shrinkage is reported but not all the other typical koro symptoms, such as fear of death, as in endemic countries. The incomplete forms of koro are regarded as the non-cultural forms, while the complete form with acute anxiety is the classical culture-bound type.
. The book described the condition as "yin
type of cold qi
invasion" which involved a sudden seizure
during sexual intercourse
with the penis retracting into the abdomen. It ascertains that the patient will die if not treated with "heaty" drugs on time.
Local official records indicate genital retraction endemics in Hainan Island and Leizhou Peninsula
in Guangdong
, China, as early as the late 19th century. There were a series of epidemic outbursts in 1948, 1955, 1966, and 1974, whenever there was social tension or impending disaster, followed by the last widespread episode in 1984–1985 and a much smaller outbreak in 1987. The 1984–1985 epidemics lasted for over a year and affected over 3,000 persons in 16 cities and counties. A mental health campaign was conducted for the epidemic and since then no further episodes of the epidemic has occurred in China. Improvement in local economic conditions, associated with a better quality of life, is suggested to contribute to the fading of the episodic occurrences of koro.
in October 1967 for about ten days. Newspapers initially reported that some people developed koro after eating the meat of pigs inoculated with anti-swine-flu vaccine
. Rumours relating eating pork and koro spread after a further report of an inoculated pig dying from penile retraction. The cases reported amounted to 97 in a single hospital unit within one day, at five days after the original news report. Government and medical officials alleviated the outbreak only by public announcements over television and in the newspapers.
An epidemic outbreak in November 1976 in Northeast Thailand caused at least 350 cases, most of them Thai and males. Popular opinion and news media echoed the victims' projection of viewing the epidemic as caused by Vietnamese food and tobacco poisoning in a hideous assault against the Thai people. Another large-scale epidemic in Thailand occurred in 1982.
In 1982, a koro epidemic episode in Northeast India affected, in majority, poorly educated people from lower socio-economic strata. There was no evidence of significant premorbid or sexual psychopathology in most cases.
belief, the witchcraft
of juju
, to feed the spiritual agency or to hold the genital for ransom. Social representations
about juju constitute consensual realities that propose both a means and motivation for genital-shrinking experience.
The epidemic began in Nigeria
and Cameroon
, and spread to Ghana
, Côte d'Ivoire
and Senegal
by 1997. Cases were reported in Cotonou
, Benin
where mobs attacked individuals accused of the penis theft and authorities ordered security forces to curb the violence, following the deaths of five people by vigilante
s. Later reports of outbreak suggest a spread beyond West Africa, including the coverage of episodes in Khartoum
, Sudan
in September 2003; Banjul
, Gambia in October 2003; and Kinshasa
, DR Congo in 2008.
Comparing West African genital-shrinking epidemics with koro in Southeast Asia, the latter has symptoms emphasized on genital retraction (instead of shrinkage) and fear of death (which is absent in African cases). A study analyzing the West African epidemics from 1997 to 2003 concluded that rather than psychopathology
, the episodes were product of normal psychological functioning in undisturbed individuals, who were influenced by the local cultural models or social representations.
, a 15th century European manual for witchcraft investigations, relates stories of men claiming that their genitals had disappeared, being "hidden by the devil … so that they can be neither seen nor felt." They were said to have reappeared after the men had appeased the witches responsible.
At least three publications of the 1880s, from U.S., Russia and England, reported genital retraction pathology, without using the Malay or Chinese term. Koro epidemics in China were first noticed in a French report in 1908 and descriptions of koro entered clinical books of western medicine in 1936. In the 1950s, koro is noted in nosological and diagnostic psychiatry.
Culture-specific syndrome
In medicine and medical anthropology, a culture-bound syndrome, culture-specific syndrome or folk illness is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture...
from Southeast Asia
Southeast Asia
Southeast Asia, South-East Asia, South East Asia or Southeastern Asia is a subregion of Asia, consisting of the countries that are geographically south of China, east of India, west of New Guinea and north of Australia. The region lies on the intersection of geological plates, with heavy seismic...
in which the patient has an overpowering belief that his penis (or other genitalia) is shrinking and will shortly disappear. Also known as shrinking penis, the syndrome is listed in the Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
. In China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
, it is known as shuk yang, shook yong, and suo yang ; jinjinia bemar (Assam
Assamese language
Assamese is the easternmost Indo-Aryan language. It is used mainly in the state of Assam in North-East India. It is also the official language of Assam. It is also spoken in parts of Arunachal Pradesh and other northeast Indian states. Nagamese, an Assamese-based Creole language is widely used in...
); or rok-joo , is to describe an individual overcome with such a belief
Belief
Belief is the psychological state in which an individual holds a proposition or premise to be true.-Belief, knowledge and epistemology:The terms belief and knowledge are used differently in philosophy....
. For females, the belief focuses on the nipple
Nipple
In its most general form, a nipple is a structure from which a fluid emanates. More specifically, it is the projection on the breasts or udder of a mammal by which breast milk is delivered to a mother's young. In this sense, it is often called a teat, especially when referring to non-humans, and...
s retracting or shrinking.
Though the syndrome is rooted in China and found mostly in Southeast Asia
Southeast Asia
Southeast Asia, South-East Asia, South East Asia or Southeastern Asia is a subregion of Asia, consisting of the countries that are geographically south of China, east of India, west of New Guinea and north of Australia. The region lies on the intersection of geological plates, with heavy seismic...
, rare and isolated cases of koro are found in people of non-Chinese ethnicity worldwide. Episodes of epidemics occurred in the endemic nations. In a different cultural setting, mass hysteria of genital-shrinkage have been reported in African nations.
Name origin
The earliest Western reference to the term koro is found in B.F. Matthes' Dictionary of Buginese LanguageBuginese language
Buginese is the language spoken by about four million people mainly in the southern part of Sulawesi, Indonesia.-History:The word Buginese derives from the word Bahasa Bugis in Malay. In Buginese, it is called while the Bugis people are called...
(1874) of South Sulawesi
South Sulawesi
South Sulawesi is a province of Indonesia, located on the western southern peninsula of Sulawesi Island. The province is bordered by Central Sulawesi province to the north, South East Sulawesi province to the east and West Sulawesi province to the west...
, Indonesia
Indonesia
Indonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania. Indonesia is an archipelago comprising approximately 13,000 islands. It has 33 provinces with over 238 million people, and is the world's fourth most populous country. Indonesia is a republic, with an...
. The word is also used in Makassarese language, meaning "to shrink"; the full dialect for it is garring koro. In Malay
Malaysian language
Malaysian or Standard Malay is the official language of Malaysia and a standardized form of the Malay language of the Austronesian family. It is over 80% cognate with Indonesian and is spoken natively by over 10 million people...
, keruk is the probable linguistic link of koro which means "to shrink", and koro may also be derived from some Malay terms which are associated with "head of turtle". The term shuk yang, adapted from Chinese, means "the shrinkage of penis".
Classification
In DSM-IV-TR, koro is listed as one of the entries in the Glossary of Culture-Bound Syndromes of Appendix I. The manual gives koro's definition as "a term, probably of Malaysian origin, that refers to an episode of sudden and intense anxiety that the penis (or, in females, the vulva and nipples) will recede into the body and possibly cause death." Attempts by numerous authors to sub-group culture-bound syndromes place koro into different classes according to the system of classification, such as the group of "specific culture-imposed nosophobiaNosophobia
Nosophobia is a specific phobia, an irrational fear of contracting a disease, from Greek "nosos" for "disease"...
" (classification with cardinal sign), "the genital retraction taxon" (classification with common factors between syndromes), and the group with "culture-related beliefs as causes for the occurrence" (classification according to how the syndromes might be affected by cultural factors).
Various authors have attempted to distinguish between complete and incomplete forms of koro, as well as cultural and non-cultural forms. Cultural forms are said to involve a cultural belief or myth which plays a role in the genesis and spread of the disease in the community, and are regarded as complete forms, fulfilling all the criteria of the symptom complex. Differentiation into primary koro (as a culture-bound expression) and secondary koro (co-morbid with a CNS disorder
Central nervous system disease
A central nervous system disease can affect either the spinal cord or brain , both part of the central nervous system. The central nervous system controls behaviors in the human body, so this can be a fatal illness.-Spinal Cord:...
or another psychiatric disorder; or drug-induced) has been proposed.
Traditional Chinese medicine
Traditional Chinese medicine
Traditional Chinese Medicine refers to a broad range of medicine practices sharing common theoretical concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage , exercise , and dietary therapy...
recognised koro as a sexual disease and classified it into two categories, namely "cold conglomeration in liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
" and "depletion of kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...
's yang
Yin and yang
In Asian philosophy, the concept of yin yang , which is often referred to in the West as "yin and yang", is used to describe how polar opposites or seemingly contrary forces are interconnected and interdependent in the natural world, and how they give rise to each other in turn. Opposites thus only...
".
Signs and symptoms
Most of the victims complain about episodes of acute attack of genital retraction or genital shrinkage, sometimes both. Each episode usually lasted several hours, though the duration can be as long as two days. There are cases in which koro symptoms persist for years with either chronic and continuous or recurrent history. On top of retraction, other symptoms include a perception of alteration of penis shape, loss of penile muscular tone; in some cases when sufferers have no perception of retraction, they may complain of genital paraesthesia or genital shortening. The cardinal breast symptom is nipple retraction, in most cases into the breast mass.Ideational components of koro anxiety neurosis include fear of impending death, penile dissolution and loss of sexual power. These cognitions of impending death with retraction and perceived spermatorrhea
Spermatorrhea
Spermatorrhea is a condition of excessive, accidental ejaculation.It is a recognized disorder in Traditional Chinese Medicine, in which certain patterns of involuntary ejaculation reflect problems with kidney qi....
has a strong cultural link with Chinese traditional beliefs, as demonstrated by the fact that in general, Asians with complaints of genital retraction believe that the condition is fatal, unlike most Westerners. Other ideational themes are intra-abdominal organ shrinkage, sex change to female or eunuch
Eunuch
A eunuch is a person born male most commonly castrated, typically early enough in his life for this change to have major hormonal consequences...
, non-specific physical danger, urinary obstruction, sterility
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
, impending madness, spirit possession and a feeling of being bewitched.
Extremely anxious sufferers and their family members may resort to physical methods to prevent the believed retraction of the penis. A man may perform manual or mechanical penile traction, or "anchoring" by a loop of string or some clamping device. Similarly, a woman may be seen grabbing her own breast, pulling her nipple, or even having iron pins inserted into the nipple. Physical injury is inevitable, which can be considered as a complication of the syndrome. These forceful attempts often lead to injuries, even to death
Causes
Psychosexual conflicts, personality factors, and cultural beliefs are considered as being of etiologicalsignificance to koro. Sexual adjustment histories of non-Chinese victims are often significant, such as premorbid sexual inadequacy, sexual promiscuity, guilt over masturbation
Masturbation
Masturbation refers to sexual stimulation of a person's own genitals, usually to the point of orgasm. The stimulation can be performed manually, by use of objects or tools, or by some combination of these methods. Masturbation is a common form of autoeroticism...
and impotence.
Cultural beliefs
Factors of cultural expectation in the genesis of koro can be built upon ideas of sex physiology in the traditional Chinese medicineTraditional Chinese medicine
Traditional Chinese Medicine refers to a broad range of medicine practices sharing common theoretical concepts which have been developed in China and are based on a tradition of more than 2,000 years, including various forms of herbal medicine, acupuncture, massage , exercise , and dietary therapy...
, with free play of imagination which links fatality with genital retraction.
In the ancient Chinese medical book Zhong Zang Jing , retraction of the penis with distension of the abdomen was described as a certain sign of death. The yin and yang
Yin and yang
In Asian philosophy, the concept of yin yang , which is often referred to in the West as "yin and yang", is used to describe how polar opposites or seemingly contrary forces are interconnected and interdependent in the natural world, and how they give rise to each other in turn. Opposites thus only...
theory proposes that an unbalanced loss of the yang humour produces genital shrinkage.
In Taoism
Taoism
Taoism refers to a philosophical or religious tradition in which the basic concept is to establish harmony with the Tao , which is the mechanism of everything that exists...
and Traditional Chinese medicine, frequent ejaculation
Ejaculation
Ejaculation is the ejecting of semen from the male reproductory tract, and is usually accompanied by orgasm. It is usually the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. In rare cases ejaculation occurs because of prostatic disease...
is regarded as detrimental to health, as semen
Semen
Semen is an organic fluid, also known as seminal fluid, that may contain spermatozoa. It is secreted by the gonads and other sexual organs of male or hermaphroditic animals and can fertilize female ova...
is considered to be related to a man's vital energy, and hence excessive depletion of semen may lead to illness or death. Some authors believe that the idea of death caused by the semen depletion resembles the idea of death caused by genital disappearance, although such linkage between koro and Taoism, which influences Chinese medicine to some degree, is only speculative.
The popularity of Chinese folklore
Chinese folklore
Chinese folklore includes songs, dances, puppetry, and tales. It often tells stories of human nature, historical or legendary events, love, and the supernatural, or stories explaining natural phenomena and distinctive landmarks.-Folktales:...
also plays a role. The novel about ghost stories Strange Stories from a Chinese Studio
Strange Stories from a Chinese Studio
Strange Stories from a Chinese Studio or Liaozhai Zhiyi is a collection of nearly five hundred mostly supernatural tales written by Pu Songling in Classical Chinese during the early Qing Dynasty.Pu borrows from a folk tradition of oral storytelling to put to paper a series of captivating,...
describes a fox spirit which can make people weak physically and sexually and shrink their tissues. Belief in koro being caused by the fox ghost among the southern Chinese has been reported.
Diagnosis
Several criteria are typically used to make a diagnosis of koro: penile (or breast) retraction, anxiety related to the retraction, fear of death as a result of retraction, and use of mechanical means to prevent full retraction. Cases that do not meet all the requirements are generally classified as koro-like symptoms or given a diagnosis of partial koro syndrome. It has been argued that the criteria are sufficient but not necessary to make a diagnosis of koro.Medicine
Genital examination reveals no actual instances of penis shrinkage or retraction. Any actual injury or damage that occurs to individuals usually arises from overly zealous attempts at preventing retraction, and treatment on the injury should be performed.In historical culture-bound cases, reassurance and talks on sexual anatomy are given. Patients are treated with psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
distributed according to symptoms and to etiologically significant points in the past. Prognosis appears to be better in cases with a previously functional personality, a short history and low frequency of attacks, and a relatively uncomplicated sexual life.
For sporadic Western cases, careful diagnostic workup including searching for underlying sexual conflict is recommended. The choice of psychotherapeutic treatment is based on the psychiatric pathology found.
Indigenous treatment
In China, traditional treatment based on the causes suggested by cultural beliefs are administrated to the patient. Praying to gods and asking Taoist priests to perform exorcism is common. If a fox spirit is believed to be involved, people may hit gongGong
A gong is an East and South East Asian musical percussion instrument that takes the form of a flat metal disc which is hit with a mallet....
s or beat the person to drive it out. The person will receive a yang- or yin-augmenting Chinese medicine potion, usually including herbs, animal penises (of tiger
Tiger
The tiger is the largest cat species, reaching a total body length of up to and weighing up to . Their most recognizable feature is a pattern of dark vertical stripes on reddish-orange fur with lighter underparts...
, deer
Deer
Deer are the ruminant mammals forming the family Cervidae. Species in the Cervidae family include white-tailed deer, elk, moose, red deer, reindeer, fallow deer, roe deer and chital. Male deer of all species and female reindeer grow and shed new antlers each year...
and fur seal
Fur seal
Fur seals are any of nine species of pinnipeds in the Otariidae family. One species, the northern fur seal inhabits the North Pacific, while seven species in the Arctocephalus genus are found primarily in the Southern hemisphere...
), pilose antler (stag of deer) or deer tail. Other foods for therapy are pepper soup, ginger soup and liquor.
Epidemiology
Among the Chinese, koro is confined to South ChinaNorthern and southern China
Northern China and southern China are two approximate regions within China. The exact boundary between these two regions has never been precisely defined...
and the lower Yangtze Valley. A 1992 study of self-report questionnaires suggests that in the epidemic area of China, koro victims are mostly Han
Han Chinese
Han Chinese are an ethnic group native to China and are the largest single ethnic group in the world.Han Chinese constitute about 92% of the population of the People's Republic of China , 98% of the population of the Republic of China , 78% of the population of Singapore, and about 20% of the...
, male, young, single, poorly educated and fearful of supernatural forces
Supernatural
The supernatural or is that which is not subject to the laws of nature, or more figuratively, that which is said to exist above and beyond nature...
and koro. The phenomenon is also found among oversea Chinese in Southeast Asia
Southeast Asia
Southeast Asia, South-East Asia, South East Asia or Southeastern Asia is a subregion of Asia, consisting of the countries that are geographically south of China, east of India, west of New Guinea and north of Australia. The region lies on the intersection of geological plates, with heavy seismic...
, especially Malaysia and Indonesia
Indonesia
Indonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania. Indonesia is an archipelago comprising approximately 13,000 islands. It has 33 provinces with over 238 million people, and is the world's fourth most populous country. Indonesia is a republic, with an...
, and less frequently among the Malay and Indonesian
Ethnic groups in Indonesia
There are over 300 ethnic groups in Indonesia. 95% of those are of Native Indonesians ancestry.The largest ethnic group in Indonesia is the Javanese who make up 41% of the total population. The Javanese are concentrated on the island of Java but millions have migrated to other islands throughout...
inhabitants of the countries. Though there are speculations that the occurrence of koro among people in Malaysia and Indonesia was the result of Chinese migrants, this cultural diffusion view is challenged since koro epidemics have been reported in Thailand
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...
and India, involving masses of non-Chinese people.
Sporadic cases of people with non-Southeast-Asian ethnicity have been reported across the globe, for example, Nepali
Nepali people
Nepali people can refer to:*People of Nepal*Ethnic Nepalis of Indian citizenry residing in Gorkhaland area of West Bengal, Sikkim, Assam, Meghalaya, Mizoram and other parts of India.* Indian Gorkhas*Lhotshampas of Bhutan.*Nepali diaspora the world over....
, Sudanese, Jordanian
Demographics of Jordan
This article is about the demographic features of the population of Jordan, including population density, ethnicity, education level, health of the populace, economic status, religious affiliations and other aspects of the population....
, Tanzanian
Demographics of Tanzania
This article is about the demographic features of the population of Tanzania, including population density, ethnicity, education level, health of the populace, economic status, religious affiliations and other aspects of the population....
, Nigerian, French
French people
The French are a nation that share a common French culture and speak the French language as a mother tongue. Historically, the French population are descended from peoples of Celtic, Latin and Germanic origin, and are today a mixture of several ethnic groups...
, British
British people
The British are citizens of the United Kingdom, of the Isle of Man, any of the Channel Islands, or of any of the British overseas territories, and their descendants...
, American
People of the United States
The people of the United States, also known as simply Americans or American people, are the inhabitants or citizens of the United States. The United States is a multi-ethnic nation, home to people of different ethnic and national backgrounds...
and Canadian. In most of the non-Chinese cases in the Western hemisphere
Western Hemisphere
The Western Hemisphere or western hemisphere is mainly used as a geographical term for the half of the Earth that lies west of the Prime Meridian and east of the Antimeridian , the other half being called the Eastern Hemisphere.In this sense, the western hemisphere consists of the western portions...
, genital shrinkage is reported but not all the other typical koro symptoms, such as fear of death, as in endemic countries. The incomplete forms of koro are regarded as the non-cultural forms, while the complete form with acute anxiety is the classical culture-bound type.
China
Most of the ancient literature concerning koro was related to Chinese ethnic groups. For example, koro (in its Chinese term of shuk yang) is documented in the old medical book New Collection of remedies of value which was published in Qin DynastyQin Dynasty
The Qin Dynasty was the first imperial dynasty of China, lasting from 221 to 207 BC. The Qin state derived its name from its heartland of Qin, in modern-day Shaanxi. The strength of the Qin state was greatly increased by the legalist reforms of Shang Yang in the 4th century BC, during the Warring...
. The book described the condition as "yin
Yin and yang
In Asian philosophy, the concept of yin yang , which is often referred to in the West as "yin and yang", is used to describe how polar opposites or seemingly contrary forces are interconnected and interdependent in the natural world, and how they give rise to each other in turn. Opposites thus only...
type of cold qi
Qi
In traditional Chinese culture, qì is an active principle forming part of any living thing. Qi is frequently translated as life energy, lifeforce, or energy flow. Qi is the central underlying principle in traditional Chinese medicine and martial arts...
invasion" which involved a sudden seizure
Seizure
An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...
during sexual intercourse
Sexual intercourse
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which a male's penis enters a female's vagina for the purposes of sexual pleasure or reproduction. The entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails...
with the penis retracting into the abdomen. It ascertains that the patient will die if not treated with "heaty" drugs on time.
Local official records indicate genital retraction endemics in Hainan Island and Leizhou Peninsula
Leizhou Peninsula
The Leizhou Peninsula or Leizhou Bandao is a peninsula in the southernmost part of Guangdong province in southern China.-Geography:Leizhou Peninsula is the third largest peninsula in China with an area of of circa 8,500 square kilometer located on the southwestern end of Guangdong, with the Gulf...
in Guangdong
Guangdong
Guangdong is a province on the South China Sea coast of the People's Republic of China. The province was previously often written with the alternative English name Kwangtung Province...
, China, as early as the late 19th century. There were a series of epidemic outbursts in 1948, 1955, 1966, and 1974, whenever there was social tension or impending disaster, followed by the last widespread episode in 1984–1985 and a much smaller outbreak in 1987. The 1984–1985 epidemics lasted for over a year and affected over 3,000 persons in 16 cities and counties. A mental health campaign was conducted for the epidemic and since then no further episodes of the epidemic has occurred in China. Improvement in local economic conditions, associated with a better quality of life, is suggested to contribute to the fading of the episodic occurrences of koro.
Southeast Asia
A koro epidemic struck SingaporeSingapore
Singapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...
in October 1967 for about ten days. Newspapers initially reported that some people developed koro after eating the meat of pigs inoculated with anti-swine-flu vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...
. Rumours relating eating pork and koro spread after a further report of an inoculated pig dying from penile retraction. The cases reported amounted to 97 in a single hospital unit within one day, at five days after the original news report. Government and medical officials alleviated the outbreak only by public announcements over television and in the newspapers.
An epidemic outbreak in November 1976 in Northeast Thailand caused at least 350 cases, most of them Thai and males. Popular opinion and news media echoed the victims' projection of viewing the epidemic as caused by Vietnamese food and tobacco poisoning in a hideous assault against the Thai people. Another large-scale epidemic in Thailand occurred in 1982.
In 1982, a koro epidemic episode in Northeast India affected, in majority, poorly educated people from lower socio-economic strata. There was no evidence of significant premorbid or sexual psychopathology in most cases.
Africa
Since late 1996, a small-scale epidemic of genital shrinking was reported in West African nations. Victims in the African outbreaks often interpreted the experience as genital theft, accusing someone with whom they had contact of "stealing" the organ and the spiritual essence, causing impotence. The perceived motive for theft was associated with local occultOccult
The word occult comes from the Latin word occultus , referring to "knowledge of the hidden". In the medical sense it is used to refer to a structure or process that is hidden, e.g...
belief, the witchcraft
Witchcraft
Witchcraft, in historical, anthropological, religious, and mythological contexts, is the alleged use of supernatural or magical powers. A witch is a practitioner of witchcraft...
of juju
Juju
A Juju is a supernatural power ascribed to an object.Juju may also refer to:-Geography:* Juju , one of seven districts on the island of Rotuma in Fiji* Juju , a village in the district of Juju on the island of Rotuma-Albums:...
, to feed the spiritual agency or to hold the genital for ransom. Social representations
Social representations
A social representation is a stock of values, ideas, beliefs, and practices that are shared among the members of groups and communities. Social Representations Theory is a body of theory within Social Psychology and Sociological social psychology...
about juju constitute consensual realities that propose both a means and motivation for genital-shrinking experience.
The epidemic began in Nigeria
Nigeria
Nigeria , officially the Federal Republic of Nigeria, is a federal constitutional republic comprising 36 states and its Federal Capital Territory, Abuja. The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in...
and Cameroon
Cameroon
Cameroon, officially the Republic of Cameroon , is a country in west Central Africa. It is bordered by Nigeria to the west; Chad to the northeast; the Central African Republic to the east; and Equatorial Guinea, Gabon, and the Republic of the Congo to the south. Cameroon's coastline lies on the...
, and spread to Ghana
Ghana
Ghana , officially the Republic of Ghana, is a country located in West Africa. It is bordered by Côte d'Ivoire to the west, Burkina Faso to the north, Togo to the east, and the Gulf of Guinea to the south...
, Côte d'Ivoire
Côte d'Ivoire
The Republic of Côte d'Ivoire or Ivory Coast is a country in West Africa. It has an area of , and borders the countries Liberia, Guinea, Mali, Burkina Faso and Ghana; its southern boundary is along the Gulf of Guinea. The country's population was 15,366,672 in 1998 and was estimated to be...
and Senegal
Senegal
Senegal , officially the Republic of Senegal , is a country in western Africa. It owes its name to the Sénégal River that borders it to the east and north...
by 1997. Cases were reported in Cotonou
Cotonou
-Demographics:*1979: 320,348 *1992: 536,827 *2002: 665,100 *2005: 690,584 The main languages spoken in Cotonou include the Fon language, Aja language, Yoruba language and French.-Transport:...
, Benin
Benin
Benin , officially the Republic of Benin, is a country in West Africa. It borders Togo to the west, Nigeria to the east and Burkina Faso and Niger to the north. Its small southern coastline on the Bight of Benin is where a majority of the population is located...
where mobs attacked individuals accused of the penis theft and authorities ordered security forces to curb the violence, following the deaths of five people by vigilante
Vigilante
A vigilante is a private individual who legally or illegally punishes an alleged lawbreaker, or participates in a group which metes out extralegal punishment to an alleged lawbreaker....
s. Later reports of outbreak suggest a spread beyond West Africa, including the coverage of episodes in Khartoum
Khartoum
Khartoum is the capital and largest city of Sudan and of Khartoum State. It is located at the confluence of the White Nile flowing north from Lake Victoria, and the Blue Nile flowing west from Ethiopia. The location where the two Niles meet is known as "al-Mogran"...
, Sudan
Sudan
Sudan , officially the Republic of the Sudan , is a country in North Africa, sometimes considered part of the Middle East politically. It is bordered by Egypt to the north, the Red Sea to the northeast, Eritrea and Ethiopia to the east, South Sudan to the south, the Central African Republic to the...
in September 2003; Banjul
Banjul
-Transport:Ferries sail from Banjul to Barra. The city is served by the Banjul International Airport. Banjul is on the Trans–West African Coastal Highway connecting it to Dakar and Bissau, and will eventually provide a paved highway link to 11 other nations of ECOWAS.Banjul International Airport...
, Gambia in October 2003; and Kinshasa
Kinshasa
Kinshasa is the capital and largest city of the Democratic Republic of the Congo. The city is located on the Congo River....
, DR Congo in 2008.
Comparing West African genital-shrinking epidemics with koro in Southeast Asia, the latter has symptoms emphasized on genital retraction (instead of shrinkage) and fear of death (which is absent in African cases). A study analyzing the West African epidemics from 1997 to 2003 concluded that rather than psychopathology
Psychopathology
Psychopathology is the study of mental illness, mental distress, and abnormal/maladaptive behavior. The term is most commonly used within psychiatry where pathology refers to disease processes...
, the episodes were product of normal psychological functioning in undisturbed individuals, who were influenced by the local cultural models or social representations.
U.S. and Europe
The Malleus MaleficarumMalleus Maleficarum
The Malleus Maleficarum is an infamous treatise on witches, written in 1486 by Heinrich Kramer, an Inquisitor of the Catholic Church, and was first published in Germany in 1487...
, a 15th century European manual for witchcraft investigations, relates stories of men claiming that their genitals had disappeared, being "hidden by the devil … so that they can be neither seen nor felt." They were said to have reappeared after the men had appeased the witches responsible.
At least three publications of the 1880s, from U.S., Russia and England, reported genital retraction pathology, without using the Malay or Chinese term. Koro epidemics in China were first noticed in a French report in 1908 and descriptions of koro entered clinical books of western medicine in 1936. In the 1950s, koro is noted in nosological and diagnostic psychiatry.
Further reading
- Cheng, S.T., A Critical Review of Chinese Koro. Culture, Medicine and Psychiatry. 1996 20:67-82
External links
- Koro: A Natural History of Penis Panics, September 16, 2002, Kuro5hinKuro5hinKuro5hin is a collaborative discussion website. Articles are created and submitted by Kuro5hin's users and submitted to queue for evaluation. Site members can vote for or against publishing an article and, once the article has reached a certain number of votes, it is then published to the site...
- Wall Street Journals "Best of the Web Today," Wednesday, October 22, 2003
- Koro - the Genital Retraction Syndrome - BBC h2g2, Page dedicated to Koro
- A mind dismembered: In search of the magical penis thieves, Harper's MagazineHarper's MagazineHarper's Magazine is a monthly magazine of literature, politics, culture, finance, and the arts, with a generally left-wing perspective. It is the second-oldest continuously published monthly magazine in the U.S. . The current editor is Ellen Rosenbush, who replaced Roger Hodge in January 2010...
, Frank Bures, June 2008.