BRITISH MEDICAL JOURNAL 28 JUNE 1975 741

in this rejection of sex, but it is unwise to overstate this. Indeed and financially successful. Cultural elements are important
practical experience leads one to the belief that individuals with because the greater the demand for male excellence in perfor-
built-in problems seek religious sanction for their prejudices mance the higher is the rate of secondary impotence. Overwork,
rather than that a religious attitude discourages a healthy sexual physical and mental strain, and alcoholic episodes are usually
outlook. found when the analysis of the problem takes one back to its
Traumatic early experiences can certainly lead to difficulties, origin. Frequently there has been marital disharmony for some
particularly in those predisposed by a low sexual drive. A clear time, perhaps connected with business problems, perhaps going
example of this was the young man whose first sexual experience back further. Certainly it is common to find that premature
was with a prostitute, an experience, it was arranged, to be ejaculation and failure of the wife to achieve orgasm over many
shared with three friends for reasons of economy. He was the years has been a feature of the marriage. Probably because of
lucky, or unlucky, companion who was deputed to be first. His the underlying disharmony the results of failure to achieve
inexperience, combined with the encouraging comments of his erection are magnified. Anxiety to avoid further failure makes
friends through the closed door, ensured his lack of success and it only more likely, and if the help of alcohol is sought further
his subsequent impotence. failure is virtually assured. The more frequent the failure the
Latent or overt homosexuals may well be found suffering more critical the partner, and the worse the situation becomes.
from primary impotence with a female partner. Here too, of Compounding the difficulty is often a wife's fear of her hus-
course, family background may be significant. band's infidelity, and in some circumstances his own seeking of
As with the other problems already considered, analysis of reassurance about his sexual abilities outside marriage.
the problem and re-education to a more healthy regard for sex In spite of the daunting nature of these problems, secondary
are most important. Specific stimulation by the female partner impotence of this type can almost always be dealt with. Analysis
may be of value, but it is unwise to expect too much of this of the problem with the couple, resolution of their underlying
approach. Often "like marries like," and a couple may be fears, shedding of business cares at least for a time, and above
content to live without intercourse by mutual consent until aU the discouragement of the man from a constant analysis of
perhaps their friends or relatives question them about lack of a his performance offer the real prospect of restored potency and
family. In such circumstances complete success for any form of marital happiness.
therapy is rare. Even if successful intercourse and pregnancy
are achieved, such couples rarely feel the need or indeed obtain This paper, and the clinical examples cited, forn part of an
any great satisfaction from their physical relationship. analysis of 200 personal cases of sexual dysfunction referred to ne
during the past eight years and previously unpublished though
publicly discussed.
SECONDARY IMPOTENCE
This is a commoner problem and usually more amenable to References
management. Physical causes may be entirely responsible or 1 Amulree, Lord, Practitioner, 1954, 172, 431.
perhaps make a major though indirect contribution to the '2Ahmed, S. H., British Journal of Psychiatry, 1968, 114, 1197.
problem. Testicular loss, general endocrine disorders, perineal 3Bergher, E., International Journal of Sexology, 1950, 4, 14.
4 Dengrove, E., Marcus, D. M., and Cook, E. N., journal of the American
prostatectomy, and neurological diseases such as multiple Medical Association, 1963, 183, 389.
sclerosis may explain the situation completely. Angina, severe 6 Taubel, D. E., American journal of Psychiatry, 1962, 119, 87.
dyspnoea, hypotensive drugs, and painful local lesions such as 6 Masters, W. H., and Johnson, V. E., Human Sexual Inadequacy. Boston,
Little, Brown, 1970.
phimosis may be important factors without interfering directly
with the mechanism of erection. If a physical cause is found it
may not or more likely will not be amenable to treatment. The Further Reading
problem then becomes one of marriage counselling. O'Malley, P. P.,Journal of the Irish Medical Association, 1968, 61, 85.
More commonly secondary impotence is a consequence of a Ovesey, L., American Journal of Psychotherapy, 1968, 22, 185.
complex of physical, social, and psychological factors. It is most Roen, P. R., New York Medical Journal, 1965, 65, 2576.
Semens, J. H., Zeitschrift fir Urologie, 1959, 52, 381.
frequently seen in those of middle age, under stress, socially Simpson, S. L., British Medical Journal, 1950, 1, 692.

Outside Medicine
Thomas Gann in the Maya Ruins
J. E. S. THOMPSON

British MedicalJournal, 1975, 2, 741-743 Murrisk Abbey, Mayo, Eire. Though born at Murrisk Abbey
he grew up in Whitstable. His parents were prominent in the
social life of that then small town, in which young Somerset
Thomas William Francis Gann (1867-1938) was the son of Maugham, seven years Gann's junior, also moved.
William Gann, of Whitstable, and Rose Gann, n&e Garvey, of Maugham named his strumpet heroine of Cakes and Ale
Rosie Gann, and has her a native of Whitstable, thinly disguised
as Blackstable, in which the early scenes of the novel are laid.
Several characters in this book have been widely recognized as
Saffron Walden, Essex portraits of persons the author disliked. Accordingly, it may
SIR ERIC THOMPSON, LITT.D., F.B.A. well be that Maugham, whose sense of spite was acutely
742 BRITISH MEDICAL JOURNAL 28 JUNE 1975

developed and whose early years at Whitstable were unhappy, convenient spot for careening-the celebrated Bartholomew
deliberately chose that name for his wanton character to pay off Sharp lived there in 1677-it became a source of logwood which
some old score or fancied insult. Gann's widow informs me
fetched very high prices in Europe because of the dye it yielded.
that no love was lost between her husband and Somerset The labour force required for cutting and transporting logwood
Maugham. She does not know the reason; I suggest it was the and, later, mahogany for Georgian homes was met by the
appearance of Rosie Gann in the novel.
introduction of negroes. When Gann set foot in Belize, as now,
they were the largest element in the population.
In outlying parts of the Colony, in the north and along the
western frontier, were Maya Indians in considerable numbers,
some long established there, others recent immigrants from
neighbouring Mexico and Guatemala. Their ancestors created
the Maya civilization which flourished from about A.D. 100
to the arrival of the Spaniards in A.D. 1540, but its beginnings
reach back to 800 B.C. or earlier.

Fantastic Implements
From the Cayo or Western District Gann was transferred in
early 1894 to the Corozal or Northern District. Both are
liberally sprinkled with Maya ruins, some almost on the surgery
doorstep. Moreover, neither district was heavily populated, so
surgery hours for treatment of malaria, hookworm, machete
wounds from Saturday-night brawls, and so on left ample time
for archaeological exploration. In those early days no domestic
ties interfered with mound digging; Gann remained a bachelor
until the age of 60. He wasted no time in indulging his hobby,
for his first paper, Exploration of two mounds in British
Honduras, appeared in the Journal of the Society of Antiquaries
for 1894-5.
One of those mounds was at a large ruin a mile or two from
his surgery at Benque Viejo, second largest village in his
practice. From later knowledge of Gann I picture him speeding
up the flow of patients through his surgery and cutting short
long-winded recitals of ills so that he could be off to see how
Thomas Gann, reproduced from frontispiece of Maya Cities the dig had progressed. That first paper has almost the earliest
(1927, Duckworth) by permission of the publishers. account of the discovery of certain fantastically shaped im-
plements, now called eccentric flints or eccentric obsidians,
which are such a common feature of Maya sites in Belize and
the neighbouring Guatemalan Department of the Peten. Gann
British Honduras was not aware that he had been beaten to the post by an Italian
Young Gann went to King's School, Canterbury, and thence who in 1891 had reported similar finds in an obscure journal
to medical school, followed in both steps by Maugham. Gann in Florence.
trained at the Middlesex Hospital, receiving his M.R.C.S. and Transfer to Corozal, in the north of Belize, whetted Gann's
L.R.C.P. in 1890. He arrived in Belize, then British Honduras, appetite for Maya ruins; in an article in the same Journal of the
in June 1892 and very shortly took up an appointment as Society of Antiquaries for 1896-7 he reported that by then he
district surgeon and district commissioner of the Cayo (Western) had opened between 50 and 60 mounds. Gann of course had
District, the latter posting surely to fill a temporary vacancy, had no archaeological training, and that showed itself in his
for the two positions were never permanently merged. failure to keep adequate notes of his excavations and even to
According to Mr. William Schofield, of Corozal, Belize, with oversee the labourers (often he would go to the dig only at noon
whose father Gann maintained a long friendship from- 1894- and sundown to collect the finds). Consequently, much im-
onward, Gann decided to practise in the Colony because of an portant information was not recorded. But Gann reflected the
interest in Maya archaeology he had already developed, and he attitude of his period, which regarded excavation as the retrieval
took up the appointment on the understanding by the Colonial of works of art or "curios," not as a means of recovering history.
Office that he would serve only in those parts of the country Moreover, archaeological techniques now taken for granted
well endowed with Maya ruins. Certainly he was never stationed were then unknown. Potsherd stratification, today indispensable,
in the Belize District or coastal districts to the south, in which came into use in the New World nearly three decades after
Maya ruins are not plentiful and those there are lie distant Gann had opened his mounds. Similarly, no one then bothered
from medical centres located in the larger settlements. to keep charcoal, for the discovery of carbon-14 dating lay far
One can only guess how this young medical student first in the future.
became interested in Maya archaeology. Those classics Incidents On the other hand if Gann had not opened those mounds
of Travel in Central America, Chiapas and Yucatan, and Incidents looters would have done so, or the mounds would have been
of Travel in Yucatan, by J. L. Stephens, with their fine descrip- bulldozed to supply road metal or to level land for plantations,
tions and illustrations of Maya ruins, were readily available, as fates which have befallen so many archaeological sites in Belize
well as Charnay's The Ancient Cities of the New World. This and elsewhere.
last may have brought him into touch with the great pioneer In his early years in Belize Gann was also at the disadvantage
Alfred Maudslay, perhaps the only man in England who knew of being very much on his own. Nevertheless, his report of
that British Honduras was Maya territory. 1900 on his discoveries at Santa Rita, discussed below, shows
That small land, about the size of Wales, is bitten out of the that he already had a good acquaintance with the authorities
east flank of the Peninsula of Yucatan which points northward in Spanish and English then available, several of the books he
towards Florida across the Gulf of Mexico. Favoured by cites being quite rare. Perhaps initially he did get advice from
buccaneers in the 17th century as a tropical hide-out and Maudslay, but he certainly studied his sources either before
BRITISH MEDICAL JOURNAL 28 JUNE 1975 743
going to Belize or when in England on leave, perhaps with the old paddle steamer Egerton arrived weekly from Belize). With
aid of a working library. only about half the outline crudely traced, mischievous Indians
one night removed the whole of the stucco surface. The Maya
Indians were said to have ground this up and used it in water
Pulverized Inscription as a sovereign cure for unspecified ailments.
Most unfortunately a long hieroglyphic inscription occupied
Soon after taking over as medical officer of the Corozal District, half the destroyed surface, a tragic loss, for not a single hiero-
in the extreme north of the country, Gann made the most glyphic text of that late period has survived. We are dependent
important discovery of his long career. The town of the same for knowledge of the writing of that period on short divinatory
name had been settled nearly 40 years earlier by Spanish- passages in a couple of Maya books. One wonders whether Gann
speaking mestizos fleeing from the Maya Indians in revolt saw the irony of his great discovery being carted off to make
against white rule in Yucatan; in the surrounding country were medicine for his rivals, the local witch doctors. I doubt whether
several Maya Indian villages. A mile or so from Corozal town, he did, for he was liable to fits of uncontrollable temper which
which then boasted a fort and small garrison as a protection sorted ill with philosophical acquiescence.
against Maya raiders from across the border, was Santa Rita,
a property of some 500 acres cleared some years earlier for
growing sugar cane. Removal of the forest had disclosed between Collection of Jades
40 and 50 ,incient mounds.
By the time Gann came on the scene in 1894 a number of Gann was not caught out again. He uncovered and copied on
those mounds had been completely destroyed; the limestone good tracing paper the remaining figures on the north and west
rocks of the cores and the dressed stone of the facings had been walls one by one, partly because they faded rapidly on exposure
carted off to build houses in Corozal. That is a process with to sunlight, but partly no doubt to ensure they were not
which the world is only too familiar: Roman villas robbed to converted into products of the Maya pharmacy. Gann's
build St. Albans Abbey; suppressed abbeys pulled down to publication of the murals-Mounds in Northern Honduras-was
build the stately homes of Henry VIII's henchmen, and so on. and is an outstanding contribution to Maya studies.
There are good grounds for believing that Santa Rita was part His medical practice brought Gann into close contact with
of the site of Chetumal, capital of the Maya province of that the present-day Maya. An important outcome was that he was
name which flourished at the time of the Spanish conquest. It able to procure a Maya text of the great rain-making ceremony
was a wealthy town, for it controlled the export to Yucatan and called ch'achac, "summon the rain gods," performed in times
perhaps to Central Mexico of huge quantities of cacao (choco- of drought. Such texts have been recorded more recently in
late) beans, for the cacao bean was the currency of all Middle other parts of the Maya area, but the early Gann version has
America. Whatever group held territory with the precise degrees important details lacking in others.
of heat and humidity needed for its cultivation was in the happy In 1918 Gann in the company of the Maya archaeologist
position of having money that grows on trees. Just as the Sylvanus Morley sailed round the peninsula of Yucatan from
British once established their "factories" in China and India, Belize to Champoton, visiting many important coastal and
so the aggressive seagoing group of Maya, the Putun Maya, with inland Maya sites. His highly readable In an Unknown Land,
strong mercantile interests had settled at Chetumal to control describing the exploratory journey, appeared in 1924 and was
the cacao trade. followed in the next four years by as many more books of travel
Gann uncovered one building at Santa Rita inside a later and archaeological exploration in the Maya area, all written in
construction. The covering of one building by a larger and later a pleasant non-technical style. In them are accounts of important
one was a regular feature of the Maya "bigger and better" Maya ruins which Gann discovered or first brought to public
attitude. What made this example of extraordinary interest was attention.
that the outside walls of the inner building had been completely Gann formed an outstanding collection of carved Maya jades,
covered with figures painted in red, yellow, blue, green, black, which with many other artifacts he bequeathed to the British
and white, a large number of which were in fair to good con- museum. They are part of the superb Maya exhibition open
dition. Maya murals are rare; these had the added importance until late in 1975 at the Museum of Mankind, 6 Burlington
of being the only examples of a vivacious blending of Maya Gardens, London W. 1. He was in fact the first man to collect
and non-Maya motifs surely attributable to those Argonauts of Maya jades. In a way that interest epitomizes the Victorian or
the Caribbean, the Putun Maya. Edwardian collector attracted by intrinsic beauty and exquisite
Unfortunately, as it turned out, the east wall was first laid workmanship. It is not the approach of the present-day
bare. When its mural unexpectedly came to light no tracing archaeologist, often more interested in finds that reconstruct
paper was to be had in Corozal. Gann was forced to copy the economic history, but it would be a poorer world were there
painted design with an improvised and far from satisfactory not room for both "schools." After all, Gann's fellow Whit-
substitute, oiled paper. The consequent delays were fatal (the stablean, Somerset Maugham, collected Zoffanys.