1806.] 



Proceedings of Learned Societies. 



49 



nent, and a biidlc, uearly a quarter of an 

 inch in breadth, extended from the 

 middle hne ot' the tumour to the bulb of 

 the urethra, where itinlenlibly difappear- 

 •ed. The ufual rounded projection of tlie 

 caput gulliitaginis was not viliblc : it had 

 waded away, and the remains weie con- 

 cealed in tlie fold forming this bridle, 

 wliich at that part was not thicker than 

 at any otiier. The fpace between the 

 tumour in the bladder and the bulb of 

 the urethra was unuiually Ihort, which is 

 the reverfe of What is commonly met with 

 in old men ; fo tliat this bridle appeared 

 to have drawn the bulb towards the tu- 

 mour, and iliortened the membranous 

 part of the canal. 



This unufual appearance led JMr. Home 

 to examine the proftate gland in its na- 

 tural Hate, in order to afcei tain whether 

 there is any part fufticiently detached to 

 move independently of the reit of the 

 gland. The refult of an accurate diffec- 

 tion was the difcovery of a fmall rounded 

 :fubli:ance fo much detached that it feem- 

 ed a difiinft gland, and ft nearly refem- 

 .blint; Cowper's glands in lize and iliape, 

 that it appeared to be a gland of that 

 kind. It could not, however, be liitis- 

 factorily Separated from the proltate 

 gland, nor could any diftinct duct be 

 found leading into the bladder. Other 

 dilfeCtions, though not producing precifcf- 

 ly-the fame appearances, led to the con- 

 .cluhon that this was a lobe of the proltate 

 gland, the middle of which had a rounded 

 form, united to the gland at the bafe next 

 the bladder, but rendered a feparate lobe 

 by two tiiVures on its oppohte fui face. Its 

 ducts palled direcdy through the coats of 

 the bladder, on which it lay, and opened 

 immediately behind the verumontanum. 

 By means of this lobe a circular aperture 

 is formed in the profiate gland, which 

 gives palfage to the vafu dtfereutia. 



'J'his new anatomical fact, it is fuppofed 

 by iMr. Home, will enable us to underftand 

 the nature of a difeafe which it was not pof- 

 hble we could have a correct idea of, when 

 we were ignorant of the exillence of the 

 part in which it takes place. It not only 

 .explains the iitnation of tho tumour, the 

 want of connection with the body of the 

 gland, and the narrownefs of its bafe 

 where that is met with, but it folves what 

 has ever appeared tlie grcated difficulty, 

 viz., how it (hould protrude into the cavi- 

 .ty of the bladder, which arifes fi'om the 

 hard fubltance of the coats of the vaj'a dcr 

 Jh-enliu being in dole contact, and 

 bound down upon this lobe ; fo that from 



Mo.MiiLY Mac, No. 14(j. 



its firft enlargement it muft immediately 

 prcfe up the inner membrane ot'the bUd- 

 dar, wliich can make very little reiill- 

 ancc. 



This lobe of the proftate gland, from 

 its fituation <iud connection with the vuj'a 

 ikfaenlia, is liable to niuiiy caufes of 

 fvvcUmg, which the body of the gland it- 

 felf is free from ; for every irritation up- 

 on the lemiiiid vellels or tiioir oriiices 

 may be communicated to it by continuity 

 of parts : and aged men, from an ig- 

 norance of thefe facts, are too often, 

 through imprudence, producing an ex- 

 citement in ihofe velfels which the parts 

 are unable to fupport ; and when this is 

 long continued, iuOainmation becomes 

 the confequeiice, which cannot take 

 place to any degree without being com- 

 municated to this lobe, and producing 

 an enlai^ement of it. 



Every violent elfort which is made to 

 empty the urinary bladder produces an 

 unufual prelfure againll tliis lobe, by 

 A>hi<:li it may he injured, ilr. 11. thinkjs 

 that the difeafed ftate of the lateral parts 

 of the gland, I'o very commonly met with 

 in the latter periods of life, luiis its origi« 

 in this particular lobe, fmce hi moft cafes 

 of a difeafed (late of the gland this lobe 

 has been enlarged in ii greater degree in 

 proportion to its li/e than any other part ; 

 and in librae iuliances the enlargement odf 

 it has been very gi'cat, while it appeared 

 to be only beginning in the lateral por- 

 tions 



Difficulty in palling the urine is a 

 fyniptoni which tomes on very early in 

 dil'eafes of the proltate gland, and arifes 

 entirely from this lobe being iucrcafed in 

 iizc ; fince any enlargement in the lateral 

 portions of the gland widens the canal in- 

 llead of diminilhing it, and they do not 

 require much force to feparate them ; 

 but the leaft increafe of this lobe tends 

 to Ihut it up. 



I'he enlargement of this lobe leads me- 

 dical prattitioners irUo an error relpect- 

 ing the nature of the complaint. The 

 orifice of the urinary bladder, which is 

 the lowefl part in the natural ftate, is 

 raife i up in proportion to the increafe of 

 this lobe ; fo that none of the contents 

 below that level can be expelled, al- 

 thougli whatever is above it is allowed 

 with more or lefs difficulty 'to pafs out. 

 In this way the perfon never evacuates 

 more than one-halt' or one-third of the 

 urine contained in the bladder ; but as 

 the water which comes away palVes in a 

 liream, and tiic quantity voided in twen- 

 G ty-four 



