Medicine: Great Men’s Weakness

Prince Bismarck. President Wilson, President Harding, “Tiger” Clemenceau, Napoleon III and Alexandre Dumas fils had only one weakness in common: prostatic hypertrophy.

Last fortnight the Great Man of Argentina, fiery Dictator-President Hipolito Irigoyen, who is almost fanatically secretive about matters of state, frankly admitted that he has it too. He called in surgeons who decided to operate at once.

In Paris famed Raymond Poincare, President of France during the War, chattily discusses his prostatic hypertrophy, sitting up in a great armchair, surrounded by vases of lilies, roses, chrysanthemums.

“I was careless and walked too much after my first operation,” confessed the grizzled statesman the other day like a penitent schoolboy, ‘but the second fixed me up. It was a complete success, complete’ The doctors have cured everything. I am quite well again. … I have been invited to Brazil as the guest of the Government and also to Argentina. I plan to go. After that, if the voyage is not too tiring, I should like to visit the United States. . . .”

In Buenos Aires, Statesmen Poincare and Irigoyen will undoubtedly enjoy comparing notes on a subject about which many men of their age, including many of the world’s rulers, have personal experience: King George of England, President Doumergue of France, President Masaryk of Czechoslovakia. King Haakon of Norway. King Fuad of Egypt.

Enlargement of the prostate by chronic inflammation is a common ailment of elderly men. It is probably not a tumor process. Although it makes the victims uneasy and uncomfortable, it is rarely painful. Authorities estimate that one of three males over 60, suffers from prostatic hypertrophy. Gonorrhea in early manhood is a frequent, but by no means the sole cause.* The prostate gland nestles between the male bladder and rectum. Anatomically it corresponds to the womb. Normally it has the shape of a large chestnut 1¼ to 1½ in. wide by 1 to 1¾ in. long. It produces a thin, cloudy, slightly alkaline, albuminous secretion, the physiological function of which is to increase the swimming speed of the microscopic male seed from a sluggish low to a high of one inch in two minutes.

There are two operative ways of reaching the prostate to remove the enlarged portions: 1) by opening through the perineum (crotch); 2) by cutting through the abdomen, between the navel and the joint of the pubic bones, and opening the bladder.

Either operation exposes the gland so that the surgeon can enucleate it with his fingernail or blunt scissors. The operation requires the best of skill and asepsis. Infection can cause more trouble than hypertrophy. Because the patients are usually elderly men whom ether anesthesia would make susceptible to pneumonia, surgeons prefer local anesthesia. The patient can be propped up in bed the day after his operation, sit in a chair after a week, be well in three weeks. Dangers against which the convalescent must guard include pneumonia, hiccoughing, gas on the stomach. Epsom salt is poison to the convalescent.

A queer thing is the fact that when a man with hypertrophied prostate dies, the swelling speedily disappears. Postmorticians cannot get the gland enlarged (for laboratory work) from cadavers.

*Dr. Winfield Scott Pugh, famed Manhattan genitourinary specialist, estimates that four out of five males have or have had gonorrheal infections.