Excerpt from On the Anatomy and Diseases of the Urinary and Sexual Organs: Containing the Anatomy of the Bladder and of the Urethra, and the Treatment of the Obstructions to Which These Passages Are Liable

I shall always allude to the neck of the bladder, as the small part sur rounding the opening into the urethra, and which therefore is a ring, a lit tle broader or thicker than the bladder itself; on the under part of which the uvula is situated, the urethra! Being before, the bladder behind it. The abruptness with which the opening commences, when viewed from within, appears to warrant the acceptation of the term, whilst the diseases which affect this part render it worthy of an accurate definition. When it loses the natural elasticity with which it is endowed, which it does from internal changes the consequence of disease, it becomes firm' and contracted, conf stituting a structure resembling in many respects thatwhich often'takes place in the urethra. In common language among unprofessional persons, a stricture at the neck of the bladder is often said to exist; but gentlemen know nothing of the exact situation of internal -parts, and suppose that an obstacle at six inches distance from the orifice of {the urethra must be at the neck of the bladder, when it is not within two inches of -'it. If you refer to surgical authorities on this subject, you will find it I believe generally stated, that stricture does not take place beyond seven inches, or-the membranous portion 'of the urethra; and all the derangements which occur beyond that part, are attributed to disease of the pros tate. This is however a very great mistake; the prostate gland is by no means so often in fault as has been presumed; and no greater error has been committed in surgery, than that which supposes the third lobe as it is erroneously called of the prostate, to be the cause of those difliculties in making water which occur so frequently in elderly people, and some times in young ones._ I am well aware that, a portion of the, prostate does enlarge and project into the bladder, preventing the flow of urine from it but I mean to affirm that: this evil frequently takes place, and is more ef fectually caused by disease of the neck of thebladder, totally'uncon nected with the prostate, than by disease of that part. A fact I consider exceedingly important, because it leads to improvement in this branch of surgery, and to the introduction of more effective means of cure.

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