The Troublesome Prostate Gland
( Originally Published Early 1900's )
THE prostate gland is a small organ that is ordinarily very well behaved if one lives a normal life, but which is capable of giving you a lot of trouble if you make trouble for it. It is probably a more important part of the generative system than most persons suppose, being regarded as the chief seat of sexual sensation in the male, its secretions contributing to a considerable extent to the bulk of the seminal fluid and its power of muscular contraction having much to do with the ejaculation thereof. The ejaculatory ducts pass through the prostate. Situated as it is, too, at the neck of the bladder, it is closely associated with the functions of that organ, and is often involved in its disorders.
The prostate gland is a partly muscular organ, weighing little more than half an ounce, about the size and shape of a chestnut, and surrounding the urethra as it leaves the bladder. It assists in con-trolling the flow of urine, and when greatly enlarged it naturally interferes with the free pas-sage of water because it constricts the urethra. On this account, men in advanced years some-times have serious trouble with it. The condition of the prostate is ascertained by digital examination through the rectum, for in that way the size and outlines of the gland may be easily felt. It lies a little forward, in the perineal region, or as one might put it, on the floor of the pelvis.
This gland is the source of much trouble in connection with gonorrheal infection, for whenever the disease reaches the recesses of the prostate it plays havoc with it, and is likely not only to make itself at home there for some time, but also to leave its effects after it has passed away. Experienced physicians agree that even though gonorrhea may be cured, the prostate gland is never quite the same afterwards as it was before. The fact is that acute prostatitis, or inflammation of this gland, an extremely painful and serious complaint, is almost always the result of gonorrhea. Some other active infection, however, such as may result from the introduction of unclean sounds or other unsterilized instruments into the urethra, may produce it. Also it may result from injury. I will discuss acute prostatitis more in detail in the chapter dealing with venereal diseases.
A less active form of inflammation of the gland, commonly known as chronic prostatitis, may result from. masturbation, frequent sexual excitement—especially when ungratified—erotic thinking, uncompleted sexual intercourse, sexual excess, the lingering traces of gonorrhea, irritat ing injections, stricture, constipation or stone in the bladder. Sexual abuses or excitement are responsible in most cases.
In connection with chronic prostatitis there is usually more or less discharge of the viscid fluid, secreted by the gland. This discharge occurs most frequently when at stool, but may take place after urinating and at various other times. It is called prostatorrhea, and it is this which is so often mistaken for spermatorrhea, which I have already referred to in the chapter on seminal losses. Quack doctors tell young men that this prostatic discharge is spermatorrhea, and that they are doomed to an early death unless they can immediately produce one or two hundred dollars for treatment.
In chronic prostatitis the gland is more or less tender and irritable. It may or may not be materially enlarged. When enlarged the urine will not flow readily, or perhaps not so freely as formerly. At times the urine may be slightly clouded from catarrhal discharges from the prostatic urethra. There may be a slight pain after urinating, and there may possibly be, at other times, dull pains reaching to the back and thighs. There may also be a slight irritation or sense of discomfort in the
perineum. Nervousness, mental depression and a hypochondriacal tendency, or the inclination to think about one's ailments and exaggerate them, usually accompany these symptoms. Continued prostatitis is thought to lead to neurasthenia in many cases, though it may be nearer the truth to say that the habits and conditions which have affected the prostate in this way have also directly produced the neurasthenic condition.
Nevertheless the complaint certainly has a pronounced effect upon the nervous system.
It is now suspected by some investigators that the prostatic secretion has a close relation to the functions of the body as a whole, like the secretions of the testicles and of the thyroid, adrenal and other glands. Such a theory would explain the influence of disorders of this kind upon the nervous system, and indicates the urgent need of overcoming prostatorrhea as rapidly as. possible. The disorder is by no means as serious as spermatorrhea; yet it is not to be ignored, or taken lightly. While less serious it is also much more common than spermatorrhea, and in practically every case when there is any question in your mind as to the nature of a discharge of this sort you may assume it to be prostatorrhea. But of course an absolute diagnosis can only be made through a laboratory examination showing the presence, or absence, of spermatozoa.
Prostatorrhea is directly due to a relaxed condition of the prostatic ducts, of which there are some fifteen or twenty opening into the urethra. This laxity naturally goes with a weakened condition of the organ. The reason why the discharge is especially marked in connection with straining at stools is because the gland is so situated that such straining causes pressure upon it, forcing out the fluid through the relaxed ducts. In acute prostatitis, when the organ is much swollen and extremely tender, any evacuation of the bowels is likely to produce excruciating pain.
The contraction of the prostate and adjacent parts after. urinating also naturally tends to express some of the secretion when the weakness is well marked.
It is a gradual enlargement of the prostate gland that commonly gives older men so much trouble. The condition may come about so slowly as not to be noticed until it is found to interfere greatly with the passing of water, at the same time inducing frequency of urination. When there is any bladder trouble in connection with it this condition is very troublesome. Such enlargement may follow inflammation of the prostate in early life, or it may be produced by the irritation of the gland through constipation, an acid condition of the urine, disease of the bladder, or any other condition causing congestion in the neighborhood. A life of sexual excess, or marked abuses of any kind in early years, may be regarded as a predisposing factor. The enlargement is sometimes painful, sometimes not.
In undertaking treatment for the prostate gland the causes of the disorder should first of all be considered. If the real cause, as is so commonly the case, should be found in frequent sexual excitement of any kind, this must be avoided. A complete sexual rest is advisable for a time, and if one is married it might be well to sleep alone. Masturbation, if practised, must be stopped, and as the severe strain of ungratified passion is most injurious, there must be no interrupted intercourse, or other practices of this sort. No treatment will do any good if you keep your mind full of sensual ideas.
Constitutional treatment is indispensable. The more vigorous your general health and the better your circulation, the more quickly you will recover. In fact, active exercise may be regarded as the most important feature of the treatment in many ordinary cases of prostatorrhea. Don't be half-hearted. Make it real exercise. Of course in the acute inflammatory conditions exercise will have to be avoided until the sensitiveness and extreme irritability of the gland have been overcome.
The hot sitz-bath is one of the most effective of all treatments when there is congestion, inflammation and irritability of the prostate. This should be taken each evening. Another exceedingly effective treatment is a rectal douche with fairly hot water. Treatment can be applied to the prostate very directly through the rectum since the latter lies right against it. The rectal douche does not mean the flushing of the entire colon. It is sufficient to confine it to the rectum and it is best to use the hot water in the form of irrigation, letting it run out as fast as it enters for two or three minutes or more. There are special appliances made for rectal irrigation which you can secure at a drug store, but you may be able to manage it with an ordinary fountain syringe. Of course when there is constipation, complete colon flushing may be desirable. occasionally, though the constipation would prefer-ably be remedied, if possible, by drinking water, eating fruit, and giving careful attention to diet in general, as well as by abdominal massage and exercise.
Irrigation of the rectum with hot water has an extremely soothing effect when the prostate is in an irritable and inflamed condition, and in those cases in which seminal losses are largely due to this excitable condition of the prostate gland, such treatment is most important, as I have already pointed out in the chapter on this subject. Taken every night before going to bed, it will so quiet and soothe the whole sexual system as probably to prevent any trouble during the night. In other words, when it is found that cold sitz-baths do not have the effect of decreasing or stopping night losses, this treatment will often do so. It may be taken in conjunction with hot sitz-baths. Sometimes when the latter are inconvenient, the same result may be obtained by placing hot wet cloths against the perineum, just back of the scrotum. One could even use a small hot-water bag, applied to the perineum for a few minutes, with soothing effect.
In acute prostatitis, developing from gonorrhea, the hot rectal irrigation is especially important, and one should use either the hot sitzbath or the hot wet packs to the perineum. It will probably be necessary in a very severe case of this kind to stay in bed, or to be as quiet as possible. If lying down, have the hips elevated on a pillow. No exercise should be attempted. A non-stimulating diet and the free drinking of hot water would be of great value. The diet should include little or no meat, eggs, nuts or high-proteid foods. In fact,, the milk diet is usually best. It may also be necessary in such a case to draw the water with a catheter (in skilled hands only), and if an abscess should develop in the prostate gland surgical help will be necessary.
Ordinary prostatorrhea, when there is no marked tenderness, inflammation or irritability of the gland, will often respond best to a different line of treatment, of which cold sitz-baths each morning form a part, with plenty of vigorous exercise, as already suggested. In such a case, after any congestion or marked inflammation may have subsided, one has to deal chiefly with the relaxed condition of the prostatic ducts. It is necessary to tone up these tissues. A cold-water jet directed against the perineum, or even rectal irrigation with cool water, will be of great service. But so long as there is irritability and marked inflammation the hot-water treatment is essential.
Massage of the prostate will usually be of value in cases of this kind, and when there is a moderate degree of inflammation without much tenderness very gentle massage will also help. This is applied by means of the fingers through the rectum, and its self-application is more or less difficult. It should never be so vigorous as to be painful or uncomfortable, and should not be attempted at all when the gland is in a very sensitive state.
When the prostate gland is in trouble the posterior urethra will often be found more or less inflamed, tender and sensitive, as a result of the same abuses or causes. As a rule the treatment for the prostate gland will also cover the requirements of the urethra as well. The hot sitz-bath will affect it directly, and gentle massage administered under or back of the scrotum will help. In both cases improvement is entirely a matter of improving the circulation and quality of blood. Therefore anything that is of use in one condition will help in the other.
For enlargement of the prostate in advanced years many doctors advise an operation for the complete removal of the gland. Of course it is possible that in some exceptionally severe cases such treatment may be necessary, but they are few indeed, if proper natural methods of treatment are adopted. Constitutional treatment for vitality building and attention to any bladder trouble present, with the correction of constipation, will usually be sufficient, combined with local treatment in the way of hot sitz-baths and hot rectal irrigation. When there is pronounced inflammation the hot-water treatment is especially necessary, but when there is no inflammation it will often be found that the application of cold wet cloths to the perineum and pelvic region is more effective, as it tones up the tissues. Always, the condition of the bladder must be investigated.
If the enlargement of the prostate reaches a critical stage at any time, involving inability to pass water, a fast of one or two days may be necessary, or perhaps the milk diet should be adopted, with complete rest. An acid condition of the urine will not only cause inflammation or catarrh of the bladder, but will also irritate the prostate. Urine that is retained is likely to develop this acid condition or to form ammonia. One treatment is to drink plenty of hot water, thus increasing the flow of urine and diluting it in such a way as to make it non-irritating. A catheter is sometimes absolutely essential under such circumstances to save life, though it should be inserted by a physician or other experienced person. Results that are nothing short of wonderful are obtained in many cases simply through hot-water drinking. Because of the increased quantity of water in the bladder the flow is stronger and the vessel is more perfectly emptied, aside from the fact that its contents are made less acid and less irritating. An inflamed bladder will recover quickly under such conditions.
It is hardly necessary to say that alcohol must be strictly avoided, for it is often the cause of difficulties of this kind. Also a non-stimulating diet should be used. Instead of tea and coffee, use hot water. And do not forget the value of the milk diet in such cases. In addition the drinking of a couple of cups of hot water first thing in the morning can be recommended.
Hot-water drinking can usually be recommended in all cases of prostatic trouble. When there are night losses to contend with one should not drink any water after four in the afternoon, but it may be taken in large quantities early in the day. If cold water is taken, it should be sipped, not poured down.