Sex and the Nose

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In print , April 2023, HNO-Nachrichten, Springer Med
By Dr. med. W. Lübbers

Hätten Sie gewusst, was das Kallmann Syndrom ist oder der Calvin Coolidge-Effekt
oder was es mit den langen Nasen der Kasperle Figuren oder den japanischen
Tengu Masken auf sich hat? Dank des Corona Lock Downs hat sich der englischen
HNO-Arzt John Reddington Young an die Arbeit gemacht und all sein Wissen
über die seit Jahrtausenden von Jahren vermuteten bzw. bewiesenen sinnlichen
naso-genitalen Verbindungen aufzuschreiben. Schon seit 1983 hat Young regelmäßig
auf englischen Rhinologen-Kongressen als „Bonbon“ über das pikante Thema
„Sex and the Nose“ referiert. Allein der Titel des Buches setzt bewusst
oder im verdrängten Unterbewusstsein eine sicher zu hinterfragende Korrelation
voraus, die aber Neugier erweckt. Denn irgendwo hat man ja schon als Vorurteil
abgespeichert, dass die Größe und Länge der Nase etwas mit den männlichen
Genitalien zu tun hat. Auch die Schwellkörper in den Nasenmuscheln werden
anatomisch und histologisch korrekt mit anderen Körperteilen in Verbindung
gebracht. Young eröffnet dem Leser in seiner fast als „Wimmelbuch“ zu bezeichnenden
Veröffentlichung seine abgründige Sammlung von surrealen Abbildungen, Karikaturen
und oft erotisch „unzüchtigem“ Material. Anatomie, Physiologie, Pathologie,
Kultur, Anthropologie und Astrologie der Nase werden bis in die tiefsten
Abgründe der menschlichen Natur und seine dunkelsten sexuellen Assoziationen
dargelegt. All das wird an zahlreichen Darstellungen der bildenden Kunst
von Goya über Magritte bis Dali erläutert und interpretiert. Die Bedeutung
des Geruchsinns wird von den „betörenden“ Pheromonabsonderungen der Achselschweißdrüsen
bis zu der Verfilmung von Patrick Süskinds Roman “DAS PARFUM“ dargestellt.
Ja, manche Bilder und besonders die Comics lassen den Leser vor Scham erröten.
Aber der im Buch oft zitierte Sigmund Freud hätte seine Freude an dem Buch
und besonders an den Schlussfolgerungen gehabt.

Nicht nur das Buch ist etwas skurril. Der 1947 in Yorkshire geborene
Autor ist ein im Ruhestand lebender Militär HNO-Arzt (Colonel !) mit der
besonderen Vorliebe für Angeln, britische Bulldoggen und der Anfertigung
von Buntglasmosaiken, er ist ebenfalls ein Preisträger für die Züchtung
von süßen grünen Erbsen. Eine regionale Zeitung führt ihn in der Liste der
„50 Coolest People in Devon“. Ein typischer Engländer mit Zwirbel-Bart,
scherzhaftem Lachen und einer großen Portion Humor, eben englischem Humor,
der nichts lieber tut, als die verwunderlichen Launen des menschlichen Verhaltens
aufzudecken. So trägt ein weiteres Buch von ihm den Titel Poetry,Physik,Pestilence
and Pox.

Also lesen und lächeln!

Journal of Laryngology and Otology
By Edward W Fisher

This book has 25 chapters with introductory sections and a summary and
is very well indexed. The book is a synthesis of knowledge from the worlds
of the practising adult and paediatric otolaryngologist (rhinology in particular),
endocrinology, comparative anatomy and physiology, literature, poetry, medical
history, social history and art – to list but a few. There are therefore
many groups of readers that would find something of interest in this book,
and I have not found any similar publication that is as well set out and
referenced. The author is a multi-talented retired otolaryngologist who
worked in North Devon during his career and has many interests, including
poetry and history. He gave a lecture on this topic for many years as part
of the rhinoplasty course at the Royal National, Throat, Nose and Ear Hospital,
London. This course was organised by Mr Tony Bull and Mr Ian Mackay, and
the book is dedicated to Mr Tony Bull, who died in 2016.

‘Sex’ is used in its widest sense, with much of the most useful material
for the jobbing otolaryngologist being in relation to the effects of hormones
on everyday clinical conditions such as rhinitis, epistaxis and olfactory
function. My own experience of teaching trainees is that the more practically
relevant subject matter is not well enough known (to the detriment of their
patients) and this book covers the ground comprehensively. Topics such as
Jacobsen’s organ (the vomeronasal organ), the terminal nerve (cranial nerve
XIII) and pheromones in animals and humans are covered comprehensively with
wide-ranging references.

The quality of the artwork, photographs and diagrams is high and there
are some that might be considered ‘erotic’ but are always relevant and make
the point well in the way that words alone could not. Art work goes well
beyond Western Europe and includes relevant Japanese artwork. The text is
liberally sprinkled with the author’s trademark humour. Professor Nick Jones,
in his preface, suggests that some readers may find themselves blushing
at some of the content. This is fair comment, but the content never crosses
the line of acceptability. This is primarily an academic treatise and the
author never loses sight of that. The author’s use of the English language
is carefully tailored to be intelligible to the layman as well as a medical
or scientific reader. The cost of the hardback book is high, which is a
great pity as the book could achieve better sales from the wider reading
public, rather than languish in specialist libraries or the library of an
ENT specialist with an interest in rhinology. The publishers may wish to
consider the feasibility of a low cost paperback version which would fall
within the budget of the general reader. The book is much too useful to
be restricted to a narrow readership.

US American Journals
A. Mudry

ChatGPT (Generative Pretrained Transformer) is an artificial intelligence
program freely accessible through a ‘chatbot webportal. When it became generally
available to the public in November 2022, it very quickly became a cultural
sensation.1 Not only does it claim to offer rapid and in-depth
understanding of complex matters; it also generates tailored responses ‘in
a conversational manner’ to the exact question posed.2 It can
respond to queries and requests with prose of such surprisingly high quality,
that they are said to be almost indistinguishable from that of a human.3
Other researchers have suggested that this excitement should be tempered
with some caution. Although ChatGPT might be a tool which could transform
science and society, we must not lose sight of the boundaries between promise
and peril with respect to artificial intelligence.4

A recent paper examined the question: “can sex improve nasal function?”
Its conclusion was that: “sexual intercourse with climax can improve nasal
breathing by the same amount as the application of a nasal decongestant
for up to 60 minutes in patients with nasal obstruction”.5 In
a further discussion of this paper, it was concluded that “controversy continues
to exist in relation to nasal symptoms and sexual arousal”.6
There is nothing new about the ‘naso-genital link’. The physio-logical connection
between the nose and sex was proposed, along with the ‘reflex nasal neurosis’
at the end of the 19th century. Another aspect of this relationship,
which also led to controversy,7 is that the nose is a symbol
of the sex organ, a kind of representation of the phallus. This idea dates
as far back as the mythology of the ancient Greeks and the folklore of the
American Indians.

These controversies, together with others, suggested an opportunity to
test ChatGPT on this subject. When posed with the question, “Sex and the
nose?”, ChatGPT answered (,
06.03.2023): “I am sorry, but I’m not sure what you’re asking. Could you
please provide more context or clarify your question?” The question was
then modified to: “What is the relationship between the sex and the nose?”
ChatGPT replied that: “there is no direct or established relationship between
sex and the nose. However, there are some differences in the appearance
of male and female noses that may be associated with gender. . . There are
also cultural differences in how noses are perceived, with some cultures
valuing a particular size, shape, or feature of the nose as a marker of
beauty or attractiveness. . . Ultimately, the appearance of one’s nose does
not determine one’s gender or sexual identity”. To the complementary question:
“correspondence between sex and the nose,” ChatGPT concluded by saying:
“It’s also important to recognise that physical characteristics do not necessarily
define a person’s gender identity or expression. Some individuals may identify
as male or female but have a nose that does not fit typical gender expectations,
and this is completely valid”.

In other words, this is a controversial and complicated topic which needs
more research than ChatGPT is able to bring to light! A pioneering step
in this direction came very recently with the publication by John Riddington
Young, of a 170-page book entitled ‘Sex and the Nose,8 An
examination of the physiological, pathological, cultural, anthropological,
artistic and historical relationships between the nasal organ and the genitalia
in man, with a few observations on the throat and the ear
’. It presents
an ‘amazing’ new approach. The book is packed full not only of medicine,
but also with poetry, obscure beliefs and stories of human behaviour.

Right at the beginning, we are told simply that the lining membrane of
the nose does contain identifiable erectile tissue. We go onto learn about
the relevance of sex in olfaction, pheromones, sexual activity and human
attraction. Throughout the 25 chapters, all aspects and interrelationships
of the ‘naso-genital link’ are scrutinised with elegance, pertinence and
humour. The lavish collection of over a hundred images illuminates the quality
of the text and allows the reader to visually travel in their own imagination,
from traditional Japanese masks (replacing the nose with a penis), to the
bronze Roman faun with an ‘equal’ sized nose and penis. Other chapters discuss
masturbation and sexual excesses “conducing to chronic rhinitis”, Kallmann’s
syndrome, nasal dysmenorrhoea, the pregnant nose, menarchal rhinitis and
Jacobsen’s organ.

In conclusion, the nose can certainly be considered as ‘a secondary sexual
characteristic.’ Any reader unfamiliar with this affirmation can simply
delve into the pages of Sex and the Nose to be totally convinced that this
is definitely a subject which merits much more attention. ChatGPT still
has a lot to learn.

  1. Thorp HH. ChatGPT is fun, but not an author. Science 2023;379:313.
  2. Patel SB, Lam K. ChatGPT: the future of discharge summaries? Lancet
    Digit Health2023;5:e107–8.
  3. Looi MK. Sixty seconds on. . . ChatGPT. BMJ 2023;380:205.
  4. Stokel-Walker C, Van Noorden R. The promise and peril of generative
    AI. Nature2023;614:214–6.
  5. Bult OC, Oladokun D, Lippert BM, Hohenberger R. Can sex improve
    nasal function? – An exploration of the link between sex and nasal function.
    Ear NoseThroat J 2023;102:40–5.
  6. Mayo-Yanez M, Herranz-Larraneta J, Calvo-Henriquez C. Commentary
    on cansex improve nasal function – an exploration of the link between
    sex and nasalfunction. Ear Nose Throat J 2022;14 [1455613221077601].
  7. Book HE. Sexual implications of the nose. Compr Psychiatry 1971;12:450–5.
  8. Young JR. Sex and the Nose. Amsterdam: Wayenborgh; 2023.




Chapter I. The Surreality
The importance of art and
illustration (particularly surrealism) cannot be overemphasised. Certain
paintings epitomise the essential allegorical harmony of the naso-genital
link. Millet’s Head, Magritte’s Le Viol. Goya’s Caricatura
. Testa di Cazzi. Abbé Mauri.

Chapter II. Classical Naso-Genital Link
The so-called
‘Naso-Genital link’ in folklore is a timeless myth that the size of a person’s
nose is an indication of the size of their genitalia. This is examined from
Classical times to the present. Lascaux Caves. pre-Viking petroglyphs. Ovid.
Astrology. Heliogabalus and Nasuti. Queen Giovanna. Cyrano de Bergerac.
Michael Scot. Massinger. Kama Sutra.

Chapter III. Eros, Nose and Throat
The sexual physiology
of the throat and even the ears. Sexual aspects of voice and throat. Infibulation,
Castrati. Antonio Moreschi. Male Infibulation. Contemporary Romanian rituals.
Chapter IV. Physiognomy 27 Giambattista della Porta; Charles Darwin and
the Captain of the Beagle. Desmond Morris and genital mimicry in African
baboons. Scrotal mimicry and pubic/moustache resonance.

Chapter V. Nasal Gestures
Cocking a snook. Fullocking
vs.Churchillian V-sign. Obscene Iraqi palm back insult. Nasal Greeting around
the world: Eskimo kiss (kunik); Maori hongi; Thai sniff-kiss; Arabs in Gulf
nasal tip-to-tip. viii Chapter VI. Nasal Erectile Tissue 39 Victorian descriptions
of erectile nasal tissue. Mackenzie’s seminal article. Discussion of physiological
evidence. Sneezing and sex. Ayurvédic medicine.

Chapter VII. Sex and the Nose in Japanese Art
Hokusai. Utagawa Kuniyoshi. Manga and Anime. Hanaji, the epistaxis trope
in manga.

Chapter VIII. Kallman’s Syndrome
Heschel of Vienna.
Aureliano Maestre de San Juan. Kallmann and Rüdin. Little Jimmy Scott. Genetics.

Chapter IX. Masturbation and the Nose
Victorian preoccupation
with evils of masturbation and its connection to nasal disease. Louis Tussaud’s
waxworks. Sigmund Freud, Wilhelm Fliess and the tragedy of Emma Eckstein.
Nasal Neurosis. Biorhythmicity. Male 23 day menstrual period based on nose.
Fliess’s Flow of Life book.

Chapter X. Nasal Dysmenorrhoea
Nasal treatments for
painful periods.

Chapter XI. The Pregnant Nose
Pregnancy rhinitis.
Life-threatening epistaxis during pregnancy. King Lear.

Chapter XII. Hormonal Rhinitis
Varieties of hormonally
related nasal diseases. Old man’s drip. Honeymoon rhinitis. Kraurosis nasi.
Weber-Rendu-Osler’s Disease (Hereditary Haemorrhagic Telangiectasia)

Chapter XIII. The Nose in the Human Sexual Response
Coital epistaxis. Amatus Lusitanus. Native American Sioux. Theophilus
Bonet. King Louis XIV. Psychiatric Nose. Masters and Johnson’s
groundbreaking research and personal involvement. Viagra.

Chapter XIV. The Nose at Puberty (Menarchal Rhinitis)
Puberty epistaxis. World Sneezing Records in adolescent girls. Guinness
Book of Records. Treatment.

Chapter XV. Vicarious Menstruation
Hippocrates and
Celsus. Nose bleeds in place of menstruation as index of pregnancy. Collop’s
On Phlebotomy. Martin Schurig. Mary Murphy’s menstrual earbleeds.
Male menstruation: Sambia tribal induced menstrual epistaxis. Dr Carrere
and the French miller.

Chapter XVI. Jacobsen’s Organ
Ruysch and his Cabinet.
Von Sömmering. Ludwig Jacobsen and his Military career.The circuitous history
of the vomero-nasal organ: Gratiolet, Dursy, von Kölliker, Potiquet. Nomenclature.

Chapter XVII. Robert Broom and the Vomeronasal System
Broom’s discovery of the function of the VNO in the animal world.

Chapter XVIII. Butenandt and Bombykol
Adolf Butenandt
and his discovery of pheromomes. Hitler and the lost Nobel Prize.

Chapter XIX. Animal Pheromones
Hagfish and lampreys.
Magic of Pheromones. Lee-Boot effect. Whitten effect. Vanderbergh effect.
Coolidge effect. Urinary pheromones. The pig with the prolapse. Boar Mate.
Perigord Truffles.

Chapter XX. Human Pheromones
Copulin and Rhesus Monkeys.
Menstrual synchrony in girls’ boarding school dormitories. Humarone. BBC
and Tomorrow’s World. Monti-Bloch and the electrovomeronasogram (EVG). Routine
contemporary nasal surgery and its effect on libido. Nitric oxide. Conscious
breathing tapes.

Chapter XXI. Smell and Pheromones
Axel and Buck’s
Nobel Prize for physiology of olfaction.

Chapter XXII. Major Histocompatibility Complex
genetic and Darwinian importance of pheromonal attraction.

Chapter XXIII. Death of the Human Vomeronasal System
How two venture capitalists and their perfume company misled scientists
for sixteen years. Didier Trotier’s proof of the non-functioning VNO.

Chapter XXIV. The Terminal Nerve
How a ‘new’ cranial
nerve (of which even now many physicians are not aware) was discovered.
Its rôle in the reception of pheromones.

Chapter XXV. Post Script: Smell and Memory
and the scent of his mistress’s nightgown. Schopenauer and the sense of
memory. Rudyard Kipling and smell cracking the heartstrings. Proustian moments.

Conclusion and Postlegomenon
Nietzsche and the sixth
sense – of veracity.

General Index

 Reference Index


In 1983, I first gave a lecture on ‘Sex and the Nose’ in the Practical
Rhinoplasty Course (an instructional course for surgeons operating on the
nose) at the Royal National Throat, Nose and Ear Hospital in Gray’s Inn
Road, London, (which was, until the NHS Management ([affectionately known
to hospital doctors as ‘Stasi’) closed it in 2019, part of University College
Hospital). I had been asked by the organisers to talk about problems when
doing rhinoplasty in a District General Hospital, but I didn’t have much
to say about this. I spoke mainly about the sexual aspects of the nose,
(a topic which I had always considered is neglected by Ear, Nose and Throat
Surgeons). I thought some of the insights my talk contained would be of
use to surgeons working on the cosmetic and functional aspects of the nose.
To my utter surprise, I was not only invited back the following year, but
every year for the next twenty years. I was put on the regular annual payroll
of the University of London and every February, I found myself on an annual
pilgrimage to give a similar lecture. After the first year, I made no pretence
about talking about doing rhinoplasties ‘out in the sticks’ (which as far
as I could see, is not any different to doing them in a teaching hospital

Over those next twenty years, I came to realise just how wide a subject
it is. I did more research and kept up with any developments in this niche
part of otolaryngology. Long before surgeons working in their specialty
started to profess an interest in sub-specialties, I had begun to state
my ‘special interest’ in the sexual aspects of the nose and this was how
I was listed by the General Medical Council on the Medical Register from
1985 until I retired from practice in 2013. As one of the few remaining
single-handed consultants (without a consultant partner), it was inappropriate
to develop a sub-specialty anyway. In fact I was the last remaining solo
consultant, (merely because I was the last man standing!)

Since most of the current UK rhinologists had been on the Rhinoplasty
course and attended my lecture, most colleagues knew of my interest and
indeed a few of them contacted me to discuss cases of interest. Over the
years I even had a few patients referred! Because everybody in general appears
to be interested in sexual matters, I was asked to give talks to post-graduate
meetings up and down the country, and indeed also in France, Germany and
the Netherlands. When lectures and lecturers were becoming somewhat of a
rarity, ‘Sex and the Nose’ appeared to be an attractive title.

Shortly after my retirement, I was asked to give the Watson-Williams
triennial lecture in Bristol. Of course I chose as the subject of my address,
‘The Physiological and Pathological Associations Between the Nose and the
Sexual Apparatus of Man.’ I thought that this would be the last time I would
ever talk about the subject, but even now I get asked to talk about it.

More than one dear friend and colleague have pointed out that I have
never written anything on this matter. I was eventually cajoled, during
my enforced isolation during the first Covid Lockdown, to put pen to paper
at long last, (whilst I am still spared!) I always used to tell friends
that the reason why I never wrote any of it down was because once it had
been published, I would no longer be asked to talk and I would be destroying
a good meal ticket.

It was not until I started writing about it, that I realised how important
the illustrations had been. They are of course an integral part of the subject.
The impact of Barbara Millett’s surrealist painting, ‘Head,’ which was always
the first picture I showed, was universal. It’s probably the only thing
most people remembered about the lecture!

Additional information

Weight 900 g



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xviii & 170