ACUTE PROSTATITIS.
Acute prostatitis is one of the most serious and painful of the acute affections to which the genitourinary system is subject. The condition which most often gives rise to it is so prevalent that the disease is quite frequently met with. Acute prostatitis with associ ated urinary retention was recognized many years ago by the cele brated French surgeon, Jean Louis Petit, as shown in his posthumous works (" CEuvres posthumes de Chirurgie," par Lesue, Paris, 1774). It is a noteworthy fact that the reputation of Petit as a careful clinical observer is borne out by his ideas of the etiology and pathology of acute prostatitis, which were in the main in accord with the more modern views upon the subject. He stated that, according to his observations, nearly all patients affected by acute prostatitis had suffered from a more or less recent attack of gonorrhoea, which in most instances had not been methodically treated.
In a general way, it may be asserted that while acute prostatitis may or may not be preceded by hyperemia of greater or less dura tion, which acts as a predisposing factor, the disease is very rarely a primary affection excepting it be of traumatic or chemical origin, or the result of pyogenesis secondary to constitutional infection, such as exists in variola and parotiditis. As usually met with it is a com plication, not a primary disease. The profound local and constitu tional disturbance resulting in a large proportion of cases of acute in flammation of the prostate, and especially in those forms in which suppuration results, are entirely disproportionate to the size and physiological importance of the organ involved. The affected struc
ture, however, is exceedingly sensitive from its abundant supply of general and special sensory nerve filaments, and assumes a position of great importance by virtue of its abundant sympathetic nerve supply and its consequent intimate relations with the various organs involved in the functions of organic life. In this respect it resembles rather strongly its colaborer in the generative function, the testis. Like the latter organ, it is surrounded by a tough resisting capsule and, in addition, by an environment of firm resisting structures. As a consequence of this anatomical arrangement the organ is very un yielding to the pressure of exuded inflammatory products, or of exaggerated blood supply. This, in connection with the exceedingly sensitive and abundant nerve filaments, is sufficient to explain the severe pain, nervous depression, and other constitutional disturbances incidental to inflammation of the organ. The same anatomical con ditions of nervous and vascular supply, and the close proximity of the affected organ to the rectum, explain the disturbances referable to the latter viscus in the course of acute prostatitis.