gement of the
prostate, the next thing is to find to what extent this interferes
with the bladder being emptied. To do this, he asks the patient to
pass as much water as he is able, and then with due precautions
introduces a soft catheter and measures the amount of urine which he
thus draws off--half an ounce, an ounce, two ounces, however much it
may be. It is this "residual urine" which causes the annoyance and the
danger of enlarged prostate, and unless arrangements can be made for
its regular withdrawal serious trouble is almost certain to ensue. The
passing of a large catheter may have the effect of so opening up the
water-way that, at any rate for a time, the irritability of the
bladder may cease, in which case the patient may be instructed in the
art of passing a catheter for himself. Or the surgeon may find that in
addition to the regular passing of a large catheter an occasional
washing-out of the bladder with hot boracic lotion is all that is
needed in the way of active treatment. At the same time, however, the
patient is placed upon a plain and wholesome diet with little or no
alcohol, and he is instructed to lead in every respect a regular and
quiet life. To many men with enlarged prostate the passing of an
instrument night and morning is no great hardship, while to others the
idea of leading what is called a "catheter life" appears intolerable,
or, having for a time been patiently carried out, is found not only
severely trying but greatly disappointing.

In some people the very first passing of a catheter sets up a local
and constitutional disturbance, the bladder being rendered irritable
and intolerant, the temperature going up, and shiverings and
perspirations manifesting themselves. This condition was formerly
called "catheter fever," and was looked upon as something mysterious
and peculiar. It is now generally understood to be the result of
septic inoculation of the interior of the bladder.

Lastly, in other persons the passing of the catheter is attended with
so much difficulty, distress or bleeding, that something more helpful
and effectual is urgently called for.

_Operative Treatment._--It has long been known that large tumours of the
uterus sometimes dwindle if the ovaries are removed by operation, and
Professor William White of Philadelphia thought that prostatic growths
might be similarly influenced by the removal of the testicles.