Page:Philosophical Transactions - Volume 096.djvu/218

Rh greater degree in proportion to its size than any other part; and in some instances the enlargement of it has been very great, while it appeared to be only beginning in the lateral portions.

Difficulty in passing the urine is a symptom, which comes on very early in diseases of the prostate gland, and arises entirely from this lobe being increased in size, since any enlargement in the lateral portions of the gland widens the canal instead of diminishing it, and they do not require much force to separate them; but the least increase of this lobe tends to shut it up.

The enlargement of this lobe produces an effect which is not generally known, and leads medical practitioners into an error respecting the nature of the complaint. The orifice of the urinary bladder, which is the lowest part in the natural state, is raised up in proportion to the increase of this lobe; so that none of the contents below that level can be expelled, although whatever is above it is allowed with more or less difficulty to pass out. In this way the person never evacuates more than one half or one third of the urine contained in the bladder; but as the water which comes away passes in a stream, and the quantity voided in 24 hours is sufficient, no suspicion is entertained of the cause of the frequency and distress in passing it, and the symptoms are referred to an irritable state of the coats of the bladder. It is only by drawing off the urine through a catheter that the disease in this lobe can be ascertained; as in that way alone the quantity of urine which is retained can be determined. No examination per anum can give the surgeon any information on this subject; since the posterior surface of the vasa deferentia only is to be felt, if the finger should reach so far; and yet it is in this way that practitioners in general pretend to judge of the greater or