Licence: Public Domain Mark
Credit: Studies on hypertrophy and cancer of the prostate. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![nient generally traverses a considerable distance in the prostatic urethra before being abruptly stopped by the obstruction (the middle lobe). Clinical Examinaiion. Prostate.—The prostate has been described as considerably enlarged in 23 cases, moderately enlarged in 8 cases, and only slightly enlarged in 5 cases. The consistence was hard in 30 cases, in places hard and in others soft in 5 cases, nodular in IT cases and soft in no cases. ]\Iarked tenderness has only been noted once in the 37 cases. In this case (Case X, completely reported above) the left lobe of the prostate contained near its apex a prominent rounded enlargement which was extremely tender on pressure. Other portions of the prostate although shown later to be carcinomatous were not tender. Sixteen of the cases were described as nodular. In the great majorit}^ of the cases, however, only a slight irregularity of surface was present and no marked nodules. In those cases which were not very far advanced in the disease the prostate often presented a smooth rounded surface, but markedly indurated. This induration was most often of stony hardness. At times there was a softer induration which gave way somewhat on pressure. The contrast, however, between the induration in these cases and the usual elasticity of the ordinary h^-pertrophied prostate was very marked. Seminal Vesicles.—It was in the region immediately above the pros- tate on each side in which the most significant changes were found, and induration in one or both of the seminal vesicles was found in 29 cases. In two cases in which the vesicles were said to be free from disease, the prostatic carcinoma presented into the bladder and vesical tumors had developed. In one case it was uncertain whether the vesicles were involved or not and in two cases no note was made. In a few cases the involvement above the prostate was in the shape of a small rounded indurated mass at the lower portion of the seminal vesicles. Generally it extended well up for the entire distance of the seminal vesicle and frequently it continued upward and outT\'ard to the pelvic wall and beyond the reach of the finger, but these cases were seen late. In such cases the examination usually revealed a mass in the shape of a bundle of indurated cords with intervening deeper indurated and soft areas extending upward and outward from the upper end of the prostate to which it was closely adherent. In only three cases were enlarged pelvic glands noted.](https://iiif.wellcomecollection.org/image/b21203556_0540.jp2/full/800%2C/0/default.jpg)
