234 ON RECENT IMPROVEMENTS IN THE 



the wound but leave the meatus urinarius free ; and outside this permanent 

 part of the dressing a loose piece of the wet boracic lint is wrapped and covered 

 with gutta-percha tissue. Then at each time of micturition the patient removes 

 the outer piece of lint, and readjusts it at the conclusion of the act, after pouring 

 over the part a little of the boracic lotion. The unirritating character of the 

 solution of boracic acid to mucous membranes, which is a peculiar feature of 

 this antiseptic, prevents any inconvenience to the urethra from such treatment, 

 which at the same time affords perfect security against putrefaction, yet allows 

 healing to proceed kindly. 



The most frequent case of operations in this situation is that for phimosis. 

 It is now about ten years since it was pointed out by Mr. Furneaux Jordan, 

 of Birmingham, that sutures are unnecessary after this operation, and that, 

 after notching the narrow ring of the preputial orifice at one or more situations 

 according to its tightness, and slitting up the inner layer of integument which 

 embraces the glans, to a sufficient degree to permit free retraction, all that is 

 required is to employ a simple dressing and to make a point of having the glans 

 freely exposed once in twenty-four hours ; the result being avoidance of the 

 unseemly notch which the stitch, if it really answered its purpose, inevitably 

 occasioned. Ever since the publication of this simple method I have invariably 

 followed it, and, as a rule, with great advantage ; but not infrequently the 

 attainment of the object has been seriously interfered with by inflammatory 

 swelling. But if putrefaction, which is the main cause of disturbance after 

 this operation, is prevented by the boracic dressing, the oedematous puffiness 

 of the prepuce, otherwise so apt to give trouble, is almost entirely avoided, 

 provided that the incisions have been made sufficiently free to allow the utmost 

 facility of retraction. It is, however, essential to the success of the antiseptic 

 dressing that the organ should be thoroughly purified at the outset, as by washing 

 the interior of the prepuce and the glans at the conclusion of the operation 

 with saturated watery solution of carbolic acid (i to 20), completely removing 

 any portions of epithelial accumulation adhering about the frenum and corona. 

 A narrow strip of the boracic lint is then wound round the neck of the organ 

 and the retracted prepuce, with the object of keeping the parts in this position, 

 except once a day when the skin is drawn freely forwards and again retracted. 

 But if, as is often the case, there is an insuperable tendency of the skin to slip 

 forwards, the permanent dressing may be dispensed mth, the general covering 

 of boracic lint being alone employed, with very free use of the lotion after each 

 act of micturition, together \vith complete retraction once in twenty-four hours. 



The last case in which I was called upon to operate for cancer of the penis 

 may be given as another illustration of the value of this dressing. The integu- 



