The American Journal of Urology and Sexology, Volume 5

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Henry G. Spooner
Grafton Press, 1909
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Page 77 - DISEASES OF THE GENITO-URINARY ORGANS AND THE KIDNEY. By Robert H. Greene. MD, Professor of Genito-Urinary Surgery at the Fordham University, New York; and Harlow Brooks, MD, Assistant Professor of Clinical Medicine, University and Bellevue Hospital Medical School. Octavo of 605 pages, profusely illustrated.
Page 274 - I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption ; and further, from the seduction of females or males, of freemen and slaves.
Page 294 - When the prostate is felt free within its sheath and separated from the urethra, with the finger in the rectum, aided by that in the bladder, it is pushed into the bladder through the opening in the mucous membrane, which, during the manipulations, will have become considerably enlarged.
Page 294 - After that period, in the human foetus, they approach each other, and their inner aspects become agglutinated together, except along the course of the urethra, which they envelop in their embrace. These two glandular organs, which constitute the lateral lobes of the prostate, though welded together, as it were, to form one mass, remain, so far as their secreting substance and functions are concerned, practically as distinct as the testes...
Page 218 - ... where the enlargement and thickening is greatest. The knife is carried deep enough to penetrate the thickened fibrous capsule and enter the infiltrated connective tissue. When the knife is through the thickened covering of the epididymis a very marked lessening of resistance will be felt. If pus be seen to escape from any of the punctures, the opening is enlarged and a small probe inserted in the direction from which the pus flows.
Page 294 - I have already explained, this portion of the enlarged prostate is covered merely by mucous membrane, so that when this is scraped through and detached the true capsule of the prostate is at once reached. Keeping the finger's point in close contact with the capsule, the enucleation of the prostate out of the enveloping sheath outside the bladder is proceeded with by insinuating the finger-tip in succession behind, outside, and in front of one lateral lobe, thus separating the capsule from the sheath....
Page 294 - An incision, varying in length from z\ to 3£ inches, according to the stoutness of the patient and the size of the prostate, is made in the median line of the abdomen, its lower end reaching to the level of the pubic arch. This incision is rapidly carried down through, or between, the recti muscles till the prevesical space is opened. Any bleeding...
Page 294 - ... the wound, and the prevesical fat scraped upwards off the bladder by the finger-nail for the whole length of the wound. The peritoneum, which should not be seen, is thus pushed upwards out of harm's way, and the bladder appears deeply in the wound, quite tense, glistening, and of a pale white colour, with large and tortuous veins coursing in its substance.
Page 294 - ... with paralysis, 1. Though all these deaths are accepted in connection with the operation, in not more than half the number can the fatal result be attributed thereto, the remaining deaths being due to disease incident to old age and unconnected with the operation. In lí)8 cases vesical calculi were removed at the same time; hut all the deaths in these cases are accepted in connection with' the prostatectomy, none being put down to the suprapubic lithotomy involved.

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