(2) Erection. The physiological nervous mechanisms consist of nerve fibres which estab lish a complicated series of reflex arcs which acting upon the blood vessels of the corpora cavernosa of the penis bring about its erection. Two factors are prominent in this blood vessel control. There is an active dilation of the small and medium sized blood vessels, so that from 8 to 10 times as much blood enters the penis, and secondly the return of this blood to the venous channels is partly prevented by the contraction of certain fibres of the ischio cavernosus or erector penis muscle which shut off the dorsal vein of the penis. Psychical stimuli after passing down the spinal cord to the lumbar region are switched off, as it were, through cerebrospinal nerves which make up the nervus erigens to the muscles of the penis. The peripheral reflex paths, which carry im pressions from the skin and mucus membrane of the genital regions, pass by way of the nervus dorsalis penis and the nervus pudendis communis to sympathetic ganglia and in con junction with psychical stimuli act upon the vegetative nerve fibres controlling the blood vessels. The spinal connections of this reflex path lie in the second sacral segment. A part of this vegetative reflex arc, is made up of many fibres and carries stimuli from the seminal vessels, the bladder and rectum. These pass through the hypogastric plexus and con tribute to the vascular action. It may happen that the spinal connection of this series of fibres may be cut or diseased. This accident will not prevent erection but there will be no erotic sensations, the erection then only being seen rather than felt. Certain quack-remedy sellers and perverse panderers make use of this mechanism empirically and endeavor to bring about prolonged erection with diminished feeling, thus endeavoring to "restore lost man hood," as they call it. These remedies and methods are extremely dangerous and bring about serious types of impotence. Certain sur gical procedures such as passing cold sounds, prostatic massage, anal lavage, etc., also pro duce at times the most serious results, especially when carried out by ignorant quacks. Since such irregular so-called doctors are not licensed no legal redress can be obtained as a result of such malpractice.
As a result of certain diseases of the spinal cord — usually transverse lesions in the cervical or dorsal region, permanent erec tion — priapism — may take place. In other spinal cord injuries or diseases as in tabes dorsalis usually lying in or involving the lum bar and sacral segments loss of the power of erection may take place. Loss of this power, however, is chiefly due to psychogenic causes and can often be cured by appropriate psycho therapy. The obstinate cases are usually amenable to psychoanalysis, by which procedure the unconscious psychogenic roots of the diffi culty -re discovered. The mechanism of erec tion has its analogue in the female and the same reflex pathways are present. The clitoris tends to become erect, also the erectile tissues of the vulva. The glands of the vulva, includ ing the large glands of Bartholini, secrete mucus and lubricate the vagina in a manner analogous to the secretion of the prostate gland in the male which serves a similar purpose.
(3) Orgasm consists in the discharge in the male of the mixed secretion called the semen into the vagina accompanied by rhythmical con tractions, followed by a sense of relief of tension and satisfaction. An analogous series of contractions takes place in the female, with a mucous discharge from the vaginal glands and movements of the uterus.
In the act of ejaculation, as in all motor ac tivities, both the sympathetic and spinal systems come into action.
The reflex functions of the former come into play in that the summation of adequate stimuli (rubbing movement) acting upon the erected organ causes peristaltic contraction of the smooth muscles of the three secretion-bear ing organs, the vas deferens, seminal vesicles and prostate. This causes the orgasm and empties the mixed secretions into the prostatic urethra. A secondary reflex of a somatic na ture now occurs, namely, a contraction of a spinal cord origin of the cross striated bulbo cavernosi and ischiocavernosi muscles which act forces the semen out of the prostattc urethra.
The sympathetic arc of this reflex mechanism is seldom disturbed, while on the other hand the somatic arc frequently is injured by,spinal cord lesions, particularly deep-seated diseases of the conus. When this injury occurs there is also disturbance of the mobility and sensa tion of parts supplied by near-by muscles. The semen under these latter circumstances is not forcibly ejaculated, but flows off drop by drop.
The relaxation following ejaculation is partly due to a passive process, decrease in tone in the N. erigentes, partly to an active process, contraction of the smooth muscle of the slcin of the penis and of the erectile bodies. Noc turnal flow of sernen during sleep or pollution may occur without sensory stitnuli acung upon the individual and may yet be accompanied by the marked and well-known feelings of passion. This may be called orgasm and is regularly accompanied by the manifestations of stnnula don in the rest of the vegetative system (my driasis, hyperidrosis and tachycardia).
An enormous variation exists among men and women with reference to orgasm. The prevailing maladjustment in men is premature ejaculation; frigidity or delayed orgasm in the female. Failure of a satisfactory sexual rapport in married life is extremely frequent and is chiefly a result of faulty sexual educa tion, largely induced by social customs. It miy be said that the human being is sex-obsessed and it is the function of a rational sexual edu cation to relegate the genital satisfactions to their proper role as but one odf the soneres ni human ha piness. The prevailing prudery of od, while based upon rational sex-ethics, was a movement which overshot its mark and is in need of revision. A more sen sible and honest handling of the entire problem, and it is a highly complicated one, must be entered into before a pragmatic sexual ethics can be evolved. The scientific application of psychoanalysis has proved of inestimable value in evolving general principles of great practical aid in this difficult field of ethics. Consult Freud, (Three Contributions to the Theory of Sex' ; VVhite, 'Mental Hygiene' ; Jelliffe, 'Tech nique of Psychoanalysis' ; Forel, 'Sexual Problem.'