147 



Pure air and cleanliness of groin and wound are to be secured. 

 Antiseptics, like the mercuric chloride lotion (li)art to 2,000) are to be 

 applied to the parts; the wound, if closed, is to be opened anew, any 

 accumulated matter or blood washed out, and the antiseptic liquid 

 freely applied. The most tense or dependent parts of the swelling in 

 sheath or penis, or beneath the belly, should be pricked at intervals 

 of 3 or 4 inches, and to a depth of half an inch, and antiseptics freely 

 used to the surface. Fomentations with warm water may also be used 

 to favor oozing from the incisions and to encourage the formation of 

 white matter in the original wounds, which must not be allowed to 

 close again at once. A free, cream-like discharge imi:)lies a healthy 

 action in the sore, and is the precursor of recovery. 



PHYMOSIS AND PARAPHYMOSIS. 



In cases of swelling, as above, the j)enis may be imprisoned within 

 the sheath (phjanosis) or protruded and swollen so that it can not be 

 retracted into it (paraphj-mosis). In these cases the treatment indi- 

 cated above, and especially tlie scarifications, will prove a useful j)re- 

 liminaiy resort. The use of astringent lotions is always desirable, 

 and in case of the protruded x)enis the application of an elastic or 

 simple linen bandage, so as to press out the blood and accumulated 

 fluid, vrill enable the operator to return it. 



TUMORS ox THE SPERMATIC CORD. 



These are due to rough handling or dragging upon the cord in cas- 

 tration, to strangulation of unduly long cords in the external wound, 

 to adhesion of the end of the cord to the skin, to inflammation of the 

 cord succeeding exjDosure to cold or wet, or to the presence of septic 

 or irritant matters. These tumors give rise to a stiff, straddling gait, 

 and may be felt as hard masses in the groin connected above with the 

 cord. They may continue to grow slowly for manj^ j'ears until they 

 reach a weight of 15 or 20 pounds, and contract adhesions to all sur- 

 rounding parts. If disconnected from the skin and inguinal canal 

 they may be removed in the same manner as the testicle, while if 

 larger and firmh' adherent to the skin and surrounding parts generally 

 they must be carefully dissected from the parts, the arteries being 

 tied as they are reached and the cord finally torn through with an 

 ecraseur. When the cord has become swollen and indurated uj) into 

 the abdomen such removal is impossible, though a partial destruction 

 of the mass may still be attempted by passing white hot pointed irons 

 upward toward the inguinal ring in the center of the thickened and 

 indurated cord. 



CASTRATION BY THE COVERED OPERATION. 



This is only required in case of hernia or protrusion of bowels or 

 omentum into the sack of the scrotum, and consists in the return of 



