Special Topic on Psychogenic Hysteria: In-depth Investigation and Prevention of Epidemic Vaginal Shrinkage in Hainan Island
Retracted penis syndrome or vaginal retraction syndrome is a psychosomatic disorder. At the Third National Conference of Neuropsychiatry of the Chinese Medical Association, doctors including Ye Tingwei presented an investigation report on the epidemic of retracted penis syndrome in Hainan Island, confirming it as a psychogenic hysteria. This type of mental illness with psychological causes is closely related to social culture, religious beliefs, and superstitious beliefs; it occurs not only in Hainan Island but also in other culturally closed and underdeveloped areas.
From late 1984 to early 1985, a condition known as "epidemic penile retraction syndrome" spread in Danxian County and other areas of Hainan Island, which was believed by the locals to be caused by supernatural forces. Male patients experienced a sudden retraction of their penis into their abdomen; female patients felt their genitals and breasts gradually retracting. The syndrome began in November 1984, initially appearing in Lingao and Danxian, and then spreading south and southeast, affecting more than ten districts and towns.
The condition lasts for up to 10 months, and the majority of patients are male adolescents, with 85.8% under the age of 30, and approximately 80% being male. Historically, penile retraction syndrome has a long history in my country. As early as the pre-Qin period, the "Huangdi Neijing" recorded that "if the penis retracts into the abdomen, it is incurable." The "Danxian County Gazetteer" of Hainan Island in the second year of the Tongzhi reign of the Qing Dynasty (1864) also recorded that "if the penis retracts into the abdomen, it is incurable."
Clinically, most patients experience a sudden and rapid onset of illness. Before the onset, they all experience varying degrees of anticipatory anxiety or a sense of impending death, sometimes accompanied by shortness of breath, chest tightness, palpitations, profuse sweating, and other autonomic symptoms. This is followed by numbness, coldness, pain, and twitching in the genital area, with the patient feeling that their penis or breasts are gradually shrinking. They are in a state of extreme fear and often tightly grip their penis, breasts, or vulva.
At this time, relatives or neighbors will rush over and nervously help the patient grasp the penis or breast, while simultaneously feeding the patient large amounts of chili sauce, ginger, and garlic juice. Alternatively, they may rub the genitals or breasts with chili, garlic, and ginger, and bang bowls, basins, buckets, or firecrackers to drive away evil spirits; some patients may pull out their own penis to request treatment, or have relatives hold their penis or breasts while they seek treatment.
After the onset of the disease, most patients present with symptoms such as nervousness, pale complexion, panic, confusion, hallucinations, night sweats, chills, and cold extremities. Below are two transcribed accounts of patients with penile retraction syndrome: Case 1: Male, 18 years old, single, a rural student from village X. He said, "On the night of May 20, 1985, I woke up in the middle of the night feeling pain and numbness in my genitals."
“I reached out and touched my penis, but it was gone, leaving only a tiny bit the size of a finger joint. It was shrinking and disappearing. I screamed ‘Help!’ and my family and neighbors grabbed my penis. They also covered me with a fishing net and whipped my whole body with peach branches. They said they had caught a ghost in the net, a female fox spirit that collects men’s penises.”
"They pulled hard on my penis. It didn't hurt when they whipped me with a peach tree, but it hurt a bit when they pulled on my penis. After about an hour, I felt much better. But around 2 a.m., I felt my penis retracting again. They repeated what they had done. My penis didn't come out until they 'killed' the vixen."
Case 2: Male, 20 years old, single, an accountant from a rural area in Zhanjiang. He said: "On May 14, 1985, I was reviewing my night school lessons at home when I suddenly heard a commotion and the sound of firecrackers. I went out to ask my neighbor what was going on, and the neighbor said: 'It's haunted, people are encountering it everywhere!' People are saying that ghosts have caused men's genitals and women's breasts to shrink into their abdomen or chest cavity."
“At 10:20 p.m., I saw the window open and heard someone jump into the bedroom. I lit a torch to search, but found nothing unusual, so I went back to bed. I felt something in front of me, but when I reached out to touch it, there was nothing there. I felt a chill and couldn’t sleep even after going back to bed; I was shivering. Suddenly, I felt my genitals retracting into my abdomen, and I tried to grab them.”
“I couldn’t feel it anymore, only a tiny bit remained. I ran out and asked my neighbors for help. One neighbor immediately lit firecrackers, banged gongs and drums; another neighbor used a fishing net to trap me underneath, then clamped my left middle finger tightly with two chopsticks. Other neighbors took turns pulling on my genitals while they kept banging the drums, slashing the floor with a kitchen knife and shouting: ‘Ghost, come out!’”
“They also hit me with their shoes. Actually, they were hitting a ghost, shouting as they hit me, ‘Ghost, come out! If you stay inside, we’ll kill you!’ I didn’t feel any pain. I was just very scared. I thought I was going to die... My penis started bleeding. They hung a picture of Zhong Kui on my bed and lit incense so that he would protect me.”
Based on the two cases above, "shrinking yang syndrome" belongs to a type of psychogenic mental illness, and its occurrence is closely related to social culture, religious beliefs, and superstitious beliefs. In particular, the legend of shrinking yang syndrome gradually spread from one village to another, creating an "unstoppable" "contagious disease." Amid this propaganda, every household prepared emergency items such as chili peppers, ginger, and garlic to ward off evil spirits.
The influence of environmental and material factors, coupled with the village's closure and prohibition of villagers from entering or leaving, and the firing of guns at night to drive away ghosts, amplified the intensity of suggestion, putting the patient in a state of extreme fear. Once the patient is subjected to sudden stimulation, such as being exposed to cold wind, getting chilled while bathing, or shivering after urinating, they will believe that they are about to have an attack, associate it with genital retraction syndrome, scare themselves, and cause inner tension.
Prevention and treatment of this disease must start with addressing its psychogenic pathogenesis. Most importantly, it's crucial to dispel superstitions; from a normal physiological perspective, this condition is fundamentally unacceptable. Therefore, strengthening the dissemination of scientific and health knowledge and popularizing sex education may prevent or even eliminate the occurrence and spread of penile shrinkage.