to be followed by a recurrence. He records a number of cases
where the prepuce alone was affected when first seen, but none wherein
the glans was attacked and where the prepuce was exempt, giving ample
evidence of the original starting-point of the disease.[94]

Erichsen also remarks on the little liability to recurrence of cancer of
the penis after a timely operation; he divides the cancer to which the
penis is subject to as being of two distinct kinds,--scirrhus and
epithelioma. The latter variety commences as a tubercle in the prepuce,
and, according to Erichsen, does not occur in the body of the penis
except as a secondary infiltration or deposit.[95] Travers states that
Jews who are circumcised are not subject to either form of cancer.[96]

Repeated attacks of herpes preputialis and some consequent point of
induration are looked upon by Petit-Radel, Chauvin, and Bernard as
frequent starting-points for the cancerous affection of the prepuce. The
aged or persons of lax fibre being more subject to these inflammatory
attacks, are also the most frequent victims of cancer in this situation.
The celebrated Lallemand, in regard to the tendency to cancer induced by
the presence of the prepuce, observes as follows:--

"Besides simple balanitis ... there also result various indurations,
which are proportionate in their degree to the length or time and
intensity with which the inciting inflammatory conditions have existed.
I have repeatedly found the mucous lining of the prepuce thickened,
hardened, ulcerated, and nodulated; at other times converted into a
fibrous or even into cartilaginous tissue of excessive thickness; in
others, still, in which it had assumed a scirrhous and cancerous nature.
I have repeatedly operated on such cases, wherein the prolongation of
the prepuce was the only recognized primary cause, the subjects being
often countrymen of from fifty to sixty years of age, who had never
known any women except their own, but who had, nevertheless, been long
sufferers from balanitic attacks, accompanied by abundant acrid
discharges, swellings of the prepuce, with more or less consequent
excoriations and narrowing of the preputial orifice."[97]

Claparede sums up the inconveniences and dangers to which the possessor
of a prepuce is liable to suffer from, as follows: "The retention of the
sebaceous secretion is liable to alter its character, converting it into
an acrid, irritating discharge, which induces more or le