TABULAR VIEW OF THE WEIGHTS, MEASUREMENTS, AND OTHER PARTICULARS RELATING TO FIFTY PREPARATIONS OF THE PROSTATE, DISSECTED BY THE AUTHOR.

I removed the greater part of these from the bodies of elderly people, as they consecutively appeared in the dead-house of a large metropolitan institution, containing a due proportion of healthy and diseased lives; no kind of selection was made, the object having been to obtain them from fair average lives, as occurring in that class of the community which is met with in such institutions.

THIRTY-THREE NORMAL SPECIMENS,

FORMING DATA FOR THE SECTION ON "WEIGHT AND SIZE OF
THE PROSTATE," AT PAGE 10.

THREE, ABNORMALLY SMALL.

No.

Age.

Weight.

Length.

Breadth. Thickness.

CHAPTER II.

THE ANATOMICAL CHARACTERS OF THE ENLARGED

PROSTATE OF AGE.

Enlarged Prostate presents several Varieties.-Two Classes; Enlargement from Analogous Elements, Hypertrophy; from Heterologous Elements, Inflammatory, Tubercle, Cancer.-The Enlarged Prostate of Age.-Physi cal Developments of this kind.-Classification of Forms.-Almost all cause Obstruction to Outflow of Urine.-Effects of on the Urethra and Neck of the Bladder.-Centric and Eccentric Enlargement.-Size and Weight of Enlarged Prostate.-Consistence.-Structural Changes of Enlarged Prostate. I. ENLARGEMENT depending on GENERAL HYPERTROPHY: 1. Of the entire Structure; rare-2. Of the Muscular Tissue only; distinct from Enlargement due to Inflammation. II. Enlargement due to Limited Hypertrophies, Tumors, and Outgrowths; the most common kind.-Home's Account of Prostatic Tumors: 1. Circumscribed Tumors.-(a) simply fibrous (b) the same with Glandular Elements 2. Limited Hypertrophies in the form of Outgrowths.-Analogy between Tumors of Prostate and those of Uterus.-Polypus from Veru-montanum; very rare.-Case. -Cases Illustrative of Defined Tumors in the Prostate.

ENLARGEMENT of the prostate may take place as the result of several different pathological actions or processes; and, therefore, presents varieties, possessing very different characters, both as to the course observed in the progress of the disease, and the structures which may be revealed by anatomical examination of the organ after death.

These varieties may be conveniently separated into two different classes.

I. Enlargements, which are constituted by an excessive formation or unnatural arrangement of elements analogous to those of which the prostate is composed.

II. Enlargements, occurring from the deposition of heterologous elements.

The first group comprehends all the forms of enlargement

which are commonly represented under the general term of Hypertrophy, and only occurring in advanced years.

The second group includes enlargements from inflammatory effusions, whether lymph or pus; as well as enlargements from tubercular deposit, malignant growths, and cystic disease (?).

The first class presents to us the main subject for consideration; inasmuch as the condition commonly known as Hypertrophy of the prostate, and which occurs only at the middle and advanced periods of life, is a form distinguished as much for the frequency of its occurrence, as most other forms are by their rarity. This chapter will be devoted to its study, while that of the second group will be deferred to a subsequent part of the work, where it constitutes chapters ix., X., and xi.

In considering the anatomical characters which distinguish this variety, those of EXTERNAL FORM and physical development may be first noticed.

Judging from the marked examples of this affection which find their way into our museums, it would not be easy to say what part of the organ, anatomically regarded, first exhibits the disposition to enlarge. Writers, and surgeons generally, seem to attribute it very decidedly to the posterior median portion (" middle lobe" of Home), as well as to regard this as the source of the most considerable development in point of size. The impression may be correct that a preponderance of the kind described exists, but it does not appear to be a large one. As regards the locality of commencing enlargement, I confess I do not think the posterior median portion is much more frequently an earlier "point du depart," than are the lateral lobes; but, as regards the rate of development, the former certainly, as a rule, progresses more rapidly than the latter. At the same time by far the larger number of the preparations contained in

four of the principal museums of London, including that of the Royal College of Surgeons, each one of which I have carefully examined, and possess written notes respecting, and amounting to a total of 123 specimens, exhibits about an equal development in size of at least three portions of the organ; that is, of the lateral lobes and the posterior median portion, while in many, the anterior portion is correspondingly enlarged. I have classified the preparations referred to in distinct groups, marked by the direction or situation in which the enlargement is chiefly manifested, a method which will afford the means of obtaining a comprehensive view of the question under consideration.

Uncommon forms of

the affection.

Common forms of the affection.

I. General enlargement of prostate, that is, both lateral lobes and the posterior median portion pretty equally enlarged, is present in 74 preparations of the 123.

II. General enlargement of prostate, but the posterior median portion enlarged in greater proportion; in 19 preparations.

III. General enlargement, but the right lobe predominating, and very decidedly larger than the left; in 8 preparations.

IV. General enlargement, but the left lobe predominating, and decidedly larger than the right; in 11 preparations.

V. The lateral lobes only enlarged; in 5 prepa

rations.

VI. The anterior portion only, or chiefly enlarged; in 3 preparations.

VII. The lateral lobes and anterior portion enlarged, not the posterior median portion; in 3 preparations.