NECROSIS OF THE PENIS. 409 



ligament of the sheath. It was removed by the knife. The catheter 

 was afterwards passed without difficult}'. 



The incision in the sheath was sutured and dressed antiseptically. 

 Considerable oedema occurred, but soon subsided. The ligature 

 sloughed away from the spermatic cord, the wound healed, and the 

 aneursis gradually ceased. Recovery was very satisfactory. 



Prof. Walley's case, yourn. Conip. Path, and Therap., 1S93, p. 361. 



NECROSIS OF THE PENIS. 



117. Two-year-old setter dog, left in hospital 21st October, i8g8. 



Daring the early part of October had been injured at the base of 

 the sheath when hunting. In forty-eight hours the prepuce became 

 greatly swollen, rendering micturition difficult. Despite treatment 

 the symptoms grew worse, and the patient was sent to us. 



Condition on Entry. — The sheath was enlarged, oedematous, and its 

 right surface exhibited two suppurating wounds from which urine 

 escaped during micturition. 



The dog having been secured on the table, an incision, two inches 

 in length, was made along the median line of the sheath, the lips 

 everted, and the penis, which seemed to be necrotic, exposed. In 

 endeavouring to draw forward the penis, the free extremity ruptured 

 opposite the anterior part of the bone of the penis. This portion was 

 removed, some fragments of dead tissue still adherent to the bone were 

 snipped away with scissors, and the bone itself slightly curetted. The 

 parts were dressed with gau^e, care being taken to leave an exit for urine. 



During the night blood-stained urine was several times passed. 

 During the following da}s the urine was expelled without difficulty, 

 and the patient, though pre\-iously thin and weak, recovered its strength 

 and condition. 



Treatment. — On the 4th Xo\ember an inverted V-shaped incision 

 was made over the inferior surface of the sheath, behind the first 

 operative wound and o\er the bone of the penis, the tissues covering 

 the bone were removed, and the urethral gutter enlarged by means of 

 cutting forceps. Although the lips of the wound were touched with 

 the actual cautery, operation was followed b}- considerable haemorrhage, 

 which returned during the night, and for several days afterwards when- 

 ever urine was voided. The patient left hospital on the 15th November, 

 and at once took its usual place in the pack of hounds. We. recom- 

 mended its being kept under observation and returned if it showed 

 symptoms of contraction of the urethra. 



The artificial urinar}- meatus contracted somewhat rapidly, and the 

 dog again came into hospital on the 19th December. 



To permit of urine being evacuated the urethral canal and the 

 tissues covering it were laid open for a distance of half an inch. 

 Haemorrhage was considerable, and for several days recurred during 

 micturition. 



From the 26th to the 30th December a subcutaneous injection of 

 one and a half ounces of artificial serum was made daily. 



On the 6th January the urethral orifice was again enlarged, this 



