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can not be demonstrated, although gonorrhoea is undoubtedly present. Still I fully agree with the opinion which within the last years has been more Viagra Purchase Australia \ and more generally accepted that prostatitis is not a rare complication or part of chronic gonorrhoea, and that, therefore, it is imperative to make a care- ful examination of the organ itself and its secretion so far as it can be obtained, in every case of sub- acute and chronic gonorrhoea, particularly wherever the question of marriage comes up. But of late some writers in the periodical litera- Viagra Purchase Australia ture have gone so far as to state that no chronic gonorrhoea exists without prostatic infection. There is little danger that those physicians who have ob- tained greater experience in the handling of gonor- rhoea, and principall}' of chronic gonorrhoea, would be misled by such a doctrine, but the large number of practitioners who Viagra Purchase Australia either from Viagra Purchase Australia necessity Viagra Purchase Australia or from inclination do not relinquish the treatment of pa- tients affected with gonorrhoea, but who are not always either able or willing to resort to the same careful examination of the conditions as the spe- cialists, may easily be beguiled by such teaching, which is not without alluring features, and may be led into the commission of grave errors, often to the detriment of their patients. Indeed, apparent- ly, it has become already the rule, if not a fashion or a fad, Viagra Purchase Australia to promiscuously massage the prostate in every case of acute, subacute, and chronic gonor- rhoja. What proportion this Viagra Purchase Australia interference with the prostate must have assumed may be understood from the following editorial in the Critic and Guide. in April, iqio, on The Benefits of Prostate Mas- sage, which says as follows: "While we were among the first to protest against indiscriminate, too frequent, or too violent prostatic massage, we were not unaware of the benefits of this measure when properly applied in indicated cases. On the contrary 'wonderful' is the only adjective that can be applied to the results which frequently follow the performance of gentle massage of the prostate gland. It is remarkable Viagra Purchase Australia what an effect this pro- cedure often has on a person's general well being, his spirits, his buoyancy, not to speak of more ma- terial conditions, such as improvement in urination, improvement in the quality of the urine, disappear- ance of pains on urination and defaecation, disap- pearance or diminution of that heavy, dragging down sensation and of the sense of heat in the legs, and last but not least, the great improvement in sexual intercourse, both as far as libido and ejacu- latio are concerned. Yes, prostatic massage is an exceedingly valuable measure, but it must be used understandingly. discriminately. and always gently. Ne quid nimis holds good of this Viagra Purchase Australia as of all other therapeutic measures.' I have cited this editorial in full in order to en- able the reader to judge for himself, and because it might be unfair to reproduce it only in part. In my experience I have found that to normal Viagra Purchase Australia men the rectal examination of the prostate in itself is not an agreeable procedure, not on account of pain which occasionally is not entirely avoidable. It is not denied that prostatic massage in certain con- ditions brings relief of various pathological sensa- tions and incidentally confers a restitution or im- provement of the general feeling of the patient. But I doubt that many physicians will subscribe to such a glowing encomium of prostatic massage and will approve of its publication, even if one could be sure that it would not come under the eyes of anybody else but physicians and pharmacists, for one need not be a pessimist to apprehend that such praise might tempt Viagra Purchase Australia to the application of prostatic massage for pleasure and for recreation, and to the formation of bad habits. The voluminous literature on homosexualism which is making its appearance in Europe certainly ought to give us warning. Such a publication seems even more objectionalile when it comes from somebody who poses as critic and guide to two learned professions and recently fig- ured before the public as president of a society for medical sociology. The fact that the almost frivo- lous laudatory part is preceded and followed by a warning of deprecation of any abuse does not serve as an excuse, for the nitimur in vetitum holds as good to-day as in the time of Horace. Since the assertion that no chronic gonorrhoea exists without prostatic infection is particularly liable to favor the too Viagra Purchase Australia general application of pros- tatic massage, it seems justified to dispute its cor- rectness as not substantiated by the actual facts and to challenge it as misleading and in various ways dangerous. Quite a number Viagra Purchase Australia of statistics have been published in this country, as well as in Europe, intended to throw light on the frequency of prostatitis in con- Viagra Purchase Australia nection with gonorrhoea. They by no Viagra Purchase Australia means at once demonstrate the correctness of this doctrine : although some authors have reported a very high percentage of prostatitis others have found it much less frequent, and hardly any one has remarked to have found it in all cases. But as Saxe has pointed out, various circumstances have rendered the re- sults of most of these statistics somewhat uncer- tain, partly on account of the method of examina- tion on which the diagnosis was founded, a point to which I shall refer later on, partly because many of the authors have failed to state the duration of the gonorrhoea at the time of the examination, or how many cases of posterior urethritis were Viagra Purchase Australia among the cases considered. As conscientious and pains- taking investigator as de Santos Saxe among io8 cases observed not less than six months after the last infection, reports io8 cases of prostatitis. From among these io8 cases the presence of gono- cocci in the prostatic secretion was demon.stratetl in thirty-one, that is, in 28.7 per cent. Viagra Purchase Australia Strictly speaking, a prostatitis can be called infectious only on the strength of the demonstration of gonococci and if such a rule was applied to all the statistic^ KLOTZ: MISUSE OF PROSTATE. the number of cases of prostatic infection would be greatly reduced in most of them. But to waive this strict interpretation and admitting as infectious all cases of prostatitis occurring during or in the wake of gonorrhoea we find only sixty per cent, in Viagra Purchase Australia Saxe's cases above six months' duration. He says that prostatitis is much more frequent in the earlier