Modern surgery, general and operative . after double castration (Hawley, in Annals of Surgery, Nov., 1903). In 1893 Ramm,of Norway, performed double castra-tion in order to cause shrinking of anenlarged prostate. In 1893, after a longseries of careful experiments, J. WilliamWhite recommended the operation ofbilateral orchidectomy for the treat-ment of prostatic hypertrophy. Heproved that removal of the testiclescauses a rapid shrinking in an enlargedprostate. Much of this shrinking maybe due to diminution of congestion andedema, but true atrophy undoubtedlyoccurs in the glandular elements. Ver
Modern surgery, general and operative . after double castration (Hawley, in Annals of Surgery, Nov., 1903). In 1893 Ramm,of Norway, performed double castra-tion in order to cause shrinking of anenlarged prostate. In 1893, after a longseries of careful experiments, J. WilliamWhite recommended the operation ofbilateral orchidectomy for the treat-ment of prostatic hypertrophy. Heproved that removal of the testiclescauses a rapid shrinking in an enlargedprostate. Much of this shrinking maybe due to diminution of congestion andedema, but true atrophy undoubtedlyoccurs in the glandular elements. Veryremarkable results have been some cases the patients becomeabsolutely comfortable and dispenseentirely with the catheter. Cystitisceases, and desire to urinate frequently becomes less marked. Unilateralorchidectomy has been employed, but it is not satisfactory. In 1894 Mearssuggested ligation of the spermatic cord. In 1895 Lauenstein suggested divi-sion of the spermatic cord. In 1896 Tilden Brown suggested ligation of the. Fig. 938.—Incising the middle lobe (Young). Castration and Vasectomy 1389 vas. Reginald Harrison in 1S96 advised section of the vas. Lennander in1S97 proposed exsection of the vas deferens {vasectomy). It is slower in itsresults, but just as certain as castration. In spite of the great simplicity oforchidectomy the mortality has been considerable (from 11 to 18 per cent.,according to some authors. Socin and Burckhardt say per cent.). Inseveral instances mental disturbance has followed the operation. Castrationis now ver} seldom performed, as vasectomy is just as useful and is is valueless in cases of fibroid prostate, does some good in adenoma,but is most valuable when the prostate is generally h>-pertrophied and proneto great congestion, causing \-iolent s}-mptoms. The testicle does not atrophyafter vasectomy, mental disturbance does not occur because the internalsecretion of the testicle is still furnished to the organ
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