Part 15 (1/2)

[90] ”Circ.u.mcision.” Dr. A. B. Arnold.

[91] Ashhurst. ”Int. Enc. Surgery,” vol. vi.

[92] ”Pertes Seminales.”

[93] ”Circoncision.” Dr. Vanier, du Havre.

[94] ”Dictionaire des Sciences Medicales.”

[95] Erichsen's ”Surgery,” page 1144. Edition of 1869.

[96] _Medical News_ of Philadelphia, page 115. Vol. for 1860.

[97] ”Pertes Seminales.” In the fourth American edition of the English translation of McDougall of Lallemand we find that he fully appreciated the dangers that lurk in a prepuce. At page 216 he says: ”Such is the condition which the parts present in cases of recent balanitis, and these are the inflammations and ulcerations that cause more or less extensive adhesions of the prepuce to the glans. Such adhesions are generally cellular, but sometimes fibrous or even cartilaginous, according to the severity and frequent repet.i.tion of the inflammation. Various degrees of induration also results according to the intensity, the duration, and the frequency of the phlogosis. Thus, I have often found a mucous membrane hardened, thickened, and covered with numerous papillae, sometimes fibrous or cartilaginous, with three times its natural thickness. I have also met with cases in which the prepuce has become cancerous. I have operated in several cases of cancer of the p.e.n.i.s, too, which certainly arose from no other cause. The patients were generally peasants between fifty and sixty years of age, who had never known other than their own wives, but who had frequently suffered from balanitis attended by abundant discharge, swelling of the prepuce, and excoriation of its opening, which was so contracted as to prevent the pa.s.sage of the glans. I have seen one case, also, in which balanitis, irritated by a forced march and the abuse of alcoholic stimulants, pa.s.sed into gangrene, by which the greater part of the glans was destroyed. Such have been the accidents which I have observed on those whose prepuce was too narrow to permit the glans being uncovered; accidents which I can only attribute to the long retention of the sebaceous matter in a kind of _cul-de-sac_, into which a certain quant.i.ty of urine pa.s.ses every time the patient makes water.”

[98] Claparede. ”La Circoncision.”

[99] Baron Boyer. ”Traite des Maladies Chirurgicales,” vol. x, page 370.

[100] I have practiced considerably among the Jewish people, but I have never seen their elderly men suffer with prostatic troubles like our own people who are uncirc.u.mcised. From having observed the tendency to prostatic complications in young people with troublesome prepuces, and that the great number of the elderly people who are affected with prostatic disease or enlargement are the unlucky possessors of long or large prepuces, I have arrived at the conclusion that the prepuce can be entered as a factor in the etiology of enlarged prostate.

[101] I have now under my care a poor consumptive who has all the appearance of having always been as virtuous as Joseph, but who, unlike Joseph, has from infancy had as a constant companion a long, miserable, s.m.e.g.m.anous, and annoying prepuce.

The young man has an oedema which first affected his feet, but one day, owing to the irritation of a slight balanitis, the prepuce swelled at once; it proceeded through the p.e.n.i.s integument to the s.c.r.o.t.u.m; the p.e.n.i.s itself retracted, leaving the integument and s.c.r.o.t.u.m to a.s.sume a translucent, puffy, cork-screw appearance and att.i.tude; from its labyrinthic pa.s.sage the urine slowly dribbles during urination in a scalding stream. In addition to the physical sufferings, he is tormented by the knowledge that his friends attribute all his disease and troubles--since the occurence of the penile oedema--to the fact that his earlier manhood must have been indiscreet, as well as sinful. The laity cannot connect any penile, scrotal, or testicular disease with anything except venereal disease; and if the physician attempts to explain matters, they simply look upon it as the good-natured and well-intentioned efforts of the doctor to deceive them and to cover up the shortcomings of some frail mortal. Many a poor fellow has to leave this world under a cloud of mistrust and a bad odor of past deviltry to which he is not ent.i.tled, and suffer all this in addition to all his physical ills, owing to his having been ornamented through life with an annoying prepuce,--the luckless heritage of having been born a Christian. Columbus in chains moralizing on the ingrat.i.tude of this world is nothing to the poor invalid with a swollen prepuce, innocently acquired, silently ”cussing” the ignorance of his relatives and friends.