The Endocrine Control of the Prostate By S. ZUCKERMAN BEIT MEMORIAL RESEARCH FELLOW (Fromi the Department of Humnan Anatomy, Oxfordl) FROM the turn of the present century until some five or six years ago, the prostate was an organ whose physiology was little discussed and even less investigated, and whose departures from the normal were events to be treated only by direct surgical methods. Within the past few years, facts about the endocrinology of this organ have multiplied so fast as to suggest a revision of present ideas on the treatment of one of the commoner of prostatic ailments-benign enlargement-and they have also achieved that measure of certainty which justifies their presentation to those whose interests in the organ are not purely scientific. Yet what is now recognized as an endocrinological approach to problems of the prostate is no new 'departure. Surgeons themselves had turned the physiological knowledge of the nineteenth century to account in the treatment of enlarged prostate by what today could well be described as one of the more drastic of endocrinological treatments-castration. This earlier phase in the endocrinological treatment of prostatic disorders, which came to a summary end about 1900, is no less interesting and instructive than that which has developed in recent years. CASTRATION AS TREATMENT FOR PROSTATIC OBSTRUCTION Enlargement of the prostate had been recognized as a clinical entity long before the dependence of prostatic growth on testicular function appears to have been appreciated. Samuel Collins, for example, described the ailment, somewhat vaguely it is true, as far back as 1685, attributing it to "indulgence in venery," and speaking of the presence of many "Hydatides-vesicles full of Liquor" in the "inward Penetrals " of the organ. Morgagni, during the earlier half of the eighteenth century, was also certainly aware of the disorder, and his extensive work on "The Seats and Causes of Diseases" (1769) contains numerous references to it, to observers other than himself who had described it, and to the part played by prostatic enlargement in obstructing the flow of urine. In 1786 John Hunter published his "Observations on the glands situated between the rectum and bladder, called vesicul] seminales," in which he wrote that" the prostate and Cowper's glands, and those of the urethra, which in the perfect male are soft and bulky, with a secretion salt to the taste, in the castrated animal are small, flabby, tough and ligamentous, and have little secretion." Whether or not he was the first to make this observation I do not know. The practice of castration, both as it applies to man himself and to his domestic animals, goes back to time immemorial, and it seems possible that the fact which OCT.-UROL. 1
