From the prostatic urethra inflammation may extend on one side or both along the vas deferens to the seminal vesicles. The production in this way of a _vesiculitis_ is made known by the reference of pain to the rectum and by the appearance of blood, sometimes with pus, in the seminal discharge. By a digital examination of the rectum the enlarged and tender vesicles can be recognized above the prostate. When the deep urethra has become seriously involved the condition of the patient is unpromising. Belfield calls attention to the triple function of the deep urethra, in that the impulse to urinate originates therein, that it is a sphincter for the bladder, and that it is intimately concerned with the sexual act. When it is disturbed by gonorrheal infection all of these functions are disturbed, the most serious symptoms being increased desire to urinate, amounting to almost constant vesical tenesmus; marked difficulty in expulsion of urine, which may increase to complete retention, and frequent bloody emissions, with chordee. The pain, the heat, and the sense of tension in the perineum and in the parts around it are distressing, as well as pain during and after urination, which is usually referred to the end of the urethra. The last few drops of urine will often be bloody. =Cystitis.=--Cystitis is the not infrequent result of the further migration of the infectious process from the deep urethra to the bladder. The process is usually acute and serves to further complicate the case and to harass the patient. Except in the nature of the exciting causes cystitis differs but little from the other varieties to be considered in their appropriate place (_q. v._). Cystitis of gonorrheal origin is likely to travel along the ureters and lead to involvement of the kidneys. Ascending infection is most commonly of gonorrheal origin. In proportion to the extent and rapidity with which the disease travels upward the case is marked by expressions of septic intoxication and infection, such as chills, fever, pain in the loins, along the ureters, and in the testicles. The kidneys may become enlarged. A more minute appreciation of the condition of affairs can be obtained by microscopic examination of the urine. In proportion as the kidney is involved, there is a preponderance of albumin, _i. e._, more than pus alone would produce. One of the numerous ways in which gonorrhea kills its victims is by the production of a _pyelonephritis_ of the type known as “_surgical kidney_.”