If Two Are Good, Would Three Be Better?

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hen you are eighty-two years old and you have sixty – four wives, you need all the help you can summon. For Kamil Pasha, a vizier (bigwig) in the Ottoman Empire, help took the form of testicle consomme. The broth, which the Pasha quaffed daily, was made by steeping the danglers of robust young hoof stock. The vizier’s enthusiasm for his vile bullion did not escape the notice of the harem obstetri­cian, Skevos Zervos. Zervos had been observing the Pasha’s staff of eunuchs and musing on the feminizing effects of destroying a man’s testicles. He began to hatch a theory of testes as the key to lifelong virility.

In between deliveries, Zervos began experimenting. He attempted to rejuvenate aging rabbits and dogs by graft­ing testicle tissue from younger specimens onto their own geriatric gonads. He went public with a paper in 1909, stirringly entitled “Curious Experiences with the Genital

Organs of the Male.” The paper’s aim was to popularize the technique so that eventually it would be available to all men.

The Pasha was not amused. He accused Zervos of plot­ting to restore his eunuchs’ manhood. Fearing for his life, Zervos fled to Athens. There, in 1910, for the first and far from the last time, strips of ape testicle were implanted into a man. Zervos advertised the technique as a cure for both impotence and senility.

Word spread. By 1916, the nut graft had gone main­stream. In the first of two JAMA articles, G. Frank Lyd – ston, a professor of genitourinary surgery at the Chicago College of Physicians and Surgeons, outlined the beneficial effects of tissue from a third testis—in this case, a human one—implanted in the scrotum beside the two that nature had bestowed.[49] Though an increase in “sexual power” and “vigorous and prolonged erections” were the most com­mon type of claimed results, the secretions of the auxiliary gonad, in Lydston’s view, erased many of the afflictions of advancing age: high blood pressure, senility, arteriosclero­sis. At one point he described curing a twenty-two-year – old youth of, among other afflictions, the “frequent writing of incoherent, rambling dissertations on architecture.” It seemed no ailment stood strong in the face of another man’s testis.

Lydston began by focusing on men whose own glands were obviously stunted or defective: the seventeen-year – old with no signs of virility and a testicle “about the size and shape of a small Lima bean,” for instance, or the twenty – one-year-old saddled with “unsatisfactory and unpleasur­able coitus” and testicles “the size of a navy bean.” (Lydston had earlier compared a withered male gonad to a hazelnut, but wisely shifted to the bean family for his size compar­isons—the word “nut” perhaps cutting a bit close to the Lydston bone.) As enthusiasm for the procedure built, Lyd­ston began expanding his patient base, operating upon men with normal-sized testes as well. Early on, he had done the procedure on himself.

While Lydston had no trouble scaring up patients, find­ing donors was more problematic. Though a single testicle, like a lone kidney, is capable of taking on the duties of its absent teammate, rare is the man willing to part with a gonad for charity. Unable to secure the sex glands of virile young men, Lydston made do with the next best thing: the sex glands of dead virile young men. It appears he had a sympathetic friend at the city morgue, and that Chicago’s young male accident victims around that time may have paid an additional price for their heedlessness. Most of Lydston’s case studies described the unwitting donor as “dead of accident.” Two hapless teens—one in 1918, one in 1915—succumbed to “a crushing injury” of the head, leading one to wonder if G. Frank Lydston occasionally prowled the back alleys of South Side Chicago armed with something larger and heavier than a navy bean.

Lydston insisted that dead men’s testicle tissue would take, provided the operation was completed before the organ had begun to decompose; though as time wore on, he began to play looser with his rules. While the first donor testicle had been out of commission just six hours at the time of the operation, later organs sat on ice for thirty-six or even forty-eight hours.

This sort of delay wouldn’t pass muster with French gonad grafter Serge Voronoff. The Russian-born emigre insisted that the gland must be transferred within seconds, lest changes in the cells compromise its vitality Voronoff dreamed of a day when special hospitals would be set up, in which “candidates for glandular grafting will remain, in readiness to receive the required organs from the fatally injured cases who will be rushed thither.”

The closest America came to such a facility was San Quentin State Prison’s death row. In a series of experi­ments—about which we’ll hear more shortly—San Quen­tin resident physician Leo L. Stanley plucked the gonads from some thirty freshly executed inmates and grafted them into thirty aged or “prematurely aged” inmates.

Meanwhile, Serge Voronoff, lacking contacts at pris­ons or morgues, was forced to come up with an alternate source of fresh testicle. Voronoff turned to apes and mon­keys: chimpanzees, mostly, and the occasional baboon. The baboon, you may be interested to learn, carries a much big­ger testicle than his TV-trainable cousin. So much so that Voronoff took to splitting the balls in two, parceling them out by halves to his patients.

The back half of Voronoff’s 1925 book Rejuvenation by Grafting is a catalogue of case studies: page after page of aging men, pillars of society, who paid the charismatic Frenchman a prodigious sum to have slices of chimp tes­ticle surgically installed in their scrotum. Along with his other medical innovations, Voronoff appears to have pio­neered the medical Before and After shots. The Befores are invariably seated, but many of the Afters are action shots—seventy-year-old men in spats and cravats, striding
and leaping across the lawn, demonstrating their newfound vigor.

Подпись: bonkBy the patients’ own testimonies, however, Voronoff’s operation was something of a bust. “The genital coldness has changed very little,” noted one. “I am somewhat more active; and the sexual function is very slightly stimulated. That is all,” groused another. And another: “I am increas­ingly wretched.”

Voronoff must have longed for the early, experimental days of his grafting career, when none of his patients com­plained or issued lukewarm reviews, because they were sheep. Beginning in 1913, he took the testicles out of more than one hundred young rams, sliced them, and grafted the strips into “miserable old beasts” who then became “young in their gait, bellicose and aggressive, . . . full of vitality and energy.” In the Voronoff tradition, selected animals were posed for portraits, standing on seamless paper and looking, to my eye anyway, no different Before and After. Charm­ingly, Voronoff named his research animals, but not the way most people name animals. He named them the way people name perfumes, or in this case, something closer to an ill-conceived line of cologne: Old Ram No. 12, Old Ram No. 14, etc.

San Quentin’s Leo Stanley had better luck than Lyd – ston had with his human subjects. He published a paper in a 1922 issue of Endocrinology, summing up the effects of 1,000 testicular grafts. The donors were mixed: 20 exe­cuted San Quentin inmates and a party mix of common hoof stock, including goats, rams, boars, and deer.

The results were nothing short of astounding. Forty – nine of 58 asthmatics reported improvement, as did 3 of 4 diabetics, and 3 of 5 epileptics, 81 of 95 sufferers of “sex las­situde,” and 12 of 19 impotent men. (These last two stand
out as especially impressive—or something—given that he was dealing with an all-male prison population.) Even more astonishing, 32 of 41 men said they could see better, and 54 of 66 acne victims—apparently taking a daily blem­ish tally—reported a decrease “in the number of pimples.” Dr. Stanley failed to mention something that David Hamil­ton, author of The Monkey Gland Affair, pointed out: that in exchange for participating in the study, the men were either paroled sooner or paid with cash. It’s probable that they felt some pressure to tell the doctor what he wanted to hear.

Serge Voronoff kept data on his patients, too, but it was a perplexing mixture of bluster and failure. “In 26 to 55 percent,” he wrote, “the physical and mental rehabilitation was accompanied by complete restoration of sexual activ­ity.” Well, was it 26 percent, or was it 55 percent?

It didn’t matter. Testicle madness was in full bloom. Bars in the 1920s were serving a drink called the Monkey Gland, and shops in Paris sold ashtrays decorated with whimsical chimps with their hands on their genitals and the words “No, Voronoff, you won’t get me!” By 1924, some 750 medical professionals and not-so-professionals were plying the gonad trade. These included not just the misguided and the deluded, but the intentionally deceit­ful. Prominent among the latter was John R. Brinkley, a Kansas-based surgeon with a diploma-mill M. D. and his own radio station. “A man is as old as his glands,” went the Brinkley slogan, broadcast far and wide on KFKB. Every Sunday, a dozen or more somber men arrived at the Mil­ford train station from points distant, to be processed for Brinkley’s miracle four-part operation to restore sexual vigor with goat glands.

At one point, Brinkley was taking delivery on forty Toggenburgs a week, housed in a corral behind the hos­pital. He encouraged his patients to personally select their donor, like diners at a Chinese seafood restaurant being ushered to the aquarium. At a hearing described in The Bizarre Careers of John R. Brinkley, the enterprising quack was forced to admit that the operation was not only useless— the patient’s immune system would attack the gonadal interloper, breaking the animal tissue down and eventually absorbing it—but often dangerous. Infections were com­mon and patients were sometimes rendered sterile. Not to mention the ill effects on the donors, who were “fed to the coyotes” after surrendering their billyhood.

These days, the only animal testicles being implanted into men are silicone prosthetics called Neuticles—in­tended for neutered pets. Silicone is FDA-approved for breast implants and a host of other human body-part plumpers, but no one has paid the millions of dollars it would take to get testicular implants (for cancer patients) approved by the FDA—mainly because there aren’t enough cases of testicular cancer to make it worthwhile. So men who have had a testicle surgically removed will sometimes order a Neuticle[50] and have a plastic surgeon install it. As long as the men don’t mention that the prosthetic is for them, not their pet, the manufacturer can’t get into trouble. These days Neuticles makes cosmetic gonads ranging from the Feline model to the Bull, accommodating, one hopes, most men’s needs.

You may well be wondering why a neutered dog would need prosthetic testicles. A vet quoted on the Neuticles

Web site says the product “helps the pet’s self esteem.” I called Neuticles founder Gregg Miller to chat about the surprising notion of pet self-esteem. He talked about the day his bloodhound Buck was neutered. “I’ll never forget it. He had just come home from the vet. He woke up. He went to clean himself, he looked down, and he looked back up at me. He knew they were missing. He was depressed for days.” Miller concedes that Neuticles’s healthy sales figures (157,000 pairs sold worldwide) may have more to do with male pet owners’ hang-ups than with pets’—a fact supported by the not infrequent attempts to order Larges for, say, a beagle.

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s far as I’ve been able to ascertain, the earliest genita­lia pushers were the Chinese. (In this case, the gonad tissue wasn’t grafted, but dried and made into pills or potions.) The Chinese Materia Medica of 1597, by the nat­uralist Li Shih-chen, promotes the penises of dogs, wild cats, and otters as treatments for impotence. Certain types of otters are deemed more effective than others: “In hunt­ing for them women in spring go into the wilds in groups and the otter getting their scent jump upon them and can­not be removed except by throttling them to death. The penis of such an animal is considered very valuable.” I had assumed that this was because the behavior denoted excep­tional bravery and virility, or possibly because the throttling produced an impressive erection, but then I had to revise my theories, for Li concludes his entry with the following enigmatic fact: “The penis of an animal found dead cling­ing to a tree trunk is most costly.” It’s possible Li’s grasp of otter biology was patchy. The freshwater otter, he writes, “is always male, and… it cohabitates with the gibbon.” Tiger penis as a cure for flagging libido is a more recent addition to the Chinese pharmacopoeia. A 1993 report by the animal rights watchdog group Earthtrust describes a restaurant in Taichung, Taiwan, selling tiger penis soup to male diners for $320 a serving. (One penis makes soup for eight, the head waitress helpfully told a foreign television reporter.) However, there is no listing for tiger penis in the Chinese Materia Medica. Medicinal uses for the tiger’s bones, flesh, fat, blood, stomach, testes (for scrofula), bile, eyeball, nose, teeth, claws, skin, whiskers, feces, and bones in the feces are listed, but none for the penis. Likewise, rhino horn[51] is listed as an antidote for typhoid, headache, carbuncles, “boils full of pus,” and “the evil miasma of hill streams,” but not impotence.

It is interesting to note that tiger penis is often taken in a potent wine, or brandy, which in and of itself might do the trick, should the man be suffering from simple per­formance anxiety. “Just prior to sex,” states the Earthtrust memo, “the consumer takes a slug.” It’s clear I’ve been spending too much time with the Materia Medica, for upon first reading this, I pictured a man taking a garden slug as he might an aspirin. (Not entirely far-fetched: the sluglike sea cucumber, like almost every other penis-shaped creature on the planet, is rumored to be an aphrodisiac.)[52]

Personally, I’d start with a prescription attributed to Aristotle. Seemingly under the sway of some ancient Gamebird Advisory Board, the author begins his list of potency restoratives with “pheasants, woodcocks, gnat- sappers, thrushes, black-birds, young pigeons, sparrows, partridges, capons.” The fowl eventually yield the stage to the chief “provokers” of erection: “watercresses, parsnips, artichokes, turnips, asparagus, candied ginger, acorns, scal­lions, shell fish,” all to be used “for a considerable time.” At some point, their efficacy probably became moot, as the men grew obese and sex began to take a back seat to the next shipment of gnatsappers.

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r. Hsu has a friend who owns a traditional Chinese medicine shop in Taipei, and he kindly agreed to take me on a field trip there. No gonads were for sale, and just one variety of penis: that of the deer. It looked like an ant­ler, but Dr. Hsu was insistent. “Deer penis,” he kept saying, as though dictating a letter. The proprietor would disap­pear into the back room and return with a stack of lidded cardboard boxes, like the shoe salesmen of my youth. Sea­horses, fossilized oysters, antler chips, dinosaur teeth (“Just because they’re hard,” sniffed Dr. Hsu). The last remedy the proprietor brought down was a bundle of dried leaves stacked like bills and tied with red cord. “Goat eat this leaf, mating one hundred times in a day,” Dr. Hsu translated for me. The proprietor handed the sheaf to me.

“Thank you,” I said. “But I don’t really need any.” I turned to Dr. Hsu. “Would you explain to him that I’m just doing research?”

A jolly-looking man browsing in the store walked over and joined our group. “You should ask for Emperor’s For­mula,” he said. Dr. Hsu explained that an emperor during the Chin Dynasty, seeking to cure his impotence or perhaps just doing research, dispatched four hundred young men and women to an isolated island and instructed them to “try all the leaves and have fun!” The man and Dr. Hsu exchanged a few words in Chinese. The man looked at me, smiling.

“I’m just doing research.”

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r. Hsu spent the drive back making sure I understood the limits of traditional Chinese medicines for erec­tile dysfunction. “Any formula,” he said, “is not better than Viagra.”

Viagra has an interesting history here in Taiwan. (And an interesting name: Ver Er Gang has been translated for me, variously, as “powerful and hard,” “firm and strong like steel,” and, my favorite, “steep and hot.”) The week before the pill was to formally go on sale—as opposed to informally, on the black market, where it had been selling briskly for some time—women’s rights activists took to the streets of Taipei, protesting its release. “Viagra has destroyed harmony at home and caused extra-marital affairs because wives cannot satisfy their husbands’ sexual demands,” one women’s health advocate was quoted as saying in Malaysia’s Sunday Sun. A gynecologist at Taiwan Adventist Hospital, where Dr. Hsu works, was also quoted, urging doctors not to prescribe the drug until they’ve been shown “written approval” from patients’ wives.

I later learned that Viagra’s release Stateside prompted a similar outcry from a faction of American women. Meika Loe, author of 77te Rise of Viagra, quotes five or six letters to Ann Landers. The sentiment runs more or less along the lines of No Name in Abilene, Kansas: “Please tell those smart-aleck scientists and those big drug companies to work on a cure for cancer and quit ruining the lives of mil­lions of women who have earned a rest.” Though Landers replied that these women represented a small percentage of her Viagra mail, the letters suggest that a little therapy tossed into the mix might not be a bad idea.

Of course, Pfizer Taiwan sailed ahead anyway. Its prof­its here and in mainland China have been, as they say, steep and hot. Perhaps the only locality where Viagra has proved a disappointment is the Wolong Nature Reserve in Sichuan Province. Wolong is home to part of China’s dwindling panda population, as well as a group of captive pandas in a breeding research facility. Pandas have trouble reproducing in captivity. Some researchers describe it as a libido issue; some 60 percent of captive pandas show no interest in mat­ing. Others seem to think that the males have erectile defi­ciencies, for in 2002, a middle-aged panda named Zhuang Zhuang was dosed with Viagra. “No result on him at all,” the BBC quoted Wolong deputy director Wang Pengyan as saying.

Wolong researcher Guo Feng, also quoted in the BBC piece, took issue with his colleague. “You can’t say Viagra has no results on pandas. That panda basically has no capa­bility. In the last few years, we’ve given Zhuang Zhuang many chances but he simply can’t do it.”

It was unfair to single out Zhuang Zhuang, for male
pandas in general are bumbling lovers. “The male giant pandas do not know where to put it,” a zoologist named Chen is quoted as saying in Inside China Today. “Some­times they climb on the females’ heads and start pushing.” Seeking to enlighten clueless male pandas, Wolong staff set about making an instructional video, which the media gleefully dubbed “panda porn.” The BBC even referred to the footage as “explicit,” though given the animal’s thick fur and diminutive penis[53]—erect, about as big as a man’s thumb—it’s hard to imagine that the pandas were able to glean much detail from the tapes. Likely more of a This End Up sort of deal. The staff tersely reported “improvement.”

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Подпись: bonkandas aren’t the only ones for whom Viagra doesn’t do the trick. About a fourth of the men who try it continue to have trouble getting hard. What’s to be tried, short of a trip to Dr. Hsu’s operating room? A few things. One can inject erection-producing drugs directly into one’s corpora cavernosa, if one is the sort who takes kindly to sticking nee­dles deep into one’s penis. The injections prompt a speedy, impressive boner that typically lasts a couple of hours. Less typically it lasts a lot longer, transforming its owner from

Hercules to Priapus[54] and requiring an awkward visit to the emergency room. A newer, kinder, gentler way to deliver these drugs is via a urethral suppository known as MUSE (Medicated Urethral System for Erection).

And then there is the vacuum constriction device, a. k.a. the penis pump. This consists of a plastic tube, into which one puts one’s flaccid penis, and a pump that pulls the air out of the tube. The resulting vacuum effect sucks blood into the organ, which is then trapped there by a constrictor ring. The penis pump was invented by a tire professional named Geddings Osbon, whose own frequent flats drove him to get creative with the company pneumatics.

As an indication of how thoroughly Viagra has deflated Osbon ErecAid company profits, witness the sad slogan “Make Your Second Choice Your Final Choice.” One journal review from last year stated that penis pumps are suggested “mainly to elderly patients with occasional inter­course attempts.”

Further along the fringes, there is acupuncture. While I was visiting, Dr. Hsu introduced me to a man who treats erectile disorders—though mainly premature ejaculation— with acupuncture. Hsu said 44 percent of men treated with acupuncture report improvement. This is less impressive than it sounds, as 38 percent will report improvement if you give them a placebo treatment.

Acupuncture for impotence is more common on the agricultural scene. “Typically one treatment. . . with the moxa-needle technique is sufficient for impotence,” writes the author of a paper on treating “overused” bull studs. Though it was not altogether clear whose impotence was being referenced—the bull or the man kicked in the balls by the bull as he tries to stick needles in its pizzle.

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he simplest, safest, cheapest treatment put forth for erectile dysfunction is to strengthen one’s pelvic floor muscles. The late gynecologist Arnold Kegel was the first to discover the beneficial effects of pelvic floor muscle toning. Initially, Kegel’s exercises were viewed strictly as a boon for women[55] They helped reverse incontinence, and they helped women have more—and/or more intense— orgasms. Kegel promptly dubbed them Kegel exercises and went on the road to promote them, inextricably linking himself to pelvic clenching and ensuring an obituary that would gloss over all other salient aspects of his career.

In 2005, a group of professors at the University of the West of England reported in BJU International (British

Journal of Urology) that Kegel exercises could cure erectile dysfunction. After three months of twice-daily Kegeling sessions, a group of impotent men showed significant improvement as compared with a control group. An “inde­pendent blind assessment”—the logistics of which I cannot begin to contemplate—determined that 40 percent of the impotent men, compared with controls, had regained nor­mal erectile function. In a further 35 percent, the condition had improved. The paper points out that Kegel exercises were more effective in the younger study subjects, subjects whose erectile dysfunction was less likely to stem from the usual band of brigands: diabetes, atherosclerosis, fibrosis.

Impressed and curious, I sent away for the instruc­tional video referenced in the paper, which was produced by Grace Dorey, one of the paper’s authors, and a phys­iotherapist named Kevin Foreman. The video begins with an introduction by Dr. Foreman (who has a Ph. D., not an M. D.). He wears a peach-colored tie and sits against a backdrop of a plain curtain. Neither his chair nor the table he sits at can be seen. Not even a lone potted plant has been recruited to share the frame with Dr. Foreman and his tie. The colors are garishly distorted, so that Dr. Foreman is the pink of an Easter ham.

Dr. Foreman explains that one pair of pelvic floor mus­cles runs along the sides of the penis like guy wires and helps hold it erect. Another pelvic floor muscle encircles the penis and, when tightened, puts pressure on the dorsal vein and helps trap blood inside the penis. Toning these muscles should, in theory, help men have firmer, longer – lasting erections.

The how-to portion of the video starts innocently enough, with anatomical drawings on a sketch pad. View­ers are instructed to simultaneously squeeze as if pretend­ing to stop the flow of urine and “tighten the back passage as if to prevent wind escaping.” I recognize this particu­lar euphemistic phrasing from one of Ms. Dorey’s patient instruction booklets (a list of which she had emailed me): Prevent It! A Guide for Men and Women with Leakage from the Back Passage.

Abruptly, the scene shifts to a man’s naked hips on a rumpled white sheet. He lies on his back, knees up, thighs spread, back passage clearly visible. Understandably, the man’s face is out of the frame. A catalogue description of the video states that the exercises are demonstrated by “a male model,” but I suspect it’s Foreman. A budget so small that it cannot accommodate a potted plant does not eas­ily accommodate modeling fees. Though I could easily be wrong. I could be talking out of my back passage.

A voiceover puts the pelvic floor muscles through their paces. At one point, we hear “Tighten! Tighten! Tighten!” in a ringing exclamatory voice. My husband, in the kitchen, heard this as “Titan! Titan! Titan!” and comes in to check out what he assumed was some deliriously campy, low – budget sci-fi pic.

“Whoah,” says Ed upon encountering Dr. Foreman’s package.

“Notice the lifting of the scrotum,” the narration con­tinues. Next the model demonstrates the exercises from a standing position, and here the camera zooms in dramati­cally. Ed and I lean back into the sofa cushions.

“Tighten! Tighten! Tighten!”

Part II was entitled “Post-Micturition Dribble.” “This is a dribble of urine that occurs after you’ve finished going to the toilet,” explains Dr. Foreman. The video cuts to a shot of a boxer-clad bottom backing away from a toilet. The skin tone situation has worsened, such that the man appears to be wearing a hot pink leotard under his boxers. The cam­era displays a close-up of a dampened blotch on the fly of the boxers. “It can be as much as an eggcup-ful and can be very embarrassing.” Is this an estimate, I wonder, or did Dr. Foreman recruit someone to dribble into an eggcup?

Given Foreman’s findings, why aren’t Kegel exercises the toast of the urological community? “That’s one study,” says American Urological Association spokesman Ira Shar – lip when I ask him about it. Indeed, a search of the medi­cal journal database PubMed unearthed no attempts to replicate the West England Kegeling study. Which seems like a shame. (A general Internet search did turn up a few self-help sites that mention Kegeling as a way to control premature ejaculation, something to which Dr. Foreman also alluded.)

Kegeling seems to me to belong in the same box with oat bran and prayer and vitamin pills, the big box that says can’t hurt, might help on the side of it. Certainly, it would be worth trying before moving on to the final frontier, the treatment of last resort: the artificial erection.

The Testicle Pushers