And, of course, their blood pressure rose, so that they ran a greater risk of having a stroke or some other cardiovascular complication.

It appears from this story that the doctors were not communicating adequately with their patients and were not educating hypertensive people properly. In an attempt to overcome this unsatisfactory situation, a community effort was made in Baldwin County, Georgia. Specially trained nurses visited hypertensive people in their homes, they took blood pressures and helped the people understand why the drugs were needed. Within a few months 86 per cent of people known to have hypertension were taking their medication, and, in nearly all, good control of their blood pressure had been achieved. Unfortunately, the effort was a pilot scheme, and once it had proved its efficiency it was abandoned. However, it showed what could be done to reduce the serious effects of untreated hypertension in the community.

It is important that action is taken by the community, and by individual people, to detect and to treat high blood pressure. If hypertension is controlled, fewer people – especially men – will have a stroke or a heart attack, and the misery consequent upon these disasters will be reduced.

The time to take action is now. The method of taking action is not difficult, but it does need community involvement.

Each community may wish to devise its own strategies, and the following suggestions may help in starting a programme to reduce hypertension and its consequences.

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Myth is still assiduously propagated by those who have an immoderate fear of homosexuality. It is completely untrue. Cases of child, or youth, molestation by older homosexuals are uncommon. Far more cases of ‘interference’ with little girls, including their rape, by heterosexual men are reported. Homosexual child molestation is essentially non-violent, in contrast to heterosexual assaults on children. Father Michael Ingram, a Roman Catholic priest and a trained psychologist, has investigated the problem. He studied 91 cases, in which boys under the age of 14 had had sex with a male adult. None of the men had been violent towards the boys, none was disturbed mentally. He found that most of the children, many of whom came from broken homes, had behaved seductively, had ‘regularly come back for more’, had ‘worshipped’ the man, and had been fully willing, co-operative participants. He could find no evidence that any of the boys was hurt in any way; and none that the boy would become homosexual as a result of the experience. In all cases the relationship between the man and the boy had been characterized by gentleness and concern.

In the past decade, particularly in the U.S.A., surgeons have devised operations to help men whose erectile impotence is caused by disease, particularly diabetes and vascular disease. Two main in gical approaches have been made. In the first, a silastic (silicone) Iplint or prothesis, cut to the appropriate length, is inserted between the loose skin of the upper surface of the penis and the underlying cylinders. The penis containing the prothesis is no longer limp, and can be inserted into the vagina, but it is not a hard, erect penis and its size always remains constant. As the author of one report, Dr Pearman, says, it ‘assists’ but does not replace the i и her factors necessary for successful copulation.

The second method is to insert an implantable inflatable prothesis into the penis. The advantage of this is that the device can be inflated by squeezing a small bulb in the scrotum when the man wants to obtain a larger firmer penis. At other times the penis is small and limp.

It is also obvious, from any of the definitions, that premature ejaculation is usually only of concern to a man whose relationship with his partner is a sharing one and who wants to help her have as much sexual pleasure as he is having. If a man’s socio-cultural background is a male-dominated one, in which no sharing sexual relationship is expected, or wanted, and in which his own sexual satisfaction, by orgasm, is the sole criterion of sexual enjoy-ment, he will perceive no problem; nor will his partner. In such cases, sex-play is brief, or absent, communication is unusual, sexual intercourse urgent, brief, and ejaculation is rapid. It is an example of the ‘wham, bam, thank you, ma’am’ pattern of sexual behaviour.

In such sexual (and marital) partnerships, a double standard of sexuality is usual. The woman may have been told that this is what she should expect in sex. Or she may be so sexually unstimulated that she welcomes her partner’s quick ejaculation as rapid relief from a resented ‘duty’ expected by her partner, irrespective of her feelings. This resentment is aggravated if, after ejaculating, the man rolls off his recumbent partner without offering any tender exchange of words, and falls asleep, snoring, next to a resentful woman, who is wide awake.

The ducts join together to form about twelve larger collecting tubules, which then join to form a tube which lies coiled and twisted alongside the testis and reaches to the vas deferens. The coiled tube is called the epididymis. If it is uncoiled it is nearly 6 metres (20 feet) long. If a man has regular sexual stimulation and ejaculates, the spermatozoa move quite quickly along the epididymis, taking from 2 to 21 days for the journey, but if he does not, they can live in the epididymis for about 70 days. The more frequently a man ejaculates the more quickly the spermatozoa pass along the epididymis.

The end of the epididymis joins the vas deferens. As I mentioned earlier, you can identify the vas deferens if you put your thumb and forefinger on each side of the scrotum where it reaches the crutch, and then roll the tissues between your fingers. The vas reaches from the end of the epididymis, up through the scrotum, and enters the abdomen through a weakened oval area just above the pubic bone on each side – called the inguinal canal. Inside the abdomen it lies close to the prostate gland, where it joins the vas from the other side. Together they enter the urethra, the tube which extends from the bladder to the eye of the penis.

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