nted bistoury, blunt-pointed scissors, and a
pair of Henry's phimosis forceps, with fine needles and fine oculists'
suture silk. The penis is allowed to hang naturally and the position of
the corona glandis marked on the outer skin with a pen and ink, which is
to serve as a guide for the incision. The prepuce is now drawn forward
until this line is brought in front of the glans and grasped between the
blades of the forceps. The prepuce is now transfixed, and, with a
downward cut, that portion is severed; the knife's edge is now turned
upward and the excision finished. The forceps are now removed and the
integument allowed to retract; with the scissors the inner mucous fold
is now split along the dorsum and trimmed off so as to leave about half
an inch in front of the corona. The parts are then brought together with
the continuous suture and dressed according to the fancy of the surgeon.
Care must be taken _not to bruise_ the parts with the forceps, as, in
such cases, sloughing of the sutured edges will be the result instead of
union. I have seen this accident happen more than once, in one case
being followed by a penitis that seriously complicated matters.

It has been my practice to use fine silver-wire and catgut sutures in
all operations on the prepuce; they excite less suppuration as well as
less irritation. In case of need, the silver can be left in longer, and
they are much easier of removal than the silk; besides, they have the
advantage of not cutting. In the after-treatment the same general plan
can be followed as with any amputated stump, except that it must not be
forgotten that at the end of this organ dwells what has been termed the
_sixth_ sense, and that heat and moisture are very apt to awaken the
dormant energies of the organ, even after it has undergone cruel
mutilation, and even has suffered considerable loss of blood; for that
reason it is best always to avoid wet or sloppy dressing, or too much
ointment, as they are more apt to cause erection than to do any good.
Besides, I find water does here, as elsewhere, interfere with the
deposited plastic matter, properly organizing into cicatricial tissue;
so that I prefer a snug, dry dressing, which is left on for four or five
days without being interfered with, and light covering, plain diet,
quiet, with fifteen grains each of bromide of sodium and chloral hydrate
at bed-time to insure rest and freedom from annoying erections. Where
the organ is large in it