1. Certain writers have credited others with having done the first radical operation for cancer of the prostate. Billroth in 1867 reported 2 cases. In 1, a, patient aged 20, he carried out a lateral perinea! incision and removal of a very soft tumor the size of a duck’s egg. Recurrence took place in 2 months; death in 14 months. In Billroth’s second case, a patient aged 56, an irregular middle lobe was present. A median perinea! incision was made with curettage of the middle lobe. The patient died 4 2. The prostatic tractor was described first on November 11, 1902 at the Cincinnati meeting of the Southern Surgical and Gynecological Association. (Trans. South Surg. & Gynec. Assoc., 15: 31–32, 1903; also Am. Med., 5: 947, 1903.)
3. In 1898, while still resident at the Johns Hopkins Hospital, I operated upon a patient who had ‘an extremely hard prostate. Using the Alexander operation, suprapubic cystotomy was done first, then perineal section, the prostate being pushed down to the perineum by an assistant’s hand in the suprapubic wound. The prostate was exposed through a median and lateral perineal incision on the right side. The base of the prostate was found to be hard and nodular. The prostatic capsule was incised transversely. An attempt was made to enucleate the lobes. This was impossible, and scissors then were inserted. The tissues were divided along the catheter, leaving enough around it to form a urethra. The 2 sides of the prostate were drawn down in turn with vulsellum forceps and excised with scissors. The right seminal vesicle, which was enlarged and tightly bound to the upper end of the prostate, was excised. Perineal drainage was provided. The patient soon had a recurrence with obstruction, required catheterization, and died 19 months after operation.