assed and the water drawn
off. But when there is an obstruction which cannot be overcome,
aspiration has to be resorted to, the needle of the aspirator being
pushed through the abdominal wall into the bladder. The point of
puncture in the abdominal wall is in the middle line a few inches
above the symphysis pubis. The bladder may be emptied in this way very
many times in the same person with only good result.

_Diseases of Prostate Gland._

The prostate gland may become acutely inflamed as the result of the
backward extension of gonorrhoeal inflammation of the urethra; it may
also be attacked by the germs of ordinary suppuration as well as by the
bacilli of tuberculosis. A sudden enlargement of a large gland lying
against the outlets of the bladder and the bowel renders micturition
difficult, painful or impossible, and interferes with defaecation.
Pressure of the seat of the chair upon the perineum also causes
distress, so the man sits sideways and on the edge of the seat. If
abscess forms, it should be incised from the perineum; if allowed to run
its course it may burst into the bladder, the urethra or the rectum, and
set up serious complication. The treatment of prostatitis (inflammation
of the prostate) consists in rest in bed, sitz-baths and fomentations.
If retention of urine takes place a soft catheter must be passed. In the
early stage of an acute attack a dozen leeches upon the perineum may do
good. The bowels must be kept freely open, and from time to time, as the
pain demands, a morphia suppository may be introduced into the bowel.

_Chronic prostatitis_ is a legacy from a recent or long-past attack of
gonorrhoea. The enlargement gives rise to a feeling of weight and
fulness in the perineum, irritability of the bladder, and a gleety
urethral discharge. Manual examination reveals the presence of a
large, hard mass in front of the bladder, and in the mass there can
often be felt softish or tender areas which seem to threaten abscess.
On urine being passed into a glass, a cloudiness is seen, and material
like pieces of vermicelli or broken threads may be noticed. These are
the castings from the long tubular glands, and are characteristic of
chronic inflammation of the prostate. The occasional passage of a
large metal bougie, the use of weak lotions of nitrate of silver, the
administration of quinine and iron, and the application of blisters to
the perineum, may be tried a