, 974 HUMAN ANATOMY. 



\\'li<-n the swelling consequent upon paraphimosis is well developed there is en- 

 counten-d lirst a funow, the coronary sulcus, which is normally found behind the 



na : in these cases it appt-ars deeper because it is intensified by the cedematous 

 swelling. Covering this furrow, and even overlapping the glans somewhat, is the 

 portion ,,f tin- prepuce which is normally in contact with the posterior face and border 

 of tin- corona. 1U hind this swollen fold is found a second deep, often ulcerated fur- 

 row indicating the position of the preputial muco-cutaneous margin; this is the actual 

 seat of constriction, and behind it is placed yet another ridge of swollen integument. 



The/asfiti fintis ( page n>dS) gives the organ some of its most important physical 

 characteristics. Tin: tensile strength of the penis, because of its tough fibrous invest- 

 ments, is sufficient to hear the entire weight of the body. That portion of this fibrous 

 iiuestment which covers the blunt extremities of the two cavernous bodies where they 

 are capped by the glans, delays, and sometimes prevents, the backward extension of 

 inflammatory or infiltrating processes, particularly cancerous infiltration, which pri- 

 marily involve the glans. This fibrous sheath, being a continuation of the deep layer of 

 tin- superficial fa>cia, also limits the forward extension of urinary and purulent infiltra- 

 tions beneath this fascia, such infiltrations leaving the glans uninvolved. The free 

 blood-supply to the penis and its rich innervation insure rapid healing in case of 

 wounds, and justify conservative treatment even although the organ has been nearly 

 severed or extensively crushed. 



( \>n tux it>n < >f the penis is often followed owing to the laxity of the skin by 

 such rapid and pronounced ecchymosis and oedema as to simulate gangrene. 



\Yhen th.- vessels cf the cavernous bodies are involved there is free subcutaneous 

 bleeding, giving rise to a circumscribed fluctuating tumor, most prominent during 

 erection. This tumor is somewhat slow in forming, and occasionally suppurates. 

 Under conservative treatment it usually disappears. When injury has not only occa- 

 sioned extensive extravasation of blood, but has lacerated the urethral canal, the 

 inflammatory phenomena observed after rupture of the urethra quickly develop. 

 Moreover, there is immediately bleeding from the meatus, which should lead to 

 prompt diagnosis and appropriate treatment. 



Wounds, if involving the erectile tissue, bleed freely, and, if transverse and ex- 

 tensive, may be followed by loss of erectile power in the region anterior to the wound. 

 /'nit'/iirc, in a literal sense, is possible only when the organ has undergone calcifica- 

 tion or ossification ( ride infra), but the term is applied to injuries that result when, 

 during vigorous erection, the penis is subjected to a sudden twist or bend. The 

 resulting condition is not unlike that caused by contusion, but the subcutaneous 

 elusion is apt to be lacking. The chief lesion is usually in the corpora cavernosa, or 

 in one of them, and is apt, as a result of obliteration of erectile spaces, to leave a 

 flail like organ, erection anterior to the break being impossible. 



Chronic induration (ossification, calcification, chronic inflammation) of the sheath 

 and erectile tissue, especially of the corpora cavernosa, is marked by the formation 

 of fibrous, calcareous, or bony thickenings or plates, which form usually in middle- 

 ag<-<! or elderly men of gouty diathesis. They cause but little pain, are easily recog- 

 ni/ed by palpation, and arc accompanied by bending of the penis to the affected side 

 <luring erection, which is incomplete in the region anterior to the induration. The 

 condition is unknown before forty or forty-five, and is probably analogous to the 

 thi( kening and toughening of the palmar fascia, which goes by the name of I hipuy- 

 tren's contraction, and which we recognize as partly due to gout and partly to some 



.mt irritation. Thus they may &E met with in both the penis and the hands of 

 the same gouty person (Jacobson). It has been suggested < Mctchnikoff) that in 

 their OBSeOttfl form they represent reversions to the condition existing in many mam- 

 mal-, and e\en in the anthropoid apes, in whom an os pfnis is present. 



/.Yni/>/i,nit>iti.\ may follow peripheral inflammation of any type, but is usually of 

 venereal origin. 



Th.- diagnosis between lymphangitis and phlebitis of the dorsal vein is based 

 upon the mm h smaller si/.e of the lymphatic vessels as compared with the vein ; upon 

 the lad that the former vessels ,1,, not p ass upward in the middle line, but are directed 

 int.. the groins; and finally upon the ability to lift the indurated vessel up from 

 the deeper parts, this not being possible in the case of the vein, since it is placed in a 



