Prostatoirhcea. By this condition is meant the abnormal flow of a viscid, glycerin like fluid from the prostate. It may arise from masturbation, or from direct injuries in the perineal region received by riding on an improper saddle, or from any influence which inflames the prostate gland, though gonorrhoea is by far its most frequent cause. In this condition there is a flow of mucous fluid, sometimes tinged with blood, which wells out in excessive amount from the prostate into the urethra, sometimes pouring out from the meatus so profusely that the wearing of a dressing is necessary in order to receive the discharge. Occasionally the discharge is promoted by the act of defecation.
In prostatorrhcea there is usually an increased frequency of urination, with pain and a sensation of weight on the perinseum and rectum.
During the first few weeks there is a great increase of eexual desire, amounting sometimes a sexual fury; but eventually the genitals become cold and flaccid and desire fails.
Under its effects some men undergo a complete mental, moral and physical shipwreck, others acquire the habit of masturbation, while others again are led by their satyriasis to cohabit with any woman whom they can approach. An overwhelming melancholy settles upon some of these patients, which influences their every thought and action, the freshness and plumpness of health giving way to emaciation and the pinched and careworn expression which adorns the advertisements of the charlatan.
If a man who has a chronic prostatitis and prostatorrhcea acquires a fresh attack of gonorrhoea, it is certain to travel back to the inflamed and unresistive tissues and there to luxuriate in an aggravated form. Unfortunately these very patients, with their sexual neurasthenia and satyriasis, are probable candidates for contracting fresh infections, being unrestrained either by love for their neighbors or by the law of self preservation.
These two glands, each the size of a pea, discharge a viscid mucus into the urethra by means of two short ducts. It is hence easy to
understand how they may become infected by invasion of the gonorrhoeal virus. If one of them become so affected it may remain indefinitely as a hardened nodule, or it may suppurate and discharge pus either into the urethra or externally. In this manner fistulas sometimes form which allow the urine to trickle away through the vents.
Peri Urethral Abscesses. In many cases of acute gonorrhoea the inflammation is not limited to the urethral mucous membrane, but also implicates some of the numerous follicles and glands which open by minute orifices on its surface.
The physician may often distinguish one or more of these enlarged follicles along the line of the urethra of a patient in the acute stage, and not infrequently hardened nodules may be found for months or years after the infection. Sometimes these nodules remain in the penis and interfere so much with erection that coitus may be impossible; or they may suppurate and open into the urethra, or externally, and cause urinary fistulas.
In other cases there are chronic indurations, or hardened masses, in the substance of the penis in its corpora cavernosa which may cause the organ to become distorted when in a state of erection, or there may be an extensive sloughing and destruction of the corpora cavernosa, resulting in deformity.
Balanitis. In individuals with a too long or too tight prepuce the gonorrhoeal pus, and other acrid secretions also, may be retained beneath the foreskin and set up an active inflammation of the glans penis and inner surface of the prepuce. This condition cannot develop in those who are circumcised. It sometimes results in erosion of the head of the penis, or in gangrene of the prepuce. Buboes, or inflammatory swelling of the lymphatic glands, may form in the groins as a result of this condition.
Gonorrhoea in the male in attended with such painful and distinctly marked symptoms that its presence is at once noticed; but in the female its early recognition is the exception.
After puberty every woman is accustomed to have a periodical discharge from the genitals, and little surprise is felt at any leucorrhceal flow, or at a moderate amount of local irritation between the menstrual periods. In fact many women are so accustomed to some vaginal discharge that they pay little attention to any increase of it, nor do they hasten to seek for medical advice under these circumstances. Discharges which by the naked eye cannot be distinguished from gonorrhea amay arise from other causes, e.g., "catching cold", uterine tumors, polypi, etc.