xecutive ability besides. On examination it was found that
he was a subject of congenital phimosis, never having been able to
uncover the glans. He had been in the habit of washing out the preputial
cavity by the aid of a flat-nozzled syringe. The prepuce was long, but
not thick; nevertheless, it was inelastic and very firm. The examination
seemed to have a good mental effect upon the man, as it made him quite
rational for the moment. He entered into the idea that this condition
had some connection with his derangement very intelligently, even
suggesting many symptoms and attacks that he had suffered from childhood
up as probably gradual-stepping processes through which his present
condition had been reached. He cheerfully submitted to a thorough
circumcision, which had the effect of ameliorating his condition. He was
subsequently sent to an asylum, where, after a short time, he was
discharged well. Some years afterward, conscious of feeling a return of
the mental derangement, he voluntarily applied for admission to the same
institution and remained until better.

This case is very instructive. The patient readily connected his
mental trouble, by a retrospective view through a series of
gradually-increasing troubles, that originated in the preputial
condition, to the phimosed condition of that appendage, and he was
certain that this prepuce had been at the bottom of all the physical and
mental trouble he had experienced. The reflex nervous train of
affections had undoubtedly produced some localized lesion in the
brain-structure. The natural sound, healthy organism of that organ, and
the bright, active nature of his mind, however, prevented a total
wreckage of the mental faculties. It is safe to assume that, had he had
the ordinary listless, unresisting mind, disposed to brood, and easily
cast down, he would, from the first derangement, have become a hopeless
and demented lunatic. The circumcision could not undo all the mischief
that had been accomplished, some of which had certainly left a permanent
taint, but the mildness of his future attacks and the better exercise of
his volition were the undoubted results of the operation.

CHAPTER XXIV.

DYSURIA, ENURESIS, AND RETENTION OF URINE.

Any dissertation on circumcision and its many uses, either prophylactic
or curative, would be incomplete without a reference to enuresis;
another reason for making a somewhat full reference to the subject would
be the undecid