AMPUTATION OF THE PENIS. 533 



Huzard determined on removing the diseased portion by ligature. To 

 accomplish this object, he provided a hollow sound or catheter, of suffi- 

 cient length to reach beyond the place proposed to be severed, and still to 

 project sufficiently out of the penis to admit of being confined by some 

 sort of circingle to the body. The end to be introduced terminated in a 

 little bulb ; the other end had a couple of rings affixed to it, for the 

 greater facility of confining it. The animal being secured in an erect 

 posture, the instrument is introduced into the urethra, and pushed on 

 until its bulbous extremity is felt beyond the part proposed to be sloughed 

 off. A ligature is then passed around the penis, immediately anterior 

 to the bulb, and, Avhen being properly adjusted, is made as tight as it can 

 be drawn, with the view of strangulating all that portion of the organ 

 which is left projecting in front of it. The other end of the instrument 

 is afterwards, by means of its rings, confined sufficiently close against the 

 belly to prevent any dependence of the parts, in which state of suspension 

 the urine can readily flow through it. At the expiration of twenty-four 

 or from that to forty-eight hours, mortification will have taken place of the 

 superficial, and to a certain depth of the subjacent parts, and a fresh 

 ligature will be required, the old one remaining undisturbed. This in the 

 course of three or four days commonly reduces the constricted part to a 

 mere pedicle, which may be safely severed with the knife. The sound 

 may now be withdrawn, and the parts left to heal over. Should the ori- 

 fice of the urethra afterwards become contracted, which will be manifested 

 by the smalluess of the stream of urine and its tardy manner of flowing, a 

 gum (or guttapercha) catheter may be introduced, and confined within it 

 for some time. Any constitutional irritation that may arise must be met 

 by antiphlogistics. 



M. Barthelemy, in the year 1826, presented a paper on amputation 

 of the penis to the Royal Academy of Medicine, detailing an interesting 

 case for which he practised some very instructive and ingenious opera- 

 tions. The case consisted in relaxation, or a sort of paralysis of the penis, 

 a sequel of a severe gastro-enteritis. Instead of pursuing Iluzard's plan, 

 Barthelemy preferred, as more expeditious and less painful, amputation 

 with the knife, thinking the hemorrhage would not prove dangerous — 

 although he had to operate on an organ in a state of erection and nearly as 

 large as his arm — from knowing that the arteries of the penis are not dis- 

 tended save during erection, lie commenced by introducing acanula or 

 hollow sound into the urethra, of sufficient length and size; and about an 

 inch beyond the place cliosen for excision, passed a flat ligature around 

 the penis, so as to arrest hemorrhage, and prevent the retraction of what 

 remained into the sheath. " An assistant now grasped the end of the 

 penis, while I with a straight bistoury performed the amputation ; which 

 was no sooner accomplished than away went the rcnniant, in spite of the 

 ligature, into the sheath. It was impossible to re-introduce the canula. 



