on of health before resorting to an operation,--that time never
came.

Although to Roux, Wadd, and Hey the credit must be given for bringing
the subject of cancer of this organ so prominently before the
profession, the knowledge of the existence of the disease has long been
a matter of record. Patissier, in the fortieth volume of the "Dict. des
Sciences Medicales," quotes from the third volume of the "Memoires de
l'Academie Royale de Chirurgie," that in 1724 an officer, aged fifty,
was attacked by a cancerous affection originating underneath the
prepuce; at the time he consulted MM. Chicoineau and Sonlier the
disease had existed for two years, the inguinal glands were implicated,
and even the suspensory ligament was affected. These surgeons,
nevertheless, determined upon an operation, and, after a long chapter of
haemorrhagic accidents, the patient finally made a recovery. Another
case, quoted by Patissier, was operated upon by M. Ceyrac de la Coste,
the patient a man of sixty, the disease originating, like the preceding
case, underneath the prepuce.

Warren, in his "Surgical Observations on Tumors," observes that cancer
of the penis begins by a warty excrescence on the glans or prepuce.
Walshe, in his work on the "Nature and Treatment of Cancer," says: "The
disease may commence in almost all parts of the organ, but the glans and
prepuce are by far its most common primary seats. It may originate
either from a warty excrescence or a pimple, or it may infiltrate the
glans, or appear as a complication of venereal ulceration. Phimosis,
either congenital or acquired, is an exceedingly common accompaniment,
and it appears probable that the irritation occasioned by this condition
of the parts may act as an exciting cause of the disease in persons
predisposed to cancer. Circumcision is, therefore, an advisable
prophylactic measure, where the constitutional taint is known to
exist."

CHAPTER XXI.

THE PREPUCE AND GANGRENE OF THE PENIS.

Another accompaniment of that preputial appendage is gangrene of the
penis, which, like carcinoma, starting in at the prepuce, may invade the
pubes and scrotum. This disease is not so rare as to merit the little
attention it has received from our text-books. M. Demarquay has
collected the history of twenty-five cases; from him we learn that the
prepuce is the most frequent seat of the start of the affection, from
whence, according to Astruc, it rapidly spreads to the skin of the who