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 Arthritis Indigestion 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 Indigestion
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.
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Hoover, C. (2003) Response to ‘Sex, drugs and animal parts: will
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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 http://www.redlist.org/search/search-
necessary to reduce harvests of all threatened species used in
TCM. Already, conservation groups such as the World Wide
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STRAND: Life processes in plants and animals Grade 11: Life processes related to homeostasis Different organisms need support, transport and excretory systems, which differ in relation to size, surface area to volume ratio AND type of habitat (aquatic or terrestrial). There is a relationship between transport and excretion systems of larger organisms and gaseous exchange mechanisms [
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