468 VETERINARY SURGICAL OPERATIONS 



Two incisions encircling the enlargement are ma'de so 

 as to meet at each side of the raphe interiorly, and so that 

 the distance between them superiorly will dispose of the 

 redundant skin. Superiorly, they should be separated one 

 inch, two inches, or even more, according to the size of the en- 

 largement, gradually converging as they approach the raphe 

 inferiorly. A subcutaneous resection of the hypertrophied 

 tissue is then made by sharp dissection with scalpel and thumb 

 forceps. The skin flap, to facilitate matters, may be drawn 

 out of the way with tenacula in the hands of an assistant who 

 is also engaged in bailing blood. When the dissection has 

 reached the level of the penis the enlargement may be de- 

 tached by blunt dissection, as it has no firm connection with 

 the body of the penis. 



The uppermost tourniquet is then removed to allow the 

 vessels, requiring attention, to bleed. These are carefully 

 managed with forceps or ligatures according to their size. 



The gap is closed with two sets of sutures, — mattress 

 sutures about inch apart, placed an inch or so from each edge 

 of the wound and interrupted sutures, a quarter of an inch 

 apart along the edges. 



The part is dusted with iodoform and the penis replaced 

 into the sheath, where it is retained by taking a stitch or two 

 across the sheath orifice. On the third or fourth day the 

 sheath stitches are untied and the penis withdrawn, to be 

 submitted to the necessary antiseptic treatment, after which 

 it is replaced and retained by again tying the same stitches. 

 At the end of eight days the wound stitches are removed and 

 if primary union has occurred the penis is allowed its free- 

 dom. 



Extirpation of the Membrana Nictitans. 



INDICATIONS. — Removal is sometimes necessitated 

 when this cartilaginous organ obstructs the cornea or ir- 

 ritates the eyeball. In certain rare cases, difficult to explain, 

 the membrana nictitans permanently lies in an outward posi- 

 tion so as to partially cover the internal zone of the cornea, 

 and thus causes defective vision and maintains a constant 

 watery condition of the affected eye from the irritation pro- 

 voked. Extirpation of the redundant portion is the only 

 remedy. 



The most common disease, however, requiring extirpation, 

 is tumors of the mucous membrane. The conjunctiva cov- 

 ering the membrana nictitans is very frequently the origin 

 of growths which, if not promptly extirpated, soon encroach 



