A few days ago I was reading an article about foreign bodies in the bladder – for what better way to while away a dull afternoon? In 1897 a doctor from Philadelphia, Francis Packard, wrote an analysis of more than 200 cases, all of which had been published in medical journals in the preceding fifty years. The range of objects that men had managed to insert up their own urethras was quite astonishing, ranging from pencils to paint brushes to porcelain buttons.
But one in particular caught my eye. Dr Packard’s article informed me that one French patient had been operated on after going to a doctor with a ‘cylinder of pork’ stuck inside his bladder. What on earth could this object be, and how did it end up there? Intrigued, I looked up the original journal article (which was in French) and discovered that the story was even better than Dr Packard suggested: something had been lost in translation.
The original case report was published in the Annales des Maladies des Organes Genito-Urinaires in 1891. The author, Pierre Bazy, was an eminent urologist of the day:
This case concerns a man of about forty who was sent to me from out of town. I saw him on September 21 1887: he was robust and vigorous, but appeared to be of extremely limited intelligence. He opened the conversation by announcing that he had a pig’s nerve [sic] inside his bladder.
Beat that for an icebreaker! But – as it turns out – it wasn’t a ‘pig’s nerve’ inside his bladder either.
I admit that I did not at first grasp what he was saying, and since the patient could not urinate, or at least only with great difficulty, I decided to check his bladder for stones, having first satisfied myself that the urethra was not obstructed.
Bladder stones were far more prevalent in the late nineteenth century than they are today; nobody is entirely sure why, but it seems likely that diet was a major factor. The usual way to detect them was to insert an instrument known as a sound into the bladder via the urethra. If a stone was present, the doctor would be able to feel the sound scraping against it.
I introduced a rubber sound; a few drops of foetid urine were emitted, but soon the flow ceased, though the bladder was still full of urine.
The doctor noticed that when he withdrew his instrument, which was hollow, the tube was blocked by whitish lumps. He decided to inject water into the bladder, hoping to flush out whatever object it contained. The results were not pleasant:
The urine that came out was utterly infected and had a sickening odour, even worse than the worst urine one would expect to come out of a bladder affected by cancer. It was whitish, milky and contained a large quantity of fairly substantial lumps, which had the appearance of bleached tissue.
Dr Bazy continued to wash out the bladder for ten minutes, until the patient could take no more. He resolved to continue the treatment the following day, when he intended to remove the foreign body – whose precise nature remained a mystery.
I was convinced that this foreign body had been present not for three days as the patient claimed, but for several months, and that the abnormal urine was the result of a terrible infection which had been completely neglected, and which the patient had not dared to mention until now.
At first the doctor assumed that the object was a normal bladder stone, a hard object composed of phosphate salts.
However, I reflected that the body introduced into the bladder was, according to the patient, organic, and that only its decomposition could have caused the horrible fetidity of the urine, and I began to believe the patient’s own statements. I knew the object to be long, since he had told me that it was the size of a pen; I had enough information to know what I must do.
Dr Bazy realised that if the object was organic in origin it would be soft, like a piece of rubber. This meant that extracting it would be similar to an operation he had performed many times before. Rubber catheters, used to treat patients who had trouble urinating, often slipped inside the bladder by accident and had to be extracted with instruments.
The following day, after emptying and washing the interior of the bladder with about 140 g of lukewarm boric solution…
Boric acid was (and remains) a useful antiseptic.
…I inserted an instrument in the form of a lithotrite, constructed for me by M. Collin and specially designed for the removal of soft foreign bodies from the bladder.
A lithotrite was normally used to remove bladder stones. Helpfully, Dr Bazy includes an illustration of the bespoke instrument used in this case It was inserted through the end of the patient’s penis and right up inside the bladder – not an entirely pleasant experience, one would imagine.
I gently fed the instrument into the bladder; almost immediately I could feel small projections, soft in consistency and separated by hollows. I was sure that this was the foreign body: I opened the jaws of the instrument and seized it firmly. It came easily when I withdrew it, but then became lodged in the middle part of the patient’s penis.
Oh, the humanity.
I pulled a little harder, the instrument slipped and the foreign body remained in the urethra; I squeezed the channel firmly with one hand to prevent the object from slipping back into the bladder, and picking up a pair of forceps I inserted them into the urethra. It took only a moment to grab the foreign body and extract it.
Job done! And quickly, too:
The various stages of the operation occupied less time than it takes to relate them. I washed the bladder again with large volumes of lukewarm boric solution, and the patient was put to bed for twenty-four hours. He was immediately urinating well; by the next day the urine had become clear and odourless.
A great result. But we still don’t know what the ‘pork cylinder’ was. All is now revealed:
Examination of the foreign body revealed that I was dealing with a pig’s penis.
That’s right: his patient had inserted a pig’s penis up his own member until it had become lodged inside his bladder. In case you’re wondering how such a thing is logistically possible, here is a helpful photograph of a man taking semen from a boar:
The phrase used in the article is verge de porc; verge means literally a rod or wand, although it is also the most common word for a penis. When Francis Packard calls it a ‘pork cylinder’ it is clearly a mistake, although it also makes rather a good euphemism.
The meatus was clearly visible, and it was possible to insert a swab into the urethra.
The meatus is the opening at the tip of the penis.
Besides, the explanations which I demanded of the patient left no room for doubt. This particular example of a porcine penis was 30 cm long.
An impressive specimen. Dr Bazy adds that he later presented it to the French Congress of Surgery, whose members were no doubt touched and delighted by the gift.
There is no need to explain the purpose of introducing such a foreign body into the urethra.
There probably isn’t any need, but in case any of my readers have led an innocent and sheltered life: he was doing it for sexual gratification. The doctor had some strong opinions on the subject.
…but I must emphasise one refinement (if it can be called such a thing) made in this case: the notion of inserting a pig’s penis inside the human member. This example of ‘mutual penetration’ utterly defies explanation and exceeds any fantasy of the imagination. One must have a truly sick mind to reach such extremes of turpitude.
The patient protested his innocence, instead offering this unlikely-sounding explanation:
He said that he had had some difficulty in urinating, and in order to relieve himself had taken the risk of probing himself; he explained that he used the materials he had to hand, and probably thought that nothing would be better at helping him to urinate than an organ of urination.
Of course! Now it all makes sense.
He was thus engaged in probing his own bladder in his room when he heard a noise at the door; afraid of being seen performing the operation, he let go of the object, which slipped into the urethral canal.
A notably feeble excuse. Then again, if you’ve just had a pig’s penis removed from inside your bladder, what are you going to say?