Priapus and the Spider Dance
Priapism (named for Priapus (“lecher” in Latin), the “phallically acromegalic” Graeco-Roman God of male procreativity, and the guardian of vineyards and gardens) is a form of functional impotence that was first described by Tripe in 1845(5), and is today classified as an emergency medical condition. It is a condition of near permanent engorgement of the shaft of the penis (but not the glans) – generally in the absence of sexual arousal, and which produces considerable pain and discomfort. As the pain results from blood trapped in the penis becoming deoxygenated and acidic, priapic engorgement can result in permanent loss of erectile function if left untreated for prolonged periods. Hence, unless the engorging blood is drained from the shaft (often through invasive means – syringe and needle methods), the condition can lead to the destruction of the spongy tissues in the penis, and permanent dysfunction. In extreme cases, priapism has resulted in rupturing of the corpus cavernosum or breakage to the surrounding circular ligament, and even death (due to blood clots forming and travelling to the heart).
Although 60% of priapism cases are idiopathic, most of the remaining 40% are associated with overdoses of the injectable drugs prescribed for impotence. Nevertheless, certain antidepressants (such as Desyrel) – particularly when taken in combination with St Johns Wort, and antipsychotics (such as thorazine and chlorpromazine), antihypertensives (such as Prazosin) and many blood-thickening drugs can have the same effect. More recently, cases of priapism have been reported following the misuse of sildenafil citrate (Viagra). Additionally, penile engorgement is a symptom of certain disease conditions, such as sickle cell anaemia, myeloma, thalassaemia and leukaemia, and (rarely) penile cancer. Priapic symptoms are also characteristic of gonorrhea (where it is termed “chordee”, and is usually accompanied by a downward curvature of the penis). Pathological penile engorgement can occur following an injury to the spinal cord or as the result of a bite from the Black Widow or Phoneutria spider.
Whilst many general practitioners and non-specialists are unfamiliar with priapism, professional urologists will determine the precise nature of the swelling (such as whether or not any penile blood exchange can be detected) and treat the engorgement with systemic decongestants (pseudoephedrine, terbutaline or salbutamol) or anticonvulsants/antineuralgics (e.g. Gabapentin), followed by needle aspiration (as mentioned above) and injections of heparin with saline. In cases resistant to such intervention, reversing agents such as metaraminol may be injected into the corpus cavernosum.
Given the potentially severe consequences of priapism, it is not a condition amenable to lay practitioners or natural medicine specialists and, therefore, any patient/client requesting treatment for such a complaint should be immediately directed to the nearest accident and emergency clinic. Nevertheless, emergency aid can be offered in cases of persistent erection lasting up to three or four hours, and for follow-up treatments aimed at reducing recurrence and avoiding infection. Just as in the case of modern medicine, natural options would be dependent upon the exact nature of the condition (and its root cause), but recommendations could include the application of icepacks to reduce swelling and the ingestion of ephedra (as a decongestant) and garlic (as a blood-thinning agent and serum antiseptic).
Historically, herbalists have prescribed a variety of substances for the treatment of priapism.
An early example was the external application of Hemlock (Conium maculatum), as recommended by Dioscorides. In the Nineteenth Century, physicians would apply leeches to remove the stagnant blood (akin to needle aspiration today). Herbal prescriptions have also included the catkins of Salix nigra (Black Willow buds) and the preferred, if illegal, choice: Cannabis indica(6) – which, in 1919, was proposed by Finley Ellingwood as “an excellent remedy in gonorrhea with sexual hyperaesthesia. Here its influence is prompt; it arrests chordee, priapism and spermatorrhea…It controls violent erection and soothes the mental anxiety which aggravates the symptoms.”
Such physiological disorders as priapism and persistent sexual arousal disorder (both of which are disconnected with true sexual desire), share an essential feature in common, the sensation of “persistent physiological arousal in the absence of conscious feelings of sexual desire…[where] no obvious hormonal, vascular, neurological, or psychological causes [can be] identified as underlying the symptoms...”(7). In contrast, hyperactive sexuality phenomena (known historically and colloquially as Satyrism in the male and nymphomania in the female, and often associated with underlying manic psychopathologies such as ADHD and bipolar disorders) require a more holistic psycho-physiological approach. Therefore, in addition to offering counselling (preferably with both partners of the client’s relationship – if one is established) specific herbal remedies can be recommended to reduce the distressful physiological, social and emotional consequences associated with such “uncontrollable licentiousness”.
Although 60% of priapism cases are idiopathic, most of the remaining 40% are associated with overdoses of the injectable drugs prescribed for impotence. Nevertheless, certain antidepressants (such as Desyrel) – particularly when taken in combination with St Johns Wort, and antipsychotics (such as thorazine and chlorpromazine), antihypertensives (such as Prazosin) and many blood-thickening drugs can have the same effect. More recently, cases of priapism have been reported following the misuse of sildenafil citrate (Viagra). Additionally, penile engorgement is a symptom of certain disease conditions, such as sickle cell anaemia, myeloma, thalassaemia and leukaemia, and (rarely) penile cancer. Priapic symptoms are also characteristic of gonorrhea (where it is termed “chordee”, and is usually accompanied by a downward curvature of the penis). Pathological penile engorgement can occur following an injury to the spinal cord or as the result of a bite from the Black Widow or Phoneutria spider.
Whilst many general practitioners and non-specialists are unfamiliar with priapism, professional urologists will determine the precise nature of the swelling (such as whether or not any penile blood exchange can be detected) and treat the engorgement with systemic decongestants (pseudoephedrine, terbutaline or salbutamol) or anticonvulsants/antineuralgics (e.g. Gabapentin), followed by needle aspiration (as mentioned above) and injections of heparin with saline. In cases resistant to such intervention, reversing agents such as metaraminol may be injected into the corpus cavernosum.
Given the potentially severe consequences of priapism, it is not a condition amenable to lay practitioners or natural medicine specialists and, therefore, any patient/client requesting treatment for such a complaint should be immediately directed to the nearest accident and emergency clinic. Nevertheless, emergency aid can be offered in cases of persistent erection lasting up to three or four hours, and for follow-up treatments aimed at reducing recurrence and avoiding infection. Just as in the case of modern medicine, natural options would be dependent upon the exact nature of the condition (and its root cause), but recommendations could include the application of icepacks to reduce swelling and the ingestion of ephedra (as a decongestant) and garlic (as a blood-thinning agent and serum antiseptic).
Historically, herbalists have prescribed a variety of substances for the treatment of priapism.
An early example was the external application of Hemlock (Conium maculatum), as recommended by Dioscorides. In the Nineteenth Century, physicians would apply leeches to remove the stagnant blood (akin to needle aspiration today). Herbal prescriptions have also included the catkins of Salix nigra (Black Willow buds) and the preferred, if illegal, choice: Cannabis indica(6) – which, in 1919, was proposed by Finley Ellingwood as “an excellent remedy in gonorrhea with sexual hyperaesthesia. Here its influence is prompt; it arrests chordee, priapism and spermatorrhea…It controls violent erection and soothes the mental anxiety which aggravates the symptoms.”
Such physiological disorders as priapism and persistent sexual arousal disorder (both of which are disconnected with true sexual desire), share an essential feature in common, the sensation of “persistent physiological arousal in the absence of conscious feelings of sexual desire…[where] no obvious hormonal, vascular, neurological, or psychological causes [can be] identified as underlying the symptoms...”(7). In contrast, hyperactive sexuality phenomena (known historically and colloquially as Satyrism in the male and nymphomania in the female, and often associated with underlying manic psychopathologies such as ADHD and bipolar disorders) require a more holistic psycho-physiological approach. Therefore, in addition to offering counselling (preferably with both partners of the client’s relationship – if one is established) specific herbal remedies can be recommended to reduce the distressful physiological, social and emotional consequences associated with such “uncontrollable licentiousness”.
Numerous plant species have been attested to exert an aphrodisiac effect (very few of which have any scientific evidence). A Pubmed search for “aphrodisiac” yielded 482 hits (in early October 2012) - the majority of which report animal model studies, with far from all indicating substantiated positive results.
In contrast,, very few plants have been documented to have the reverse effect - afterall, “for as long as humans have been having sex, they've been struggling to get in the mood.” (Neal Santelmann, Forbes.com). Far more often, reduced libido is cited as an undesirable side-effect of various medications (such as Atomoxetine - a selective norepinephrine reuptake inhibitor used for ADHD). Indeed, this side-effect, observed in patients placed on selective serotonin re-uptake inhibitors (SSRI antidepressants) has been so effective that it is now commonly used as a specific treatment for “obsessive sexual preoccupation”. Further, the drug-treatments forced upon sex offenders to reduce the libidinous aspect of their psychopathology include antihormonals (such as cyproterone acetate and medroxyprogesterone acetate) and luteinizing hormone-releasing hormone agonists. The anti-priapic drug, Trazodone, has also had some success in treating female sexual hyperactivity, as has another chemical agent normally used for the treatment of bipolar disorder (Depakote).
Interestingly, although hormone replacement therapy has been shown to have a markedly beneficial effect in increasing libido in menopausal women, this effect is counteracted if hormones are ingested (orally administered) – this is due to the so-called “bolus-effect” which “induces the liver to increase its production of a substance, "sex hormone binding globulin" (SHGB) which binds to circulating testosterone, leaving less "unbound" or "free" testosterone available to maintain libido. This is not well known and is often not recognized as a cause for a diminished libido.” - (Dr. Nosanchuk).
Despite the apparent lack of interest(8), members of religious orders and the military, along with, one might suspect, apothecaries involved with treating the exhausted "other half" of an over-amorous spouse; have found a few solutions through the ages. Indeed, the British Military of the Nineteenth Century reputedly laced the soldiers’ tea with bromide salts to reduce their “randiness” and “excitability of the brain”. Bromides were, at the time, widely used as sedatives; and the effect on libido was likely a lucky (or unlucky!) happenstance. Old-wives-tales still abound in many militaries that the food or beverages for the recruits are laced either with bromide or potassium nitrate (“Saltpetre”) to reduce the urges of the enlisted men. Veteran soldiers (including those in the pharmaceutical and medical divisions) frequently give witness to cast doubt on this as a true occurrence. No solid evidence exists to substantiate Saltpetre’s reputation as an anaphrodisiac, and the substance is actually quite toxic if taken in any abundance – it can cause anemia, methemoglobinemia, headache, stomach upset, dizziness, kidney damage, and can raise one's blood pressure to a dangerous level.
One would assume, therefore, that such a debilitating compound would be disadvantageous if fed to a modern military unit and a more likely cause for the average soldier’s declining sexual activity might simply be sheer stress and fatigue!
In contrast,, very few plants have been documented to have the reverse effect - afterall, “for as long as humans have been having sex, they've been struggling to get in the mood.” (Neal Santelmann, Forbes.com). Far more often, reduced libido is cited as an undesirable side-effect of various medications (such as Atomoxetine - a selective norepinephrine reuptake inhibitor used for ADHD). Indeed, this side-effect, observed in patients placed on selective serotonin re-uptake inhibitors (SSRI antidepressants) has been so effective that it is now commonly used as a specific treatment for “obsessive sexual preoccupation”. Further, the drug-treatments forced upon sex offenders to reduce the libidinous aspect of their psychopathology include antihormonals (such as cyproterone acetate and medroxyprogesterone acetate) and luteinizing hormone-releasing hormone agonists. The anti-priapic drug, Trazodone, has also had some success in treating female sexual hyperactivity, as has another chemical agent normally used for the treatment of bipolar disorder (Depakote).
Interestingly, although hormone replacement therapy has been shown to have a markedly beneficial effect in increasing libido in menopausal women, this effect is counteracted if hormones are ingested (orally administered) – this is due to the so-called “bolus-effect” which “induces the liver to increase its production of a substance, "sex hormone binding globulin" (SHGB) which binds to circulating testosterone, leaving less "unbound" or "free" testosterone available to maintain libido. This is not well known and is often not recognized as a cause for a diminished libido.” - (Dr. Nosanchuk).
Despite the apparent lack of interest(8), members of religious orders and the military, along with, one might suspect, apothecaries involved with treating the exhausted "other half" of an over-amorous spouse; have found a few solutions through the ages. Indeed, the British Military of the Nineteenth Century reputedly laced the soldiers’ tea with bromide salts to reduce their “randiness” and “excitability of the brain”. Bromides were, at the time, widely used as sedatives; and the effect on libido was likely a lucky (or unlucky!) happenstance. Old-wives-tales still abound in many militaries that the food or beverages for the recruits are laced either with bromide or potassium nitrate (“Saltpetre”) to reduce the urges of the enlisted men. Veteran soldiers (including those in the pharmaceutical and medical divisions) frequently give witness to cast doubt on this as a true occurrence. No solid evidence exists to substantiate Saltpetre’s reputation as an anaphrodisiac, and the substance is actually quite toxic if taken in any abundance – it can cause anemia, methemoglobinemia, headache, stomach upset, dizziness, kidney damage, and can raise one's blood pressure to a dangerous level.
One would assume, therefore, that such a debilitating compound would be disadvantageous if fed to a modern military unit and a more likely cause for the average soldier’s declining sexual activity might simply be sheer stress and fatigue!