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Comment on: “History of testosterone therapy through the ages”

International Journal of Impotence Research (2023)Cite this article

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In a recent IJIR contribution Rostom et al. have the history of formal research into androgenic functions of the testicle begin with the well-known 1849 transplantation studies by Arnold Berthold (misspelled “Berthauld”) [1]. This often-made reference appeals to the question of whether early references to testicular functions, including Berthold’s, were based on notions of internal secretion. Berthold’s work identified various organ “sympathies” but in 1849 only briefly inferred that the “strange consensual and antagonistic relation between the individual and reproductive life [Individual- und Gattungsleben]” was “determined by the productive relationship of the testicles, that is, by their influence on the blood and then by the corresponding influence of the blood on the general organism, of which the nervous system makes up a very important part” [2]. Nothing was new. For centuries, relayed notions of a testicular/seminal vapor, ferment, recrement, stimulant or nutrient had an unrivalled explanatory purchase on sex/gender differences and sexual differentiation in the broadest of terms: cognitive, developmental, behavioral, ergogenic. Even Charles-Édouard Brown-Séquard’s 1889 self-injections with preparations of suc testiculaire initially hinged on a then centuries-old proto-endocrinological idea, of semen being reabsorbed into the bloodstream whether entirely or in part, which he sought to exploit for what he called its “dynamogenic” or “nerve-tonic” properties [3]. Where the notion of resorbed semen informed Brown-Séquard’s hypogonadal concept of male aging, hygienist Joseph-Henri Réveillé-Parise (1782–1852) already tied it to oligozoospermia [4]. Contemporaries widely considered Brown-Séquard’s antics pharmacologically unoriginal, even regressive, as animal testicles had always been part of the materia medica. This refers importantly to rooster and boar testicles prescribed as aphrodisiacs or semen augentia (sperm-boosters, or what in India were called śukraśodhana, शुक्रशोधन). However, this usage cannot be called proto-endocrinological where, as multiple authors on the subject suggest, the dietary rationale refers to ancient through early modern concepts of sympathetic medicine (“similia similibus curantur”) rather than, say, seminal reabsorption [5]. This latter concept, of mid-seventeenth-century origin, rather inspired a longstanding and widespread behavioral hygienics concerning masturbation and sexual continence. Brown-Séquard famously got into hot water for advising masturbation incomplète (without ejaculation, “though sufficient to cause some venereal spasms”), for instance [6]. Interestingly, since midcentury this proto-endocrinological reasoning had taken a backseat to neural reflex theories of sexual physiology, such that by the late 1880s seminal resorption was being professed most vocally by American phrenologists, homeopaths, assorted hygienists, and anti-onanists. In short: Brown-Séquard became “the father of endocrinology” and “the father of hormonal therapy” by re-topicalizing what had been a well-established but unproven and therefore waning medical hypothesis, initially applied narrowly to combat the “adynamy” associated with the aging male.

The idea that Berthold would have been “the first to postulate a humoral effect of the testes on distant organs as a general principle and is therefore widely recognized as the ‘Father of Endocrinology’” [7], merits nuancing on the same historical grounds. Experimental and therapeutic interest in semen as containing some resorbable vital force was well-established by the late eighteenth century. In a 1799 work Valeriano Luigi Brera (1772–1840), a substitute professor of clinical medicine at the University of Pavia, mentioned transdermal applications (embrocations, pomades) of lamb, goat or dog semen, in a wider therapeutic system he christened anatripsology [8]. One of the first examples of an emergent interest in transdermal therapies, the two-volume work on the subject saw a fifth edition in 1812 and a German translation in 1800 [9]. Brera specifically discussed a successful multimodal trial with an onanist:

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    Diederik F. Janssen

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Janssen, D.F. Comment on: “History of testosterone therapy through the ages”. Int J Impot Res (2023). https://doi.org/10.1038/s41443-023-00791-5

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