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I have seen cases wherein this seemed to be the most important problem involved: by the time the IMPOTENCE man came to psychiatric attention, a hopeless problem, and often 45 he was convinced he had his wife, to protect herself, long since ceased being affectionate with context) (in it is true that the vast majority of cases of im- potence are due to psychological causes, it is also true that impotence can be produced by or associated with organic ease; the most frequent of such in this chapter.

SEXUAL INTERCOURSE Comparing male and female 41 physiological response, Bors and Comarr (i960) make the following observation: "The sequence of events in the female comparable with those is in the male, considering the embryological development of the respective structures. , the para urethral and glands of Skene; and ejaculation the rhythmic contraction of the . . muscles. " IMPOTENCE WITHOUT MUCH QUESTION, THE MOST licly documented PUB- case of impotence was that of Louis XVI of France (reign 1774-1789).

Men does not increase sexual (Kenyon, 1941). Findings differ as to what testosterone does to the female sex drive. Rubenstein desire or erectile ability et al. " It appears possible that testosterone increases sexual drive and erection ability in castrated men (Daniels and Tauber, 1941; Simpson, 1950), but that it reduces sex drive and erectile ability in intact men (Vermooten, 1947). If the latter point is correct, it give testosterone to impotent testicles. Carmichael et al. would make matters worse men who have to functioning (1941) early pointed out the im- SEXUAL INTERCOURSE 25 portant ps}chological factors involved in giving impotent new and presumably curative results when, unknown to the a tained only inert oil men drug; after noting successful patient, the injections con- and no testosterone, it was realized that a placebo effect had been established.

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Recent Advances in the Assesment and Management of COPD by P. S. Shankar

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