Koro and Fox Spirits in the 1984-1985 Hainan Epidemic.

1
Christopher Mark Graham Norman.

1.0 Introduction:

This paper is specifically concerned with the Hainan ‘Koro’ epidemic of 1984-1985, during which

time the issue of fox spirits emerged in the ethnographic literature. This is the first anthropological

study to investigate the fox spirit issue in detail. The approach taken here shows that Koro, which is

often portrayed as a Culture bound Syndrome, is not an issue of individual psycho-pathology based

on the Oedipus complex and castration anxiety, at least in Hainan, but is a social phenomena that is

triggered by political rumours and fortune tellers predictions. The paper begins by outlining the

history of the term Koro and then specifically considers the Hainan Koro epidemics.

1.1: The History of the Koro Metaphor:

The word Koro has a long and diverse history, is either of Malay, Indonesian or Bughat origins and

can be found in Mathes' Dictionary of Burginese Language of South Sulawesi (1894). The term was

first used in a British Medical Journal in 1895 by Dr. J. C. Blonk, a Health officer, to describe the

genital retraction syndrome suffered by a Native legal officer in what is now Indonesia (Chowdhury

1988:182). The first Chinese record of Koro phenomena is recorded in the archives of the Tang

district of Guangdong province, Southern China, where an epidemic, recorded as Sou Yang, occurred

in 1865. (Tseng et al:1988). The application of the term Koro has not been restricted to the Chinese,

but has been applied to Rural Thai (Gwee 1968), Vietnamese, Indians and Nigerians in the medical

and anthropological literature. Both individual cases and epidemics have been recorded under the

general category of Genital Retraction Syndromes, which have often been extended to include the

shrinkage of other parts of the human anatomy (Chowdhury 1988).

It needs to be emphasised here that the Han nationals that are affected by Koro do not use this term,

which was first applied to Singapore Chinese by Gwee (1963) and later extended more widely by

Yap (1965). Instead the Hans prefer to use the more indigenous terms Sou Yang/Souk Yang, to

describe the lessening of Yang (Vital) forces, which are synecdochically represented by the shrinkage

of protruding body parts, which are regarded as Yang. Notably among the 232 cases recorded in the

1984-1985 Hainan and Leizhou epidemics by the Chinese Koro team, 37 cases involved female

nipple retraction and others the retraction of noses and tongues among small children (Tseng et al

1988; Cheng 1997). If women can experience this phenomenon, it seems problematic to state

emphatically that Koro is related to castration anxiety. It therefore seems more appropriate to regard

Chinese Koro in terms of the more indigenous concept of Sou Yang, the lessening of the Yang

positive principle, signifying Life, light, heat, male, and which stands in mutual correspondence to

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Christopher Mark Graham Norman.

the other side of this dialectic, Yin, which signifies Death, darkness, coldness, female. In the Chinese

worldview, protruding body parts are regarded as Yang (Unschuld 1985) and therefore in both male

and female versions of Sou Yang, the main concern is the lessening of Yang, represented

synecdochically by the shrinkage of Yang body parts. Given that Koro has often been predominantly

interpreted as a phenomena experienced primarily by males, through creating a simile between the

penis and a turtle’s head, it seems necessary if Koro does mean Turtle’s head to ask what this long

lived creature really represents in Chinese tradition. One answer to this question can be found in a

footnote to Yap’s ‘Koro - A Culture bound Depersonalization Syndrome’:

‘Koro is a Malay word and means the head of a Turtle (or a Tortoise). The Chinese
until the Ming Dynasty [1368-1644 AD] used the Turtle as an artistic and literary
symbol for longevity and the vital forces, but later the term acquired scatological
connotations’. (Yap 1965:46).

The footnote continues quoting page 225 of Van Gullik’s (1961) Sexual Life in Ancient China:

‘There is an obvious similarity between the head of this long lived creature and the glans penis.’

(Quoted Yap 1965:46 ff.). Yap comments: ‘A passage is quoted on p. 279 [of Van Gullik] from a

Ming treatise on the art of attaining longevity through coitus reservatus, wherein the retraction of a

tortoise’s head is used as a simile’. The Ming treatise, is concerned with Taoist sexual hygiene, and it

is emphasised that the simile of a tortoise head represents longevity, and refers to abstaining from

ejaculation which depletes the male life force (Van Gullick 1961). On this basis the simile, though

representing the penis shrinking, is not concerned with shrinkage into the abdomen that ultimately

causes death! For here the turtle head simile refers to the drawing in of Yin (in this case the essence

of the female orgasm), to strengthen Yang (Van Gullick 1961:279). On the basis of Van Gullick’s

work, it would appear that Sou Yang is concerned with more than mere genital retraction, as

represented by the Koro metaphor, under which the specifically Chinese phenomena of Sou Yang has

been discussed. The terms Sou Yang (Mandarin), and Suk Yeong (Cantonese), like the term Koro, are

inevitably translated as shrinking penis (Yap 1965 Rin 1963), by translating Suk/Sou as shrinking

(according to a Chinese dictionary it also means old, withering, contracting, shortening, reducing and

decreasing), and translating Yeong/Yang as penis (Cheng 1996). What appears to have occurred is

that the term Yang, existing in Chinese dialectical philosophy, signifying the masculine principle, has

been replaced by the metonymy of the penis, which is merely a representation of Yang. The

following Case examples, two of which were obtained from the 1984-1985 Hainan Koro epidemic

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Christopher Mark Graham Norman.

(Cases A & C), are fairly typical of the general literature on Koro:

Case A: A single male agricultural student from Bao village in Hainan, during the
most recent Koro epidemic in 1985, awoke on 20th May from his sleep at
approximately midnight and felt numbness in the genital region. He states: `I felt with
my hand but could not feel my penis, just the size of a fingertip; it was shrinking,
disappearing. I yelled for help, my family and neighbours came and held my penis. `
(Jilek 1986:276).

Case B: ‘H.K.F., a male student aged 34... was at a cinema show when he felt the
need to micturate. He went out to the latrine in the foyer, and as he was easing
himself, he suddenly felt loss of feeling in his genital region, and straightaway the
thought occurred to him that he was going to get penile retraction. Sure enough he
noticed that his penis was getting shorter.... He felt cold in the limbs, and was weak
all over, and his legs gave way under him. So he sat on the floor, all this time holding
onto his penis. About half an hour later the attacks abated...At 24 years of age, he
exposed himself to a prostitute, and was infected with gonorrhoea, and since then he
has abstained himself. He heard of Shook Yong [Sou Yang] from his friends and also
heard about fatalities during intercourse previous to the attack’. (Gwee 1963).

What is clear from this case is that the initial panic about the possibility of genital retraction may

very well have resulted in somatisation, and contributed to the genital retraction itself. Case C,

obtained from Dr.G M. Mo’s Chinese Koro study team seems to support this view:

Case C: ‘Mr. A, 28 years old, single, and an officer worker.... In May 1985 during a
Koro epidemic in Haikang was in the midst of preparing for an examination for job
promotion...One evening he heard the frightening sound of a gong being beaten and
terrifying noises made by people who were panicking in the neighbourhood. He
suddenly became anxious and experienced the sensation that his penis was shrinking.
He was seized with panic and shouted loudly for help. Several men in the
neighbourhood rushed in and tried to rescue him by forcefully pulling his penis’
(Tseng et all 1988:1541).

Case C demonstrates that Koro, occur in a particular social context, i.e. the panic going on outside

and the sound of gongs, along with the potential stress of exams, may contribute to Koro experience.

I therefore now turn to giving consideration of the socio-historical context in which Koro epidemics

have occurred on Hainan Island.

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2.0: The Socio-Historical Context of Koro Epidemics on Hainan:

Although the Island of Hainan is populated by a minority of ethnic Yao, Miao and Zhaung tribes

living in the Nanling Mountains near Guangxi and Hunan, and several hundred thousand Li people

(Kaplan & Sobin 1982:38), none of these groups have ever been recorded as susceptible to Koro.

The outbreaks appear to only affect the Island’s Han nationals living on the coast, and the

neighbouring Leizhou Peninsula (Kaplan & Sobin 1982:38) whose main occupations are agriculture

and fishing (Tseng et al 1988). The Han nationals of the region include Hakkas, who are ‘members of

a distinct linguistic group descended from North Chinese migrants’ (Fairbank and Reischauer 1979:

292) that settled in southern China during the Tang dynasty (Van Gullick 1969:211) and migrated in

large numbers to Hainan in the late 1800’s. Where they ‘managed to maintain their customs and

preserve their language’ (Kiang 1991:36). Notably the Hainanese language and dialect:

‘…differ[s] from Guangzhou and other dialectics used by the majority of the
inhabitants in the Guangdong province proper...and the islanders are still considerably
influenced by ancient beliefs in gods and ghosts. Fishermen always consult fortune-
tellers to predict safe sailing times’ (Tseng et al 1988:1539).

Koro epidemics have been recorded as having occurred on Hainan Island in 1865, 1948, 1955, 1966,

1974, and sporadically in August 1984, followed by a larger epidemic between November 1984 and

May 1985 involving, mostly but not exclusively, young men (Tseng et al 1988). Notably all these

dates except the most recent correspond with major political events on the Chinese mainland. In 1864

the Hakka led Taiping rebellion was defeated, 1948 the eve of Maoism, in 1955 Land reforms

policies were implemented throughout China, 1966 The Cultural revolution took place, and in 1974

the great leap forward campaign began. In 1953 when land reforms came into being and were

implemented by the setting up of village councils throughout China in 1955, a Koro epidemic

occurred on Hainan (Mo et al 1987) and the island was left alone. Interestingly the Guangdong

branch of the Chinese communist party argued that the implementation of land reform policy in

Hainan at that time was not possible, as localism was so firmly entrenched (Vogel 1969:211). In the

region’s theoretical party organ ‘Shang Yu’ the provisional secretary of the Guangdong communist

party, Lin Li Ming wrote:

‘The Hainan anti-party localist group, headed by Feng Pa-Chu...began during the

latter half of 1956 to resort to anti-party conspiratorial activities.... They blocked and

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Christopher Mark Graham Norman.

disrupted the thorough implementation of the party’s policies’ (Vogel 1969:212).

Consequently in official party circles the island was referred to as the ‘Independent kingdom of Feng

Pai-Chu’(Ibid.). Such factors have been mentioned in relation to Hainan Koro epidemics by Dr. G M

Mo, head of the Chinese Koro team based in Hainan during the 1984-1985 epidemic, and were

presented at the International Symposium on Cultural Psychiatry at Budapest in 1991 (Prince 1992).

However, Raymond Prince the editor of ‘Transcultural Psychiatric Review’ and its editorial advisor

Wolfgang Jilek, who was invited to Hainan by Dr. Mo to report on the epidemic, dismissed these

factors.

In the 1984-1985 Hainan Koro epidemic the issue of fox spirits emerged for the first time (Jilek 1986.

Prince 1992. Cheng 1996 ) and it has since been argued that: ‘two medical world views were being

expressed in the Hainan epidemic; the Yang/Yin humoral theory and a more primitive interpretation

of illness linked to spirits or ghosts’ (Prince 1992:128). However, these worldviews are not in fact

separate as Prince (1992) proposes, they are interrelated. As has already been pointed out with

regards to Van Gullick’s (1961) analysis of an earlier Ming treatise on longevity, that Yin can be seen

as strengthening Yang, and vice versa, i.e. Yang can strengthen Yin. It is this latter relationship that

has a direct bearing on Hainanese Koro epidemics. Yin and Yang do not exist independently of one

another, but are interdependent. The term Yin originally meant the shady side of a hill, and the term

Yang its sunny side (Pokert 1978 Unschuld 1985). It may therefore be said that Yang can be related

to the attributes of that sunny side in that it is light, dry, and warm and a place where life will

flourish. Whereas Yin, the shady side, has the attributes of darkness, dampness and coldness where

things may not grow quite so easily, and therefore has a relationship to death and its mysteries.

Further links can be shown as follows: dryness is associated with hardness, hardness is associated

with strength, men are strong and therefore the male is Yang. Whereas dampness can be associated

with softness, an attribute often associated with the passivity of women in Chinese society, who are

thus Yin. This extends to the Chinese perception of the body; where the soft parts such as hair and

skin are regarded as Yin, and the hard parts, such as bone, are regarded as Yang. This is brought out in

the double burial of Cantonese Funeral rituals:

‘..Human flesh, in the absence of life, presents a dangerous combination of Yin

(female) forces. Bones, which are charged with auspicious wind and water, are
primarily Yang-the male element...Women ...deal exclusively with yin remains of the
corpse (i.e. the rotting flesh).... Men avoid the corpse whenever possible but commune

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Christopher Mark Graham Norman.

freely and enthusiastically with the Yang remains [the bones]... The realm of ancestors
is thus pure (flesh free) and exclusively male (Yang)’ (Watson 1982:179).
.

What is learnt from this is that women have a special association with the world between life and

death, the liminal phase of the ghost of the deceased whose very presence evokes a sense of

dangerous pollution for the living. Women as ‘transient beings’ (Watson 1982) stand at the gateway

between this world (Yang), and another (Yin). For not only do women deal with the most dangerous

part of death (Yin) when the deceased is between this world and that of ancestors (Yang), they also

bring life (Yang) into the world, through their ability to give birth (Yin). This world of Yin, existing in

harmony with the world of Yang, includes not only women, who stand in a closer relationship to Yin

than Yang, but also the inside of the body, death and its spirits, night and its nocturnal animals such

as the fox.

2.1: Fox Spirits and the 1984-1985 Hainan Epidemic:

The origins of Southern Chinese fox beliefs can be traced to the Tang dynasty, when the Hans moved

to Guangdong (Prince 1992) and there emerged a ‘domestic fox cult connected with fertility rites’

(De Groot 1907 Vol 5 II: 211). Such traditions continued among rural people in Northern and Central

China into the 1930`s, when fox shrines could be found on farms near Peking, and were propitiated

during runs of bad luck (Jameson 1932). A similar tradition continues in Japan’s Southern rural and

coastal districts to the present day (Smyers 1999), where it is also associated with witchcraft and

sorcery (Blacker 1992), and it is believed that:

‘In Southern Guangdong folk tradition, female fox spirits..make men

mentally ill and [this] is reminiscent of Japanese emic theory in which
fox spirit possession is a major cause of mental disorder, as mentioned
in Lady Murasaki`s classic novel `The Tale of Genji` A D 1800’
(Jilek 1986:278).

In order to gain some understanding of Hainan fox spirit phenomena, it is necessary to provide some

detail of the Chinese perceptions of the cosmological forces that relate the spirit to the human world,

and the protection that is afforded against fox spirits in Hainan, before discussing the traditional

Chinese calendar and festivals, which demonstrate the link between these worlds.

2.2:Perceptions of the Supernatural

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Christopher Mark Graham Norman.

The Chinese supernatural world is based on the idea of a ‘universal spirit’, which animates all things,

both animate and inanimate, in accordance with the Yin/Yang dialectic (Berwkowitz et al 1969:72).

The Yang aspect, known as Shen, is one of the three treasures, along with Jing and Chi. Their inter-

relationship may be explained as:

‘[Whereas] Jing is the source of life, and Chi the ability to activate and
move,
Shen is the vitality behind Jing and Chi in the human body. While animate
and inanimate movements are indicative of Chi, and instinctual organic
processes reflect Jing, human consciousness indicates the presence of
Shen... The origin of Shen is analogous to the origin of Jing:.. Shen does
have a material aspect. It is a fundamental substance of the human body....
Shen is a Yang substance... Extreme Shen disharmony can lead to
incoherent speech, insomnia, un-consciousness and violent madness’
(Kaptchuk 1983:45-46).

Shen refers both to what may be termed the human soul, and other entities, in a world of which it is

part, such as gods and ancestors, which are regarded as benevolent spiritual beings. The human soul,

Shen, in its Yang aspect is called Hun, and its Yin aspect is called ‘P’o, which is believed to have

seven parts which correspond to the seven emotions, an alternative name for P’o is Kuei’ (Elliott

1955:28). The division of the soul into Shen and Kuei is mirrored in the celestial sphere where Shen

refers to Gods and Kuei to malevolent spiritual beings. Moreover, in the supernatural world, a god,

Shen, may provide protection against malevolent Kuei. The relationship may be demonstrated by the

protection, which was sought against fox spirits in the 1984-1985 Hainanese epidemic.

2.3: Shen Spirits and Political Allegories in Hainan:

2.3: Shen Spirits and Political Allegories in Hainan:

In Hainan and Leizhou, the god Zhong Kui, to whom offerings were made by sufferers and their

families, affords protection against Sou Yang causing spirits. The god’s image was thus in great

demand and his picture could be found in people’s homes and at the hospital outpatient department in

Haikang, Leizhou, during the epidemic period (Jilek 1986:278). According to Chinese mythology,

Zhong Kui was a Tang dynasty physician, who after being rejected in public examinations on account

of his ugly features, committed suicide in the presence of the Emperor who:

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Christopher Mark Graham Norman.

‘Posthumously honoured Zhong Kui making him a deity and giving him the title:
Great Spiritual chaser of demons for the whole Empire. As such [Zhong Kui] is one of
the seven ministers in the Qu Xie Yuan, the Taoist ministry of Exorcism charged with
the expulsion of evil spirits from dwellings` (Ibid.).

Just as there is a link between the somatic, psychic (Unschuld 1985) and the supernatural (Elliot

1955) there is a link between the supernatural and the political. Such beliefs originate from the idea

of China’s legendary Emperor, Huang Ti (Yellow Emperor) who was said to have descended from

heaven. Subsequent Emperors have thus also been regarded as sons of heaven and their rule placed

under its protection (Christie 1968). Bureaucratic administration and organisation on earth was thus

regarded as a reflection of a higher heavenly world. Although Imperialism ended with the fall of the

Ch'hing (1644-1911) links between heavenly gods and earthly leaders are still made, for example:

‘Mao Tse Tsung’s image, in some areas, is identified with the image of Zhong Kui
and held to have demon expelling properties, in part due to various political speeches
made by the leader when he called upon the people to “crush the devils… [and]…
drive out the evil spirits of counter revolution as does Zhong Kui”.’ (Jilek 1986:279).

Dr. G M. Mo has pointed out that during Hainan epidemics ‘Superstitious predictions and political

rumours circulated before and during each outbreak’ (Ibid:274). However, in 1984-1985 there were

no socio-political factors involved: ‘The epidemic was triggered by a fortune teller who predicted

that 1985 would be a bad year [for Hainan] and that all of the people would suffer from many

disasters (Tseng et al 1988:1540). Unfortunately there exists no precise date for this prediction in any

of the literature, or reference to the fortune-teller’s gender, which could perhaps provide some useful

insights into the outbreak. It is known that the earliest case of Sou Yang occurred in the month of

August, shortly after the prediction was made (Tseng et al 1988. Cheng 1996), and that the Sou Yang

causing spirit was known as ‘Hu Li Jing: meretricious beauty, bewitching as a fox...descended from

heaven’ (Jilek 1986:278). By examining the Chinese festivals which correspond with the fortune

teller’s prediction, further light will be shed on the issue of heavenly female fox spirits making love

with mortals, and associated fertility beliefs.

2.4: The Chinese Calendar and Festivities:

The traditional Chinese calendar for determining festival dates is based on the lunar cycle. The New

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Christopher Mark Graham Norman.

Year begins on the second moon after the winter solstice (Berkowitz et al 1969). In 1983 the solstice

was on 4th December, the second new moon being on the 1st February 1984 (Para Research 1983),

the date of the Chinese New Year. The beginning of each month is in accordance with the New

moon, and its process marked by its cycle during that month. The seventh moon of the year, on the

26th August 1984, is the first of the seventh month. During this month, three festivals take place: On

the seventh day, the Double seventh festival, on the fourteenth, the field festival when the gods are

believed to be in the fields, and the Hungry ghost festival, when the Kuei are given offerings, to leave

the living in peace (Berkowitz et al 1969). Since during these festivals fortune tellers often make

predictions, it seems likely that the prediction precipitating the 1984-1985 epidemic was made during

the double seventh, as according to Dr. Mo one of the story themes that prevailed during the Hainan

epidemic was of ‘a beautiful goddess descended from heaven’ (Jilek 1986:278).

2.5: Festivals and Spirits:

The double seventh festival is based on a 2000-year-old story. There are various versions, the most

popular being the story of a weaving maid, who was the seventh and most beautiful daughter of the

Jade Emperor, but who was so lonely that she came to earth and married a cowherd. The Emperor

ordered her return, and the cowherd followed her back to heaven. The two lovers were eventually

separated and are represented by the star formations known as Niu Lang (cowherd) and Zhi Nu

(weaving maid), which can be observed in the sky each year at the time of the double seventh

festival, when the weaving maid is believed to return to earth, occasionally bringing her sisters with

her (Berkowitz 1969:56). One festival custom involves married women fetching water, believed to

have medicinal properties from a river or certain wells. This is based on the belief that ‘the weaving

maid and her sisters sometimes bathe in a river at dawn, after union with her mortal lover’ (Ibid:58).

This suggests that the weaving maid's female sexual fluids (Yin) and those of her mortal male lover

(Yang), infuse the water with the properties of what ancient Taoist belief called the ‘Elixir of

Immortality’ (Humana and Wu 1971). This background may provide some coherence to the use of

the fishnet in the methods of exorcising the Sou Yang causing fox spirit, as illustrated by a more

detailed account of

Case A:

‘They covered me with a fish net and beat me with the branches of a peach tree all
over my body but not on my head. The peach tree branches are the best to drive out
ghosts or devils. They said they would catch the ghost in the net. They were beating

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Christopher Mark Graham Norman.

drums and setting off firecrackers. They said that it was a fox ghost that got into my
body, a female fox spirit.... they yelled “get out of him fox ghost.”...’ (Jilek
1986:276).

The use of peach tree wood to drive out ghosts and devils originates from the Chou dynasty1 (De

Groot 1910 Vol 6 II). Jilek also noted that Mugwort, still used in Chinese medicine was ‘hung over

doors to prevent evil spirits from entering… [Indicating] … a historical connection between

shamanic healing and classical Chinese medicine’ (Jilek 1986:280 ).

1
1030-22 BC.

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Christopher Mark Graham Norman.

3.0: Conclusion:

It seems that political decisions concerning land reform policies in Hainan, made in accordance with

the desires of policy makers on the mainland, encouraged political rumours, and along with fortune

teller’s predictions at Chinese festivals and related supernatural beliefs precipitated Koro/Sou Yang

epidemics. The political and the supernatural, as has been shown, often exist in a seamless unity, and

like the psychic and its relationship to the somatic, may be regarded as unseen and disruptive Yin

forces, which if left uncontrolled disrupt the everyday world of the living in its Yang aspects. On the

most basic level, it would appear that it is the anticipation of the wrath of these Yin forces that

generates latent anxiety, which is eventually somatised, and manifests in Sou Yang epidemics.

Hainan Sou Yang therefore appears to be a complex phenomena which demonstrates important links

between ancient Chinese medical traditions and the remnants of what appears to be an early ‘fertility

cult’, rather than with Freudian Oedipal or castration anxiety.

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