4. =Rectum=. Note _contents_ (amount, color, consistence, odor,
etc.), _color_ and _character of mucosa_ (normally grayish red
or reddish gray, smooth and translucent, solitary follicles just
visible). Normally the rectum should contain formed brownish féces;
in catarrh the contents are fluid and not formed, while the mucosa is
covered with a thick glassy mucus. In obstruction of the gall-ducts
the féces are gray (“clay-color”). In catarrhs and chronic passive
congestion the mucosa is red. Decubital ulcers are often green from
the imbibition of bile, and are surrounded by hæmorrhages. They are
circular or correspond in shape to the fécal mass pressing upon them.
Traumatic ulcers, hæmorrhages, diphtheritic inflammation, follicular
ulcers, foreign bodies, stricture, fécal impaction, hæmorrhoids,
fissures, fistulous tracts, tuberculosis, syphilis, adenomatous
polyps and carcinoma are the most common pathologic conditions. The
oxyuris vermicularis is the most common animal parasite. Gonorrhœa
of the rectum is not uncommon. Stricture is most commonly caused by
syphilis.
5. =Prostate.= Normal size is about that of a walnut or
horse-chestnut. Weighs 19-25 grm. Average dimensions are 2.7
cm. long, 4.0 cm. broad, 2.0 cm. thick. Note form, consistence,
color of cut-surface (smooth or granular), amount of secretion,
corpora amylacea (color brown to black), size of gland-spaces,
cysts, abscesses, tubercles, neoplasms. The most common pathologic
conditions are: hyperplasia (usually inflammatory, the result of
old gonorrhœal infection, less commonly due to chronic pyogenic
infection), neoplasms (carcinoma is relatively common, usually
developed in a prostate showing chronic inflammatory hyperplasia,
adenoma, myoma, fibroma, myofibroma), cysts, acute inflammation
(usually gonorrhœal), typhoid prostatitis, abscesses, tuberculosis,
syphilis (rare) and atrophy. Thrombosis and the formation of
phleboliths are very common in the prostatic veins; they are usually
associated with gonorrhœal infection. The inflammatory hyperplasia
may involve one or all three lobes of the prostate. In old men
showing no evidences of prostatic inflammation the prostate may be
atrophic.
6. =Seminal Vesicles and Duct.= Should be symmetrical. Note size,
contents, character of wall, and appearance of lining membrane. They
measure 3-5 cm. long, 1-2 cm. broad and 0.7-1.5 cm. thick. Gonorrhœal
inflammations and tuberculosis are the most common conditions. In
old men the vesicles contain a brownish-yellow mucoid substance.
As a result of chronic inflammation the walls of the vesicles are
thickened, often hyaline; the lumen is sometimes wholly obliterated.
Calcification of the wall is not uncommon. Concretions are found in
the vesicles following obstruction. Cystic dilatation may occur.
Primary neoplasms (carcinoma and sarcoma) are rare.
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