examined by Dr. Packard, the prepuce was entirely
unretractable in 54, partly so in 3, and wholly so in 36; while in 1 it
only half-covered the glans and in 4 the glans was wholly uncovered, 1
of these 4 being an infant only five weeks old.

Dr. Packard also gives the result of 172 examinations by himself, of
from twelve to seventy-three years of age, and 106 examinations by Dr.
Maury, a total of 278, in whom 100 had a long prepuce, 97 a
partly-covered glans, and 81 (of whom 2 had been circumcised) in whom
the glans was exposed.[83] As to adhesions, there is an unaccountable
diversity of opinion as to their constancy as a natural condition, being
frequent enough to class them as physiological occurrences. Dr. A. B.
Arnold, of Baltimore, states that his experience in reference to
preputial adhesions leads him to conclude that the frequency of its
occurrence has been much overstated. In the number of children that he
has circumcised, which exceeds 1000, he has met with it in less than
four per cent. of the cases. He also mentions that in the adult the
adhesions show greater firmness.[84]

On the other hand, Dr. Bernheim, of the Paris Israelitish Consistory,
observes that, of over 3000 newborn whom he has examined, with but few
exceptions he found the presence of preputial adhesions. He remarks,
however, that in the majority these are detached or broken by the first
attempt at erection.[85]

Bokai, out of 100 children, found 8 who were over seven years of age,
who were perfectly free; while of the remaining 92 under that age 6 more
showed no adhesions and 86 had various degrees of adhesions.[86]

Dr. Holgate, of the out-door department of Bellevue, considered that all
phimosic cases have adhesions; while Dr. Moses, of New York, out of some
fifty circumcisions performed at the eighth day, found only adhesions
three times.[87]

These observations are, however, in perfect accord. If we connect the
statement of Dr. Arnold, in regard to the increasing character of the
firmness in the adhesions of the adult, with the statement of Dr.
Bernheim, that the first erection is often sufficient to break up the
existing adhesions in the infant, we must conclude that they are nothing
more at first than a slight agglutination, which the slight manipulation
required to properly locate the position of the glans, and to space out
the prepuce preparatory to the operation of circumcision, must, in the
majority of cases, be sufficient to l