loop, mostly for carcinoma, one of the fifty being for
gangrene and one other for a large papillary tumor. That one surgeon was
able to report forty-eight cases of carcinoma or cancer that were
treated by one special system of operating tells us plainly enough that
the unfortunate possessor of a prepuce, no matter how normal or
unobjectionable it may seem to be in the prime of man's existence, or
however physiologically necessary it may be deemed, runs too many risks
in holding on to his possessions.

The views set forth by Hutchinson in the beginning of this chapter are
precisely those that are held by the writer, who would even go further,
by advising all such as have, in their youth or since, suffered with
balano-posthitis in any degree or form, or whose prepuce shows a
tendency to elongation with age, to have the same removed at once; where
the prepuce is not redundant, but only tight, a slight operation, such
as slitting, will at once remove the possibility of any future danger,
without keeping a man from his business a single day.

It may here be remarked that, although always favorably impressed with
the great benefits arising out of circumcision, nothing ever resulted in
such a serious consideration of the subject as seeing a professional
brother dying with a cancerous affection of the penis. The disease had
originated in the mucous lining of the prepuce, and when seen in
consultation with his attending physicians the gland had already
disappeared and the inguinal glands were affected. The man was in the
prime of life, and, aside from the local trouble, a specimen of perfect
health and physique. He informed us that while a youth he had suffered
from repeated attacks of herpes preputialis; that he had suggested
circumcision more than once to his father, who also was a physician, but
who, unfortunately for the son, could not see any merit in circumcision.
To his eyes there was nothing that circumcision could do but what could
be accomplished by washing and personal attention to cleanliness. When
older, the prepuce gave him less trouble, and for a long time after his
marriage it ceased to trouble him altogether. The idea of the necessity
of circumcision did not occur to him again until the appearance of the
cancerous disease; even then, not appreciating the danger, and looking
upon the trouble as a simple transient result of some inflammatory
action, he waited until the parts would be in a better state or
conditi