Before urologists recognized the physical nature of impotence, treatments generally fell into three categories-aphrodisiacs, surgery/transplants, and mechanical treatments.

Aphrodisiacs

Innumerable substances have been used to increase sexual performance. Oysters, lobsters, eggs, and spices are examples. Spanish Fly, a substance made by grinding the wings of certain beetles, was a favorite of that party animal, the Marquis de Sade. It is illegal in the United States both because of the unproven nature of its effectiveness and a tendency to cause seizures or death. Many of these substances actually do nothing more than irritate the genital organs. The user interprets this irritation as increased sensitivity, thereby giving the impression of increased performance. Rhinoceros horn has been used (unsuccessfully) for so long that its name has become synonymous with sexual arousal. Unfortunately, its popularity has led to such widespread slaughter of the animals that they face extinction. Ancient Egyptians believed eating crocodile penises increased virility. Anyone capable of eating a crocodile’s penis probably didn’t need any more help proving his manhood.Surgery/Transplants

The idea of using animal testes to treat impotence began in the Middle Ages, when a standard treatment for “the male malady” was to place the testicles of a cock under the bed. Another option was eating the rooster’s testes. You could guess that putting them under the bed was much more popular. The Malleus Maleficarum was a guide to witchcraft during that era that asserted witch’s spells caused impotence. This was a major reason witch-hunting became so widespread. French physiologist Charles Edouard Brown-Sequard injected himself in the 1880s with an extract from the testicles of dogs that he claimed made him smarter, stronger, and more virile. After ten injections, he reported improved erections, as well as a stronger jet of urine and “power of defecation.” He made no claims about the effect this had on the dogs. His “Elixir of Life” became an instant best-seller. Its 1889 launch rivaled that of Levitra, even without a famous spokesman.

Eugen Steinach in 1920 pioneered surgical treatment of impotence with a revolutionary idea-vasectomy. He believed blocking the vas deferens (the tubes semen passes through) would force maleness factors back into the bloodstream instead of letting them go to waste on the sheets. The erections probably weren’t much better, but with female partners spending less time pregnant, there was much more opportunity. Two recipients of the Steinach procedure were Sigmund Freud and Nobel Prize winner William Butler Yeats. Freud, the person most responsible for the mistaken impression that impotence was primarily psychological, set back our understanding of the disorder by decades. Taking him out of the gene pool probably did more to help the science of impotence therapy than anything else Steinach did. Many respected universities have subsequently been involved in the transplantation of animal or human testicular tissue. Swiss professor Paul Niehans treated tens of thousands of men with testicular cell injections in the early twentieth century. His procedure sometimes went straight to the root of the problem by injecting a booster shot directly into the patient’s testes.* Patients receiving the treatments included Charlie Chaplin (and you wondered why he walked that way), Aristotle Onassis, and Pope Pius XII. Chaplin was a well-known womanizer, but the Pope’s interest in this treatment remains a mystery. Another researcher in Chicago proudly stated his initial patient checked himself out of the hospital four days after surgery in order to satisfy his newfound potency. He fully understood the rule: “Never waste an erection.” Dr. Leo Stanley removed the testicles of recently executed prisoners at San Quentin in the 1920s. He transplanted them into other, more fortunate (albeit impotent) prisoners, reporting improvement in strength, well-being, and libido among the recipients. When the supply ran low, he substituted goat, ram, boar, and deer testicular tissue. Why he wanted to improve libido among prisoners is still not evident. It remains unclear whether any of these early attempts at treating impotence with human or animal testicular tissue actually worked. Most of the researchers mentioned eventually fell into disrepute-but at least Aristotle Onassis got the girl.

Mechanical

Hot metal rods inserted into the urethra during medieval times failed to revive erections. No one wanted a second treatment, so failures went unreported. Many types of splints have been used, including hollowed-out antlers and horns. Encouraged by finding the penis bone (baculum) in some animals, early surgeons placed rib cartilage into the penis. Although these initial attempts failed, penile prostheses have more recently proven particularly reliable.

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