Page:Proceedings of the Royal Society of London Vol 1.djvu/246

Rh also, in some measure, between the lateral portions of the prostate gland and the bladder. It was evidently a lobe of the prostate gland: and its ducts passed directly through the coats of the bladder, and opened immediately behind the verumontnnum.

A still more distinct appearance of this lobe was afterwards found in a subject twenty-four years of age; a representation of which accompanies this paper.

This newly acquired anatomical fact enables us, Mr. Home says. to understand the nature of a disease, of which we could not have a clear idea while we were ignorant of the existence of the part in which it originates : it also enables us to explain various circum- stances respecting the disease, particularly what to our author has ever appeared the greatest difﬁculty, namely, the protrusion of the tumour into the cavity of the bladder. This protrusion arises from the hard ubstance of the coats of the vasa deferentz'a being in close contact, and bound down upon the lobe; so that, from its ﬁrst en- largement, it must press up the thin coats of the bladder. The situa- tion of this lobe, and its connexion with the vase deferentia, also render it liable to many causes of sweuing, from which the body of the gland is free ; since every irritation of the seminal vessels, or of their oriﬁces, may be communicated to it by continuity of parts.

There is much reason, our author says, to believe that the diseased state of the lateral parts of the gland, so common in the later periods of life, has its origin in the lobe here described; for, in most of the cases examined by him, this lobe has been enlarged in a much greater. degree, in proportion to its size, than any other part of the gland; and the difﬁculty in passing the urine, which comes on very early in the disease, is, hir. Home thinks, owing to the enlargement of this lo'be; since an enlargement of the lateral portions of the gland widens the canal instead of diminishing it. The enlargement of the lobe also occasions the bladder to retain a considerable part of the urine; and as the urine passes in a stream, and the quantity voided is sufﬁcient, no suspicion is entertained of the cause of the frequency and distress in passing it; but they are referred to an irritable state of the coats of the bladder.

From the above observations it appears that the small lobe of the prostate gland here treated of is, from its situation and the circum- stances in which it is placed, more liable to become diseased than any other part of the gland; and that it produces symptoms of dan- ger and distress which are peculiar to itself, but which have been hiththr) supposed to arise from the body of the gland becoming en- large.

The present paper is a continuation of that communicated to the Society by Dr. Herschel last year. in which ire considered the direc-