On the causation and nature of hypertrophy of the prostate / by Reginald Harrison.

  • Reginald Harrison
Date:
[1885?]
Catalogue details

Licence: Public Domain Mark

Credit: On the causation and nature of hypertrophy of the prostate / by Reginald Harrison. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    6 of residual urine seems to have preceded, and not to have been the consequence of, an enlarged prostate. Instances in practice are not uncommon in elderly males where all the symptoms usually assigned to prostatic enlargement are present, without there being evidence, beyond the presence of some residual urine, that any physical change in the gland has taken place. I have frequently noticed that condition of unnatural contractility about the muscles connected with micturition, to which Sir James Paget's expression of stammering with the urinary organs may be applied, precede prostatic hypertrophy. I have a case under observation, where a locomotive engine-driver, aged 53, has, owing it is believed to the constant concussion connected with his occupation, been a stammerer of this kind. Rectal examination now shews that his prostate is commencing to enlarge, as not only is it breadthening, but a distinct band of what I take to be muscular tissue is to be felt stretching across and filling it up. I was able to demonstrate this to my House Surgeon, Dr. Collins, and my clinical class, who had no doubt about the facts, whatever the construction placed on them might be. The sequence of events in this case appears to have been enforced retention by reason of the man's employment, incomplete emptying of the bladder, irregular and spasmodic efforts to expel residual urine, ter- minating in commencing hypertrophy of the muscles princi- paHy involved, namely, those associated with the expulsive action of the bladder. The frequency with which the floor of the gland is the first to shew the hypertrophic change, seems to strengthen the inference I have drawn from the development of the inter-ureteral bar, and to indicate that both conditions are the direct result of straining and an excess in the expulsive action of the bladder and associated parts. Structurally, the inter-ureteral bar and the hyper-
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