were found in a
poultice, which had been applied with a view of relieving the
congestion,--a very dear price to pay for retaining the prepuce, that
the exquisite sensitiveness of the tactile faculty for enjoyment,
resident in the corona of the gland, might not be interfered with.

Gross does not mention this affection in his work on surgery, but Agnew
devotes considerable space to its description, dividing the disease into
two forms: the inflammatory, such as may follow venereal primary sores
or operations on the penis, not excepting circumcision; and the
obstructive variety, such as may follow embolism or any mechanical
obstruction, either purposely or accidentally applied. Of the latter he
gives a number of quoted instances; he only admits seeing one case, that
of an aged man in the Pennsylvania Hospital, in whom the disease was
caused by embolism of the dorsal artery.

J. Royes Bell, in the "International Encyclopaedia of Surgery," pays more
attention to it than any of our American authors; mentioning, among the
causes which may give rise to it, the exanthemata, especially small-pox,
and the poisoning by ergot of rye and erysipelas. Among the local causes
lie mentions phimosis, paraphimosis, and balano-posthitis.

Bell quotes the case reported by Mr. Partridge, in the sixteenth volume
of the "Transactions of the Pathological Society of London," wherein a
sober man, aged forty, lost the whole of his penis up to the root,
during the course of a typhus fever. Also the case reported by Mr. Gay,
in the thirtieth volume of the same "Transactions," wherein a
cabinet-maker, aged thirty-one, lost his penis through the probable
results of rheumatic phlebitis, and due to the presence of a plug in the
internal iliac vein. In the twelfth volume of the "Transactions" of the
same society he finds the record of the case of a soldier who lost his
penis through gangrene induced by syphilitic phagedena.

In the consideration of the subject of the prepuce as connected with
penile gangrene, it must not be overlooked that the presence of a
prepuce may be the inciting cause of some rheumatic affection (the
writer has repeatedly seen such), just as such cases are often the
result of stricture; as cases of rheumatism that have resisted all
remedial means, but that have readily given way to the dilatation of a
stricture, are by no means uncommon; not a mere muscular reflex
rheumatic pain, but even when accompanied by a rheumatic blood
co