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ImpotenceReview - Impotence
A Cultural History
by Angus McLaren
University Of Chicago Press, 2007
Review by Tony O'Brien, RN, MPhil
Feb 19th 2008 (Volume 12, Issue 8)

Me husband can dance and caper and sing

And do anything that's fitting for him

But he cannot do the thing I want

Because he has no courage in him

(English folk song, Trad.)

If there is one ray of light in the history of impotence, it is that the taboo nature of the topic throughout most of western history has given rise to a rich vein of humor, in jokes, songs, anecdotes, and in the preposterous claims made about the causes of impotence, and its possible remedies. Why do women fake orgasms? Because men fake foreplay. Angus McLaren's research covers over two and half millennia and provides enough memorable quotes to hold the reader's interest throughout this book, if the more serious scholarship becomes a little taxing. Actually, it doesn't become taxing at all. Impotence. A Cultural History is a highly readable and informative account of an issue that has taken on new significance in the past decade as the pharmaceutical industry has emerged as the dominant player in the age old issue of impotence.

The book begins in the classical periods of Greece and Rome and ends in the 21st century, showing that views of impotence, like constructions of masculinity, have varied according to the cultural norms of the times. If the currently dominant view that impotence is a medical condition (erectile dysfunction), with a demonstrated basis in pathophysiology and a drug to treat it, this is not the end of the affair, but simply one more installment.

Impotence. A Cultural History is presented in ten evenly spaced chapters. The first covers both Greece and Rome, showing the vast differences in the place of the erection between those cultures and our own. McLaren draws on surviving literature, aware that this necessarily reflects the interests of the ruling elite. For the ancients, sexual performance through the erect penis was as much about social status as about sex; its purpose was utilitarian rather than the demonstration of intimacy. The theme of performance anxiety, albeit for very different reasons, is established in this chapter and remains evident throughout the book. From Rome, the focus fastforwards to the late middle ages, by which time the Christian church has assumed authority to speak, a role that brought contradiction and conflict. The view of the Church was that impotence was a serious matter because of the potential threat it posed to the institution of Christian marriage. Failure to perform could lead to annulment. Demonic theories held that impotence could be caused by a disgruntled spouse; men might be called upon to demonstrate their prowess to panel of clergy.

Two more chapters advance the narrative to the 19th century. The early modern period saw a rise in the comic representation of impotence, illustrated by the story of the parson who discovered a lady consorting with her coachman.

"When the parson told the husband, the latter explained she was hard to satisfy and that he paid the coachman twenty pounds a year for that service. The shocked parson protested that he should have been told: he would have done it for ten."      

McLaren quotes from numerous poems, showing how humor provided one means of engaging with issues of masculinity. There are also reports of court cases and examples of advice given to non-performing husbands. By the end of the early modern period impotence came to be subjected to rational analysis, and the dominant discourse moved towards a scientific construction.

The remaining chapters cover the past two centuries. Here, McLaren provides some extended discussion of constructions of impotence and masculinity that are more familiar because most still have considerable currency. McLaren takes issue with the view that excessive desire can be thought of as equally problematic in men and women. The lustful male is not the equivalent of a nymphomaniac; he is the ideal man, she the violation of the ideal woman. This gendered difference in ideals of sexuality is a theme throughout the book. The Victorian era, whatever its reputation for prudery, saw the development of numerous quack cures for impotence. The emergent medical profession was in the difficult position of wanting to differentiate itself from the quacks, but of having little to offer apart from reassurance. There was no shortage of theory, however, with excessive indulgence blamed for poor performance. Seminal fluid was said to operate according to its own economy and could simply become exhausted through over use. Masturbation, therefore, was frowned upon, linking religious morality with medical science.

In another of McLaren's telling anecdotes we learn of a novel justification of what we otherwise know as premature ejaculation. Spanish scientist Gregorio Marañón argued that quick love making was a matter of design. Evolution led to:

"abbreviating the reproductive act, diminishing its duration, and leaving the normal man free time to work for the progress of Humanity. In the cases of frogs, which have nothing better to do, coitus lasts for several weeks." 

How noble!

McLaren provides an extended discussion of the career of Marie Stopes, Scottish feminist crusader, author, and in this account, schemer and manipulator. Stopes' life is in itself a compelling story. Here McLaren's attention is on her role in advocating for women's sexual needs, especially through her marriage manual. Freud is discussed, although more in terms of his influence on others than in terms of his theoretical work. McLaren concludes that the early twentieth century upheaval in sexual mores, for all its attempts at revolutionary change, left issues pretty much as they were: sex was about penetration, homosexuality was an aberration, and women were the responsive partners of dominant men. The eugenics movement and study of the sex glands attempted to establish a normative science of sexual performance, leading to some unlikely alliances of interest, for example between sexual reformers and racial supremacists.

McLaren then explores the impact of Kinsey in the middle of the century, and Masters and Johnson slightly later. This is a marvelous chapter which traces the emergence of a more psychological and interpersonal understanding of sexuality, and the rise of the 'sex therapist'. The pendulum swung away from biological models. People were encouraged to talk to therapists, doctors, even to their partners. With so much talk of impotence, there were concerns about an increase, much as there were following each of the world wars. But McLaren argues this was as likely to be an artifact of increased interest in sex, as it was to be a real increase. He quotes one skeptic to the effect that: "If more people played baseball, more would inevitably report difficulties in hitting the ball". Of course greater participation in sex really would lead to more people experiencing problems, but in a less liberal context they would simply keep it to themselves.

In what could be regarded by Pfizer as a marketing coup, the final chapter is entitled Viagra, although with the subtitle Hard Science or Hard Sell? Anyone with an email account knows there is a fair bit of hard sell, but what about the science? McLaren does a superb job of outlining both the social context of the Viagra phenomenon and the triumph of the medical-pharmaceutical complex in establishing ownership of impotence. This is not a simple matter of unilateral medicalization, even although doctors and pharmaceutical companies have actively pursued the agenda of impotence as a disease best referred to by the opaque term 'erectile dysfunction'. The public, though, and men in particular, are also active in the process of medicalization, readily buying into the quick fix of the little blue pill. Rosenfeld and Faircloth reached a similar conclusion in their Medicalized Masculinities. Viagra, though, is not the success story it is sometimes thought to be. Many patients don't return for a repeat prescription. The market has expanded though, something else noted by Rosenfeld and Faircloth, and Viagra is used by some groups as a recreational drug.  

The final line of the book states that "[Impotence] is not history". One does get the sense from McLaren's book that the currently dominant medical view is far from invulnerable. Whatever future developments take place, one also gets the sense that Impotence: A Cultural History will be important reading for anyone with a serious interest in this area.  

© 2008 Tony O'Brien

Tony O'Brien RN, MPhil, Senior Lecturer, Mental Health Nursing, University of Auckland, a.obrien@auckland.ac.nz

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