The Great Koro Epidemic of 1967

Posted by budak under Reflections
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In the year 1967, Singapore was gripped by the fear of shrinking organs, an incident that has enterred the casebooks of psychiatric medical history. (Warning: risque content!)

While trawling the net for entirely innocent factoids, I came across this footnote of local history known as The Great Koro Epidemic of 1967.

Koro is a mental condition in which men become obsessed with their penis (err…. doesn’t this happen all the time?), believing it to be afflicted by shrinkage with the ultimate result of retraction into the body. Some sources cite a role in Chinese metaphysical beliefs, where abnormal sexual acts (visiting prostitutes, masturbation or nocturnal emissions) disturb the yin-yang balance, leading to a loss of the yang (or male) force with accompanying consequences on key organs.

Apparently, countless Singapore men were afflicted with a raging delusion that their penises were shrinking and retracting into the body, a fate which causes mass panic and mortal anxiety. This phenomenon, known as Koro, arose following press reports of Koro cases due to the consumption of pork from a pig that had been inoculated against swine fever. Needless to say, pork sellers had a bad year. The coy headline of the Straits Times on 5 Nov 1967 (A Strange Malady Hits Singapore Men) gave little indication of the true girth of the problem.

Professor Kua Ee Heok of the Department of Psychological Medicine, National University of Singapore, in his monograph, Transcultural Psychiatry, has this to say of Koro:

“Koro refers to a syndrome, which has for its central theme a fear of death due to the person’s conviction that his penis is shrinking into the abdomen. The panic-stricken man often clutches on to his penis with bewildered spouse and relatives assisting. The term koro is thought to derive from the Malay word kura which means “tortoise” – the symbolic meaning is that the penile retraction is compared with the retraction of the head of the tortoise into its shell. The syndrome in traditional Chinese medicine is known as suo-yang, which literally means shrinkage of the male sexual organ. In women it may take the form of retraction of the vulval labia or nipple.

Koro is often viewed as a form of panic disorder with the symptom-complex of fear of penile retraction and impending death, palpitations, sweating, breathlessness and paraesthesia. The factors, which contribute to the occurrence of koro, include beliefs and attitudes pertaining to sexuality. A common Chinese belief is that the loss of semen weakens the body, and loss of yang occurs with masturbation and nocturnal emission. The loss of semen through sexual excesses is thought in traditional Chinese belief to lead to fatal ill-health. Personality traits associated with koro have been described as nervous temperament, suggestibility, sensitivity and immaturity.”

Dr. Kua also cites a report in the Singapore Medical Journal (1963, 4, 119-121) in which Dr. Gwee AL, describes a Koro case involving a male Chinese aged 34, seen on 24 March 1956.

“He was at a cinema show when he felt the need to micturate. He went out to the latrine in the foyer and, as he was easing himself, he felt a sudden loss of feeling in the genital region, and straightaway, the thought occurred to him that he was going to get penile retraction. Sure enough, he soon noticed that he penis was getting shorter. Intensely alarmed, he held on to his penis with his right hand and shouted for help, which however was not forthcoming as the latrine was deserted during the show. He felt cold in the limbs, and was weak all over, and his legs gave way under him. So he sat down on the floor, all this time holding on to his penis. About half an hour later, the attack abated.”

Dr. Gwee also authored a later study (in the Singapore Medical Journal 1969, 10, 234-242) about the 1967 epidemic, which affected over 500 persons. From this report, Kua notes the following sociological background to the outbreak:

“ …before the outbreak of the epidemic, there was concern about chickens being injected with oestrogen to increase their growth. Some men were afraid that the oestrogen in the chicken would cause gynaecomastia and avoided chicken meat. At about the same time, there was a rumour that contaminated pork was being sold on the market and that diseased pigs were being inoculated against swine fever. This triggered off the epidemic and a possible explanation of the outbreak is that the inoculation of the pigs was seen to be similar to the injection of chickens with oestrogen.”

It was also noted that the epidemic “subsided rapidly after ressurance and explanation from the doctors through television, radio and newspaper.”

Chris Buckle of the University of Ottawa, highlights the Singapore Koro Epidemic in his study entitled: A Conceptual History of Koro.

“In July 1967, all swine in the country were inoculated with an anti-swine fever vaccine. It was an event that brought much public concern and considerable media attention.

On October 30th a small Chinese language paper reported that “people developed koro after eating the meat of pigs inoculated with anti-swine fever vaccine”. A few days later, the same paper reported that an inoculated pig had died from penile retraction.”

Within the week, public hospitals were seeing hundreds of koro patients, and Buckle notes that no statistics exist for the presumably high number of individuals who were treated by family or traditional Chinese physicians. It was reported that “men resorted to clamps, pegs, and even weights to ensure that their tackle remained in its rightful place.”

Reflecting perhaps the high degree of public trust in state bodies in those good old days, koro cases increase exponentially following a statement by the then-Ministry of Primary Production (now AVA) that “emphatically denied rumors of pork contamination.” Buckle writes that as a result, “an alarmed Ministry of National Development issued an immediate statement claiming that ‘no one in Singapore need worry over the safety of pork from pigs slaughtered at the government abattoir where every carcass is carefully examined and stamped as fit for human consumption before they are released to the market’”.

The outbreak subsided after press statements by the Singapore Medical Association that “koro is a culturally determined form of emotional ill-health affecting primarily the Chinese…the present incidence of koro is essentially due to fear and rumors which have no foundation”. Meanwhile, advertisements for Australian pork began to appear in the papers. The Chinese-language Nanyang also reported that a man in the ministry of production had apologised for comments about the link between the swine vaccine and koro. The final nail on koro’s coffin came with the televised statement of the Deputy Director of Medical Services, Dr. Lim Guan Ho, who stressed that koro “is only a disease of the mind and the victim requires no medical treatment at all.”

I wonder if any readers of sufficient seniority might have recollections (not necessarily of personal encounters with koro though) of this incident??

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