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Show £12 AMPUTATIOS or Inn PENIS. OPERATIONS on THE PENIS. ment is to be withdrawn, the knife still being kept elevated, had burst through the prepuce with a very malignant-like dis.tortion. But the prepuce being freely cut open, the luxuriant crop of harmless warty excrescences started forth. The penis has been cut off when the prepuce was the sole diseased part. and cutting itself out, the preputium is laid open. I have always cut the preputium in the middle, not on the sides; and the two flaps have contracted in a way natural enough. It will however be observed, that a large branch of the veins is apt, to be cut in this way. When the parts are not previously inflamed, when we are operating for a natural phymosis, there happens a thing which those operating in the diseased state of the parts are not aware '74 \\ 915 The venereal wart has a spreading mushroom-like top, and slender base; and if the intermediate parts can be seen, they retain their natural appearance. A tubercle formed in some of the glands of the preputinm is often the beginning of can- of, namely, the separation of the two lamina of the skin, as in fig. 2, for example. In this case, we take our smallest needle, and make a stitch with a common thread, drawing the skin together at the angle or termination of the incision; and if the frenum. 0f the advanced state of the disease, the following description was taken when the parts were before me. there is troublesome bleeding (at least disagreeable if not alarming to the patient), we include the bleeding orifice in this slight stitch, which is to be brought away on the removal. W'ithin the open sore it is a dark red, covered with a sanious discharge -, the bottom of the sore is not spongy, but solid: there are deep excavations-irregilar, cauliflower-like ex- of the dressings. crescences: the margin of the skin is swelled, tuberculated, The dressing required is merely a slip of dry lint introduced betwixt the lips of the wound; and the supportng of the pe- nis against the pubes by any slight bandage. Many surgeons prefer doing the operation by two lateral incisions. It requires no further description. There will be cer in the penis. It is at first an irregular warty excrescence, with abroad base, in the substance of the preputium, or on and standing out from the sore, whilst the irregular ridgy edge is curled inward. The skin in the neighbourhood has a purple colour, is thickened and hard ; the discharge ofl‘en- sive and peculiar in smell: the urine sometimes bursts out aside from the erosions of the urethra. less haemorrhagy in this manner of performing the operation; but that is never a matter of importance. AMPUTATICN OF THE PENIS. Ixs‘rnrnr.ws.--Scaipel, two tenaculums, dissecting forceps , sponge, lint, &c. The surgeon will find occasion for two assistants. Simple as the operation is, I have taken up six, and have seen eleven vessels tied on the penis, after amputation of a large cauliflower excrcscence. The young surgeon must well remember the necessi ty of carefully distinguishing the cancerous disease of the penis from the more common warty excrescence. I have seen a man just about to lose his penis, on account of a combination of phymo- sis with th se warty excrescences from the glans, and which OPERATION. WHEN the penis is to be amputated for a corroding, spread~ mg, or gangrenous ulcer, the operation should, it possible, be delayed till the high excitement and rapid progress of the disease be subdued. The operation should not be performed if the glands of the groin be diseased in consequence of the state of the penis. In judging of the plan of our incision, the state of the skin is our guide. We leave no hardness, no coil of vessels, nor speck which has a resemblance to the disease of the extremity 0f the penis. The confirmed disease in the skin is shown by small grains felt under the surface. There is also a state of increased aetion, which I dread in the neighbourhood of can- , mu ulnar-h .MHH . |
