Prostate

“ 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. ”

“ In 65% of all men, the vital prostate gland shows up soon after all. No pain is experienced, but as this distressing condition continues, sciatica, backache, severe bladder weakness, constipation, etc., often develop.
PROSTATE TROUBLE
These are frequently the signs of prostate trouble. Now thousands suffer these handicaps needlessly! For a prominent American Scientist after seven years of research, discovered a new, safe way to stimulate the prostate gland to normal health and activity in many cases. This new hygiene is worthy to be called a notable achievement of the age. ”

“ The size of the prostate gland varies considerably with the age of the person. In early life it weighs but a few grains. As puberty approaches it becomes larger, and in the adult weighs from half an ounce to an ounce. In old age it enlarges considerably, and sometimes presses upon [pg 828] the bladder so as to impede the flow of urine. This condition is often confounded with stricture, gravel, or stone in the bladder, by inexperienced physicians. Hypertrophy, or enlargement of the prostate gland, is not an unfrequent disease in the adult or middle-aged man. ”

“ Its secretion has been shown to be necessary to the vitality of the sperm cells. The regression of the prostate, its retirement from the field of sex competition, is the central episode of the male climacteric. Accompanying its shrinking are prominent an irritable weakness, despondency, and melancholia, which may emerge at any time if there is disease or disturbance of it. The influence of the prostate upon man's mental condition, and its contribution to the sex index, still remains to be investigated in detail. ”

“ 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. ”

“ The membranous part of the urethra, M, Fig. 2, Plate 53, enters the apex of the prostate, and traverses this part in a line, nearer to the upper than to the under surface; and that portion of the canal which the gland surrounds, is named prostatic. The prostate is separated from the pudic artery by the levator ani muscle, and from the artery of the bulb, by the deep perinaeal fascia and the muscular fibres enclosed between its two layers.
The prostate being a median structure, is formed of two lobes, united at the median line. ”

“ Inflammation of the prostate.—If the prostate gland becomes the seat of this disease, it will cause great inconvenience and may result in painful treatment, surgical operation, loss of health and mental vigor, with possible loss of the power to become a father.
If both testes become inflamed, the victim often becomes sterile. A dangerous and painful operation is sometimes required. He will never be what he once was, or might have been. ”

“ 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 irritation set up in the parts by the friction of the catheter causes inflammation and exudation in the lining membrane. This extends to the structure of the prostate itself and increases the hypertrophy or enlargement. It will, therefore, be seen how important it is to early resort to treatment to relieve the first manifestations of this affection. A disease of so delicate a nature, and one so often confounded with other maladies by inexperienced physicians, should only be intrusted for treatment to expert specialists of large experience in the management of this and kindred maladies. ”

“ The capacity of the bladder varies much in cases of enlarged prostate;487 in general the organ bears a good deal of distention, and the urgent symptoms do not appear rapidly. Nevertheless, it is the duty of the surgeon, immediately on being called, to relieve the bladder. When the prostate is very large, and retention has continued long, it is impossible to reach the cavity by a common catheter. Those who employ this instrument in such cases are often much puzzled; they continue long in their fruitless endeavours, and, from rashness, generally produce a discharge of much blood, but no urine ”

“ If the trocar pierce the bladder at this point, the seminal vessels converging to the prostate from either side, and the recto-vesical serous pouch behind, will escape being wounded. If the prostate happen to be much enlarged, the relative position of the neighbouring parts will be found disturbed, and in such case the bladder can be punctured above the pubes with greater ease and safety. ”

“ 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. ”

“ 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. ”

“ Such are enlarged prostate with its usual obstruction and frequent chronically-distended bladder, with ammoniacal, purulent, and decomposing urine, or stricture with frequent over-contraction of the bladder, forcing the urine backward as well as forward. In diseases of the female generative organs we are more likely to have the hydro-nephrosis and pyelitis as separate affections, since the compression which so frequently arises in cases of cancer or of pelvic inflammation is likely to be above the bladder, thus preventing the regurgitation of urine as well as its passage downward. ”

“ If this natural boundary betwixt the external and internal cellular tissue is broken up, there is scarcely a possibility of preventing infiltration of the urine, which must almost certainly prove fatal. The prostate and other parts around the neck of the bladder are very elastic and yielding, so that without much solution of their continuity, and without the least laceration, the opening can be so dilated as to admit the fore-finger readily through the same wound ”

“ I have practiced considerably among the Jewish people, but I have never seen their elderly men suffer with prostatic troubles like our [330] own people who are uncircumcised. From having observed the tendency to prostatic complications in young people with troublesome prepuces, and that the great number of the elderly people who are affected with prostatic disease or enlargement are the unlucky possessors of long or large prepuces, I have arrived at the conclusion that the prepuce can be entered as a factor in the etiology of enlarged prostate. ”

“ 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 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. ”

“ On comparing this series of figures, it must appear that the third lobe of the prostate is the product of diseased action, in so far at least as an unnatural hypertrophy of a part may be so designated. It is not proper to the bladder in the healthy state of this organ, and where it does manifest itself by increase it performs no healthy function in the economy. When Home, therefore, described this part as a new fact in anatomy, he had in reality as little reason for so doing as he would have had in naming any other tumour, a thing unknown to normal anatomy. ”

“ 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 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 metal sound on the prostate or its cauterization, tumors, calculi and inflammations, e. c., gonorrhoea, may often excite erections. The prostatic mucous membrane is supposed to be the seat of the pleasurable sensations. During any kind of sexual activity, the prostatic area is intensely congested, and its nerves are in a high state of tension. Excitations at the neighboring parts of the genital organs, as evoked by hemorrhoids, stone in the bladder, full bladder, worms or full rectum, may also produce erections. ”

“ Poisonous agents must be eschewed or used with the greatest circumspection.
CHRONIC PROSTATITIS. Causes. Follows acute. Same causes less potent. Lesions: as in acute, or sclerosis, and abscess. Symptoms: delayed urination, last glairy or purulent, constipation, defecation followed by urethral discharge, little genital ardor, rectal palpation, tenderness of prostate to hand or catheter, atony of hind limbs. Treatment: open air life, idle, milk or succulent diet, saline laxatives or enemata, avoid generative excitement, castrate, check masturbation, iodine, camphor, antiseptic irrigations. ”

“ 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. ”

“ 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. ”

“ No one will so fully comprehend this as the practical physician. Cases are constantly under the care of the medical man, suffering with conditions too numerous to mention, complicated with many strange lesions. Every case must necessarily be studied from its own merits, in and of itself, or success will not follow.
It is not uncommon to come in contact with spermatorrhœa and impotence, both together, also complicated with organic disease of testicles, prostate gland, and anus or rectum. ”