Its influence on the rectum is felt in the flattening of its cavity from before backwards, and by its projection it causes the rectum to rise up on either side of it. Htemorrhoids and prolapsus ani are by no means unfrequent attendants on enlargement of the prostate.
On examining with the microscope sections of an hypertrophied prostate with Mr. Quekett, I found numerous crystals in its ducts, which disappeared on adding dilute tnuriatic acid.
Atrophy. — The prostate is liable to atro phy, but the disease is rare. I have met with it myself occasionally in very old persons. When the gland is altogether diminished in size it is usually, more consolidated in its tex ture. It is, however, liable to another form of atrophy (eccentric atrophy), by which I mean a thinning of its tissue generally, and its conversion into one or more cysts, in conse quence of continued pressure exerted by the increase in size of calculous concretions in its follicles. " Cases sometimes occur, in which the whole of one lobe, or even the entire organ, is converted into a thin fibrous capsule, the proper substance of the gland beim:, almost wasted."—(Crosse's Pathology.) In tase cases the ducts of the prostate are usually increased in size, so as to arrest the progress of the catheter. It generally occurs in connection with urinary calculi, or long-standing stricture. Dr. Baillie met with one instance of atrophied prostate ; it occurred in a case of ectropium of the urinary bladder, and malformation of the organs of generation ; the utriculus pros taticus was larger than natural.
Inflammation. — Inflammation, acute or chronic, not unfrequently attacks the prostate, leading to increase of size, and suppuration of the gland. It is very commonly the result of suppressed gonorrhceal discharge, and follows the employment of copaiba, cubebs, and power fully stimulating injections. The signs of this condition are easily understood. With care ful and somewhat active treatment by leeches, cupping in the perinmum, warm fomentations, &c., the disease terminates in resolution ; but permanent enlargement or suppuration are the too frequent consequences of inflamed pros tate. An irritable state, characterised by an
uneasy sensation referred usually to the end of the penis, and attended by an increase in the secretion of the gland, which can be drawn out in threads, with a frequent desire ofmaking water, indicates an inflamed condition of the prostatic ducts. The discharge is occasionally puriform in appearance.
Abscess. — If the inflammation be unsub dued, suppuration often occurs. The whole tissue of the gland is, in some instances, in filtrated with pus ; in others a single abscess, of large size, or numerous small abscesses occupy one or both lobes of the prostate. Sir Benjamin Brodie relates an instance of an old man, the subject of abscess of the prostate, containing at least half a pint of pus, which escaped through the catheter, after the urine had been drawn off. Many similar instances are recorded. These large collections are generally the result of an attack of acute in flammation on an already enlarged prostate. Smaller purulent deposits are met with in various parts of the gland ; so that when after death the pus is washed away, the prostate is found riddled with holes. Such deposits are not uncommonly associated with suppuration of the vesiculm and the adjacent structures ; and are frequently consequent on intense sexual ex citement and onanism. Lallemand gives many instances of this, and relates one in particular, where the urethral membrane was perforated by numerous apertures, through which the pus escaped, so as to present a sieve-like appear ance, which he compares to the cribriform lamella of' the ethmoid bone. Mr. Curling* mentions a similar case of a young man ex cessively addicted to onanism, and who died with symptoms of cerebral congestion. The prostate was converted into .a multilocular cavity, and the urethra was perforated by numerous large apertures. These openings are the orifices of the prostatic ducts preter naturally enlarged, suppuration most probably commencing in the minute follicles of the gland. A secretion .of a puriform fluid often takes place from the prostatic ducts in cases of severe attacks of gonorrhcea, and small ab scesses give way one by one.