s large as prunes. The patient had
felt them in their position, but had imagined the condition to be a
natural one.

E. L. Keyes gives their composition as being of calcified smegma, urate
of ammonium, triple and earthy phosphates and mucus, and as symptoms and
results: pain, purulent discharges, interference with urination and the
sexual act, involuntary emission, ulceration of the preputial cavity,
and impotence.

Enoch mentions a child of two years in the Charite, who, being operated
upon for phimosis, was found to have a preputial calculus occluding the
urethral meatus. At the autopsy a calculus as large as an egg was found
in the bladder.

The presence of these formations, although not necessarily dangerous in
themselves, may, by their effects and in the irritation they induce, be
the means of producing serious mischief. The only preventive or remedy
for this condition is circumcision.

Acquired phimosis has been mentioned as a result of inflammatory lotion,
such as is connected with balano-posthitis; it sometimes happens that,
the act of coitus being done forcibly, especially with public women, who
are apt to use very astringent and constricting washes, the prepuce
becomes injured, with the result of producing a phimosis. One man will
produce the same results through the means of some vaunted wash or dip
which is supposed to act as a prophylactic to any venereal infection.
One patient had developed a chronic herpetic affection by the constant
use of an iodized ointment which he regarded as an infallible
prophylactic. Many cases of phimosis result from the attending
inflammation that follows on the liberal domestic application of nitrate
of silver to an abrasion after connection, in the mistaken idea that the
party labors under, that he is destroying some venereal virus.

By the irritation that all these applications and accidents induce,
warts and vegetations are the but too frequent results. These I have
never seen in a circumcised individual, and their occurrence and
frequency, as well as persistency, are directly proportionate with the
degree of tightness, thickness, or redundancy of the prepuce and the
irritability of the gland. As remarked by Lallemand, in reference to the
victim of nocturnal enuresis becoming a future victim of nocturnal
emissions, so it may be said of the person subject in early life to
either warts, excoriations or vegetations on the penis, that it is this
class that furnishes in aft