VI Neuroses, Reflex in Female Diseases......... 182 New York Sanitarium from a Home Standpoint..................... 528 Ninth Volume, Close of......................... 527 Street Sprinkling in Cities........... 126, 393, 423 161 204 Suppuration, Recent Studies upon the Nature of................... 67 Obituary, Dr. Wm. A. Byrd..... 97 Suprapubic Cystotomy.. 69 Dr. Jno. H. Cashon... 37 Surgeon's Life, A. 421 -Dr. Jas. A. Gray 486 Surgery, The New.... 385 --Dr. W. C. Stephens.. 37 Surgeon to Tennessee State Penitentiary Dr. Moses Gunn.... 525 Report of....... 76 bst trical Expedients. 29 Syrupu, Rob rans... 86 Obstructed Urethra 191 Opthalmia Sympathetic..... 355 Syphilis and Skin Eruptions, Horsford's 154 Opium and Camphor, Reciprocal Anti- dotes 118 Our Advertise s................ 8888888 T 38 Papoid......... 415 To Err is Human......... Paraldebyde and Urethran.. 64 Tracheotomy, Difficult... Past and Future...... 32 Tribula ions of a Medical Student............ 144 Pasteurism in Russia.......... 202 Trismus Neonatorum, Ether for... 513 Perineorraphy 230 Truth Through Error.. :65 Phrenologist, taking the Starch Out of..... +3 Typhoid Fever........... .............. ..56, 101, 223 -Treatment of at Roose- velt Hospita'..... 244 201 Typho-Ma'arial Fever......... 250 Placenta Prævia........ 488 Pleurisy, Treatment of by Hay's Method.. 117 Hospital 192 Preparations, Sp. cia'. 84 Priapism, Iodide of Potash in.......... 380 Urethran and Pa aldehyde.. 64 161 191 Prognosis in Valvular Disease of Heart..... 149 Prostatic En argements 1 Treatment of aft r Removal of 243 Protection for Medicine.. 148 Urethral Caruncle... 501 Pyæmia and Septicæmla... 361 Urinary Diseases, Napthaline in.... 29 245 Q Hæmostat cs.. 502 Query.. 265 Question of Pronunciation...... 203 Uterine Hæmorrhage, Hydrastis in 161 Puerperal.. 383 N.SSH THE SOUTHERN PRACTITIONER. AN INDEPENDENT MONTHLY JOURNAL, A CLINICAL LECTURE BY DUNCAN EVE, M. D., Professor of Surgery aud Clinical Surgery, Medical Department University of Tennessee. [DELIVERED AT CITY HOSPITAL.] GENTLEMEN :—I present to you, by courtesy, this morning Mr. L. M——, who is suffering from chronic cystitis of many years' standing. Mr. M. resides in our neighboring county of Sumner, and has now reached the advanced age of seventy years, the last of which have been years of intolerable suffering. You perceive that he is extremely anæmic; and you will not wonder, when I inform you that in his efforts at micturition he is frequently seized with spasms. He is suffering now, as I informed you, with chronic cystitis, resulting from prostatic enlargement. Upon examination I find that he passes his urine by drops mixed with ropy mucous and blood, and so great is the tenesmus consequent upon these efforts that he is frequently thrown into nervous rigors. In consultation with my colleagues I have determined to perform in his case the usual operation for lithotomy to secure drainage; an operation suggested and practiced successfully by my father, the late Professor Paul F. Eve, M.D., and subsequently by myself with most satisfactory results. The condition of his urethra is such as utterly to preclude the idea of dilatation, and all the circumstances considered, I have determined upon the usual lithotomy operation as the most feasible in his case. I shall now place him upon preparatory treatment, and upon the occasion of the operation, which will occur in a few days, I will speak of cystitis consequent upon stricture or prostatic trouble. I now desire to call your attention to prostatic enlargements as a source of many troubles which will doubtless frequently demand surgical interference at your hands. I wish to invite your attention more particularly to this subject because I am satisfied the profession has not given that attention it should to early enlargements of the prostate gland, and the general management of its advanced stages seems a matter of considerable doubt. That the physiology and pathology of the gland is but imperfectly understood is evident, and upon this hypothesis may hang the usual empirical treatment of its lesions. These glands, or as some term them, muscles, are organs resembling chestnuts in size, lying, in the erect position of the body, with their flattened surfaces upward, and their apices in relation with the deep perineal fascia or triangular ligament which here gives passage to the urethra. The base of the gland is in such near apposition to the vesical outlet that in case of enlargement it encroaches upon it, giving rise to obstruction to the free passage of urine. Thompson says that the glandular structure of the organ, which forms about one-third of its entire bulk, is found distributed in the lateral lobes, and the muscular fibres are divergent from the center to the circumference of the organs. Thus we have an ample space for the products of secretion and |