1042 childless white house: infertile american presidents

1
RESULTS: Gallieni’s urologist was the renowned pioneer of French urology, Georges Jean-Baptiste Marion (1869 –1960) who treated the General for urinary retention, inanition, edema, and the uremia of chronic obstructive uropathy. A vegetarian, Gallieni’s doctors first prescribed calories with meat protein despite worsening oliguria. A cystoscopy 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 day 2. Marion, “calm and stoic”, transfused 200 grams of his own blood post-op day 5; by May 27th, the general was dead. CONCLUSIONS: General Gallieni suffered from prostatism for years, even declining the position of Supreme Commander of the French 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 mourned by all of France. Marion went on to train hundreds of urologists over a 50 year career, author seminal texts in urologic surgery, and was voted into membership to the esteemed French Academy of Medicine in 1934. Source of Funding: None 1041 BILLROTH AND BRAHMS–PERSONAL ENCOUNTER OF MEDICINE AND MUSIC Boris Hadaschik*, Heidelberg, Germany INTRODUCTION AND OBJECTIVES: Theodor Billroth has contributed in many aspects to the field of surgery and urology. For example, in 1867 he performed the first radical perineal prostatectomy for prostate cancer in Vienna. The purpose of this study is to describe both Billroth’s life and surgical career as they were influenced and stimulated by his close friendship to the composer Johannes Brahms. Thereby, we aim to shed light on the close association between medicine and music in general. METHODS: During 1865 and 1894, Brahms and Billroth wrote themselves 332 letters which have been analyzed for this study. Furthermore, a literature search including coeval and contemporary work has been conducted. RESULTS: Theodor Billroth and Johannes Brahms met 1865 in Zurich, Switzerland. After Billroth accepted the chair of surgery at the University of Vienna in 1867, Brahms moved to Vienna in 1869. During the following years, Billroth analyzed most of Brahms’ compositions prior to publication. Similar to his teaching of medical students and assistants, Billroth stimulated Brahms to publish many of his later works. Regarding Urology, Billroth not only conducted the first radical prostatectomy, 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 same well.” Furthermore, music helped Billroth coping with the demanding and heteronomous working life of a surgeon. Source of Funding: None 1042 CHILDLESS WHITE HOUSE: INFERTILE AMERICAN PRESIDENTS Yefim Sheynkin*, Jonathan Melquist, Kevin Gioia, David Schulsinger, Stony Brook, NY INTRODUCTION AND OBJECTIVES: Historians or medical community rarely discuss infertility problems in American presidents’ families. We examined all cases of the childless first couples with particular 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- George Washington, James Madison, Andrew Jackson, James Polk, James Buchanan and Warren Harding- did not have children. Their medical problems with presently known effect on fertility are summarized in Table 1. Martha Washington, Dolley Madison and Florence Harding had children from previous marriages. Rachel Jackson had no children from her previous marriage. CONCLUSIONS: Infertility was long considered a woman’s problem. If a man was not impotent, his fertility was never questioned. Previous pregnancy, normal child bearing, young age and absence of significant medical problems could be the only historic evidence of female reproductive health. Based on this criteria, female factor can be reasonably excluded in Martha Washington, Dolley Madison and Flor- ence Harding. Sarah Childress Polk was healthy 21 year old woman when married James Polk. Only Rachel Jackson had no children from her previous marriage while her first husband later had 4 children with his second wife. Significantly more medical information is available about male partners in these childless couples. With the exception of James Buchanan, the only bachelor in the history of American presidency, all five future presidents prior to their marriages had medical problems that could have a significant negative impact on fertility. George Washington and Warren Harding were accused of having children from extramarital affairs. However, it has never been substantiated. Similarly, Sarah Polk’s miscarriage was mentioned by only one and not very trustworthy source. Name Age at marriage Previous diseases with negative impact on fertility Age at the diagnosis Reproductive effect Washington 27 Smallpox, Malaria, Tuberculosis Smallpox-19, Malaria-17, Tuberculosis-19 Smallpox: Azoospermia Malaria:Treatment with Cinchona bark inhibits Leydig cell steroidogenesis and spermatogenesis, impairs sperm motility Tuberculosis: epididymitis James Madison 43 Epilepsy 19 Oligospermia, teratospermia, asthenospermia, Hypogonadism Andrew Jackson 24 Smallpox,Malaria 13 Snallpox: Azoospermia Malaria: Treatment with Cinchona bark inhibits Leydig cell steroidogenesis and spermatogenesis, impairs sperm motility James Polk 29 Urethra/Bladder surgery for bladder stones 17 Ejaculatory ducts obstruction Warren Harding 26 Mumps Postpubertal (“early manhood”) Testicular atrophy,azoospermia, oligospermia, asthenospermia, teratospermia Source of Funding: None Vol. 185, No. 4S, Supplement, Monday, May 16, 2011 THE JOURNAL OF UROLOGY e419

Upload: david

Post on 31-Dec-2016

213 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: 1042 CHILDLESS WHITE HOUSE: INFERTILE AMERICAN PRESIDENTS

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