TREATMENT - TUBERCULOSIS OF THE PROSTATE.
Where prostatic tuberculosis is secondary to disease of other important organs, the treatment is that of the primary disease, except ing in so far as local measures of palliation may be instituted. Where it is primary or secondary to tuberculosis of contiguous organs, the treatment of the local difficulty assumes a more promi nent position. The general treatment of the disease should be based upon the same principles as tuberculosis elsewhere, due considera tion being given to tonic and alterative treatment, nutrition, and change of climate. The method of hypodermic medication by iodine and chloride of gold in the form of Clark's solution offers some hope of benefit or even cure. The local treatment should consist first of irrigation of the bladder and prostate with a warm solution of boric acid, followed by the instillation of iodoform emulsion. Iodoform in the form of rectal suppositories has seemed beneficial. Instillations of nitrate of silver and other irritant astringent drugs are rarely beneficial, and are most likely to prove injurious ; it has even been asserted that such treatment may precipitate ulceration. When possible to do so, it is best to irrigate the bladder and prostate by means of a short urethral tube rather than by instruments which necessitate more or less mechanical irritation of the prostate. Al
though the practice is not universally accepted, the author is convinced that putting the bladder at rest and providing through-and-through drainage at an early period of the disease is likely to prove curative in quite a proportion of cases. When abscesses form they should be evacuated, scraped, and packed with iodoform gauze; all sinuses should be thoroughly curetted and treated with iodoform. Interstitial injections of iodoform emulsion into the affected gland constitute a logical method of treatment and are likely to prove of curative value. Cases are reported where large tubercular abscesses of the prostate have been opened, curetted, and drained with resulting cure, but in marked cases of prostatic tuberculosis recovery is rare. Sooner or later, the bladder, kidneys, or distant organs become secondarily affected. When prostatic tuberculosis is secondary to tubercular dis ease in other important organs the death of the patient is inevitable.