However, Mr Wilson, in his lectures at the College of Surgeons, in 1821, must have caused considerable confusion. After having first stated that ‘that it appears to occur most frequently in those persons, who, either from living a life of strict celibacy, have not used the genital organs so much as nature seems to have intended, or who have injured both the genital and the urinary organs by a life of excess’ then unhelpfully adds, ‘many persons have suffered much from the enlargement of the prostate gland, who have lived a moderate and quiet life, without approaching to either of the above-mentioned extremes’. 12