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Exploring the use of viagra in place of animal and plant potency products in traditional chinese medicine

Exploring the use of Viagra in place of animal and plant potency products
in traditional Chinese medicine

W I L L I A M V O N H I P P E L 1 ∗, F R A N K A . V O N H I P P E L 2 , N O R M A N C H A N 1A N D C L A R A C H E N G 31School of Psychology, University of New South Wales, Sydney 2052, Australia, 2Department of Biological Sciences, University of AlaskaAnchorage, 3211 Providence Drive, Anchorage, AK 99508-4614, USA, and 3Department of Psychology, Ohio State University, 1885 Neil Avenue,Columbus, OH 43210, USADate submitted: 17 August 2004 Date accepted: 24 August 2005 treatment for a problem of such personal significance andscope, the possibility emerged that other treatments of Recently, conservationists have debated whether
unknown efficacy might rapidly disappear.
consumers of animal and plant potency products
One such set of treatments happens to be of conservation used to treat erectile dysfunction (ED) in traditional
concern, specifically, the consumption of animal and plant Chinese medicine (TCM) might be switching to Viagra,
potency products derived from threatened species, prescribed consequently consuming fewer of these animals and
by practitioners of traditional Chinese medicine (TCM). A plants. To address this question, a survey examined
number of animal and plant products are consumed in this the medical decisions of male consumers of TCM in
tradition to treat ED (Bensky & Gamble 1993), and some Hong Kong who were over the age of 50. As predicted,
of these animals and plants are threatened with extinction these consumers reported selectively switching to
(IUCN [World Conservation Union] 2000), in part because Western medicines to treat ED, but not to treat other
of the collection that takes place to serve the TCM market (for health ailments. These findings provide support for the
example see Gaski & Johnson 1994; Gaski 1998; von Hippel & possibility that Viagra may have conservation benefits
von Hippel 2002). For these reasons, when Viagra was for certain species.
introduced to the market, we suggested that it might reduce Keywords: animal potency products, erectile dysfunction, trade in animal sexual potency products (von Hippel & von threatened species, trade, traditional Chinese medicine, In response to our suggestion that TCM consumers might be switching from animal potency products to Viagra, andthat such a switch might be responsible for decreased trade INTRODUCTION
in certain animal parts, Hoover (2003) presented a two-part Chinese people drive cars, talk on mobile phones and have rebuttal. His first claim was that the preliminary evidence used computers to transform their way of life. Despite deep- reported in our research regarding reindeer velvet and seal seated mistrust of Western ways, these products have become penises was misleading because data from other species in ubiquitous in China. British people drink tea, eat rice and have other sites and other years did not support these conclusions.
used gunpowder to transform their way of life. Despite deep- His second claim was that Viagra was not having an impact seated mistrust of Eastern ways, these products have become on trade in animal products because TCM consumers were ubiquitous in the United Kingdom. Why should Viagra be extremely unlikely to switch to Western medicines and unable to cross cultural boundaries (Hoover 2003) when other treatments. This conclusion was based on prior research (Lee et al. 1998) in which he and his co-authors documented a Prior to the commercial availability of Viagra in 1998, no great deal of suspicion toward Western medicine on the part of product in any medical tradition had been demonstrated in TCM consumers. As Hoover and his colleagues have variously double-blind studies to be an effective and non-intrusive noted to the media and in print, the advent of aspirin did not treatment of erectile dysfunction (ED). With the advent of eliminate the demand for rhinoceros horn and thus the advent Viagra, the ED treatment landscape in Western medicine of Viagra was unlikely to have an impact on the demand for changed from procedures that were highly disruptive, painful or involved surgical manipulation to the act of swallowing a We suggest, however, that failure to achieve an erection is pill. With this sudden availability of a simple and effective not directly comparable to having a headache, a fever, arthritisor the many other ailments for which consumers still preferTCM treatments. Perhaps the most relevant manner in whichtreating ED differs from these other ailments lies in the fact ∗ Correspondence: Dr William von Hippel e-mail: w.vonhippel@ that the effect of Viagra is visible and immediate, whereas the effect of most Western medicines is hidden and often delayed.
Additionally, ED is a problem of great importance to quality of life (National Institute of Health Consensus Conference 1993).
Previous TCM
Thus, it is possible that Viagra will make inroads in a market Current TCM
that has previously been resistant to Western treatments Current Western
(von Hippel & von Hippel 2004). To test this possibility, we conducted a survey of TCM consumers in Hong Kong.
The goal of this survey was to assess whether these TCM consumers showed any evidence of selective switching to aWestern medicine for the treatment of ED, but not for other Number of People 20
Figure 1 Frequency counts reflecting usage of TCM and Western
In January 2004, we surveyed Hong Kong men aged 50 and medical treatments for four different health problems. ∗ p < 0.05, ∗∗ p < 0.01, ∗∗∗ p < 0.001.
over who were consumers of TCM. ED is associated with age;approximately 48% of men aged 50 and over experience somedegree of ED (Feldman et al. 1994). By choosing only menaged 50 and over, we increased the probability that some would be consuming products designed to treat ED. By choosingonly consumers of TCM, we were able to provide the clearest If consumers of TCM products are selectively switching to test of the hypothesis that consumers of TCM products are Viagra as a treatment for ED, then they should be less likely selectively switching to Viagra. People of unknown medical to be currently taking a TCM remedy for ED than to have habits may be a blend of consumers of TCM and Western previously taken such a treatment. Similarly, they should be medicines, and thus data from such individuals would be more likely to be currently taking a Western remedy than a ambiguous with regard to whether TCM consumers are TCM remedy for ED. In contrast, consumers of TCM should switching to Viagra. We conducted the study in Hong Kong be equally or more likely to be currently taking a TCM remedy because it is a globally-significant TCM marketplace and for arthritis, indigestion or gout than to have previously taken perhaps the best model for global TCM trends (Lee et al. such a treatment. Similarly, they should be less likely to be currently taking a Western remedy for arthritis, indigestion Recruitment was achieved by approaching Chinese men or gout than to be currently taking a TCM remedy for these who were seeking treatment in a large TCM clinic in Hong ailments. To test these predictions, frequencies of responses Kong and appeared to be over the age of fifty, and asking if they for each health problem were tallied.
would be willing to participate in our survey on ‘Men’s health Comparisons of previous to current use of TCM treatments over fifty’. With the consent of the participating clinic, the were as predicted (Fig. 1). A greater number of participants men were approached by a male native-Cantonese-speaking indicated that they are currently taking a TCM remedy for experimenter, who wore a laboratory coat and a name-tag arthritis, indigestion and gout than indicated that they had that accurately identified himself as a psychologist. The previously taken such a remedy. This difference was not experimenter explained in Cantonese that he was conducting significant in the case of arthritis (χ2(1) = 1.33, p > 0.20), a survey of men’s health over the age of 50, and asked if but was significant in the case of indigestion (χ2(1) = 4.00, they were age 50 or over and willing to answer a few questions p < 0.05) and gout (χ2(1) = 4.17, p < 0.05). In contrast, in about their health behaviour. Two-hundred-and-fifty-six men the case of ED, a greater number of participants indicated that between the ages of 50 and 76 (mean = 55.5, SD = 6.8) agreed they had previously taken a TCM treatment than indicated that they are currently taking such a treatment (χ2(1) = 12.60, The experimenter then asked participants to indicate whether they had previously taken, were currently taking, Perhaps the most important comparison involves current or had never taken a TCM remedy for four different use of TCM versus Western treatments. Here, the results are health problems. Participants responded to this question again consistent with the hypothesis that TCM consumers regarding arthritis, digestion problems, ED and gout. The are selectively switching to Western treatments only for ED same question was then asked about these four maladies, but and not for the other ailments (Fig. 1). If we eliminate the participants were now asked whether they had previously consumers who report that they are currently using both TCM taken, were currently taking, or had never taken a Western and Western treatments, analyses indicate that participants remedy for each of these ailments. After answering these were significantly more likely to be currently taking a TCM questions, participants were paid HK$ 50 in the form of treatment than a Western treatment for arthritis (χ2(1) = 8.33, a traditional New Year’s gift and were thanked for their p < 0.01), indigestion (χ2(1) = 14.88, p < 0.001) and gout (χ2(1) = 6.25, p < 0.05). In contrast to this general preference treat ED. When interviewed in a TCM clinic while waiting Prev TCM/Curr West
to see a TCM practitioner to treat a health problem, our Prev West/Curr TCM
respondents provided three key findings. First, they were more likely to have previously tried a TCM treatment for ED than to be currently using a TCM treatment for ED (Fig. 1).
Second, they were more likely to be currently using a Western treatment for ED than a TCM treatment for ED (Fig. 1).
Third, for those consumers who reported previously treating Number of People
their ED, several had switched from a TCM treatment to a Western treatment whereas none had switched from a Western treatment to a TCM treatment (Fig. 2). These findings stand Arthritis
in contrast to their behaviour regarding other health maladies,for which they were more likely to be currently using a TCM Figure 2 Frequency counts reflecting people who have previously
treatment than to have previously used such a treatment, more used a TCM treatment but are currently using a Western likely to be currently using a TCM treatment than a Western treatment, and people who have previously used a Western treatment (Fig. 1), and more likely to have switched from treatment but are currently using a TCM treatment for four a Western treatment to a TCM treatment than vice-versa Perhaps because achieving an erection is so important to life satisfaction (National Institute of Health Consensus for TCM treatments, these men were more likely to be Conference 1993), or perhaps because the effects of Viagra are currently taking a Western treatment than a TCM treatment apparent to the naked eye, TCM consumers seem willing to for ED (χ2(1) = 5.40, p < 0.05). All of these analyses remain switch from their traditional medical practices to embrace a significant if the consumers who report that they are currently treatment that does not address underlying imbalances as the using both TCM and Western treatments are split evenly cause of physical maladies. It should be noted, however, that between the two categories (four consumers of ED treatments, a few of our TCM consumers spontaneously mentioned that seven consumers of arthritis treatments, 22 consumers of although they thought Viagra was better than TCM products digestion treatments and seven consumers of gout treatments).
at enabling them to achieve an erection on demand, they Finally, we examined those consumers who stated that they nevertheless felt that the underlying cause of ED was not had previously used either Western or TCM treatments for treated by Viagra and was more effectively addressed by TCM the different ailments, to assess whether these individuals approaches (reflected in the fact that four participants were had then switched to current use of a TCM or Western currently relying on both TCM and Western treatments of treatment (Fig. 2). Here again the pattern was consistent with ED). This sentiment is consistent with the findings of Lee the other findings, such that participants were more likely to et al. (1998) and it demonstrates that, even in a case as clear- switch from Western to TCM treatments than from TCM cut as having an erection or not, some consumers may adopt to Western treatments in all cases except ED, where the a blend of approaches that represents what they regard as the pattern was reversed. More specifically, analyses revealed best practices of various traditions.
that participants were more likely to have switched from The current results are consistent with the possibility that previous use of a Western treatment to current use of a TCM Viagra is reducing trade in threatened species used to treat treatment than vice-versa for arthritis, indigestion and gout, ED. Although Hoover (2003) provides trade data for a variety although sample sizes were only large enough in the case of of species, such as seahorses, that are inconsistent with this indigestion to analyse statistically (χ2(1) = 5.54, p < 0.02). In possibility, our survey results are consistent with the failure contrast to these findings, in the case of ED, participants were of the seal penis market to show a rebound in price or volume more likely to have switched from previous use of a TCM (Department of Fisheries and Oceans 2003). Thus, at this treatment to current use of a Western treatment than vice- point, findings with the international trade data must be versa (although sample sizes were again too small for reliable regarded as mixed with regard to our hypothesis.
statistical analyses). Indeed, not a single participant who was In the case of the Canadian seal trade, despite the 2001 a previous user of a Western treatment for ED reported being and 2002 resurgence in the harvest of harp seals (Phoca a current user of TCM for ED, suggesting that previous users groenlandica) as a result of improved markets for pelts and oil of Western treatments for ED were simply not taking any (Panel on Seal Management 2001; Department of Fisheries treatment for the problem at the current time.
and Oceans 2003), there has been no commensurate surge inthe sale of these animals’ genitalia (Department of Fisheriesand Oceans 2003). It is our prediction that the price of DISCUSSION
seal penises will remain low and the market for them will The results of this survey support the hypothesis that TCM remain limited, reflecting a permanent decline in demand.
consumers are selectively switching to Western medicines to Seal penises currently have little use outside of the animal potency trade, and thus their trade provides a relatively clear Department of Fisheries and Oceans (2003) Atlantic seal hunt 2003– picture of the impact of Viagra and other new ED drugs on 2005 management plan. Fisheries and Oceans Canada, Ottawa, the consumption of TCM animal sexual potency products.
This depressed trade in seal penises, in combination with our Feldman, H.A., Goldstein, I., Hatzichristou, D.G., Krane, R.J. & survey of TCM consumers, indicates that Viagra and other McKinlay, J.B. (1994) Impotence and its medical and psychosocialcorrelates: results of the Massachusetts Male Aging Study. The new ED drugs may be having a conservation benefit, at least Journal of Urology 151: 54–61.
with regard to certain animal species.
Gaski, A.L. (1998) While supplies last. The sale of tiger and other The TCM pharmacopeia includes many species of endangered species medicines in North America. 1996–1997.
threatened plants and animals that are not used primarily to TRAFFIC North America, Washington, DC, USA.
treat ED (Bensky & Gamble 1993). The species used primarily Gaski, A.L. & Johnson, K.A. (1994) Prescription for extinction: to treat ED represent only a small fraction of threatened- endangered species and patented oriental medicines in trade.
species use, and all of these species are also used to treat at TRAFFIC International, Cambridge, UK.
least some other ailments. It is not clear whether other Western Hoover, C. (2003) Response to ‘Sex, drugs and animal parts: will medicines will eventually make inroads in the treatment of Viagra save threatened species?’ by von Hippel and von Hippel.
these ailments among TCM consumers, but our data on Environmental Conservation 30: 317–318.
selective switching for ED suggests that they have not done IUCN (2000) The 2000 IUCN Red List of Threatened Species. Cam- bridge, UK: IUCN Publications Service Unit. Searchable database so yet. Therefore, comprehensive conservation strategies are [www document]. URL necessary to reduce harvests of all threatened species used in TCM. Already, conservation groups such as the World Wide Lee, S., Hoover, C., Gaski, A. & Mills, J. (1998) A world apart? Fund for Nature (WWF), TRAFFIC and Project Seahorse Attitudes toward traditional Chinese medicine and endangered have engaged TCM groups to conserve the very species upon species in Hong Kong and the United States. TRAFFIC East Asia, which TCM depends. But the shift in TCM practices toward TRAFFIC North America, World Wildlife Fund Washington, a conservation ethic will need to be accelerated if it is to reverse National Institute of Health Consensus Conference (1993) Impotence. NIH consensus development panel on impotence.
Journal of the American Medical Association 270: 83–90.
Panel on Seal Management (2001) Report of the eminent panel on seal management. Communication Branch, Fisheries and Oceans This manuscript was greatly improved by the thoughtful comments of two anonymous reviewers. This research was von Hippel, F.A. & von Hippel, W. (1998) Solution to a conservation supported by research grants from Pfizer Inc.
problem? Science 281: 1805.
von Hippel, F.A. & von Hippel, W. (2002) Sex, drugs, and animal parts: will Viagra save threatened species? Environmental References
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von Hippel, W. & von Hippel, F.A. (2004) Is Viagra a viable Bensky, D. & Gamble, A. (1993) Chinese Herbal Medicine. Materia conservation tool? Response to Hoover, 2003. Environmental Medica. Revised Edition. Seattle, USA: Eastland Press, Inc.
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