nst the
gritty calculus. If the stone has been arrested higher up, its position
may be detected as a small, hard, sensitive knot on the line of the
urethra, in the median line of the lower surface of the penis, or on the
floor of pelvis in the median line from the neck of the bladder back to
the bend of the urethra beneath the anus. In any case the urethra
between the neck of the bladder and the point of obstruction is liable
to be filled with fluid, and to feel like a distended tube, fluctuating
on pressure.

_Treatment of urethral calculus_ may be begun by an attempt to extract
the calculi by manipulation of the papilla on the end of the penis. This
failing, the calculus may be seized with a pair of fine-pointed forceps
and withdrawn from the urethra; or, if necessary, a probe-pointed knife
may be inserted and the urethra slightly dilated, or even laid open, and
the stone removed. If the stone has been arrested higher up it must be
extracted by a direct incision through the walls of the urethra and down
upon the nodule. If in the free (protractile) portion of the penis,
that organ is to be withdrawn from its sheath until the nodule is
exposed and can be incised. If behind the scrotum, the incision must be
made in the median line between the thighs and directly over the nodule,
the skin having been rendered tense by the fingers and thumb of the left
hand. If the stone has been arrested in the intrapelvic portion of the
urethra, the incision must be made beneath the anus and the calculus
extracted with forceps, as in stone in the bladder. The wound in the
urethra may be stitched up, and usually heals slowly but satisfactorily.
Healing will be favored by washing two or three times daily with a
solution of a teaspoonful of carbolic acid in a pint of water.

_Preputial calculus (calculus in the sheath, or bilocular
cavity)._--These are concretions in the sheath, though the term has been
also applied to the nodule of sebaceous matter which accumulates in the
blind pouches (bilocular cavity) by the sides of the papilla on the end
of the penis. Within the sheath the concretion may be a soft,
cheesy-like sebaceous matter, or a genuine calculus of carbonate,
oxalate, phosphate and sulphate of lime, carbonate of magnesia, and
organic matter. These are easily removed with the fingers, after which
the sheath should be washed out with castile soap and warm water and
smeared with sweet oil.

DISEASES OF THE GENERATIVE ORGAN