moval of the plaster-of-Paris bandage and what appeared to be a complete and satisfactory result, and wearing an ordinary rubber bandage, he was in the stable attending to some duties when with a slippery floor under him his foot gave way suddenly and the same accident happened again, absolutely the same as far as the gap was concerned; perhaps not quite as extensive, that is, the gap was not quite so wide as at the first time, but there was the same inability to extend the leg. He is at the present time lying in bed with a plasterof-Paris bandage on and we are hoping of course for as good a union as before. I had a consultation in this case and the same conclusion against operation was arrived at, that Dr. Stetson speaks of. Our patient was old. He also had urinary trouble and there was the slight arterio-sclerosis of which he speaks, and signs of the same muscular weakening or degeneration which probably permits such an accident to occur in these cases.

ARTICLE XXV.

THE PRESENT STATUS OF THE SURGERY OF THE PROSTATE GLAND.

BY PAUL THORNDIKE, M.D.

OF BOSTON.

READ JUNE 9, 1903.

THE PRESENT STATUS OF THE SURGERY OF THE PROSTATE GLAND.

THE reader has been asked to give a short résumé of the present condition of prostatic surgery. It becomes evident at once that to do this in the fifteen minutes' time allotted for the purpose, makes a detailed account of technical procedures quite impossible, and little more can be attempted than to mention briefly the various steps which have brought prostatic surgery where it is to-day, and to consider with equal brevity the class of cases best adapted to each of the operative procedures which are in use at the present time. If this paper serves to help the practitioner of medicine to formulate and arrange his ideas as to the treatment of cases of obstructive enlargement of the prostate which are so common in every physician's practice, its object will have been attained.

Bel

Bottini performed his first cautery operation over thirty years ago and continued the use of his instrument up to the time of his very recent death, but the operation never gained an extensive repute until within the last few years. field of Chicago performed the first prostatectomy in 1885, but it was not until the publication of a series of cases of prostatectomy, by McGill of Leeds in 1888, and the communication of Mr. McGill and his colleagues of the Leeds Infirmary, at the meeting of the British Medical Association in 1889, that the surgical world realized the practicability of a radical operation for the removal of obstructing prostatic masses.