Shen-K’uei Syndrome: A Culture-Specific Sexual Neurosis in Taiwan

Abstract

Shen-k’uei means “vital or kidney deficiency.” In classical Chinese medicine, shen (kidney) is the reservoir of vital essence in semen (ching), and k’uei signifies deficiency. Shen-k’uei is a culture-specific disease that is described in classical Chinese medical texts and widely understood in Chinese communities. We shall refer to the shen-k’uei “syndrome” because it includes various symptom manifestations and illness behaviors. For example, Rin (1966) described two rare forms of this syndrome among Chinese male patients in Taiwan: koro and frigophobia. Both are recognized as culture-bound psychiatric syndromes among Chinese. In the one fear that the penis is shrinking and that its retraction into the abdomen will lead to death and in the other fear of cold owing to loss of seminal essence, which is believed to reduce the body’s ch’i (vital essence) and through it the male component (yang) which produces an imbalance between hot/cold bodily constituents, relate to traditional Chinese cultural beliefs and rules concerning male genital sexuality. Although both conditions can be explained in terms of contemporary psychiatric concepts, their symptomatology and illness behavior are meaningful only in the context of Chinese culture. A third form of the shen-k’uei syndrome is a psychological condition popularly associated with excessive semen loss owing to frequent intercourse, masturbation, nocturnal emission or passing of “white turbid urine,” which is believed to contain semen. It is this commonly occurring, but heretofore unstudied, sexual neurosis that we will discuss in this paper as the core shen-k’uei syndrome.