Inability to do physical work; mind lively. Memory poor, especially for proper names. Angry, storming, sullen, irresolute, full of fear. Sleep superficial, restless; lively dreams. Ejaculation praecox; nocturnal erections, pollutions. Onanism; result of onanism and sexual excesses. Congestions, heat on vertex; palpitation without cause. Venous engorgement in portal system. Haemorrhoids.

FROM a large number of observations during 10 years I shall try to show that prostatic enlargement play an important role in cases which are considered neurasthenic or reflex sufferers.

First two histories of prostatic hypertrophy.

Mr. S., 60, consulted me November, 1931, on account of chronic bronchial catarrh with asthma. He also complains of frequent urge to urinate, especially nights, with slow and difficult micturition. After reliving the asthma and bronchial catarrh the patient was given prostate massage twice weekly. and internally Ferrum picricum 4x there times daily, which improved the micturition difficulty.

December, 1932, till February, 1933, and from then on almost year, usually in December, more massages courses became necessary. On account of hardness of the prostate and patients mental depression Aurum iodatum 4x was given with an occasional dose of Sabal serrulata 2x. It is always possible to relieve the micturition greatly.

Mr. Sch., 59, has frequent urination with small stream. Five massages and Selenium 6x improved so much that patient got along without treatment for about four years, when a few massages were necessary; internally Aurum iodatum 4x on account of depressed mood. The after treatment was Sabal serrulata 2x.

In both patients of the pycnic (short-strong-thickset) type there was a typical prostata hypertrophy. I wish to call special attention in these two cases to the mental depression which I have found in many prostatic, and o the massage. I do not think that massage has any effect on the hypertrophy itself, but without doubt, relieves the accompanying venous stasis and thus the micturition difficulty as well as the depression.

The two following cases are essentially different:.

Mr. G. P., 45, came under my treatment complaining of pressure in the region of the stomach, eructation and some difficult breathing in climbing. Objectively I found only a swelling of the liver of about an inch, and a distinct prostatic swelling with much pain.

This patient also was depressed and irritable. Carduus marianus 2x alternating with Ferrum picricum 4x and prostate massage twice weekly improved the objective as well as the mental constitution which latter became more balanced in about six weeks.

Mr. O. V., 49, came under my care in 1930 complaining of painful pressure in hypogastricum, full feeling, palpation and mild breathing difficulty in climbing. Blood pressure 155.80, accelerated pules of 84 while lying down, enlarged, painful prostate. Irritable and easily depressed mood. Treatment and result the same as in last mentioned case.

In these two patient there certainly was an enlarged prostate gland, but apparently not a hypertrophy unless it was just beginning. The massage caused a diminishing of glands to about normal size (not part action of the homoeopathic remedy ? S.W.S.), therefore the enlargement must have been caused by congestion. This can be considered part of the unquestionable abdominal plethora. It seems essential to me that the action on the moods and improvement of the irritability were quite evident.

In the following report we have younger patients before us. Complaints which suggest prostatic hypertrophy recede to the background or are lacking entirely. These patients are usually of the slender asthenic type.

Mr. W. F., 40 complained of attacks of fear, evenings; easily exhausted, unable to do any mental work; easily exited; libido decreased; feeble urinary stream. General examination Dermographism. Reflexes very lively. Prostate much enlarged, especially left lobe, and very sensitive. The treatment was regular prostata massage; internally Acidum phosphoricum 3x. can concentrate better; the general working ability normal.

Mr. P. L., 28, since his 14th year has suffered frequent attacks of depression, ennui, inclined to brooding. The last months brought a dull pressure in head; ability to work and concentrate very low, as also the libido. Examination negative except for enlarged and painful prostate. Massages and Ferrum picricum 4x reduced the swelling and relieved the pain, and changed the moody condition to happiness and love of work to a degree the patient had not had for years.

Mr. E. K., 24, is trembling all over during frequent attacks of excitement which were caused by slight difficulties. During the last years erections are weak with ejaculations too soon. Heart action excited; respiratory arrythmia. Dermographism very pronounced. Reflexes lively. Prostate much swollen and painful. treatment and result same as in previous case.

Hans Triebel