r and its lining
membrane, as well as in the ureters and kidneys, in many
cases of stricture, as well as of the great amount of
prostatic irritability and enlargement that is due to the same
cause. How similarly these results can be and are actually
produced by phimosis is undeniably expressed by the
post-mortem appearances in the poor infant described by
Golding Bird to the London Medical Society, and mentioned in
the London _Lancet_ of May 16, 1846. The bladder and ureter
were like those of a man who had long suffered from stricture.
From the remarks of Dr. J. Lewis Smith, that phimosis may be
productive of inguinal hernia and prolapsus of the rectum, and
the observations of Edmund Owens and Arthur Kemp, both high
authorities on children's diseases, being both connected with
children's hospitals, as well as the remarks of Mr. Bryant in
his "Surgical Diseases of Children," who all concur in looking
upon phimosis as a great factor in hernia, Bryant having
observed thirty-one in fifty consecutive cases of phimosis, we
are certainly warranted in assuming that phimosis is not only
a mere local timely inconvenience that will disappear with the
approach of puberty, but a condition which, in the more easily
affected organism of the child,--lacking, as it does, that
resistance that comes with our prime,--is productive of
serious harm; as even the first few years of life, even a few
months of infant life, with a phimosis, are sufficient to so
change the structures of parts that the poor child will grow
into a man with an impaired kidney or sacculated ureter. The
strain required to induce a prolapsus of the bowel or a
rupture into the inguinal canal is exerted as much on the
bladder, ureter, and kidney as on the other localities.
Physicians who have taken the pains to observe must have
noticed, more than once, how the child afflicted with a
phimosis has not only at times to wait for the stream of urine
to appear, there seemingly being some obstruction to its
starting, but how often such a case is afflicted with a
stammering, halting urination. A child thus started out into
lif