Sex and the Nose

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!

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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.

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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 19^th 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
(https://chat.openai.com/chat,
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.

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ENT & AUDIOLOGY NEWS

For regular attentive readers of our magazine, JRY will need no introduction.
The word ‘polymath’ barely does him justice: a Colonel in the Medical Corps with
an MPhil in poetry and apparently one of the “50 coolest people in Devon” against
some stiff competition.

For many years, the author gave a lecture on ‘Sex and the nose’ for the London
Rhinoplasty Course which attained near legendary status, and this beautifully produced
and illustrated volume is clearly a labour of love, representing decades of thought
and erudition in this peculiarly neglected field. After all, most rhinologists of
my acquaintance think themselves competent in both areas, and I am deeply flattered
the editorial team clearly thought I was sufficiently proficient to provide an expert
assessment.

The breadth of the scholarship involved can only be hinted at in a brief review,
but if you have any curiosity about male infibulation, the origins of fullocking,
the etymology of smegma, Little Jimmy Scott’s falsetto or Aunt Mabel’s thoughts
on munitions workers’ menses then you need look no further. The prose style is delightfully
discursive, dry scientific literature frequently interspersed with personal anecdotes
and irreverent insights.

We begin in the classical world with the thoughts of Aristotle and Celsus, and
move rapidly on to physiognomy and its pitfalls, the anthropology of gestures involving
the nose and controversy over the presence of mucosal erectile tissue. After a brief
discourse on Japanese Shunga art, we turn to Kallman’s syndrome and then Freud’s
crackpot friend, Wilhelm Fliess, and his appalling mismanagement of Emma Eckstein.
We also learn of the author’s mother’s thoughts on onanism in a Blackpool waxwork
museum and St Clair Thompson’s somewhat controversial views on the aetiological
role of self-pleasure in post-nasal drip.

The hormonal effects on nasal physiology during pregnancy, menstruation, sexual
excess and puberty are discussed at length and we learn that the author’s mess bar
bill as a House Officer was settled by his consultant in 1968. In a book brimful
of thought-provoking facts, this certainly made me pause.

The second half of the monograph is dominated by an even-handed treatment of
the controversies over the vomeronasal organ and its potential role in the human
pheromonal response. Here, the author’s scholarship and clarity of thought come
into their own, with a lucid and well-referenced account of a potentially highly
confusing area. I remember well the brief flurry of concern that septal surgery
could impair pheromonal perception with potentially catastrophic effects on sexual
performance. Subsequently, a North Devon audit demonstrated significant improvement
in sexual prowess post septoplasty, but I remain unsure whether to include this
in my patient information pamphlet. They do audit differently in the West Country.

This lavishly produced volume would pass as a coffee table book but, given its
contents, may provoke some extreme reactions. My current long-suffering registrar
absent-mindedly picked it up and leafed through it as I was holding forth at length
at my desk: “Good Lord,” she interjected, “this is completely unhinged!” It is indeed,
and gloriously so.

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European annals of otorhinolaryngology, head and neck diseases
Ollivier Laccourrye

In this book, the British otorhinolaryngologist John Riddington Young examines
the physiological, pathophysiological, cultural, anthropological, artistic and historical
relationship between our nasal appendix and our genital organs.

The book is the mature fruit of a lecture, “Sex and the nose”, which he first
gave in 1983 in a practical course in rhinoplasty organized by the London Royal
National Throat, Nose and Ear Hospital, and which was so well received that he was
asked to repeat it several times, not only in the UK but also in France, Germany
and the Netherlands, in various scientific meetings. In retirement since 2013, he
finally turned it into a book. As he says in his Preface, “I never wrote any of
it down because once it had been published, I would no longer be asked to talk and
I would be destroying a good meal ticket.

The author has all that British phlegm and sense of humor that are the envy of
the world. He also seems, to judge by his publications list, not to have let himself
be entirely consumed by otorhinolaryngology, with 12 non-scientific books and mosaics
and paintings to his credit and, among other activities proper to an accomplished
life, seeking to master the art of calligraphy.

Any lover of the English language is well advised to buy this book. You will
come out of it wiser and better informed, and happy to know that otorhinolaryngology
can be the source of such a delightful work, beautifully illustrated by the editors.
The reproductions of René Magritte’s “Rape” and Barbara Millett’s “Head” are magnificent.

Introduction

Preface

Prolegomenon

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
Alegre. 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
Shunga.
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
The
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
Rousseau
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

Acknowledgements

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
anyway!)

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!