The penis is the most worshiped organ in the history of humanity. Understanding the basis of this venerability is essential for appreciating the psychosocial implications of penile malformations and their surgical correction. Since incalculable antiquity man’s attention has been disproportionately drawn towards this tiny appendage. Spontaneity of erections and the ensuing pleasure must have drawn the admiration of mankind and influenced its undue interest in this organ. This is evident from the engravings of Los Casares cave (Riba de Saelices, Spain) and Saint-Cirq cave (Le Buge, France) which belong to upper Paleolithic period (38,000 to 11,000 BCE) [1]. They depicted penis as huge as its owners themselves (Fig. 3.1). By etching impractically enormous size penis, prehistoric man probably had tried to emphasize the importance that he attached to penis.

Structural similarity of the penis to a variety of elongated objects must have prompted primitive man to attribute bizarre properties to this curious organ. Erect penis, because of its penetrating nature, was typically envisaged as a piercing weapon such as dagger. In fact, the vagina is named so because it resemblance to a ‘scabbard’ or ‘sheath of sword’. As a weapon is expected to harm enemies, sexual rape committed by the erect penis was considered punitive. Primatologists have observed this behaviour even in monkeys wherein the leader of a troop will sodomize an intruder from another tribe. In civilized societies too, rape is a consistent component of war crimes.

A punitive weapon is also deemed to be protective. Thus, erect penis was considered apotropaic [2]. Phallic amulets and tintinnabulae were used by ancient Greeks to avert evil eyes. They erected stone columns known as Hermae in street corners and in front of each house to ward off malicious sprits and to bring in good luck (Fig. 3.2). These pillars displayed the head of the Greek God Hermes and his prominently erect phallus. Superstitious belief in the apotropaic power of phallus was such that it led to the defeat of Greeks in 415 BCE. The night before the departure of Athenian fleet to Sicily, someone – playing either a drunken prank or a ploy – brought down several hundred erections of Hermae [3]. It is rumored that the vandal was Alcibiades, the beloved student of the great philosopher Socrates. Greek soldiers woke-up in the morning only to find themselves morally emasculated by this bad omen. This not only led to the failure of Sicilian invasion but also the ultimate defeat of Athens in the hands of Spartans [4]. Bhutan, a small country in the eastern Himalayas, still holds the traditional belief in the apotropaic power of the penis. Every Bhutanese house is painted with not only erect but also ejaculating phalluses near doorways and building corners. By casting out evil eyes these phalluses are believed to bring in wealth and good luck. Thus, the punitive and protective penis had also become a sign of prosperity.

Prosperity to a primeval man must have meant enough meat from hunting. When rival groups competed for the same meat, manpower was needed to chase them away and secure the food. Therefore, ability to bear more offspring was considered essential for prosperity. When man was not aware of the reproduction secrets he looked at women, who gave birth to new individuals, with much awe and fear. Later, when men discovered their indispensable contribution of insemination in reproduction, matriarchate was replaced by phallocentric patriarchy [5].

Phallic supremacy was not challenged even when hunter-gatherers settled with agricultural life. Man probably drew analogy between the shaft of an erecting penis and the trunk of a growing tree. Therefore, the penis was considered a sign of fertility not only in human reproduction but also in agricultural production. People began to worship phallic structures for higher crop yield and the penis began to occupy a central position in many fertility rituals. Ancient Romans erected and worshiped ithyphallic Priapus in fields and woods. Even today, public procession of decorated phallus is common during Japanese harvest festivals such as Kanamara Matsuri of Kawasaki and Honen Matsuri of Komaki [6].

The penis was revered as the ultimate power of production and protection, therefore, it became a symbolic attribute of monarchs who did not want anything less than the ultimate power. Phallic rituals became inseparable from royal affairs. As a part of coronation rites, Egyptian Pharaohs were expected to ‘sow their seeds’. Although it is generally considered to be plant seeds, it also implies the demand on Pharaohs to demonstrate their procreative ability [7]. In cannibalistic primitive societies, heir apparent ate the penis of deceased leader symbolizing the inheritance of leadership status. As a permanent reminder of this transfer of power, the successor held in his hand a phallic replica of the predecessor’s erect penis. Stone, bone, ivory and wood carvings of Paleolithic era unearthed from Spain and France depict human penises with exposed glans [8]. There are no corroborative archeological evidences for the prevalence of circumcision among prehistoric men. In fact, any surgical intervention prior to the era of antibiotics is thought to be a survival disadvantage according to Darwinian principles. Hence, the exposed glans in these portable art works probably represent retracted prepuce of fully erect penis. Many archeo-pathologists erroneously think that these phallic objects could have been used as dildos. But, why would women of that era have resorted to dildos when live penises were freely available without any social or moral inhibitions? They are also unlikely to be drumsticks, cord makers or tent holders because they need not had been so exquisitely carved and decorated for these purposes. They are most likely to have been used as batons signifying transfer of power. With advancing civilization holding a phallic baton was considered too embarrassing and hence it was replaced with symbolic staffs.

Although phallic batons were obsolete long before, kings as late as eighteenth century and some high officials even today, while assuming office, take oath by placing their hands on the crotch (read penis and testis). Even in the Old Testament aged Abraham asked his eldest servant who ruled over the household, “Put, I pray thee, thy hand under my thigh and I will make thee swear by the Lord, the God of Heaven” (Genesis 24: 2, 3). In this “under the thigh” is a euphemism for the penis. By guaranteeing the sacredness of oath, the penis attained the status of divinity. In fact, it had already possessed several attributes of godliness such as punishing the wrongdoers, protecting the believers, granting productivity and prosperity, and finally symbolizing omnipotence. Thus, the erect organ was begun to be worshiped in many phallic cults that are known to exist since prehistoric times [9].

Explicit or surreptitious adoration of phallus is common in major religions of the world. The earliest evidence of phallic worship is obtained from the excavations of Mohenjo-Daro and Harappa, the twin cities of Indus valley civilization (50,000 to 1300 BCE) [10]. Pasupathy alias Siva was the chief deity of this civilization. According to Hindu mythology one revered sage Bhrigu went to see Siva at which time the latter was engaged in amorous pursuits with his wife Parvathi [11] (Fig. 3.3). Even after knowing the arrival of the sage, Siva did not interrupt coitus. Bhrigu took this as personal insult and cursed Siva that he be not worshiped by his divine figure but by the symbol of his erect penis. Since then Siva has been worshiped in ‘lingam’ form. In fact, the Sanskrit word ‘lingam’ means ‘penis’. Even today millions of men and women worship lingams in Indian temples. The most remarkable of all is the gigantic lingam at the temple of Gudimallam, a village in South India. This stone phallus dating back to 300 BCE accurately depicts the anatomical details of a fully erect penis such as exposed glans, retracted prepuce, frenulum, coronal sulcus and penile shaft. However, causal devotees will least suspect as to what they are actually worshiping when the lingam is presented to them with floral decorations (Fig. 3.4).

Disguised phallic worship is not unknown in other parts of the world. Romans worshipped detachable bronze idol of Priapus in which the ithyphallic God appears as an old man covered with a shawl. Dismantling the statue during worship will, however, reveal the huge phallus hidden underneath the old man’s cloak (Fig. 3.5). In contrast to this geriatric Priapus, fresco at the House of Vettii in Pompeii (circa 62–79 CE) depicted him as a young robust warrior [12] (Fig. 3.6). Contradictions in these art works indicate that what it matters more important, is the giant phallus rather than the deity himself. Worshiping a nude deity is obviously less embarrassing than exclusive veneration of erect phallus. Probably for this untold reason Digambara Jains worship their 24 male Tirthankaras (omniscient teacher-gods) in nude posture. For example, the 57 ft tall Gommateshwara statue (circa 980 CE) at Shravanabelagola (South India) exhibits a 4-ft long phallus which can never go unnoticed by devotees (Fig. 3.7).

Min in ancient Egypt and Priapus in Rome were also worship in nude form (Fig. 3.8). However, they did not disguise the penile connotation of adoration. Unlike the flaccid penis of Jain Tirthankaras, these gods were portrayed with erect phallus. Phallicism was further made clear by the attending rituals. For example, wild lettuce – a plant which when rubbed and squeezed would discharge white sticky sap resembling semen – was made the sacred symbol of Min. Obscene words referring to male genitals and sports like naked climbing on an erect pole were routine during the orgies of Priapus.

In medieval Europe there were several fertility shrines in which devotees consumed the scrapings of statue’s phallus to get cured of sterility and impotence. At one such shrine of St. Guignole located at the port city of Brest, the phallus of the poor saint could not withstand the frantic scrapping of young girls and it did not last even for few days after replenishments. Monks of the shrine devised an ingenuous solution to this problem. Accordingly, they secretly bored a hole at the crotch of the statue through which a wooden phallus was clandestinely projected out. As fast as the devotees scrapped the phallus from the front of statue, the monk as industriously and swiftly pushed the wooden peg from behind thereby creating an illusion of spontaneous elongation of the phallus. This miraculous growth added to the reputation of the shrine and attracted much more pilgrims!

It is quite logical to assume that the penis is curative if it were divine. For obvious reasons, it was initially believed to cure infertility and impotence; but later its healing power was extended to many unrelated diseases. The panacean property of penis is illustrated by the saga of the holy foreskin. It was supposed to be the foreskin of Jesus Christ, the Preputium Domini as the Vatican would call it. Jesus, in conformity with Jewish tradition of his times, was circumcised on the eighth day of birth. According to the Infancy Gospel, the excised foreskin was preserved in an alabaster box of spikenard oil. It was later procured by Mary Magdalene whose relationship with Jesus was variously disputed as disciple, companion and wife. Mary, probably, gave back the foreskin to St. Peter (pun unintended). After changing several hands, the Byzantine empress Irene gave it as marriage gift to Emperor Charlemagne (742–814 CE) who in turn donated it to Charroux Abbey of France. Patients queued up to worship the holy prepuce to get rid of their chronic ailments. In 1422 CE, even the English King Henry V was said to have begged to borrow and finally stole the relic of holy prepuce to easy the labor pain of his French wife. Soaring popularity of pilgrimage to Charroux prompted the holy foreskin to multiply and by the dawn of twenty first century there were at least 21 churches claiming to hold the authoritative appendage of Jesus Christ [13].

It is pathetic that the organ believed to possess curative powers was itself left to suffer malformations and diseases without any proper remedy. This medical apathy was partly due to the divine status of the penis. Everyone looked at it with much veneration and awe; but no one dared dissecting it to study the architecture. Lack of proper anatomical knowledge halted the progress of surgical correction. For example, the great Galen of Pergamum (circa 129–199 CE) preached that there were two separate tubes in the penis, one for semen and another for urine. He formulated his theories not only by extrapolating his knowledge on animal anatomy but also by exercising his fertile mind. Domineering influence of Galen was such that no one dared to challenge his views for the next 1200 years. Unlike Galen who had never dissected human cadavers, Leonardo da Vinci (1452–1519 CE) had the opportunity to dissect executed criminals of Florentine town. This renowned Italian artist of Renaissance Period was the first to accurately draw the anatomy of the penis and to describe the pathway of sperms from the testes. Although his contemporary artist Michelangelo was also claimed to have known the tricorporal anatomy of penis, Michelangelo never drew it explicitly and the codified anatomy in the painting of Prophet Jonah on the ceiling of Sistine chapel is subjected to subjective interpretations. Accuracy of Leonardo’s drawings was such that when the great anatomist of Padua, Andrea Vesalius (1514–1564 CE), independently described penile anatomy, he was accused of plagiarizing Leonardo’s works [14].

Leonardo was also the first to solve the centuries old mystery of penile erection. Prior to him everyone experienced it; but no one knew the mechanism of erection. Aristotle (384–322 BCE) probably mistook vas deference for the fine ropes of a pulley system. According to him the penis lifts up by the sheer weight of testes and the penopubic attachment acts as fulcrum for the mechanical leverage. He supported his arguments by citing that the penis no longer erects when the pulley system is destroyed as in castration. Galen, drawing analogy between the penis and metal rods that expand on heating, held that the penis is pushed from inside out by the heat of passionate love making [15]. He explained sweating that occurs during coitus was also the effect of this heat. Andreas Vesalius (1514–1562 CE), who boasted to have corrected 238 mistakes of Galen, conceded to this misconception and depicted the vagina as invaginated penis (Fig. 3.9). However, no one bothered to ask him as to why then the vagina did not expand and evaginate under the heat of passion. Hippocrates (circa 460–370 BCE), the father of medicine, believed that erections occur due to air (pneuma) inflation of corporal tubes akin to blowing of balloons. He pegged his reasoning on the air hunger noted during intercourse. It was Leonardo who brilliantly questioned the incompatibility of Hippocratic hypothesis and observed facts. “If it were air”, Leonardo argued, “the erect penis would not be as hard as a wood”. His dissections of executed criminals, who had reflex erections during hanging, revealed the turgid organ been filled fully with blood. Additionally, observing the redness of glans during tumescence convinced Leonardo to conclude that erection is caused by inflow of blood.