User:Haemo/Koro

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Contents 1 Symptoms, classification, and causation 2 History 3 See also 4 References 5 Contemporary events 6 Southeast Asia: Koro 7 Africa 7.1 Benin 7.2 Congo-Kinshasa 7.3 Sudan 8 Medical viewpoints 9 See also 10 References 11 External links

[edit] Symptoms, classification, and causation

As a medical condition, genital retraction syndrome occurs when an individual is overcome with the belief that their external genitalia (in females including the breasts or nipples) are retracting, shrinking, or being removed temporarily or permanently; this retraction is also believed to result in death in some cultures or cases.^[1][2] Generally considered to be a culture-related specific syndrome, the instantiation of GRS is closely related to the culture in which it appears, resulting in many different names for a phenomenologically similar cases of GRS. For example, GRS has been reported as "koro" (or "lasa koro", meaning "shrinking of the penis") in South-east Asia, "rokjoo" in Thailand, "jhinjhini bimari" in India, and "suo-yang" (Mandarin) (or "shook-yang", Cantonese 縮陽) in China.^[1][3]

In general, there are two divisions of classification for GRS events (in particular, koro) — that of individual, or epidemic occurrences. Epidemic forms are a sociogenic illness or mass hysteria (sometimes called "penis panics"^[4]) in which large numbers of people are afflicted with the syndrome,^[2] sometimes leading to violence against those suspected of causing the symptoms to manifest.^[1] Partly as a result of this distinction, the nosology of GRS (and its inclusion in the DSM-IV) has been controversial; the early position held that GRS was culturally bound and became disputed following the discovery of culturally distinct occurrences. Culturally-bound illnesses are generally believed only to manifest in members of a given culture, but koro-like afflictions (collectively called GRS across several cultures, leading scholars to debate whether these are unique cultural syndromes or part of a universal syndrome — some have suggested it is properly classified as form of body dysmorphic disorder, while the medical establishment has weakened the link to merely "culture-related".^[2][5] Other scholars have argued that epidemic koro is nosologically distinct from individual cases of koro, as a non-Western form of mass hysteria. The "medicalization" of what some academics believe to be merely a non-Western manifestation of mass hysteria is argued to be derived from ethnocentrism and systematic bias in Western medicine.^[6]

The complex nature of GRS has led to differing positions on what causes it, and to what degree these causes create the symptoms. Biomedically, GRS or koro has been understood to be the cultural manifestation of other related medical conditions, such as tumors, strokes, epilepsy, drug withdrawal or use, schizophrenia, anxiety, and hypochondria. Epidemic koro is often spread by rumor, afflicting many people without a primary organic cause. Psychologically, it is related to castration anxiety in men; GRS was first introduced in this respect to the medical literature as "koro", though the etymology of the term remains in dispute.^[7]

[edit] History

The earliest known references to GRS come from China around 7000 BCE, where is was known as "suo-yang" — literally meaning "shrinking penis". The first Chinese medical textbook, the Yellow Emperor's Classic Text of Internal Medicine (Nei Ching), written between 476 and 221 BCE describes suo-yang. In the context of traditional Chinese medicine, suo-yang was described as being caused by an imbalance in the body's Yin and Yang. An excess of sexual activity depleted the body's Yang by expelling sperm and "without sperm, a person will not be will and the manifestation is one of retraction of the genitals with spasm of muscle, the bones of the chest are depressed, and the hair color is poor. Death usually occurs in autumn". This early understanding of suo-yang was a symptom, rather than a condition and evolved in to the modern idea of koro through later Chinese writings.^[2]

Later physicians, between (206 BCE and 907 CE), described different versions of the condition, detailing an "intense feeling of impending doom" and attempted to localize the suo-yang to the kidney (where sperm was believed to reside) or the liver. They also developed a variety of treatments for the condition, including acupuncture. These were collected in the first full description in 1835 by Pao Siaw-Ow, who describes suo-yang as:

In the 'Yin-Yang transposition... the patient feels heavy and short of breath, the lower abdomen is tense and the genitalia may be affected by spasm or retraction'. In the 'Yin type of fever... after intercourse between the male and the female ...the result is pain in abdomen, the scrotum in the male or the nipples in the female may be retracted.' and 'after intercourse between the male and the female, the penis retracts with sever pain the the feeling of death... speed is essential, for delay will mean the case cannot be saved.^[2]

The condition was first reported to the Western world in 1875, with inclusion of the term "lasa Koro" in a Buginese dictionary which described it as "a shrinking of the penis, a sort of disease that is not unusual amongst the natives and must be very dangerous".^[2] The term entered the medical literature in 1895, identifying it as particular to certain peoples of South-east Asia. These early writings were largely ignored until the 1930's, when renewed interest was directed at the condition from a psychoanalytic perspective; conduction that it was essentially Freudian in nature. The first direct observation by Western medicine occurred in 1948, in which F. Kobler described it as "acute castration fear based on superstition".^[2]

While GRS was first observed as koro in Southeast Asia, a body of literature soon emerged where "koro-like" cases were observed in other cultures overseas — while initially located in Taiwan and Indian, other cases were documented in Canada, the United Kingdom, the United States, and in immigrant populations from ex-Soviet nations like Georgia. A large volume of cases was also observed across Africa, especially in Sudan and Nigeria. While originally believed to be an isolated and rare syndrome, evidence soon emerged that GRS was much more common than most academics believed; in Hainan province, documentation of epidemic koro was revealed going back more than a century. The most-studied case of epidemic koro occurred in Singapore during 1967, affecting more than 500 people — incidentally, it was observed that most of those afflicted were not familiar with suo-yang (or other conditions), and instead the mass hysteria centered around contemporary fears regarding female estrogen supplements and the water supply.^[8]

This movement and diversification of how koro was perceived by those afflicted, and how epidemic koro spread were often related to contemporary aspects of the culture. For example, a 1977 outbreak of koro in Thailand reflected the xenophobic concerns of mainy ethnic Thais; at the time, many ethnic Vietnamese were fleeing to Thailand, and the epidemic of koro held them responsible for trying to sabotage Thai reproductive fitness. An Indian epidemic, detailed in 1981, was closely related to conflict between local ethnic groups and the government; following the suppression of a violent uprising by local groups, they spontaneously began to manifest epidemic koro. In general, reports of epidemic koro of this nature are related to contemporary social cases, and a fear of emasculation, impotence, or domination.^[8]

[edit] See also

[edit] References

[edit] Contemporary events

In cases where the fear of the penis being retracted is secondary to other conditions, psychological diagnosis and treatments are under development. It is becoming increasingly clear that these forms of mass hysteria are more common than previously thought.

The phenomenon is often, but not always, associated with occult belief, such as witchcraft. These panics frequently, but not exclusively, occur in places where access to education—particularly in science and human biology—is limited, or otherwise restricted (for example, when government policies restrict such education). Others have been reported under the influence of drug use. (Compare with castration anxiety.)

[edit] Southeast Asia: Koro

Penis panics in southeast Asia have become known under the term "Koro" (which means "head of the turtle" in Malay). Some anthropologists have referred to Koro as a culture-bound syndrome, but it is phenomenologically related, if not identical, to penis panics in various cultures. Koro most commonly describes the extreme fear that the penis is retracting into the body, including the idea that such retraction will bring about death. It can also refer to beliefs of "genital theft" or some kind of sorcery which has resulted in the loss of the penis. Sometimes the testicles are also believed to be affected.

Koro also tends to reflect a certain xenophobia among some groups, whereby foreigners are often blamed as the ones behind the "attacks".

In Chinese, the term used for the condition is the Chinese term shook yang (suo yang, 縮陽). Outbreaks of Koro in China were reported in 1948, 1955, 1966, 1974 and 1984/85, although none have been reported in the 20 or so years since (Tseng 2006).

A condition called "Bang-utot" (or bangungot) matching the description of Koro is a repeated theme in William S. Burroughs' book Naked Lunch.

Although Koro goes back to ancient times, beliefs have evolved to better suit modernity. Whereas in the past the causes were usually identified as supernatural, e.g. sorcery, a recent Koro episode in Northern Thailand placed the blame on Vietnamese Communist agents who supposedly put chemicals in the water supply.^[1]

Sufferers may resort to extreme physical measures to prevent the believed retraction of the penis. As well as affecting individuals, Koro-like syndromes can often occur in an outbreak of mass hysteria.

Koro most commonly strikes men, but rare cases are known to involve women and the fear that either their external genitals or nipples are retracting into the body.

Aside from the emotional distress, Koro by itself is not physically harmful, and no actual retraction takes place. Injuries have occurred when stricken men have resorted to apparatus such as needles, hooks, fishing line, and shoe strings, to prevent the disappearance of their penises.

An epidemic struck Singapore in 1967, resulting in thousands of reported cases. Government and medical officials alleviated the outbreak only by a massive campaign to reassure men of the anatomical impossibility of retraction together with a media blackout on the spread of the condition.

Koro has been successfully treated with a course of alprazolam and imipramine (which are psychiatric medications, the former used to treat anxiety disorders).

[edit] Africa

The belief has triggered waves of panic in Senegal, Benin, Ghana, Zimbabwe, Nigeria, Sudan and Congo-Kinshasa at various times in the last decade.^[2]

[edit] Benin

On November, 2001, in the commercial capital of Cotonou, Benin, authorities have ordered security forces to curb violence, following the deaths of five people by vigilantes. There have been reports of at least 10 such attacks. Four of those who died were burned, another man was hacked to death. Correspondents say that mobs have attacked indivduals accused of using magic to steal men's penises.^[3]

[edit] Congo-Kinshasa

On April, 2008, Kinshasa, Democratic Republic of Congo, the police arrested 14 suspected victims (of penis snatching) and sorcerers accused of using black magic or witchcraft to steal (make disappear) or shrink men's penises to extort cash for cure, amid a wave of panic. Arrests were made in an effort to avoid bloodshed seen in Ghana a decade ago, when 12 alleged penis snatchers were beaten to death by mobs.^[4][5]

[edit] Sudan

In September 2003, the Middle East Media Research Institute reported a hysteria in Khartoum, capital of Sudan.^[6]

Sudanese victims were made to believe by force of suggestion that their penises would melt away after they shook hands, shared a comb, or received a verbal curse. The so-called "penis-melting" has been blamed on Zionists trying to wipe out the Sudanese people by making their men unable to reproduce.

The hysterical reports were spread throughout Sudan by means of cell phone text-messaging.

Sudanese police investigated the claims and have found no evidence of anything supernatural, and that it is likely a hoax which victims believed through the power of suggestion. Mr. Abul-Gasim Mohamed Ibrahim, Sudan's Minister of Health, issued official statements to calm the public's fears.

Local media also contributed to the idea's spread. The Sudanese columnist Ja'far Abbas has warned visitors to avoid shaking hands with "a dark-skinned man". In reference to the electronic comb which was supposed to have caused one man's penis to disappear, Abbas writes, "No doubt, this comb was a laser-controlled surgical cyborg that penetrates the skull, [passes] to the lower body and emasculates a man!!"

The phrase "Penis-melting Zionist cyborg combs" has been coined to describe this humorous story. It was originally incorrectly attributed to Wall Street Journal's James Taranto writing in his "Best of the Web Today".^[7] However, the article in question has no such phrase, nor anything similar beyond the aforementioned quote.

[edit] Medical viewpoints

Documented cases have not typically indicated 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. Medical response generally consists of informing patients that the genitals anatomically cannot retract or shrink in the manner typically feared.

As one academic work states, GRS seems to be similar in many ways to the Western category of panic attack, with sexual elaborations. It seems probable that, in a culture where sexual anxiety is high and stories exist of death by genital retraction, a man in the right frame of mind could panic at the observation that his genitals are shrinking in response to cold or anxiety.

[edit] See also

• Vagina dentata

[edit] References

• Cheng, S.T., A Critical Review of Chinese Koro. Culture, Medicine and Psychiatry. 1996 20:67-82
• Tseng, W.S., From Peculiar Psychiatric Disorders through Culture-bound Syndromes to Culture-related Specific Syndromes. Transcultural Psychiatry. 2006 43(4):554-576
• Psychology - The science of mind and behaviour. Michael W. Passer & Ronald E. Smith. 3rd edition P.542 (Sociocultural factors for Anxiety disorder)

[edit] External links

• World Health Organization article about Koro, with bibliography
• Koro: A Natural History of Penis Panics, September 16, 2002, Kuro5hin
• October 22 report by the Middle East Media Research Institute: "Panic in Khartoum: Foreigners Shake Hands, Make Penises Disappear"
• Wall Street Journal's "Best of the Web Today," Wednesday, October 22, 2003
• "Genitals ‘Disappearance’ Rocks Patani Community", Nigerian Daily Independent's 7 March, 2006 report
• Koro - the Genital Retraction Syndrome - BBC h2g2, Page dedicated to Koro
• Lynchings in Congo as penis theft panic hits capital

Category:Mass hysteria Category:Sexuality and society Category:Culture-specific syndromes Category:Andrology Category:Penis