WASHINGTON, Aygestin 5 Mg D. C.
It was no less distinguished surgeon than Freyer
of London who in his admirable textbook on
"Surgical Diseases of Buy Aygestin the Urinary Organs" said:
"The disgusting practice of massage of the pros-
tate, advocated by some surgeons in America and
on the Continent, should never be had recourse
to. It is useless and has grave objections at-
tached to its employment." It is the purpose of
this paper to invite to the members of the society
a renewed interest in this often overlooked dis-
ease, chronic prostatitis, and to detail some of the
brilliant results obtained by this "disgusting and
dangerous practice," prostatic massage. No prac-
tice which affords relief to distressing symptoms
can possibly be disgusting and I am still looking
for immediate or remote dangers from this im-
portant addition to therapeutic measures.
The name, chronic prostatitis, implies its own
definition but is also usually understood to include
chronic catarrhal processes in the seminal vesi-
cles and ampullje of the vasa deferentia. The
most potent etiological factor Buy Norethindrone Acetate is gonorrheal in-
fection. This is the probable cause in a majority
of cases. A study of 50 cases in my practice has
shown a history of gonorrhea in 32 or 64 per cent,
and no history of gonorrhea in 18 or 36 per cent.
This is, I believe, closely in accord with the ob-
servations of others. A further study of my cases
has convinced me of the growing importance of
other factors, notably, masturbation and long con-
tinued sexual excitement without intercourse. A
study of the gonorrheal cases impresses me that
in many of them a chronic catarrhal process Aygestin Tablets had
been existent before the invasion by the gonococ-
cus and that in these cases gonorrhea runs a more
protracted and severe course. Other causes of
less importance are injury, descending infection,
and excessive intercourse.
A recent communication by Hichens and Brown
of the Mulford laboratories has given us our most
exact information on the bacteriology of chronic
prostatitis. The decreasing importance of the
gonococcus and colon bacillus and the prominence
of the various staphylococci, streptococci, and
bacilli of the diphtheroid type are strikingly illus-
trated by their work. It is undoubtedly true that
the prostatic mucous membrane is an excellent
host for a great variety of organisms.
The essential tissues of the prostate are the
glandular and the muscular tissues, the stroma,
*Read before the George Washington University
Medical Society, January 17, 1914.
nerves, blood-vessels, and lymphatics. The stroma
and muscular elements arise from the capsule and
ramify around the gland acini. The glandular ar-
rangement has all the complexity of the acinous
and tubular types. It is only natural that infec-
tions of the posterior urethra must invade the
prostatic Aygestin Cost ducts and this practically always oc-
curs. The infection may travel to any or all parts
of the gland and give rise to various degrees of
inflammation. Young, Geraghty, and Stevens have
described the tissue changes as involving both the
parenchymatous and periacinous elements, the
periacinous infiltration appearing to be most
prominent. The gland acini may in some cases
be dilated ajid filled with desquamated epithelium
and leucocytes, in other cases only vestiges of
the gland elements remain, the predominant tis-
sue here being of a fibrous nature. The muscular
elements are thinned out from pressure by the
dilated gland sacs. Grossly the gland may ap-
pear normal in size and Norethindrone Acetate Tablets appearance or show en-
largement and irregularities. Palpation may re-
veal areas of induration or softening. Associ-
ated with these changes are found various de-
grees of inflammation in the seminal vesicles and
ampullaj of the vasa deferentia. The normal se-
cretion of the prostate consists principally of
lecithin and this in chronic prostatitis is largely
or wholly replaced by pus. Generic Aygestin
The nerve elements in the prostate command
the greatest attention. Sensory fibers reach the
prostate from the Aygestin Price tenth and eleventh dorsal, the
five lumbar, and the first, second, and third sacral
nerves. The secretory fibers come from the sac-
ral plexus of the sympathetic. Large ganglionic
areas are found underneath the capsule. The rea-
son for this Aygestin 5mg remarkable and abundant nerve sup-
ply is not understood. Undoubtedly it concerns
in large degree the sexual function and plays an
important part in the various sexual disturbances
of the Aygestin Online male. Certain it is that inflammatory dis-
turbances in the prostate gland may cause most
remarkable symptoms.
The symptoms of chronic prostatitis are usually Buy Aygestin Online
classified as urinary, sexual, and referred, follow-
ing the designation of Young, Geraghty, and Stev-
ens. While most cases may be grouped under
these headings I have frequently encountered
cases which had no other complaint than a ure-
thral discharge, and others which had no signs
or symptoms whatever of chronic prostatitis and
which on rectal examination and examination of
the expressed Buy Cheap Aygestin secretion showed marked inflam-
mation of the gland. The sexual symptoms are
usually closely identified with disease of the col-
liculus or verumontanum. Space will not permit
a discussion of this interesting and important
condition.
In detailing the symptoms of chronic prostatitis
the author asks the reader's indulgence in an
analysis of 50 cases gathered from his practice.
Although the number of symptoms appears large
it will be noticed that there is a similarity in dis-
tribution and character and one soon learns to
suspect the existence of this disease when a new
symptom presents itself. An example of this oc-
curred recently:
Case I. — J. H. O., aged 25. Had gonorrhea five
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