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While penitential manuals listed what was prohibited, trial records documented what people were accused of. Artificial penile nodules are inert objects inserted beneath the skin of the penis pump to enhance the pleasure of female/male sexual partners during intercourse. Moreover, one of the first treatment options for erectile dysfunction (ED) was detailed in the Kama Sutra, detailing dildos and penis extensions made of wood or reeds tied to the waist. It is probably a representation of a courtesan or entertainer performing a sexually-explicit show.

George Taylor, M.D., was the first American to create a steam and foot/hand crank device in 1869. Taylor’s “Manipulator” turned a wheel, which pushed a rod that created a movement on a handle or padded surface. The patient would either hold on to the handle and receive the vibration or oscillations or sit or stand against the padded surface to receive the movement from the machine. The poulaine was used at dinner parties in the courts and homes of the affluent for under-the-table titillation.

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