To wash the hair properly there is a simple routine that should be followed. It is basic but many men get it wrong.

First, using the tips of the fingers massage the scalp for one minute by pressing down firmly and using a rotating motion. Do not scratch or use fingernails. This massage stimulates the scalp and helps blood flow through to feed the hair roots as well as relax tightness or tension and, most important, loosens grime or dead skin cells ready for washing.

Under tepid water — not hot — soak the hair and then work in a small amount of shampoo. Gently, as in the massage. Let the cleansing properties of the shampoo do their work. This washing should last one minute.

Rinse thoroughly.

If you feel the hair needs a second shampoo follow the same gentle routine. Again rinse thoroughly. Clean hair will squeak as it is rinsed so keep rinsing until it does.

Towelling the hair dry, continue to be gentle. Never rub violently but pat the hair and firmly massage the head so that the towel absorbs all the moisture. Then reshape the hair using fingers or a wide-toothed comb. If you finish off with a hairdryer keep the nozzle well away from the hair so that the hair is not cooked and, if you can, leave just a little moisture on the hair so that the final drying is natural. This will ensure the hair still has bounce to it rather than be stiff and tortured.

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It is unfortunate that one of the reactions to M-M is an inability to see any situation or happening in other than a bad light and to take any setback, however minor, as a personal affront or defeat. Nothing is quite what it should be or what you believe righteously it should be.

Without realizing what is happening many men complain privately and publicly at every turn and it is not until someone, a relative or friend, quite likely in ill-humour, points it out that they then notice how they are behaving. (Often they will believe their complaints are well justified nonetheless.)

Of course there is a lot in normal everyday life to complain about but it is difficult for anyone to be with a man who constantly grumbles and who appears impossible to please or permanently in a moaning mood. Around him tempers fray easily and people are inclined to shy away, short on sympathy. The sad fact is the more he complains the more likely he is to be disturbed by M-M and the more his emotional equilibrium is at risk.

If you are in a complaining phase and must complain, do so only about major issues or when complaint is fully justified. World affairs, politics or taxation seem acceptable areas and so possibly are occasions of faulty laundry service or restaurant food that is bad. But if you feel you must complain about your boss or about how badly your lover is treating you make sure you complain to someone with a sympathetic ear (who has not heard your complaints before) and permanently avoid complaining about how badly life is treating you.

As all therapists would advise, stop demanding sympathy. Get out and start trying to make the alterations you want to your life as it is your responsibility alone to sort out your life to your satisfaction. A man who complains incessantly is a bore, not sympathetic.

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After the bad news, what can be said to have improved over the years for a man now between thirty-nine and forty-five? Not much.

Usually he is wiser, more compassionate, more understanding, more secure. Generally he becomes more concerned with relationships than with achievement — the obvious exception being the freelance man whose future depends on being able to accumulate capital in order to cushion his retirement. Instead of feeling propelled to compete at work or within the social circle, men after forty enjoy better relationships with their families and wish to be with sons and daughters more for leisure. They begin to enjoy friends and neighbours more. People begin to matter.

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He also feels trapped. Even at the top of a successful career ladder and with a solid and secure company behind him he can feel trapped in his business world with a future offering no promise.

At the age of forty-plus and with at least twenty working years ahead, work has become a drudge. He wants change. He feels trapped by circumstances and hates himself for blindly getting himself into such a predicament.

For most men the rungs on the work ladder are obvious, each step clearly defined. With an equal amount of ability, flair, work achievement and luck the ladder can be steadily climbed. But for a man around forty the work world has shrunk. Promotion is harder to come by, the opportunities less. In fact, from thirty-five onwards opportunities within a company thin out and the possibility of switching to, or finding, work with stimulating or interesting prospects, equally rare. Something must be done.

In an effort to prove their worth, as much to themselves as to others, some take on excessive work loads. They need to impress. They work late, take paperwork home, work weekends. They are prone to stress and heart attacks.

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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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