Given such a cheerless and unappealing topic, this book is surprisingly upbeat and a pleasure to read. The many life stories of trauma and unhappiness resulting from real or imagined sexual impotence presented here are often touching and depressing, but Everett Zhang has managed to skilfully weave these individual cases to produce an overall picture of men and women seeking ways to satisfy their desires rather than accepting their lot, so that instead of being a “negative event… [the impotence epidemic in China] is a positive one, because it signifies the ontological shift in human existence in China from downplaying desire to promoting the desire to desire” (p. 15). Zhang therefore goes beyond the study of the sexual adversities of some Chinese men at the turn of the century. He offers insightful explanations to more general societal phenomena such as why “men's medicine departments (nanke)” in Chinese hospitals only appeared in 1984, whereas “women's medicine (nüke)” has been a fixture since traditional times.

Using mainly theories developed by European philosophers such as Lacan, Deleuze and Foucault, and supported by data gathered from over ten years of fieldwork in Beijing and Chengdu, Zhang argues that the ostensible social tensions and dislocations in the immediate post-Mao era may have given rise to an “impotence epidemic,” but this serves only to demonstrate that Chinese society is becoming less restrictive and the Chinese people more assertive in acknowledging and seeking their individual aspirations and desires. Despite its title, then, the book is not just a sociological or statistical exploration into an “epidemic” in China. “Epidemic” may be an exaggeration, but the term does reflect the popular perception of a “masculinity crisis” in late 20th-century China. And this “crisis” has been highlighted and discussed in numerous accounts from creative works in literature to scholarly treatises, with many blaming the Cultural Revolution's puritanical policies and political upheavals for the perceived problems.

However, the book is by no means an anti-Mao diatribe, and even though it contains a large dose of theorizing it is anchored firmly on excellent ethnographical research, made possible through Zhang's connections in two large hospitals in Beijing and Chengdu. There, he interviewed more than 300 men and women confronted with impotence. The amount of time and energy invested in the fieldwork is huge, and the results show that the care Zhang has taken to develop his thesis has been rewarding and worthwhile. The often personal and at times heartbreaking accounts of his informants (for example, patients who have never had any physical contact with a woman until after the age of 30) confirm Zhang's argument that erectile failures cannot be explained by looking at the medical histories of individuals. To understand this phenomenon, it is essential to explore “a wide range of experience – social stratification, sexual desire, family obligations, gender relations, one's ethical orientation, and ultimately, life itself” (p. 226).

Interestingly, the holistic approach, favoured by Traditional Chinese Medicine, partly explains why the advent of Viagra in China did not spell the end of TCM for treating the problem of erectile dysfunctions. Indeed, Pfizer was probably surprised and disappointed that the China market for Viagra was rather minimal given there was meant to be an “impotence epidemic” in that country. Men who suffered from erectile failures did not turn away from TCM as feared by its practitioners. It seems Chinese patients do not just want a one-off lift to their sexual desire and performance; they seek a long-term solution, not just for impotence, but more importantly for a better quality of life in general. Zhang's findings suggest that many tend to utilize both TCM and Viagra in attempting to restore their potency, but they seem to believe that “potency” in a more general sense cannot be activated and maintained by simply popping a pill.

While it is impossible to cover the whole area opened up by this research, Everett Zhang has done an admirable job in showing the various reasons for and manifestations of that holistic approach. Zhang has clearly made a tremendous contribution not only to anthropology and sociology, but also to other research fields such as gender studies, history of medicine and cultural studies. Indeed, Zhang has utilized sources from diverse fields such as philosophy, literature and medicine from both China and the West. He has also, over many years, accumulated a rich resource of personal observations of semiotic signs such as street notices and advertisements related to sexual matters or erectile dysfunctions. As a result, the book is amply illustrated by such images as well as other inserts such as photographs of eminent Chinese sexologists and doctors that Zhang interviewed.

Zhang's informants are mostly men and women who instead of silently enduring the frustrations and bitterness resulting from sexual dysfunction, actively seek help in two of the largest cities in China. While he sympathizes with his informants, he sees the individual search for fulfilment as a positive development in an otherwise depressing “epidemic.” I applaud the optimistic and thoughtful tone he has adopted, and I fully recommend the book to anyone interested in China or how human beings cope with misfortune. As I said at the beginning, the topic is not a joyous one, but the book is a pleasure to read and I have no doubt it will be cited for years to come.