29 



4. The Peri-vesicular or ^'pan-inflammatory" Type usually is 

 the result of severe inflammation of the vesicles, with probable rup- 

 ture of some of the smaller cysts or abscesses upon the surface. 

 The vesicles are, as a rule, considerably enlarged and buried in a 

 dense mass of adhesions which involve neighboring structures. 

 The vesicles cannot be palpated on i)hysical examination, and it is 

 only on careful post mortem dissection that they may be studied. 

 This type, however, is quite rare, — two cases only having come to 

 my attention. In both, the vesicles themselves were markedly 

 affected. 



Microscopically, changes in the vesicles are quite frequently en- 

 countered, even in the absence of gross manifestations. In the 

 •acute catarrhal forms, the mucosa and submucosa are hyperaemie. 

 The lining cells show various forms of degeneration, and there 

 are, as a rule, inflammatory exudates in the lumen. As the in- 

 flammation progresses, the lining cells degenerate further, and 

 become cast off into the lumen of the glandular cavities, as in 

 Plate VI. The normal clear mucous secretion becomes mixed with 

 fibrin, leucocytes, and cellular debris. These changes may involve 

 merely parts of the organ, or they may be quite extensive. With 

 large sections, one may find the inflammation in all stages, from the 

 mildest catarrhal type, to complete degeneration and exfoliation 

 of the secretion-forming mucosal cells, and filling of the cavities 

 with degenerated cells, leucocytes, and debris. Frequently the inter- 

 stitial tissue is in no way affected, but at times it is thickened by 

 ©edematous exudates, leucocjiies, and fibrin. The chronic inter- 

 stitial form is characterized by a considerable increase of con- 

 nective tissue, — producing marked atrophj', or even complete 

 obliteration of the glandular cavities. Microscopically the sup- 

 purative form may be diffuse over the entire gland, or as stated 

 previously, may be in the form of localized abscesses, with or with- 

 out a thick connective tissue Avail. The parenchyma in these cases 

 is usually extensively degenerated and atrophied in those parts 

 that have not undergone suppuration and necrosis. The cysts 

 appear to be of the ordinary retention type, and may or may not 

 be accompanied by extensive changes in the lining epithelium. 



Both the abscess formation and cystic conditions are undoubt- 

 edly initiated by an obstructive inflammation of all or part of the 

 excretory duct. This is, however, a protective mechanism, for 

 Avhere the duct is closed the bacteria and exudates are unable to 

 reach the urethra and contaminate the semen. 



Prostate and Cowper's Glands: These glands were more or 

 less neglected in the early part of the work, but later were sub- 

 jected to the same examination as other parts. Of the thirty-six 

 of each type of gland examined, I failed to find one with any gross 

 changes, l)ut two prostates were found that presented a mild 

 catarrhal inflammation of the mucosa. It is probable that Cow- 

 per's glands, as well, occasionally undergo inflammatory changes. 



