294 On the Sarcocele of Egypt. 
is no fear that the sarcocele will be reproduced; but the re- 
medies for elephantiasis should be continued. 
There are some general precepts for this operation: the 
testes should be carefully avoided, and also the corpora ca- 
vernosa and spermatic chords. Two oblique incisions be- 
ginning from the prepuce, one passing down below the testis 
on each side of the tumour. The parts between the testicles 
and corpora cavernosa must be deeply cut with a double- 
edged knife, carefully avoiding the testes, and the portion 
below the line formed by these incisions should be removed. 
Tf there stil] remain some sarcomatous substance round the 
penis or testes, it should be dissected away. The corpora 
cavernosa and testes are to be covered by the skin which is 
left, and the edges may usually be appreximated and con- 
fined by ligature, or by plaister and bandage. The parts 
discharge, retire and cicatrize without difficulty. If he- 
morrhage occurs, the vessels should be secured immediately 
with ligature, or (if their orifices cannot be discovered) by 
actual cautery. The success of the operation will, be im- 
proved by continuing the use of internal remedies. 
Case I, 
Jacques Moline, a Copt, and cook to the convent of Ca- 
puchins at Cairo, consulted me for a considerable tumour 
in the scrotum, which he had had for many years; it wag 
of a pyramidal form, and weighed about six pounds, The 
right testicle corresponded with the superior part of the tu- 
mour, and was sonnd; the penis had almost disappeared ; 
- the left testis was confounded with the fleshy mass which 
formed the sarcocele, and could not be felt: I still doubted 
if it formed part of the tumour, for he had never felt pain, 
This swelling was formed of a deuse (conenneuse), and in 
some parts almost cartilaginous, substance. In the middle 
of the irregular mass the testicle was discovered diminished 
in size; the wound was properly dressed. ‘The treatment 
was not disturbed by any untoward accident, and on my 
departure for Alexandria } left the patient advancing to his 
recovery, 
Case If, 
Mahammet Ibrahim, about sixty vears of age, was blind 
and affected with the elephantiasis, which he had had for 
many years. His legs were halfas large again as his thighs, 
and his feet were monstrous. The skin towards the superior 
part of the leg was sinooth and marbled, and there were 
many 
