PROSTATE GLAND. 



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is especially seen in old subjects : it corre- 

 sponds with the anterior extremity of the 



Fig. 103. 



Front view of the bladder and prostate. 



a, bladder ; b, ureters ; c, uvula vesicaj ; d, prostate 



gland ; e, openings of prostatic ducts ; f, a probe 



passed into the sinus pocularis ; g, g, bristles in vasa 



ejaculatorium ; h, membraneous portion of urethra, 



trigonum vesicce, and is known by the names 

 of the uvula vesicce, luette vesicate, valvula 

 pylorica of Amussat. In the healthy state of 

 the bladder and prostate, this elevation is 

 frequently scarcely perceptible, unless the 

 bladder is much contracted ; but it is subject 

 to considerable increase in size, and is gene- 

 rally involved in those cases of enlarged pros- 

 tate which are of such frequent occurrence in 

 the old person, and where the third lobe is 

 the seat of hypertrophy. Mercier describes 

 this vesico-urethral valve as a semicircular 

 fold, raised suddenly at a right angle from the 

 posterior surface of the neck of the bladder, 

 and composed of a tissue somewhat resem- 

 bling muscle ; and Mr. Guthrie, in his lectures 

 delivered at the College of Surgeons in the 

 year 1830, directed attention to it as fre- 

 quently the seat of disease totally independent 

 of any enlargement of the third lobe of the 

 prostate ; but to this I shall again direct 

 attention when the morbid anatomy of the 

 prostate is under consideration. 



Intimate Structure. The prostate comes 

 under that division of the glandular system, 

 inappropriately termed conglomerate. Miiller 



places it in his fourth order of glands "g/ati- 

 dulcc ex ccllulorum contextu spongioso componitce, 

 med'ris ccllulis in ductus excretorios hiantibus, 

 sine lobulorum divisione cowposita." It is ar- 

 ranged by Cuvier under the head of supple- 

 mentary glands of the male organs of genera- 

 tion. The external covering of the gland, de- 

 rived, as already described, from the vesical 

 fascia, having been removed, we come to a. 

 deeper layer, which closely surrounds the 

 glandular tissue; it is most intimately con- 

 nected with it, so as to be detached with 

 the greatest possible difficulty, and can evi- 

 dently be shown to send processes into the 

 gland, which are probably continuous with the 

 fibrous tissue between the follicles. On the 

 surface of this the lymphatics of the gland are 

 seen to ramify : this is best shown after pre- 

 vious immersion in water. If a simple section 

 is made, the gland presents a spongy cellular 

 aspect, and an opaque fluid oozes out from the 

 cut surface ; but its intimate structure can 

 only be made out by microscopical examin- 

 ation of thin sections, or by injections with 

 mercury or coloured size, or by inflation ; the 

 outline of its follicles may, however, be seen 

 by a minute injection of its blood vessels, 

 which ramify in a delicate plexiform manner 

 on their surface. It is not a gland of much 

 complexity of structure or arrangement. 

 Briefly, it may be said to be composed of 

 minute terminal follicles, opening into canals 

 or tubes, which unite together to form ducts, 

 which open in an oblique manner on the pros- 

 tatic portion of the urethra. The orifices of 

 the prostatic ducts are situated principally 

 close to and around the most elevated portion 

 of the veru montanum, in the form of a cres- 

 cent, the larger ducts on the side, and the 

 smaller on the posterior aspect of this body 

 If a longitudinal, vertical section is made, 

 many of the ducts of the prostate are seen 

 passing upwards, towards the under part of 

 the veru montanum, in a straight direction ; 

 the interior of some of them being slit open in 

 the section, whilst others pass obliquely be- 

 neath the mucous membrane for some dis- 

 tance prior to their termination. They vary 

 in number from ten to fourteen, but as many 

 as thirty have been seen. Their diameter 

 ranges from one-sixth to one-fourth of a line. 

 It sometimes happens that two or more ducts 

 unite, and open by one common orifice, large 

 enough to admit the end of a small probe. 



To unravel the structure of the gland, it is 

 requisite to inject the ducts separately, as the 

 follicles to which they lead have no commu- 

 nication with each other, as the representation 

 given by Miiller would lead one to imagine ; 

 each duct will be found to give oft' tubes, 

 which passing in a straight direction, separate 

 gradually from each other, and terminate in 

 minute cells or follicles, which, according to 

 Weber, range from one-sixteenth to one- 

 twelfth of a line in diameter. Miiller says 

 that the larger cells are visible to the naked 

 eye, and that with a simple microscope the 

 smaller cells, situated within the larger, and 

 formed of an exceedingly delicate membrane 



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