31 3 16 7 J. -J. Rousseau and His Urologic Diseases Hiroshi Saitoh (Department of Urology, Saitama Medical School, Saitama Medical Center, Kawagoe, Saitama 350-8550, Japan) Jean -Jacques Rousseau (1712-1778) is the 18th -century thinker who has most profoundly influenced to vast areas of present-day philosophy, education, literature, politics, and religion. On the other hand, he was said to have been a complicated man who showed genius mixed with madness. His thought was full of paradox and contradiction, and he hardly could be considered a normal person. I studied his urologic diseases as described in his autobiography, Les Confessions, as well as his other works and letters. He described difficult urination accompanied by urgency in a pattern most consistent with congenital urethral stenosis, congenital urethral valves or neurogenic bladder. However, he noted no symptoms suggestive of urinary tract infection or renal dysfunction in early childhood, only later complaining of urinary tract infection symptoms. He eventually underwent transurethral manipulations with urethral sounds and catheters as treatment for difficult urination. Severe urethral pain in his later life may have been related to so-called prostatism or prostatodynia. He finally complained of a severe headache following a morning walk and breakfast. He died suddenly soon afterward, presumably of cerebrovascular disease, at the age of 66 years. Keywords: Rousseau, pathography, urology, urination J Saitama Med School 2004;31:183-193 (Received June 11, 2004) Jean-Jacques Rousseau, 1712-177866 18 1-8) 1) 1) 1, 3, 8-10) Pathography 11) 16 6 11 12) 3, 13) 3) 3) 14, 15) 1 1 6 1764 1767 52 55 2 7 12 1769 1770 57 58 16) 1755 43
17) 1758 46 18) 1762 50 19) 1762 50 18) 1762 50 20) 1777 65 1 3) 2) 21) 11712 1742 0 30 1 1 16 303 2 1735 1736 23 24 5 242 5 242 5 244 1741 29 6 251 252 6 257 6 272 6 273 6 283 284 8 392 21742 1762 30 50 1744 32
7 320 10 7 344 12 262 1748 36 3) 3) 1749 1750 37 39, 8 392 8 10 50 8 396 4) 1758 45 28 1758 74 20 9 14 10 108 1761 49 algalie; sonde creuse 14) ; une grosse pierre prostate étoit skirreuse et d une grosseur surnaturelle 11 199 1866 11 199 5) 1762 50 301 306 3 1776 1778 64 66 1776 1778 64 66
26 4 5 22 30 1694 1778 3) 7 2 8 11 3) 6) 1 5 246 48 56 58 1632-1704 58 108 6 284 1750-62 115 116 3 125 1 De Medicina48 68 20 229 30 60
108 22) 23 26) 21) 6) 1) 2) 3) 19683 4) 5) 7) 8) 9) 32218 10) 1 11 3) 46 44 11 176 114 46208 6 252 83 2 79 114 29 6 272 274 294 304100 212 6 251 11 206 306 5 228 33 8 392 8 392 6 257 273 8 392 396 11 206 11 199 8 396 20 114 10 108 10 108 118 150 137 6 274 7 348 12 262 263 112 112 112 35 18 154 48 6 273 274 8 405 6 250 38 28 745 211 11 176 63 20 6 274 11 176 5 242 52 114 5 242 6 272 75 79 27 74 5 242 98 6 283 595 202 6 273 118 6 273 113
un vice de conformation dans la Vissue rétension d urine 14) fréquens besoins d uriner 1,5,6,7,8,10,11 1, 3) 6 257 8 396 9 9) 1 23 1 22) 7) congenital urethral valve neurogenic bladder 66 11 199 2 1748 36 sonde 14) bougie 14)
27, 28) 3) 5 1533-159259 16 19) 29) 1808 187365 30, 31) 19) violente néphretique, colique néphretique silent stone 49 66 prostatisme sans prostate prostatism prostatodynia X 1769 182152 32) 19) surnaturelle 49 skirreuse squirreux
déclarer mal 3) 1 19, 33) 10) 36 21, 7) 18, 19) 8) 3 1772 64 20) 3, 20)
3 1778 66 8 3 1, 3, 7) 1, 3) 3) 1) cerebrovascular accident; C.V.A. intracranial aneurysm 1778 5 7) 1 34-39) prostatism symptom complex prostatisme sans prostate : silent prostatism prostatodynia: dysuria Dysurie 2 3) 1712 6 28 1778 7 2 1 1 6 2 7 12 116 2 4 19 5 6 1732 1742 20 30 7 1742 1749 30 378 1750 1756 38 44 9 11 1757 1762 45 5012 1765 53 3) 1 2 1 2 7 303 2 1760 48 6 2511764 52 30 30 6 8 392 3 Mme de Warens 3) 1) 1728 17 28 20) 3) 3, 15)
4 120 501000 28 400 31 1000 37 900 1000 3) 501 35 3000 800 7 309 8 383 5 1758 46 3) 6 1768 56 5 5 1746 1752 34 40 8 388 7 empowerment advocacy Quality of Life, QOL 21) 8 18) 19) 1761 49 6 3) 304 1762 50 3) 1).. : ; 2001. 2)... : ; 1999. 3).. : ; 1951. 4).. : ; 1970. 5).. : ; 35. 6).. : ; 2000. 7)... : PHP; 2002. 8)... : ; 1975. 9). J. -J.... : ; 48. p. 327, 371-2. 10)... : ; 1958. p. 146, 238. 11).. : ; 2001-2004. 12).. : ; 2002. 13).. : ; 57. 14) Rousseau Jean-Jacques. Les Confessions. Geneve: Gallimard; 1959. 15).... : ; 1979. 16).... : ; 2002. p. 48, 154. 17)... : ; 2002. 18).... : ; 2001. 19).... : ; 2003: p. 322. 20).... : ; 2002. 21).. : ; 2003. 22). 2000;8:15-25. 23)..,. : ; 1995. p. 32, 80, 88-128. 24)...,. : ; 2000. p. 32, 135, 147, 219, 288, 406, 484. 25)..
: ; 2003. 26).. 2004;17:1-7. 27)... : ; 1991. p. 286. 28) C:.. : ; 1996. p. 66. 29).... : ; 2002. 30)...,,. : ; 1982. p. 1-14. 31).. : ; 1996. 32)... : ; 2003. 33).. 2004;31:137-46. 34),,.. : ; 58. 35).. : ; 2001. 36) Tanagho EA, McAninch JW. Smith s General Urology, a Lange medical book, Tokyo: Prentice- Hall International Inc; 1984. 37) Clinical Practice Guideline. Benign Prostatic Hyperplasia. Rockville: AHCP, Publication; 1994. 38) Dorland s Illustrated Medical Dictionary. 25th ed. Philadelphia: W.B.Saunders; 1965. 39).. : ; 1949. 2004 The Medical Society of Saitama Medical School