s flaccid state, it is better to support it on a
small oakum-stuffed pillow, made for the purpose, than to let it hang
downward. Should the stitches give way and the skin tend to retract, the
plan proposed on a previous page can be followed to advantage. In
urinating, care must be taken not to soil the dressings; some patients
are very careless about this if not warned. The penis should hang nearly
perpendicular while in the act, and all dribbling should have ceased and
the meatus and underneath be mopped dry with some soft cotton before
raising the organ; nothing so irritates the parts, retards union, or is
more offensive than a urine-saturated dressing.

Dr. Hue, of Rouen, uses an elastic ligature, which he introduces into
the dorsal aspect of the prepuce by means of a curved needle. This he
ties in front, and in three or four days it cuts its way through.
Although Hue reports a large number so operated upon, the tediousness of
the procedure and the swelling and oedema, as well as the active pain
that must necessarily accompany the operation, will hardly recommend the
ligature in preference to the incision by the knife.

Dr. Bernheim, the surgeon of the Israelitish Consistory of Paris, has
operated on over eleven hundred circumcisions, besides the cases of
phimosis occurring in his general practice. His opinion of the procedure
of M. de Saint-Germain by dilatation is not favorable. He has employed
it in a number of cases of phimosis, at the time unfit for a more
radical operation. He has, however, observed that cicatricial
thickenings and recontractions are very apt to occur, and, as to the
septic accidents mentioned in connection with circumcision, he has noted
that they are as liable to occur in hands that are as careless and
slovenly with what they do with their dilating forceps as they are with
what they do with their bistouries. Dr. Bernheim prefers the
circumcision forceps of Ricord, as modified by M. Mathieu. This
instrument he prefers by reason of its gentler pressure, which, at the
same time, is all-sufficient to properly fix the prepuce. In applying
the forceps, he includes as little as possible of the lower part,
keeping away as much as possible from the frenic artery. The dorsum of
the inner fold he cuts with the scissors. In children under two years of
age, he simply turns this back over the free edge of the integument; in
children over two years of age, he uses serres-fines. In children, he
uses a piece