Lancet-Clinic Volume 113, No. 6

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1915 Excerpt: ... tuberculous process in the epididymis. Such an induration may require several years before it breaks down; some never do, the condition becoming arrested and fibrosis resulting. The finding of a nodule in the epididymis of one who has had a urethritis, but who never had an acute epididymitis, should be the occasion for close scrutiny of the affected organ. Of course, where a patient had had a gonorrheal epididymitis, a thickening at the globus minor is nearly always left as a reminder, and not too much importance should be attached to the condition for fear of making a neurasthenic of the individual. The symptoms of tuberculous disease in the seminal vesicles may be so slight as to defy a positive diagnosis: Bloody and painful seminal emissions, bladder irritability, a cystoscopic picture of bladder inflammation localized to the region over the vesicles, and the characteristic indurated and nodular feel per rectum, are the commonest findings in those suffering from extensive involvement. In most of these cases there will be found some evening rise of temperature and much more physical exhaustion than is common in the vesiculitis due to the extension of urethral infection. Tuberculosis of the prostate as a primary lesion is probably not common, but extension into it from the bladder, epididymes and vesicles takes place occasionally, such extension being limited to the region of the gland immediately surrounding the urethra and ejaculatory ducts. In primary involvement of the gland, the condition may be entirely symptomless until abscess formation takes place, after which the symptoms are those of gonorrheal prostatic abscess, viz.: frequent, painful and bloody urination of a terminal character, urethral discharge slight or absent while the urine contains mu...