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A woman in Nigeria narrowly escaped a recent lynching from an enraged crowd after a market trader claimed she had stolen his penis. This is an example of Koro, (as it is most commonly known in the West), a belief that the genitals have been stolen, or in other parts of the world, that they are fatally shrinking into the body. Bizarre as it sounds, the belief in Koro is several thousand years old and occurs internationally. This article examines historical and contemporary accounts of Koro and looks at some of the explanations for this intriguing phenomenon.

Belief in fatally retracting genitals, or a belief in genital theft, is usually known by the name 'Koro'. The word is of uncertain origin but is thought to derive from the Malaysian word for tortoise, (sometimes locally used as a slang term for the penis), perhaps with a nod to the tortoises' ability to retract its head into its body. It takes several forms, including a fast spreading social belief that tends to cause panics and widespread concern, and a more isolated form, usually the problem of a lone individual.

Koro as a social belief

To many people it is perhaps surprising that a belief in Koro can be particularly widespread but this belies that fact that the belief has a long and distinguished history. It is first mentioned in China (known there as 'suo-yang') where it is cited in the ancient Chinese text 'The Yellow Emperor's Classic of Internal Medicine', a traditional medical manuscript which dates from about 300 BC. Similar descriptions appear in Chinese volumes throughout the ages, and the idea exists as a folk belief among some Chinese and Asian peoples today.

Minor Koro epidemics have seized localised parts of Asia at various times, including a well documented 1967 outbreak in Singapore. As the panic spread hospitals became inundated with people worried that their penises were shrinking into their body. Many had resorted to pegs, clamps and even a constant firm grip from concerned family members attempting to prevent the member from vanishing entirely. According to an analysis of the incident reported in the Singapore Medical Journal, the panic stemmed from rumours that pork, poisoned from a swine fever inoculation, was causing genital shrinkage. Similar outbreaks in the Guangdong region in China have been related to an alleged sighting of the beautiful Hu Li Jung, a genital thieving fox spirit traditionally thought to wander the countryside in search of male victims.

In affected parts of Africa, Koro is more commonly related to the work of sorcerers or black magic, and involves alleged penis theft rather than retraction. The belief is of unknown vintage (historical sources are scarce) but periodically creates panics, sometimes resulting in fatal consequences for the unfortunately accused. Recent outbreaks have been reported in Nigeria, Benin and Ghana and usually involve the public accusation of penis theft, often after an unexpected or unwelcome touch from a stranger.

Whilst penis theft would seem a fairly simple charge to refute, victims in an 1990 Nigerian outbreak (reported on by psychiatrist Sunny Ilechukwu) often believed that their penises were returned at the point of public accusation. Some even went as far as undress to prove their accusation to onlookers, subsequently claiming that their 'returned' penis had been replaced but was shrunk, leading them to think it must be a ghost penis or perhaps the wrong one.

Isolated Koro Sufferers

Cases of Koro have also been reported in most nationalities including American, European and Middle-Eastern persons. Sufferers tend to show a couple of marked differences to Asian and African Koro sufferers, mainly that they tend not to believe that genital retraction will be fatal, and that it tends to present more commonly in the context of mental illness, rather than social scares. A recent study reported on three cases of Koro in American males who all formed penis retraction beliefs after smoking Cannabis. In these cases the researchers suggested that Koro was brought on by a combination of pre-existing worries over penis shape, anxiety and bad reaction to situational cannabis use. Perhaps due to a `bad-trip' experience or its ability to trigger or exacerbate psychosis and anxiety in a minority of individuals.

Koro in a Greek Cypriot man was reported in one medical case study from the British Journal of Psychiatry. In this instance the person was concerned that his penis was shrinking into his body, a claim accompanied by depression, psychotic symptoms and heightened anxiety. The gentleman concerned was treated by doctors with mood stabilising and anti-psychotic medication after which his penis-related concerns abated.

Other case studies have reported on Koro after depression following stroke, in relation to phobia for AIDS, after a brain tumour and during schizophrenia. In some cases the individuals had heard about Koro before suffering themselves, an unlikely belief perhaps triggered by later unfortunate events, but in others the belief seemed to arise without previous cultural contact.

In September 2003, a Sudanese merchant was visited by a customer who had travelled to Khartoum from West Africa. The two men became embroiled in an argument during which the West African grabbed the shop-keeper's hand and shook it violently; almost immediately the merchant could feel his penis beginning to shrivel as it withdrew into his body. Terrified at the thought of losing his manhood, the merchant became hysterical and had to be taken to hospital where doctors could find nothing wrong with him.

This was not an isolated incident: in the days afterwards, at least another 40 men were hospitalised after having had their penises ‘stolen' by a mysterious West African.

The shrinking penis panic that swept through Khartoum in 2003 was the latest outbreak of koro, a psychiatric disorder that causes men to believe their penises (or, more rarely, women to believe their labia) have shrunk back into their bodies. Koro usually occurs as isolated cases but in appropriate circumstances it can manifest itself as a wave of panic that sweeps through cities, countries or even entire continents. As a consequence, hospitals and police stations can become clogged with dozens or even hundreds of people all reporting the magical theft of their manhood.

The Khartoum panic of 2003 typifies how mass koro epidemics occur. For weeks the streets had been alive with rumours of a mysterious West African (sometimes called ‘Satan's Friend', at other times identified as a Zionist troublemaker) who was causing men's penises to disappear after shaking their hands. In September, a local newspaper printed the story of the merchant's vanishing manhood; this seemed to raise levels of panic, because afterwards the hospitals were flooded with dozens of hysterical men claiming that their penises had been stolen.

Doctors couldn't find a single case of a missing organ and proclaimed the illness to be psychosomatic - but this didn't stop the local police from rounding up 50 unfortunate foreigners on suspicion of practising sorcery. The panic continued for several days with one Sudanese newspaper reporting that: "The situation has reached the point where a wife accompanying her husband to the front door at home bids him farewell by saying, ‘Be careful not to shake hands with men, but you can shake the girls' hands as much as you want'." As with most koro panics, after a couple of weeks the hysteria died down leaving the Sudanese authorities bemused as to its origin.

In fact, what happened in Khartoum was part of a general wave of koro hysteria that has been sweeping central and western Africa for over a decade. The first traceable outbreak occurred in Nigeria in 1990 when rumours of ‘strangers' who could magically steal penises swept through Lagos.3 The trouble seems to have remained in Nigeria until August 1996, when three suspected penis snatchers were hanged by a mob in neighbouring Cameroon. In the following year, the koro panic spread westwards through Togo, Ghana, Ivory Coast, Senegal and Gambia. In each country there were violent riots that saw dozens of suspected sorcerers lynched; one incident in Nigeria in 2001 claimed the lives of eight Christian evangelists who were burnt to death by an angry mob; another in Ghana caused 12 deaths.

The panic in Khartoum was the most northerly recorded incidence of African koro and is unusual in that Sudan doesn't share a land border with any of the other koro-stricken countries. However, the fact that the Sudanese blamed West African magicians for the vanishing penises suggests that this was the continued expression of the panics that had swept through other African countries between 1990 and 2003 and which still periodically fl are up. (The latest outbreak of African koro occurred in Nigeria in March 2006 when two alleged penis-snatchers were arrested in separate incidents.)

Although Africa has produced the most spectacular episodes of mass koro, the disorder did not originate there. Koro is better known from Southeast Asia where it is linked to large communities of ethnic Chinese workers. (The term is believed to come from the Malay word for a turtle, perhaps because the shrinking penis mimics the way this animal's head withdraws into its shell.) Like the African panics, Asian koro only occurs in closeknit ethnic communities that have a strong belief in the power of ritual magic. This link between ethnicity and koro has led to it being described as a "culture-bound syndrome", which means that only those who believe in the ability for penises to disappear magically will end up experiencing it.

Koro has an ancient history in the Far East, but the most spectacular and best-studied epidemic occurred within the Chinese community living in Singapore. In October 1967, rumours that local pork was impregnated with female hormones led to at least 446 men (and 23 women) turning up at hospitals insisting that their genitals had shrunk. One hospital had 97 patients on a single day and saw several men who had clamped their private parts with various objects so as to halt the perceived shrinkage; others arrived with friends and neighbours hanging onto them.

The Singapore outbreak lasted only a few days and afterwards was the subject of a government-led psychiatric study which concluded that: "…in a susceptible individual, hearsay information about koro, along with pre-existing sexual fears and subjective sensations in the genitalia associated with such phenomena as sexual intercourse, urination, defecation, or trauma, leads to the vicious circle of the delusion of genital shrinkage, attendant panic, and enhanced fears of a delusory nature, with even greater panic and crude attempts to prevent the disappearance of the penis."

Mad, Bad and Dangerous to Know ?

Freud believed that castration anxiety was an important stage of personality development, and although this is not a popular view among psychologists today, it is not difficult to see how Koro beliefs may relate to many common sexual anxieties. Body satisfaction and worries over correct and desirable body shape are also common, and in mental illness they may reach delusional intensity. Body Dysmorphic Disorder is a syndrome where sufferers come to believe that a particular part of their body (often regarded as quite normal by third parties) is particularly ugly, unshapely or undesirable. Whilst there is no evidence that Koro may be directly related to this disorder, it is easy to see how body concerns can be incorporated or even fuel unlikely beliefs.

The type of social Koro that creates panics could be easily dismissed as the result of primitive thinking of superstitious people, but as sociologist Robert Bartholomew has documented, industrialised societies have much modern history of similarly unusual social scares. This includes not one, but several widespread panics sparked by dramatisations of the Orson Welles play `War of the Worlds'. This would suggest that society is great shaper of our beliefs, and we are much more likely to believe what our neighbours believe than we would like to admit.