n trying to lay
out the disease antiphlogistically.

I do not assume that preputial irritation is at the bottom of _all_
cases of dysuria or enuresis, any more than it would be rational to deny
that cases of circumcision performed in some cases of diabetic enuresis
have proved fatal as a result of the operative interference; but it is
safe to assume that, in the great number of cases in whom some
irritating conditions were found and removed, the enuresis or dysuria
was due to such preputial irritation. It is also logical to assume, with
West and Henoch, that the organ should in all cases be examined, and its
condition rendered as harmless as possible. That the condition of
preputial irritation has not been fully recognized by all parties as a
cause of enuresis does not do away with the fact that it does exist, any
more than the refusal of the prelates and doctors of Salamanca to listen
to Columbus did away with the fact of the existence of the American
continents.

A. L. Ranney, in his "Lectures on Nervous Diseases," pages 174, 175,
speaks of enuresis in children as being a reflex cachexia, "excessive
stimulation of the centripetal nerves connected with the so-called
'vesical centres' of the spinal cord,"--a condition which may be
produced by either worms in the intestines or by preputial irritation.
Ranney advises a careful exploration of the urethra and rectum in these
cases, and the elimination of all local causes of the conditions.

Probably the most remarkable case of the immediate continuous effects
resulting from phimosis is the one recorded by Vidal, in the fifth
volume of the third edition of his "Surgery." This was a young man with
a congenital phimosis, having but a very small aperture; on an operation
to relieve the phimosis there was a gush of water, but this only fell at
the feet of the patient, without being ejected at any distance; the
urethra was found to have undergone precisely the same dilatation back
of this preputial orifice that it usually undergoes back of a stricture;
the whole urethra from the meatus backward was found to have exceeded
the calibre of that of the vesical neck; the bladder was greatly
dilated.

CHAPTER XXV.

GENERAL SYSTEMIC DISEASES INDUCED BY THE PREPUCE.

Aside from all the local affections or reflex neuroses, either mental or
physical, that a prepuce may induce, there are an innumerable train of
diseases that may originate in this one cause that at first sight