On April 9th 1878 the professor of surgery at the University of Maryland, Dr Alan Smith, gave a talk at a meeting of the state medical society. His subject was lithotomy, the surgical removal of bladder stones, an operation he had performed many times. Dr Smith’s presentation referred to ‘fifty-two successful cases of lithotomy’, but you can be quite sure that when his audience left the hall that evening there was one in particular that they were thinking about:
A middle-aged gentleman from a distance, suffering from well-marked symptoms of stone in the bladder, consulted me some time ago. Upon uncovering the organ in order to introduce the sound, I was amazed to discover that the penis was double.
Well, that would certainly be a bit of surprise.
The organs were separated from each other above by a deep sulcus, below which they were closely united.
A ‘sulcus’ is a furrow or groove.
They were slightly under the average normal size, and were unprovided with any prepuce [foreskin].
Let’s face it, if you have two penises you’re hardly worrying about their size.
The one upon the right of the median line was normal in every respect, being traversed by an urethra beginning at the extremity of the glans, while the one on the left had the urethral opening below and just in advance of the scrotum.
This sounds like hypospadias, a condition in which the urinary tract ends at an anomalous opening in the shaft of the penis rather than at its tip.
The scrotum was natural in every respect, and contained two testes of normal size. Upon making an examination, I of course passed the sound [probe] into the urethra of the right-hand penis. The instrument slipped readily into the bladder, but I could not detect by its aid the slightest symptom of calculus.
The patient was, after all, there for the removal of a bladder stone or calculus, rather than for the doctor to gawp at his unusual appendage(s).
Very much surprised at this, I asked the patient through which opening he passed his urine, and was informed that he used both; and, what was more curious still, that he could use either at will, or that he could first pass a quantity of urine through one, and immediately after discharge about the same amount through the other.
Now that’s what I call a party trick. These days he’d make his fortune on a TV talent show.
Then for the first time it occurred to me that there were two bladders; and calling for two utensils, I desired him to first discharge from the right-hand organ. From this there flowed a quantity of clear, amber-colored, healthy urine; while, when directly afterward the same act was performed by the one on the left in a separate vessel, the fluid was ammoniacal and turbid with mucus and pus.
Obvious signs of infection.
At once the case was clear; he had two bladders.
Not a sentence which most of us will ever have cause to construct.
The one which I had not yet examined contained the stone sought for. I then attempted to pass my sound into the second urethra, but found the canal contracted and tortuous. Substituting, however, a bougie tipped with steel, I was rewarded by striking immediately a large calculus.
A few days later Dr Smith operated to remove the bladder stone. He seems to have made a bit of a mess of it, however:
Violent hemorrhage ensued after the operation, and continued very profuse in spite of the most strenuous efforts to arrest it, till he became almost perfectly exsanguine.
In other words, until he had almost bled to death. Unless the patient suffered from some unusual condition which hindered clotting – which is quite possible – this could only be attributable to surgical error.
The pulse ceased to beat at the wrist after the bleeding had continued several hours, and only slight heart-sounds could be detected.
These are pretty serious complications for a comparatively minor procedure – even at this early date.
However, after almost every drop of blood had escaped, the hemorrhage ceased; he commenced slowly to react, and progressed to perfect recovery.
A bizarre and unusual case, but not unique. In a slightly earlier textbook, Van Buren and Keyes’s Surgical Diseases of the Genito-Urinary Organs, the authors describe a strikingly similar case of double penis. So similar, in fact, that Dr Smith became convinced that his patient and Van Buren’s were one and the same:
Upon writing to my patient and questioning him about it, he assured me in the most positive terms that he did not know Dr. Van Buren, that he had never consulted him, and that no physician had ever examined him but myself.
It’s almost as if the man with twin penises had an identical twin.