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Thomas Hardy Says of One of His Most Fascinating Heroines : (P DR. J. BELL PETTIGREW: ANATOMICAL PREPARATION-MAKING. 1399 if it were safe to attempt to make it. It is quite clear, I think, that the phrase " total extirpation of the prostate"" ANATOMICAL PREPARATION-MAKING AS has been used in error and by surgeons who have been for- DEVISED AND PRACTISED AT THE tunate in having only met with the simpler or adenomatous form of prostatic enlargement, where large masses are easily UNIVERSITY OF EDINBURGH AND shelled out. AT THE HUNTERIAN MUSEUM it has Then, again, in connexion with prostatectomy, OF THE ROYAL COLLEGE been denied that when the bladder has long been dependent upon the catheter, say for 12 months, it can regain its OF SURGEONS OF aatural expulsive power when the prostatic obstruction ENGLAND. has been removed. I have, however, been able conclu- sively to prove that this denial is not correct. I have BY J. BELL PETTIGREW, M.D., F.R.C.P. EDIN., LL.D., proved that the bladder can act naturally and com- F.R.S., &C., pletely, and for many years, too, after the removal of CHANDOS PROFESSOR OF MEDICINE AND ANATOMY AT THE prostatic obstruction, and I proved it by the public exhibi- UNIVERSITY OF ST. ANDREWS. tion of a case, about which there could be neither doubt nor cavil, before the Medical of London on Society HAVING of late years been frequently asked by anatomists, March 6th, 1893. My patient had used a catheter for 20 and others to an account of years, and for 10 years had not passed a drop of urine except physiologists, surgeons, give my by catheter. On account of great vesical troubles I opened methods of making and preserving anatomical dissections for the bladder suprapubically on March 10th, 1892. I teaching, examination, and museum purposes, I feel it to be removed a small stone nine weighing grains, and then my duty to comply with the request. I should possibly have .removed the collar of tissue which into prostatic projected attended to this matter ago, but did not deem it of the bladder below and on both sides of the urethral long orifice. When shown before the society 12 months after the sufficient importance to demand separate treatment. As, operation the patient was seen to be well and comfortable however, my anatomical and other friends think otherwise I and all his urine was passed by his natural efforts. I am glad have no option but to accede to their wishes. It will save to say that now, in his eighty-second year, nine years after time, and possibly add interest, if I treat the subject the he is able to write me that he is in operation, very good historically and from a personal point of view. ,health and that no catheterism has been since he necessary connexion with in the winter of 1855, left my care. This case is a very and successful one My anatomy began happy when I attended a course of anatomical lectures at the and shows what can be but we must not Royal accomplished, i of of under the late Dr. John that the is a and one, and ICollege Surgeons Edinburgh forget operation grave dangerous Struthers, then teacher of anatomy at the Extra-mural have found no reason to change the views I expressed when Medical" School of and a most and I exhibited the above case in 1893. These views may be Edinburgh, painstaking enthusiastic( anatomist. He became summed as follows. I believe that subsequently professor up Firstly, suprapubicof( at the of Aberdeen and did much to should never be undertaken at the outset of anatomy University prostatectomy make the Aberdeen Medical School a success. he ’catheter life unless auto-catheterism is difficult or Latterly regular became1 at the Council of Medical Education In cases of real I have seen my colleague well-nigh impossible. difficulty and of the United President of the several patients where vasectomy has been performed, and ’. Registration Kingdom, Royal of Surgeons of Edinburgh, and a knight of there has been no lessening whatever of the catheter College thet realm. I did no dissection or anatomical reading under difficulty. It must be understood that I believe that cases IDr. Struthers as I had not then made up my mind to become where catheterism is are very rare, and regular impracticable a medical chief to test nerves it is for these that I would recommend student, my object being my only suprapubic pro-aas to anatomical I also this winter should never be under- procedure. (1855) :statectomy. Secondly, prostatectomy aattended a course of natural at the Free Church taken as as the catheter life is a tolerable history long ordinary one. of under the and if catheter life becomes intolerable, College Edinburgh sagacious thoughtful Thirdly, suprapubic fFProfessor William The natural lectures should be resorted to. By means of this pro- Fleming. history cystotomy VIwere a source of to me as I had been the bladder can be and great pleasure always ceeding thoroughly explored any’ond of all kinds of natural and dead. The stone which in these cases have objects living removed, may easily escaped (’ectures of Dr. Struthers and Professor determined detection by the more usual methods of examination. Fleming ne to medicine as a The prostatic growth can be fully examined and re- n adopt profession. The winter of 1856 found me a medical moved if the operator think it right to do so. If he deem fully fledged sttudent at the of Here I came under removal inadvisable he can leave the patient with a supra- University Edinburgh. he of a pubic tube for permanent after-wear with the certainty influence quite galaxy of genius and talent. The that he will have materially improved the condition of "Jniversity of Edinburgh was then, and during my medical the sttudent in the zenith of its as a medical patient. Finally, should the operator decide to remove the days, reputation chool. The bristled with names. prostatic obstruction there is a very good prospect, but not st professoriate literally great a’here was not a who had not written his certainty, of the power of natural micturition being restored single professor to the I would therefore recommend all ame in large letters on the scroll of fame. John Hutton patient. strongly n,!alfour J. Allman natural and their advisers to be content with the "’ taught botany, George history, prostatic patients yvVilliam John Goodsir John catheter life as as it is and in the vast Gregory chemistry, anatomy, long tolerable, Bennett James mid- majority of cases, with reasonable care, it will remain [ughes physiology, Young Simpson ’ Robert Christison materia Thomas Traill tolerable into extreme old the end comes Hdfery, medica, age-until probably iedical William Henderson James other channels. I believe as Mr. Jonathan jurisprudence, pathology, through that, —m’(iller James clinical and Thomas Hutchinson once said to often be surgery, Syme surgery, me, ’’ good surgery may L. the of The teachers in the Extra- combined with bad practice." The work of the world is not aycock practice physic. Lural Medical School were less and always done by those who are well. It is not m’ scarcely distinguished completely icluded the well-known names of Stevenson Macadam wise for the to run risks on the chance of elderly grave only l(n; William Sanders comfort. There is much truth in ;hemistry), John Struthers (anatomy), obtaining complete William T. Gairdner and Warburton Thomas of one of his most what)hysiology), Begbie Hardy says fascinating )ractice of James Patrick Heron Watson, "In what she was not he overlooked heroineswhat she : (p physic), Spence, considering id Joseph Lister Alexander Keiller (midwifery), was and forgot that the defective can be more than the an (surgery), " and entire. aniel Haldane (pathology), and Douglas Maclagan D2enry D. Littlejohn (medical jurisprudence). There was - ke.en rivalry as between the university professors and the PROPOSED NEW WORKHOUSE INFIRMARY FOR teaachers of the Extra-mural Medical School, It was a case ExETER.-At the meeting of the Exeter Board of Guardians of diamond cut diamond. held on Nov. 12th it was decided to obtain plans for a new There was, moreover, at the time of which I write much workhouse infirmary to contain 150 beds at a cost not inttellectual activity at both centres of medical education in exceeding,£80 per bed. It was further determined that the Edlinburgh. Great discoveries were being made and new building should be constructed in sections, and that the first methods of teaching and research were being adopted. Syme section, comprising the administrative block, labour wards, waS dazzling the world by his bold, original surgery ; and isolation and children’s wards, should be taken in hand Sinmpson was receiving one long, continuous ovation because as soon as could be made. arrangements of his discovery of chloroform ; Bennett was inaugurating a 1400 DR. J. BELL PETTIGREW: ANATOMICAL PREPARATION-MAKING. new era in the teaching of clinical medicine by his habitual time it was written. He was noted for his great clinical use of the microscope and his exact methods ; and Lister acumen and slashing oratory, and, at times, for his scathing was laying the foundation of a world-wide reputation by his sarcasm. He was, notwithstanding, one of the kindest and researches on the blood and his investigations of rudimentary most entertaining of men. As his class assistant for two forms in their relation to antiseptics. years I knew him well. The intellectual activity and fame of the professors and Simpson was a great power in the University. He was extra-mural teachers at Edinburgh naturally attracted justly celebrated for his originality and persuasive eloquence.
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