. The principles and practice of modern surgery. is thickened, it should be seizedbetween the blades of a forceps, and be shaved off. Then four or fivesutures should be passed through the margin of the incision, so as todraw together the edge of the skin and that of the mucous lining of theprepuce, that they may unite by adhesion. If this is not done, the skinand mucous membrane will be separated by the swelling that follows theoperation, and the wound, instead of being a mere line, will be half aninch wide. II. Paraphymosis is said to exist when a tightFig. 134. prepuce is pulled back over th
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. The principles and practice of modern surgery. is thickened, it should be seizedbetween the blades of a forceps, and be shaved off. Then four or fivesutures should be passed through the margin of the incision, so as todraw together the edge of the skin and that of the mucous lining of theprepuce, that they may unite by adhesion. If this is not done, the skinand mucous membrane will be separated by the swelling that follows theoperation, and the wound, instead of being a mere line, will be half aninch wide. II. Paraphymosis is said to exist when a tightFig. 134. prepuce is pulled back over the glans, constricting it, and causing it to swell. Treatment.—The surgeon first compresses theglans with the fingers of one hand, so as to squeezethe blood out of it, —then pushes it back with thathand, whilst he draws the prepuce forwards withthe other. If this fail, the constricting part ofthe prepuce must be divided with a curved pointedbistoury. III. Cancer of the penis may begin either onthe glans or on the prepuce, —and invariably oc-. DISEASES OF THE TESTIS. 473 curs to elderly persons who have had phymosis. It forms a foul, ragged, excavated ulcer, gradually destroying the whole organ, and contaminat-ing the glands in the groin. Treatment.—The part must be amputated before the glands are affected.The surgeon stretches it out with one hand, and cuts it off with one sweepof a bistoury; bleeding vessels are then to be tied, and cold to be applied, and after three or four days a piece of bougie is to be introduced into theorifice of the urethra, and to be retained there during the cicatrization. IV. Epispadias is a congenital malformation, consisting of an imper-fect closure of the urethra on its upper surface. Hypospadias is a simi-lar deficiency of the under surface. They sometimes may be relievedby paring the edges of the skin on each side of the fissure, and unitingit by suture, —provided that the urethra is pervious to the end of thepenis. An American surgeon has