WITH reference to the female we saw in the preceding chapter that the lower portion of the genital canal simply becomes dilated to form a copulatory organ. This dilatation is regulated by corrugations and occlusory muscles. In the next few chapters we shall discuss the formation of the male copulatory organ in full detail. A certain essential prolongation we have already mentioned. We now come to the phenomena of congestion by means of which this otherwise most insignificant organ is temporarily enabled to serve as a copulatory organ.
Every organ receives an increase in blood supply when it is functioning actively, and conversely an increased blood supply is an indispensable condition for active functioning. This interdependence is a biological law of the first importance also in the sexual life. This most urgent of all functions requires a hyper-congestion. We shall now examine the anatomical mechanism by which the lower portion of the male genital tract is enabled to become hyper-congested.
It goes without saying that the wall of the urethra contains blood vessels, for there are no organs without them. At the point where the urethra pierces the muscular layer of the perineum, these blood vessels must naturally experience the pressure of this muscular layer. The blood in the arteries, which have muscular walls, will not be much affected by this, but the blood in the wide veins, which have flaccid walls, will be greatly congested by this pressure. So it is evident that in the evolution of higher animal orders a plexus of swollen and enlarged vessels was necessarily formed. The tissue is known as cavernous tissue and is also found as a vascular swelling on the heads of many fowls, e.g., the comb of cocks. The vascular congestion in the urethral wall commences at the point where the canal pierces the perineal muscles. Below the prostate and above the muscular layer lies a small portion of the urethra, and here there is no cavernous tissue, but from the muscular laver downwards the whole urethral wall is formed of such cavernous tissue. It is a prolongation and thickening of the urethral wall with its connective tissue and not of the skin. Only on the lower aspect (while pendulous this is the posterior aspect) of the penis, the urethral canal may be easily palpated in its entire length.
In the female, the same conditions prevail, though on a smaller scale. Here, too, the opening of the urethra with its vascular system is situated beyond the external occlusory muscles.
Here a similar congestive effect is produced but only on the anterior aspect of the urethra, as the vagina is situated at its posterior aspect. Thus immediately in front of the urethra, i.e., between urethra and os pubis, a cavernous papilla has formed about the size of a pea, in appearance somewhat like the glans penis. It does not, however, enclose the urethra. In the female mole, however, the urethra pierces the clitoris, as it does the penis in the male.
The local prolongation and thickening would in themselves be insignificant. It is, however, a typical vascular plexus, as even from childhood the penis is constantly changing its dimensions proportionately to the local blood pressure. During cold or after Ioss of blood it is very small; under the influence of blood congestion or skin stimuli it is, however, considerably larger. But only after puberty (every time some sexual stimulus occurs) this phenomenon reaches its height and becomes then of considerable biological significance, as it not only increases sexual desire, but also forces it upon our consciousness. We remarked a similar case concerning the descent of the testes. In such moments when sexual desire bursts into flame. it appears as if all our energy had concentrated at this extreme point, in the same way as a Leyden jar seeks to discharge itself at its extremity.
We imagine that this phenomenon is the real starting point and origin of our sexual life. If this were so, then there would be but Iittle sexual life in fishes, amphibia and birds, and the sexual life of the female would be specially insignificant. The actual importance of this phenomenon, however, we shall be able to discuss only in Part II. For the present we have to consider the anatomical reasons which enable this excessive blood congestion to take place.
The whole arrangement of the blood vessels in this organ greatly favours congestion. Nearly everywhere else in our body we find two veins to one artery. This is what we should expect, for blood flows quickly in the arteries but very sluggishly in the veins. But here on the superior aspect of the penis (anterior in the flaccid condition) there is only one vein to two arteries. This explains why even at a very tender age this organ is so prone to swellings and congestions. I have often seen a child born with an erected penis when too much pressure is exerted on the body to deliver an aftercoming head.
If, in the adult, congestion occurs in this vascular system in the originally soft connective tissue stream of the cavernous bodies has Become a strong network of very firm fibres and trabeculae(1), surrounded by a capsule of fairly strong connective tissue pierced transversely by blood vessels.
If in the adult congestion occurs in this vascular system in consequence of hyper-tension in the full seminal vesicles, or of some other even insignificant cause, i.e., if more arterial blood than usual flows in, causing an increase in local blood pressure, all the connective tissue fibres are rendered taut and many of the thin-walled veins are then almost completely constricted. The more blood that flows in at high pressure through the arteries, the more the venous return will be impeded. The whole organ will then become extremely hard and swell almost to bursting point.
This mechanism is considerably augmented and maintained by the perineal muscles, the external occlusory muscles, which, evolutionally, were probably the cause of the development of this cavernous tissue. This muscular layer impedes venous return to a certain extent by its normal muscle tone, but it does so far more when it contracts actively. As long as no congestion is present and the vascular system is relatively empty, this muscular layer cannot produce an erection, since it is not a proper sphincter muscle. If, however, slight congestion occurs, e.g., through a stimulation of the seminal vesicles, then this muscular layer can act very energetically(2).
When complete erection has occured in the male, another very striking phenomenon may occasionally be observed to take place at short intervals. This is a throbbing movement-a convulsionwhich is not due to pulsations of the heart, for which it is far too infrequent, but is produced by the convulsive contraction of the perineal muscles. When erection occurs, one can produce these throbbing movements by a strong, voluntary contraction of these muscles.
During such throbbing movements only a very slight increase in circumference is experienced, together with a slight shortening of the penis. In mechanical parlance there is a tendency towards assuming a spherical shape.
Generally an erection is not of long duration. After a few minutes or more the blood pressure subsides and everything returns to its original condition, as though nothing had happened.
If, during the flaccid condition, the same abrupt muscular contractions are performed with a view to producing an erection artificially and of set purpose, failure will result, for the “conditio sine qua non”, the congestive condition, is absent. And if one should try to produce a voluntary erection by mechanical compression, it would be extremely difficult to avoid compressing the arteries as well as the veins, thus favouring local anaemia, quite apart from the inhibiting action of pain.
The occurrence of an erection is thus not altogether under our control; it is a phenomenon by which we are often overtaken in the most awkward circumstances, and which may remain absent just when it is required. One should, however, only talk of impotence when in an adult erections do not occur at all. Thus in practice the question arises how consciously to control the first congestive condition of stimulation, both to cause and to prevent it. We can answer this only in Parts II and III.
It is fortunate that the external voluntary occlusive muscles, not being proper sphincters, are unable totally to cut off venous return, and can only aid in producing congestion. If it were possible to cut off the venous return altogether, gangrene would supervene, for the tissue would necessarily die if the blood supply were interrupted. This fact would, secondarily, endanger the individual’s life itself.
The extent of the interference with the venous return and of the tension may be gathered from scars sometimes found in post-mortems, which can only be explained on the assumption that during life the cavernous bodies must have become fractured internally, possibly through a fall or blow, like a stick of sealing wax.
There are exceptional cases on record of pathological erections (priapism). In such cases one should try all the measures suggested in Part III. In severe cases a physician should be consulted.
The volume of the penis in the erect condition is on an average four or five times as large as the original volume. During the greatest tension its length from the os pubis is about 1 1/2 fingers length instead of 1 in the flaccid condition, and the width about 2 fingers breadth instead of 1 1/2. And yet this is only the visible external part. The internal part of the erection is curved round the os pubis and hidden between the thighs and behind the scrotum.
Such a condition of erection and throbbing produces in us a warm feeling of glow and pulsation. The skin of the penis. where ever it is movable, retains its normal yellowish-red flesh tint. For it is not a skin congestion but a congestion in the urethral wall. Only on the glans, where, as we shall see, the skin is transparent and close-fitting, the colour changes from pale red or livid to the deepest blue of venous blood, the latter especially round the margin of the glans.
Such a considerable swelling must, of course, have an influence on the position of the whole organ. If the investing membrane of the penis were not firm, then the whole organ would assume as far as possible a spherical shape during the period of maximum tension because that shape alone would equalise the tension at all points. But the membrane is tubular and can therefore only increase in length and thickness, and so must change its position. In the previous chapter we saw that the whole organ bends up-wards at the external surface of the os pubis to which it is closely attached by connective tissue. This portion of the penis which is not visible externally can therefore not change its position. In order to yield as far as possible to the internal pressure the pendulous portion which is visible must alter its position so as to be in the same line as the fixed portion. It therefore raises itself up, and then the tension is as nearly as possible equal at all points. Hence the name erection, i.e., raising up.
Gravity, however, that is to say, the weight of such a large volume of blood, will have considerable modifying effect. In every attitude of the body the direction of erection will be the resultant of these two forces, blood pressure and gravity, and the effect of the convulsive contractions of the perineal muscles will be to compensate, or, on account of the throbbings, even to over-compensate the effect of gravity. When the body is vertical the penis will be much above the horizontal. If we eliminate the action of gravity in this direction by lying down on one side the penis will almost touch the abdominal wall. An infantile erection, however, with its small increase in blood pressure will have reached its maximum when the small penis makes an angle of 90 deg. with the abdominal wall. That is probably the extreme, as I once discovered. A mother had for some reason to take her son aged 5 or 6 out of bed while he was fast asleep. The above mentioned attitude was visible. She was greatly embarrassed by it and tried several times to press it down. This of course could only have increased the erection but it remained at the same angle which seems to be the maximum for children, though it is the minimum in the adult. The internal tension and the external increase in bulk are very slight in children.
Above we have advanced the hypothesis that during evolution of the species a vascular plexus developed owing to the congestive effect of the perineal muscles. We shall now inquire further why this vascular plexus grew forward along the os pubis. The tubular form of course is due to the fact that it is a prolongation of the urethra.
It is a matter of experience in mechanics that if a tube of complicated form is subjected to very high internal pressure, it will assume as far as possible its original shape, since every deviation from this form may reduce, but can never increase its capacity. Similarly, our joints will assume the semi-flexed attitude of their intra-uterine life, if they are subjected to high internal pressure by effusion of blood, pus, or serum.
Here, I think, the ease is similar. In the foetal condition, curled up in the uterus with the legs pressed tightly together, the continuation of the urethra could not escape caudally, but could only grow along the abdominal wall.(3)
During normal pregnancy, while the foetus lies head downwards owing to gravity, the penis can only grow downwards towards the head. Only when the child begins to walk does the penis begin to point towards the feet.
Later on, in adult life, every time congestion occurs, the tubular must assume as far as possible its original position, quite aside from the fact that it is fixed to the os pubis by connective tissue. In young children, in spite of the small increase in blood pressure, the erect position of the penis is easily assumed because recently that position was habitual. Thus, a childish erection has nothing sexual about it. The genitals of a child are really only foetal developments of an otherwise embryonic rudiment, so erections in children should not be considered as evidences of precocious sexuality, but merely as a return to a foetal position due to blood pressure. We shall further see, in Part V, that the childish sexual character does not develop on account of an internal sexual need, but simply because the child develops in a sexual world. This does not mean to imply that the formation of the sexual organochemical substances may not sometimes commence in the pre-puberal period.
Only after puberty, the spasmodic increase in blood pressure which we know as the sexual erection reaches its full development, together with the mature stimulus of the sexual organochemical sub-stances and the associated mass-production of reproductive cells. As we have seen above, the male genital canal, when flaccid, assumed the form of an S lying on its side, thus – sideways S.
The path of the sperm-cells begins at the lower part of the letter, i.e., at the testes, travels upwards towards the abdominal cavity, enters it, describes a circle there (surrounding the os pubis) and finally travels upwards again at the external surface of the os pubis, where it finds exit. This remarkable phenomenon, erection, with its congestion and feeling of tension, has always stimulated man’s emotions.
In all savage races, the first complete erection is always greeted with joy. Now, for the first time, the youth is considered fit to take his place as an adult and is permitted to take part in the chase and in battle. During initiation, he must prove his manhood by suffering without flinching all sorts of ordeals, e.g., tattooing, skin incisions, circumcision, introduction of rings into the nose or ear, knocking out of teeth, etc.
In our civilisation and with our clothing, there is no proper appreciation of this developmental phenomenon. It must, unfortunately, be concealed. This concealment spoils our character. Our tight-fitting clothes(4) give an oblique direction to the penis, which in fact diminishes its usefulness for copulation. Why should not our clothes be made a little looser and why do we not “dress” one day on the right side and the next on the left?
With us Christians those pagan celebrations of puberty are sublimated as Confirmation, when we are received as members worthy of reception into the Church. And why should we deny, or even proscribe, the sexual element in it? As regards stability of character and sexual life, the savage races can teach us a good deal.
1 In the dog and some other mammals a few of these trabeculae are cartilaginous.
2 The extent to which a complete male erection depends on the contraction of the external occlusory muscles can easily be observed on one’s own sphincter ani. 3 In some animals, e.g., the bull, the penis, even in adult life, grows along the abdomen for some distance before becoming visible.
4 The nipples of women are often deliberately rendered almost useless by close fitting garments.