. Modern surgery, general and operative. ts are fairly good. The scars contract and the gland atrophies. During the period of healing a steel sound should be passed from time to time (Bangs). It is alleged that fibrous stricture of the neck of the bladder may follow in some cases. ^ Bottinis operation is the procedure tobe selected for a sclerotic prostate and forhypertrophy in a feeble and aged individualwith damaged kidneys. It is not probablethat the cautery operation will ever re-place prostatectomy. The best instrumentis Youngs modification of Freudenbergsinstrument (Fig. 1017). Figures 1
. Modern surgery, general and operative. ts are fairly good. The scars contract and the gland atrophies. During the period of healing a steel sound should be passed from time to time (Bangs). It is alleged that fibrous stricture of the neck of the bladder may follow in some cases. ^ Bottinis operation is the procedure tobe selected for a sclerotic prostate and forhypertrophy in a feeble and aged individualwith damaged kidneys. It is not probablethat the cautery operation will ever re-place prostatectomy. The best instrumentis Youngs modification of Freudenbergsinstrument (Fig. 1017). Figures 1018 and1019 show various methods of making thecuts as advised by Hugh H. Young. Whenthere is a distinct and pedunculated medianlobe the ordinary plan of burning fails entirely; but, as Young shows (, 1020), if an oblique cut be made on each side across the base, this lobe 1 For description of this operation see Freudenberg, in Berliner klin. Woch., No. 46,1897; and Willy Meyer, in Med. Record of March 5, 1898, and May 12, Fig. 1020.—Incising the (Young). middle lobe 15^6 Diseases and Injuries of the Genito-urinary Organs will drop out of the way and quickly atrophy. Bottinis operation does notgain in public confidence. Castration and Vasectomy.—In 1886 Sanitzin demonstrated clinicallythe shrinking of a large prostate after double castration (Hawley, in Annals ofSurgery, Nov., 1903). In 1893 Ramm, of Norway, performed double castra-tion in order to cause shrinking of an enlarged prostate. In 1893, after a longseries of careful experim£nts, J. William White recommended the operation ofbilateral orchidectomy for the treatment of prostatic hypertrophy. He provedthat removal of the testicles causes a rapid shrinking in an enlarged of this shrinking may be due to diminution of congestion and edema,but true atrophy undoubtedly occurs in the glandular elements. Very re-markable results have been recorded. In some cases the patients becomeabsolutely co
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