Consent is an important issue in sexual relationships that needs to be observed by both parties, whether it is a casual meeting, a first date, or a marriage. The point needs to be made as strongly as possible to both men and women that it is not okay to cross another person's boundaries. If your partner says 'enough' or 'stop now', it means exactly that.

Debra recalls one early experience. 'The first sexual experience I remember was at a school dance and the lights were down low. This boy put his hand up my dress. I didn't have a clue what he was doing and before I knew it he had his hand inside my panties having a good grope around. The worst thing though was that I had my period at the time and it was in the days before I started using tampons. Very messy. Absolutely humiliating. I didn't go out with him again. It would have been too embarrassing. It was ages before I would let a boy get anywhere near me.'

This is a very simple example of the impact that sexual contact without consent can have.

A recent study by the Australian Institute of Criminology found that acquaintances, dates and boyfriends accounted for thirty-nine percent of rape cases and husbands and ex-husbands accounted for thirteen percent ... and they were only the ones that were convicted. There is no easy answer to the problem of 'date rape', and it is probably far more common than we realize. The effect on your attitude to future sexual relationships can be very similar to the effect of any sexual abuse — being afraid of intimacy, feeling dirty, not being able to trust a partner. Part of the answer lies in the best possible preparation of both men and women for their early sexual experiences. Asking each other what you want, working out exactly what types of sexual activity you both consent to and respecting the wishes of your partner are essential elements of any relationship.
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Many people say their first time was when they were drunk at a party or a dance. This happens so often because your usual inhibitions disappear. The best of intentions can be blown away in a matter of minutes by the influence of drugs and alcohol. All the self-talk and assertiveness in the world is not going to protect you if you drink so much alcohol, or do so many drugs, that your judgment goes out the window. The old story of waking up to a stranger in bed next to you who doesn't look a bit like the person you thought you brought home can be a jarring reminder of the tricks alcohol can play on a brain.

It is very easy to be coerced into intercourse before you are ready if you don't have a lot of self-confidence and if you are not willing to stick up for your rights. Some of the methods of coercion are more sophisticated than others. It's hard to believe that old lines like, 'I'll tell everyone you're frigid' or 'What's wrong with you? All your friends do it!' or "Why not, are you gay or something?' can work, but they have stood the test of time. Parents would do well to prepare their children with a healthy dose of cynicism and a few clever retorts.
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Scarlet fever does not occur often nowadays, and is a much milder illness than it used to be, for reasons not well understood.

Cause

Scarlet fever is caused by a Streptococcus germ, spread by sneezing and coughing.

Clinical features

Symptoms of scarlet fever vary greatly between children. The commonest symptoms are a mildly sore throat, swollen, tender lymph glands in the neck, a mild fever, and a characteristic rash. The rash covers the whole body and consists of tiny red spots. The tongue may be bright red (strawberry tongue). Nowadays complications of scarlet fever are very rare, due to effective treatment with antibiotics. Rheumatic fever used to be a serious complication, but is rarely seen in association with scarlet fever now.

Treatment

Scarlet fever can be treated effectively with antibiotics of the penicillin group. (If your child is allergic to penicillin, other antibiotics can be used.)

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"Why would a woman let a man put his thing in her?"

When you grow up and can take care yourself and others, there times when a woman wants to love, to hold, and to kiss and touch a man, and a man wants to do the same thing. Sometimes, but not every time, the man and woman want to join together and have the penis inside the vagina. This is one of the most important things to do in all the world, and a baby can start to grow when the sperm goes with the egg. It is a way of loving, a very special grown-up way of sharing yourself with someone, so it should only happen when you are married and going to be together forever.

    "How can a baby eat in there?"

The baby is inside something like a space capsule, and food and other things needed to live are brought in from the mother. There is a special capsule filter that only lets in what the baby needs to live. The baby grows in this capsule and gets food through a cord attached at her or his belly button. The mother and baby are a team and are living together making each other healthier.

"Why doesn't the baby drown in the water in the sac?"

You are very smart. Yes, there is something like water made by the mother that the baby floats in inside the uterus. It keeps the baby from getting hurt and keeps the baby safe and healthy. The baby can't drown because he or she does not breathe through the mouth until he or she comes out. It's just like a person in space, with all the food and even their oxygen coming in through that special cord.

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I hate those X-rated videotapes. They are disgusting. A bunch of naked bodies humping each other. I like the parts where you can see some feeling, but that almost never happens.

WIFE WITH HUSBAND PRESENT

I get turned on a lot with those tapes. I feel guilty, but I got one out to look at while he was at work and I masturbated. I know it's filth, but some parts turn me on.

WIFE IN PRIVATE INTERVIEW

The early perspectives assumed that men looked and women felt. I did not find this assumption to be the case with the couples \ interviewed. Women were aroused by visual stimulation, and sometimes were quite specific in their report. "I love the turn in the shoulders by a man's neck, sort of the neck and shoulder area. I love to sort of smooth out his suit coat or jacket by running both my hands out from that turn on both sides of his neck to his outer shoulders. I love to look at men in the theater from behind and look at their shoulders." This wife's report illustrates a strong visual reaction, and other examples were similar.

The individual love maps of men and women, not their gender, determine what stimuli will elicit a sexual response at any given time. If we tell women that they do not respond visually, then they are likely to report that they do not. If we ask open questions without gender bias, we get the same range of responses in husbands and wives.

Talk together about your reactions to erotica and you will discover that both of you are turned on and off to various visual cues. Asking whether or not a woman is turned on to X-rated material is like asking if someone is turned on to books. It depends! And remember, the sexual-response system is not a closed energy system with an on-and-off switch. It is a flowing, ever-changing system. We do not really get turned on or off, we respond to varying degrees.

When we free our relationship from the mechanical orientation of the early sex perspectives, we learn that we we always "on," and in control of our response through our selection, sharing, and awareness of our love maps and the variables that determined it.

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I suppose to you this will sound perverted. We have done almost everything together. We haven't missed a posture. But we never seem to experience anything together. We sleep next to each other, but not with each other. Our sex life is like masturbating, like using each other to masturbate. You might say we are the founders of the term "completing the act."

WIFE

Super Marital Sex Rule: Any part of the marriage that is ignored will disappear, and this rule is particularly true for sex. For most couples, the amount of enjoyment they derive from their sexual relationship corresponds with the amount of attention they pay to their sexual interaction. The sexual return from a marriage will usually match the intimacy investment. The following are ten areas in which the couples failed to invest appropriately or enough.

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In obsessional-compulsive disorder, there may be recurrent ideas or images entering the mind, such as phrases, pictures and disagreeable ideas, often obscene.

There may be aggressive impulses to hit or injure someone, suicidal thoughts, a desire to swear in church or to take off one's clothes.

With phobias, there may be extreme anxiety and an unreasonable fear of an object or a situation. These are regarded by the sufferer as groundless and irrational but he cannot control them.

Some phobias are clear-cut, and psychotherapy can often reveal the repressed anxiety that caused the fear of the phobic situation. The connection may be subtle but easy to recognise.

In other cases, there is no clear connection between what caused the repressed fear or anxiety and the resulting phobia.

In treating phobias, behavior modification and learning techniques may be required. Another method is desensitisation.

In this, the person is exposed, initially in thought, to the situation which he most fears. He starts by thinking of himself in that situation in a mild way, then mentally removes himself before the anxiety is severe. This goes on until he imagines himself in the worst possible situation, without anxiety.

Next, he is placed in the real situation, for a short time and removed as soon as he shows anxiety. Finally, he can be fully exposed and able to cope without anxiety.

Another technique is implosion, the reverse of the slow process of desensitisation.

Here the person is placed, at once, into the worst possible situation he can imagine. This creates extreme anxiety and it is believed the shock is so great that the anxiety disappears.

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A further operation is lumbar sympathectomy, which involves cutting the sympathetic nervous chain in the lower back. This chain controls the tone in the arterial wall. When the nerves are cut, the arteries permanently dilate and blood flow can increase. Sometimes both operations are combined.

The bypass operation is the same principle as in coronary bypass surgery, where atheroma blocks one of the coronary arteries and a vein is used to bypass the obstruction.

There is no doubt about the marvels of modern medicine, but how can we convince our patients to avoid the bad habits that lead to many of these problems?

Changing our diet and avoiding smoking would reduce the incidence of atheroma.

The diagnosis of intermittent claudication can be made on the history alone. When the doctor examines the legs, he may be unable to feel the pulses in the feet. This indicates obstruction to blood flow.

In the past, various drugs were used in an effort to dilate the narrowed arteries and improve the blood flow. Unfortunately, these have proved disappointing.

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