File:The practice of surgery (1910) (14776089091).jpg

Identifier: practiceofsurger00mumf (find matches)
Title: The practice of surgery
Year: 1910 (1910s)
Authors: Mumford, James Gregory, 1863-1914
Subjects: Surgery
Publisher: Philadelphia and London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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out—from the urethra. 1 Hugh H. Young, Jour. Amer. Med. Assoc, October 24, 1903. INFLAMMATION OF THE PROSTATE 413 Swelling, desquamation, necrosis, and suppuration supervene, theusual attendant efforts of nature to arrest the invasion. The gonococ-cus and other pus-producing cocci are the ordinary invading organisms,while rarely the organisms of tuberculosis and syphilis may be implantedhere. The patient experiences a sense of weight, heat, and pain in theperineum. Often there are frequency of micturition and tenesmusfrom involvement of the bladder. There may be great prostration anda general constitutional disturbance. Frequently the onset of the attackcomes with a chill. The abscess may open into the urethra, rectum, orbladder, or into the peritoneal cavity even, through burrowing upward.Either the parenchyma of the prostate or the muscular tissue or bothmay be involved. Sometimes there is urinary obstruction, and inextreme cases the process may go on to destruction of neighboring
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Fig. 247.—Massaging the prostate.Sketch showing position of hand andforearm. Fig. 248.—Sketch showing relative posi-tion of surgeon and patient. parts through gangrene, to peritonitis, phlebitis, thrombosis, and py-emia. Occasionally acute symptoms gradually may subside, leavingbehind a chronic process which is marked by a general thickening andenlargement of the prostate, associated with a cord-like thickening ofthe vesicles and ducts, and in some cases by a well-defined abscess.The most important symptom of chronic prostatitis is a discharge fromthe urethra of a milky fluid, in greater or less quantity, especially afterdefecation, followed by pain in the course of the urethra. The reader will probably conclude that the treatment of prostatitisvaries with varying forms of the disease. In acute prostatitis one en-joins absolute rest, thorough evacuation of the bowels, urotropin, andthe application of either heat or cold to the perineum and hypogastrium.Sometimes constant cold rect

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