1042 childless white house: infertile american presidents
TRANSCRIPT
RESULTS: Gallieni’s urologist was the renowned pioneer ofFrench urology, Georges Jean-Baptiste Marion (1869–1960) whotreated the General for urinary retention, inanition, edema, and theuremia of chronic obstructive uropathy. A vegetarian, Gallieni’s doctorsfirst prescribed calories with meat protein despite worsening oliguria. Acystoscopy was performed on April 20, 1916 and, with catheterization,the general convalesced somewhat. A month later, the patient under-went prostatectomy, likely via the suprapubic approach, Marion’s pre-ferred technique. “Internal bleeding” was documented on post-op day2. Marion, “calm and stoic”, transfused 200 grams of his own bloodpost-op day 5; by May 27th, the general was dead.
CONCLUSIONS: General Gallieni suffered from prostatism foryears, even declining the position of Supreme Commander of theFrench army in 1911 due to ill health. Victor of the Battle of the Marne,1914, he served his country heroically up to his death. He was mournedby all of France. Marion went on to train hundreds of urologists over a50 year career, author seminal texts in urologic surgery, and was votedinto membership to the esteemed French Academy of Medicine in1934.
Source of Funding: None
1041BILLROTH AND BRAHMS–PERSONAL ENCOUNTER OFMEDICINE AND MUSIC
Boris Hadaschik*, Heidelberg, Germany
INTRODUCTION AND OBJECTIVES: Theodor Billroth hascontributed in many aspects to the field of surgery and urology. Forexample, in 1867 he performed the first radical perineal prostatectomyfor prostate cancer in Vienna. The purpose of this study is to describeboth Billroth’s life and surgical career as they were influenced andstimulated by his close friendship to the composer Johannes Brahms.Thereby, we aim to shed light on the close association betweenmedicine and music in general.
METHODS: During 1865 and 1894, Brahms and Billroth wrotethemselves 332 letters which have been analyzed for this study.Furthermore, a literature search including coeval and contemporarywork has been conducted.
RESULTS: Theodor Billroth and Johannes Brahms met 1865 inZurich, Switzerland. After Billroth accepted the chair of surgery at theUniversity of Vienna in 1867, Brahms moved to Vienna in 1869. Duringthe following years, Billroth analyzed most of Brahms’ compositionsprior to publication. Similar to his teaching of medical students andassistants, Billroth stimulated Brahms to publish many of his laterworks. Regarding Urology, Billroth not only conducted the first radicalprostatectomy, but described intermittent self catheterization for neu-rogenic bladders and percutaneously drained a hydronephrotic kidney.
CONCLUSIONS: Next to similar socioeconomic foundations,music and surgery share both structural and emotional analogies.While both professions require meticulous technique, personal interac-tion is a prerequisite for success. “Science and art scoop for the samewell.” Furthermore, music helped Billroth coping with the demandingand heteronomous working life of a surgeon.
Source of Funding: None
1042CHILDLESS WHITE HOUSE:INFERTILE AMERICAN PRESIDENTS
Yefim Sheynkin*, Jonathan Melquist, Kevin Gioia, David Schulsinger,Stony Brook, NY
INTRODUCTION AND OBJECTIVES: Historians or medicalcommunity rarely discuss infertility problems in American presidents’families. We examined all cases of the childless first couples withparticular emphasis on male factor infertility.
METHODS: Review of marriage histories and medical biogra-phies of 44 American presidents and their wives.
RESULTS: Out of 44 American presidents, only six- GeorgeWashington, James Madison, Andrew Jackson, James Polk, JamesBuchanan and Warren Harding- did not have children. Their medicalproblems with presently known effect on fertility are summarized inTable 1. Martha Washington, Dolley Madison and Florence Hardinghad children from previous marriages. Rachel Jackson had no childrenfrom her previous marriage.
CONCLUSIONS: Infertility was long considered a woman’sproblem. If a man was not impotent, his fertility was never questioned.Previous pregnancy, normal child bearing, young age and absence ofsignificant medical problems could be the only historic evidence offemale reproductive health. Based on this criteria, female factor can bereasonably excluded in Martha Washington, Dolley Madison and Flor-ence Harding. Sarah Childress Polk was healthy 21 year old womanwhen married James Polk. Only Rachel Jackson had no children fromher previous marriage while her first husband later had 4 children withhis second wife.
Significantly more medical information is available about malepartners in these childless couples. With the exception of JamesBuchanan, the only bachelor in the history of American presidency, allfive future presidents prior to their marriages had medical problems thatcould have a significant negative impact on fertility.
George Washington and Warren Harding were accused ofhaving children from extramarital affairs. However, it has never beensubstantiated. Similarly, Sarah Polk’s miscarriage was mentioned byonly one and not very trustworthy source.
Nam
e
Age
atm
arria
ge
Previous diseaseswith negative
impact on fertility Age
atth
edi
agno
sis
Rep
rodu
ctiv
eef
fect
Was
hing
ton
27Smallpox, Malaria,
Tuberculosis
Smallpox-19,Malaria-17,Tuberculosis-19
Smallpox: AzoospermiaMalaria:Treatmentwith Cinchona barkinhibits Leydig cellsteroidogenesis andspermatogenesis,impairs spermmotility Tuberculosis:epididymitis
Jam
esM
adis
on
43 Epilepsy 19
Oligospermia,teratospermia,asthenospermia,Hypogonadism
And
rew
Jack
son
24 Smallpox,Malaria 13
Snallpox: AzoospermiaMalaria: Treatmentwith Cinchona barkinhibits Leydig cellsteroidogenesis andspermatogenesis,impairs spermmotility
Jam
esP
olk
29
Urethra/Bladdersurgery forbladder stones 17
Ejaculatory ductsobstruction
War
ren
Har
ding
26 Mumps
Postpubertal(“earlymanhood”)
Testicularatrophy,azoospermia,oligospermia,asthenospermia,teratospermia
Source of Funding: None
Vol. 185, No. 4S, Supplement, Monday, May 16, 2011 THE JOURNAL OF UROLOGY� e419