The Systematic Treatment of Gonorrh a (Paperback)

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: CHAPTER IV EXAMINATION OF THE PROSTATE The prostate should be examined in every case of gonorrhoea if the patient is to have the best possible prospect of freedom from relapse when treatment has been concluded. The exact part played by this organ in the reappearance of a discharge some long time after active signs have disappeared is not yet evident, but it is significant that, in a very large number of such cases, the prostate is found enlarged and pus is obtained on massage. In the acute case this gland becomes infected much earlier than is generally believed, and it is no uncommon thing to find pus formation at the end of the first week of the attack. This being so, it becomes necessary to know at what stage to examine in routine treatment, and also what signs, developing subsequently, should lead to further investigation of the condition of the prostate. Routine Examination is best done after the patient has been under treatment for a week or ten days, except in cases of acute prostatitis, which require to be dealt with as described later. At this stage the patient has little discharge, and the early tenderness and irritability of the whole lower urinary tract are wearing off, thus facilitating the examination and minimising the attendant discomfort. The practice of examining every casewhen first seen is not good, for, besides occasioning anxiety and introspection in the patient, a wrong conclusion may frequently be drawn. Thus, with a recently infected patient coming under observation early, examination of the prostate may reveal nothing, or but slight enlargement and tenderness, whereas a week later there are definite signs of inflammation and suppuration. Such a case, being found normal at first, might be treated for a considerable time before symptoms or signs poi...