DISEASES OF THE GENERATIVE ORGANS. 171 



Swelling of the sheath, penis, and abdomen. — This occurs in cer- 

 tain unhealthy states of the system, in unhealthful seasons, as the re- 

 sult of operating without cleansing the sheath and penis, or of 

 keeping the subject in a filthy, impure building, as the result of 

 infecting the wound by hands or instruments bearing septic bacteria, 

 cr as the result of premature closure of the wound, and imprison- 

 ment of matter. 



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

 Antiseptics, like the mercuric-chlorid lotion (1 part 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 to a depth of half an inch, and antiseptics 

 freely applied 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, creamlike discharge im- 

 plies a healthy action in the sore, and is the precursor of recovery. 



Phymosis and paraphymosis. — In cases of swelling, as above, the 

 penis may be imprisoned within the sheath (phymosis) or protruded 

 and swollen so that it can not be retracted into it (paraphymosis). 

 In these cases the treatment indicated above, and especially the scarifi- 

 cations, will prove a useful preliminary resort. The use of astringent 

 lotions is always desirable, and in case of the protruded penis the 

 application of an elastic or simple linen bandage, so as to press the 

 blood and accumulated fluid out, will enable the operator to return it. 



Tumors on the spermatic cord. — ^These are due to rough handling 

 or dragging upon the cord in castration, 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 exposure to cold 

 or wet, or to the presence of infection {Staphylococcic^ hotriom/yces) . 

 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 many years until they reach a weight of 

 15 or 20 pounds, and contract adhesions to all surrounding parts. If 

 disconnected from the skin and inguinal canal they may be removed 

 in the same manner as the testicle, while if larger and firmly 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 up 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. 



