SEX AND DREAMS: THE PENIS

Now how do dream erections come about? To explain this, îne has to understand how the penis works. I still remember when, nearly 30 years ago as a freshman at university, I had to go through initiation ceremony with 20 seniors in the student room. Âåñause I was a medical student, I was asked an anatomy question: “Which part of the body can grow ten times its normal size in a few seconds “I answered the first thing that came to mind: 'The penis!' I was immediately ridiculed by the seniors as being a sex maniac, d' cheap, and one-track minded ... I can assure you the experience was most embarrassing. The correct answer, I learned later, was the pupil in the eye, which can dilate ten times in size. According to most authorities, the penis can grow only a little over twice size when erect.
To understand how the penis can double in size, one has to know something about how the penis is constructed. The penis is 1ike two spongy sausages side by side, or a double-barrel shotgun. It can be filled with blood by the opening and closing of a special form of valve system. When the valve of the incoming blood vessel is opened and the valve on the outgoing blood vessel is closed, a lot of blood is trapped in the spongy component of the penis. The penis becomes turgid and erect. It is estimated that the blood flow in the flaccid penis is 5 ml per minute. At the start of the election, the blood flow may go up to 100 ml per minute. When the penis reaches a stable turgid state, the blood flow is maintained at about 50 ml per minute. The control of this valve system is not a completely voluntary one. If a man decides to have an erection, even if he desperately wants to, he may not be able to have one. This is because the valves around the spongy part of the penis are controlled by the autonomic nervous system. This system controls (various bodily functions, such as stomach movements, and is not directly under our control. Remember the time when you burped in public and were embarrassed? You had no way of preventing the burp, because burping is under the control of the autonomic nervous system.
In fact there are two major groups of activities in the body, which are controlled by two separate systems. These are like the gear changes of our cars—automatic and manual:
The automatic system is controlled by the autonomic nervous system. This regulates our stomach movements, heart rate, blood pressure, etc. and, of course, male erection
The manual system is controlled voluntarily by our brain; for example, you can move around or sit still whenever you want
The only time that these two systems are not under our control is during dreaming. In REM sleep, the manual system is no longer working and the muscles are completely relaxed, even in the most tense people. So when a man dreams, on the one hand the genitalia f their compulsory exercises, on the other hand the muscles body are having a compulsory rest.
*18/23/6*

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EPILEPSY AND PREGNANCY

Women with epilepsy are quite often concerned about getting pregnant. There appear to be five reasons for this concern. They wish to know:
if they are likely to hand their epilepsy on to their children;
whether their fits will get worse during pregnancy;
whether it is safe for the baby that the mother should take anticonvulsants drugs during pregnancy;
if there will be any problems in the newborn baby from these drugs;
if they can safely breast feed the baby.
With regard to handing on epilepsy to one’s children – as mentioned earlier, if one parent has epilepsy, the chances of one of the children having epilepsy are no greater than in the population at large. If both parents have epilepsy, it would appear that the risk of a child having epilepsy is about 10 per cent. So in fact the chance of a child inheriting epilepsy, particularly idiopathic epilepsy, is negligible.
As far as seizures during pregnancy are concerned, the situation is not as clear as it might be. There is evidence that for some women, seizure control may deteriorate, while for others there may in fact be no change or even an improvement. A patient told me recently that “she would like to remain pregnant forever” as she had not had a single fit during her pregnancy, compared with six fits in the preceding nine months!
As a general working rule, it is suggested that people who have more than one grand mal fit a month are those who are most likely to have a deterioration in seizure control during pregnancy. The deterioration, if it occurs, is most likely during the first three months of pregnancy. There are a number of theories why this may happen, but none has been proved. It may be of value to check the blood anticonvulsant levels during pregnancy, especially if there is a deterioration in seizure control. The blood levels may fall, necessitating an increase in dosage during the pregnancy.
The main concern for parents is whether the anticonvulsants can harm the unborn baby (foetus). It is known by most people with epilepsy that this is a potential hazard. The effects include physical abnormalities in the baby, a process known as teratogenesis. Abnormalities have been reported in the offspring of mothers on all the commonly used anticonvulsants with the exception of carbamazepine. This is particularly applicable to phenytoin, barbiturates and sodium valproate. Babies born to mothers who have been on carbamazepine have not been shown to have any physical abnormalities, but have a smaller head size than other babies. This has not been shown to be any handicap to the babies who have been followed up for five years.
The risk of abnormalities in the baby is difficult to assess, but it seems to be most common in mothers on polytherapy (receiving numerous drugs), especially if they are on three or more anticonvulsants. The risk in mothers on phenytoin, with or without other medications, appears to be about a 10% chance of the baby showing features of the ‘foetal hydantoin’ syndrome. This syndrome consists of cleft palate, abnormalities of the fingers, possible heart abnormalities and mild mental retardation. Thus, at present, if it is possible, it would seem wise to try to change patients over to carbamazepine before conception. This may not be possible in all patients and, of course, many women will first visit their doctor when already pregnant, at which time there is no purpose in making the change.
Anticonvulsants taken by the mother during pregnancy may have some effects on the baby immediately after birth, as they are transmitted to the baby across the placenta. These include the possibility of a mild bleeding tendency and some drowsiness. In mothers who have been taking barbiturates, the infant may occasionally show features of a withdrawal reaction with irritability, jitteriness and poor sucking. None of these features is [...]

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