444 CLINICAL APPLIED ANATOMY. 



THE PROSTATE GLAND. 



Prostatitis. The prostate is situated at the meeting place 

 of the genital and the urinary tracts; hence it follows that 

 there are three sources through which it may become infected 

 and inflammation result. First, by way of the urethra, and 

 particularly by the gonococcus ; secondly, along the excretory 

 tube of the testicle and through the common ejaculatory duct, 

 and especially by the tubercle bacillus : lastly, along the ureter 

 through the bladder and the first part of the urethra, either by 

 septic or tuberculous organisms. The orifices of the numerous 

 glands of the prostate and the wider aperture of the sinus 

 pocularis afford convenient nesting-places for the bacteria derived 

 from any one of these channels. 



Inflammation of the prostate leads to severe pain, on account 

 of the denseness of its capsule, and frequently to retention of 

 urine, because of the obstruction to the urethral passage from 

 the bulging forwards of the floor of the tube. 



Pus within the substance of the prostate most commonly 

 finds its way into the urethra or into the bladder, through the 

 lower part of the trigone ; occasionally into the rectum, in front 

 of which the prostate lies, only separated by its capsule and 

 some loose cellular tissue ; still more rarely, through the skin of 

 the perineum. 



In opening a prostatic abscess from the perineum it is important 

 to warn the patient that urine will almost certainly flow through 

 the wound, seeing that if the abscess has already partially 

 evacuated itself into the urethra, the wound in the perineum 

 will constitute a direct tract from the urethral passage to the skin. 



Enlargement of the Prostate. It would be out of place to 

 discuss the various theories as to the exact etiology and histology 

 of enlargement of the prostate. It will be sufficient to show how 

 this enlargement anatomically alters the outflow of urine. 



The two lateral masses of the prostate often called lobes 

 are united together by a thin commissure anterior to the urethra, 



