er in the muscular, osseous,
or nervous systems; and that the removal of these abnormal conditions of
the penis frequently affords marked relief, and, at times, perfect and
permanent cure."

In the discussion that followed the reading of Dr. Sayre's paper, Dr. De
Forest Willard, of Philadelphia, remarked that he had operated by simply
stripping back the prepuce and that he did not circumcise, but that he
looked upon the subsequent cleanliness of the parts as the greatest
safeguard, not only as against reflex irritation, but also against
masturbation. Retained filth and smegma are far more likely to call a
boy's attention to his penis by their unrecognized irritative effects
than washing can possibly do. His practice is in accordance with the
belief that young children can be relieved by the simpler methods, such
as dilatation; but he also observes that when a child has reached eight
or ten years of age, and has never been able to expose the glans,
contraction is almost certain to be present, and circumcision must be
performed. In adults there is rarely any escape when the prepuce is
tight.

Dr. I. N. Love, of St. Louis, said: "It has been my judgment and my
practice for many years, in these reflex irritations, to pursue the
radical course of circumcision. I believe thoroughly in the Mosaic law,
not only from a moral but also from a sanitary stand-point. All genital
irritation should be thoroughly removed. It is all very well to instruct
the mother or the nurse to keep the parts within the prepuce clean, but
they can not or will not do it. Complete and proper removal of the
covering to the glans takes away all the cause of disturbance. Dr. Sayre
takes a more pronounced position on this subject than the majority of
those who have discussed his paper. An improper performance of a
surgical procedure is no argument against the operation, but rather
against the operator. For the reasons I have given, I am in favor of the
radical application of the Mosaic rite of circumcision."

Dr. J. Lewis Smith, the president of the Section, believed in the evil
results of the reflex irritation due to abnormality of the prepuce. In
many instances the causative relation of the preputial disease to the
symptoms which it produces is not so apparent as it may be in others,
but after correct treatment of the prepuce they disappear. There was one
result of phimosis which, he observed, neither Professor Sayre nor those
who contributed to his pa