Prostate gland

“ Difficulty in passing the urine is a symptom, which comes on very early in diseases of the prostate gland, and arises entirely from this lobe being increased in size, since any enlargement in the lateral portions of the gland widens the canal instead of diminishing it, and they do not require much force to separate them ”

“ The operator has to attend to two sensations, the running of the beak along the staff’s groove, and the resistance afforded by the prostate gland; while he is overcoming the latter he becomes unconscious of the former, and at the time he impales the prostate, [14] loses all certainty of the beak being within the groove; this difficulty depends as much on the curve of the staff as on the nature of the Cutting-Gorget, and is one that every candid surgeon must acknowledge frequently to have experienced.
The first impediment a surgeon meets with, is the giving the first impetus to the Gorget ”

“ This lobe of the prostate gland, from its situation and connection with the vasa deferentia, is liable to many causes of swelling, which the body of the gland itself is free from; for every irritation upon the seminal vessels or their orifices may be communicated to it by continuity of parts: and aged men, from an ignorance of these facts, are too often, through imprudence, producing an excitement in those vessels which the parts are unable to support ”

“ This is a purely sexual gland, which in animals only becomes large and active during the breeding season, and may even be hardly distinguishable at other times; moreover, if the testes are removed in infancy, the prostate remains rudimentary, so that during recent years removal of the testes has been widely advocated and practiced for that hypertrophy of the prostate which is sometimes a distressing ailment of old age. It is the prostatic fluid, according to Fürbringer, which imparts its characteristic odor to semen. ”

“ The employment of the Gorget in the division of the prostate gland, has been stigmatized as substituting mechanism for skill; if that were the only remark that could apply to this instrument, it would be rather an argument in its favor than an objection to its general use, as the success of the operation would depend less on individual dexterity. But the objection to it in my opinion is, that, from the manner in which it is introduced into the bladder, it cannot divide the parts according to Cheselden’s operation. ”

“ It will be noticed that men past 50 years of age are often forced to rise in the night once or oftener to make water. This, and the delay that sometimes occurs before the stream will start, are usually due to enlarged Prostate Gland—a common condition in men past 50. Many and many a man at this age finds his sexual power declining and cannot understand it—Enlarged Prostate Gland.
As the gland enlarges and becomes stiff and its tissues hardened and brawny, it presses upon and deprives the Sexual Nerves of power and sometimes paralyzes them, causing total Impotency. ”

“ Disease of the Prostate Gland is frequently caused by solitary indulgence. Venereal excesses produce congestion and the gland is overnourished. It becomes greatly enlarged, a condition called hypertrophy. This affection gives rise to a heavy feeling or pressure in the region below the bladder, and often interferes seriously with urination, and gives great pain and uneasiness, and often results in grave and dangerous complications. ”

“ Dysuria—i.e. difficult urination, strangury—may have several causes. Cantharides, absorbed from a blister, may produce it temporarily. The more continuous states which cause it are—stricture of the urethra, enlargement of the prostate gland, and calculus in the bladder. In stricture, when the patient can pass water, it is apt to be in a twisted stream. Dribbling often occurs when the prostate is enlarged. ”

“ Now it is the business of this mucous fluid, which comes from the prostate gland, to form a "carrying medium" for the spermatozoa which originate in the testicles. There are small ducts leading from the testicles into the pocket which contains the prostate fluid. ”

“ When such men as Bangs and Keyes are agreed on a subject of this kind, then even though in a certain number of cases the changes in the prostate leading to its enlargement are evidently inflammatory, it is well to consider that the functional over-activity of the gland superinduced by the practice may lead at least to an enlargement of the glandular elements with the consequent interference with urination which so frequently comes in old age. ”

“ Beyond question we are justified, from the information at our disposal, in concluding that the prostate gland begins to secrete comparatively late. But, on the other hand, it is equally clear that certain glands whose secretion in the adult forms part of the semen, begin to secrete long before any spermatozoa have been formed in the testicles, and may in this way give rise to the formation of a semen incapable of fertilising the ovum. ”

“ Even with this little discharge of prostatic fluid, and when no sign of spermatorrhœa existed with it, the young man may experience all the phenomena of true and long-standing spermatorrhœa. His mind suffers, as well as his body, with imaginary nervous phenomena too numerous to mention. But in these conditions it is not uncommon to find very troublesome disease of the prostate gland, brought on by gonorrhœa, sexual excesses or masturbation, existing alone or with true spermatorrhœa. ”

“ Earthy phosphates are often mistaken for pus and also seminal fluid. Phosphates are always found in decomposed urine, otherwise they indicate brain affections, acute cystitis, etc. Experience has taught us that the voiding of urine loaded with phosphates is a forerunner of cystitis, or enlargement of the prostate gland, or both. In fact, persons so affected are "prone to serious consequences from mild attacks of almost any and every acute disease." ”

“ Hence we can readily see that not only by reflex nervous irritation are those parts debilitated, through the contraction of the urethra, but the affection is apt to extend by continuity of the mucous membrane, and thus become more and more manifest, through symptoms of disease of the testicles, prostate gland and seminal vesicles, and these disorders become more and more seated the longer the morbid condition of the urethra is allowed to run on, until there may be an entire loss of the sexual functions, occurring at an age when there should be present the most vigorous manhood. ”

“ The Prostate Gland swells and becomes enlarged, the Seminal Vesicles become weak, baggy and filled with a thin, glairy fluid that oozes out into the urine and urine canal on any little strain, exertion or excitement; especially when, after being in the presence of the opposite sex, weak, feeble erections follow. The testicles become flabby and stringy and no longer make strong, healthy, fecund vital fluid. The constant calls upon them has exhausted them as also the nerves that gave them life, strength and vitality. A heavy dragging 17 We Offer Special Help to Impotent Men. ”

“ When the operation is properly performed, that is, when the wound in the prostate is sufficient for the passage of the calculus, the connexion between the prostate and the arch of the pubes remains; and affords an opposing barrier, when the finger is attempted to be thrust upwards by the side of the bladder. The consequences attending the destruction of the attachment of the prostate are worthy of consideration. ”

“ Follicular Prostatitis implicates primarily the follicles and gland ducts and finally the entire gland tissue. It is usually associated with and doubtless often proves an extension from an adjacent infective urethritis, and tends, in persistent cases, to go on to interstitial inflammation and abscess, or hypertrophy. This is characterized by more or less swelling of the prostate, with increased vascularity of its mucosa and the oozing from its openings and gland ducts under pressure, of a thick, yellow, gelatinoid fluid containing pus and granular epithelial cells and sometimes striæ of blood. ”

“ Tumors of the former are usually associated with sex 41abnormalities, and feeding young animals the gland substance seems to stimulate growth of the testes.
Many arguments have been brought forward to show that the prostate produces an internal secretion. It is a well known fact that this organ atrophies after castration, and enlarges as the sex life dwindles. As has been previously stated, Serrlach and Pares reached the conclusion that the gland produces an internal secretion which controls the testicular functions and regulates the process of ejaculation. ”

“ Chronic inflammation in the prostate has been claimed as a factor, but contested on the ground that inflammation never increases normal growth though it may cause degeneration. The exudate of inflammation, tends, however, on its temporary arrest, to undergo organization, and such organization inclines to assume the structure which is normally built up by the adjacent trophic cells. The products of inflammation may, therefore, well contribute to hypertrophy, and above all to the increase of the simpler tissue represented by the fibrous framework of the gland. ”

“ The treatment of enlarged prostate is palliative—attention to the general health, the occasional administration of anodyne suppositories or enemata, prevention of accumulation in the lower bowels, either by gentle laxatives or the throwing up of bland fluid, and the avoiding as far as possible all sources to excitement, of mind as well as body. The radical cure, it has been said, is extirpation of the gland, but the cool proposal of such an operation would indicate either ignorance, or dereliction of principle, or mental obliquity, or all combined. ”

“ Those who are unaccustomed to morbid examinations may be inclined to be sceptical on this point, and may think that an injury done to the prostate and neck of the bladder, by a cutting instrument, would be productive of more serious evil to the constitution, than a laceration of reticular texture. ”

“ The seminal vesicles secrete a peculiar mucus, which is thick, fibrinous, glairy, and albuminous. This secretion constitutes the bulk of the semen.
Prostate.—The prostatic gland has a double function. It is the main point wherefrom the stimuli for the sexual impulse start. The internal secretions of the prostatic parenchyma send libidinogenous substances into the blood. The colliculus, rich in nervous elements, sends also out nervous libidinogenous stimuli. The principal function of the prostate is its secretion which imparts to the otherwise sluggish spermatozoa their lively movements. ”

“ As the direction in which the prostate should be divided (in order to adhere to Cheselden’s operation) , is obliquely downwards and outwards, the increasing the angle at which the knife enters the bladder will incur no risk of wounding the pudic artery. When the stone is unusually large, it will be necessary to dilate the prostate in withdrawing the knife.
This want of power to regulate the size of the incision is an objection to which the Gorget is acknowledged to be open. Whether the stone be large or small, the same opening, and that a small one, must serve in either case ”

“ III. State of the Glandular System after Growth.
Puberty commences about the period that growth finishes. A gland till then inactive in man, enters suddenly into activity. The prostate follows it in its development. In woman the breasts swell, separate, and acquire in a short time a size which they would not have done in many years, if they had grown according to the same laws as in the preceding state. The other glands, far from being weakened, in proportion as these become stronger, increase their action also ”

“ In the majority of cases it will merely be necessary to pass the knife along the director, and, having cut the [27] prostate, to withdraw it without carrying it out of the groove; varying the angle according to the age of the patient, the width of the pelvis, and size of the stone. ”

“ The prostate has no function proper to itself per se. It is a thing distinct from the urinary apparatus, and distinct likewise from the generative organs. It may be hypertrophied or atrophied, or changed in texture, or wholly destroyed by abscess, and yet neither of the functions of these two systems of organs will be impaired, if the part while diseased act not as an obstruction to them. In texture the prostate is similar to an unimpregnated uterus. In form it is, like the uterus, symmetrical. In position it corresponds to the uterus. The prostate has no ducts proper to itself. ”