tinued hot water. These subjects are, also, more prone to gouty and
rheumatic affections, asthma, and other neuroses.

Among the many cases of nervous disorders simulating other diseases that
I have seen relieved were two Jewish lads with an imperfection of the
meatus. They were two brothers, and from the history of the cases, and
that given me by the mother of the lads in regard to the father, the
malformation must have been hereditary and congenital. It consisted of a
partial occlusion of the meatus by a false membrane, which divided the
meatus in two, horizontally, but which was closed at the posterior end
of the lower passage, which readily admitted a probe from the front as
far as the occlusion, about a third of an inch to the rear. The
restoration, or rather the making the anterior urethra and meatus to
their normal condition, relieved both boys of asthma, under which they
had labored for years.

The many cases simulating the general disturbances that accompany many
kidney disorders, that are simply the result, in their primary causes,
of preputial irritation and the disturbances to the kidney function due
to the same cause, have long induced me to look upon the prepuce as a
great and avoidable factor to some of the many forms of kidney diseases,
prostatic enlargements, vesical diseases, and many other diseases of the
urinary organs, which we know full well can result from strictures, as
the latter need not always act in a purely mechanical mode to do its
full extent of mischief.

One result of these preputial irritations not generally or particularly
mentioned in any of our text-books--a condition far-reaching as regards
its own results, and more annoying and serious than it appears at first
sight--usually begins with a reflex irritability of the anal sphincter
muscle, or a rectal irritation of the same order, which in time produces
such organic change that an hypertrophied and irritable, indurated,
unyielding muscle is the result. Agnew, of Philadelphia, describes the
condition, but does not mention this frequent cause under the name of
sphincterismus; once this is established, the train of resulting
pathological or diseased conditions that may follow are without
end.[108] This is no fancy sketch, nor will the student of the pedigree
and origin of diseases feel that the case is exaggerated or imaginative.
These are some of those cases that are always ailing, never well and
really never sick, but who are, never