rculation, which is followed by a turgescence of
the glans. In the treatment of such a case, the indication is, first, to
reduce by gradual pressure the size of the glans, so that the prepuce
may be replaced over it; secondly, to lessen the inflammation by the
ordinary means.

[Illustration]
Plate 57.--Figure 2.

Fig. 3, Plate 57, exhibits the form of a gonorrhoeal phymosis. The
orifice of the prepuce is contracted, and the tissue of it infiltrated.
If in this state of the part, consequent upon diseased action, or in
that of Fig. 1, which is congenital, the foreskin be retracted over the
glans, a paraphymosis, like Fig. 2, will be produced.

[Illustration]
Plate 57.--Figure 3.

Fig. 4, Plate 57, shows a form of phymosis in which the prepuce during
inflammation has become adherent to the whole surface of the glans. The
orifice of the prepuce being directly opposite the meatus, and the parts
offering no obstruction to the flow of urine, an operation for
separating the prepuce from the glans would not be required.

[Illustration]
Plate 57.--Figure 4.

Fig. 5, Plate 57.--In this figure is represented the form of the penis
of an adult, in whom the prepuce was removed by circumcision at an early
age. The membrane covering the glans and the part which is cicatrised
becomes in these cases dry, indurated, and deprived of its special sense.

[Illustration]
Plate 57.--Figure 5.

Fig. 6, Plate 57.--In this figure the glans appears protruding through
the upper surface of the prepuce, which is thickened and corrugated.
This state of the parts was caused by a venereal ulceration of the upper
part of the prepuce, sufficient to allow the glans to press through the
aperture. The prepuce in this condition being superfluous, and acting as
an impediment, should be removed by operation.

[Illustration]
Plate 57.--Figure 6.

Fig. 7, Plate 57.--In this figure is shown a condition of the glans and
prepuce resembling that last mentioned, and the effect of a similar
cause. By the removal of the prepuce when in the position here
represented, or in that of Fig. 6, the organ may be made to assume the
appearance of Fig. 5.

[Illustration]
Plate 57.--Figure 7.

Fig. 8, Plate 57, represents the form of a congenital hypospadias. The
corpus spongiosum does not continue the canal of the urethra as far
forwards as the usual position of the meatus, but has become defective
behind the fraenum praeputii, leaving the