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Five Quarts_ A Personal and Natural History of Blood - Bill Hayes [103]

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agree was homosexual, “investigated the male member as no one before him ever had.” He filled page after page with detailed anatomical drawings along with quirky observations. Leonardo noted, for example, “The woman likes the penis as large as possible, while man desires the opposite of the woman’s womb. Neither gets his wish.” (I’ll assume Leonardo came to this conclusion anecdotally.) Further, the male reproductive organ, to his eye, was ideally situated on the firm base of the pubic bone. “If this bone did not exist,” Leonardo hypothesized, the penis during intercourse “would turn backwards and would often enter more into the body of the operator than into that of the operated.” In other words, one would end up screwing oneself.

Once blood was correctly implicated in erections, new discoveries were made and new misconceptions arose. Dutch scientist Reinier de Graaf, history’s next great investigator of the penis, correctly documented in 1668 that the penis does not, in fact, contain a single ounce of fat. What you see is lean flesh and blood. Its size will not change with weight gain or loss. De Graaf was also correct in declaring that the key to maintaining an erection is not getting blood into the penis but keeping it there. Alas, his theory that trapping blood in the penis depended on muscular constriction was interesting but wrong, as was the contention of subsequent scientists that valves in the blood vessels did the job.

Not until the early 1980s did the actual mechanism come to light. As it turns out, the process depends on what sounds like a physiological contradiction: A man gets hard because a crucial part of the penis softens. With the sudden influx of bright red arterial blood, the smooth-muscle tissue lining the three cylinders of the penis relaxes and, as a result, expands so fast that the veins through which blood normally returns to the heart get flattened against the shaft’s outer walls. In effect, a hematological flash flood has taken place, leaving all exits blocked. (A separate mechanism impedes urination, freeing the urethra to transport only semen.) With circulation cut off and the store of oxygen waning, the penis darkens in color, just like when you tighten a rubber band around a finger. The floodwaters typically will retreat soon after ejaculation. However, in the condition called priapism—named for the Greek god of virility and sexual prowess, Priapus, whose endowment, shall we say, was legendary—erection persists well beyond the point of enjoyment. Brought on by certain medications, injury, blood disorders such as sickle-cell anemia, or, in many cases, by reasons leaving doctors scratching their heads, priapism is painful and becomes dangerous if it lasts more than four hours. If the penis is not decompressed, the trapped blood starts to clot and must be extracted using a remedy that will make any man wince: A large needle is inserted into the shaft and the thickened, almost black blood is sucked out.

To the other physiological extreme is erectile dysfunction, for which several well-advertised treatments are available. Drugs such as Viagra and Cialis, contrary to popular belief, neither increase libido nor trigger an immediate erection. Rather, they depend on a key ingredient not in the pills: arousal. But once that’s fired up, Viagra, for example, stimulates the release of a chemical that increases blood flow to the penis while also inhibiting an erection-wilting enzyme.

Now, returning to women: The clitoris, unlike the multipurpose penis, exists solely for pleasure. I can think of no other body part where so little blood does so much good. Engorgement exposes the clitoris, normally hidden within the vulval cleft, and amplifies the sensitivity of its eight thousand nerve fibers—twice the number found in the entire penis, in a much smaller area. Though blood is the common agent, erection and engorgement are significantly different processes, as science writer and author Natalie Angier clarifies in Woman: An Intimate Geography (1999). Because the clitoris does not share the penis’s distinctive

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