304 Mr. H. Earle on the re-establishment of a portion 
it must perish. Two ligatures were employed to assist in 
retaining it in the desired position, and some straps of adhesive 
plaster and a bandage completed the dressings. The day 
following the operation, it was evident that some urine had es- 
caped by the side of the catheter ; and on the third day, when 
it became necessary to remove the dressings, it was found 
that the portion of the flesh which had been denuded of 
skin had sloughed, but that a sufficient quantity had united 
above and below to form a canal open at one side, and large 
enough to include the whole catheter. 
This result was quite as favourable as could, under all 
circumstances, have been expected ; and I was led to enter- 
tain sanguine expectations of ultimate success. The two 
surfaces, from whence the integuments had been removed, 
were now suffered to heal ; but as the cicatrix on the right 
side contracted, it drew the newly formed canal rather to 
that side, and tended to increase the opening into it. It was, 
consequently, determined not to attempt any thing farther 
until all contraction had ceased. So much, however, had 
been gained by this operation, that when the catheter was 
introduced, and the finger pressed on the left side, no urine 
escaped, and some could be made to pass through the penis 
without the aid of the catheter. My patient however, soon 
after this, became much disordered in his health, and had an 
attack oflepra vulgaris, to which he had for years been sub- 
ject, on which account for some months nothing was attempted, 
except several times freely excoriating the edges of the canal, 
and thus endeavouring to unite them by keeping them in 
contact. In this we were constantly foiled by the astonishing 
rapidity with which the skinning process took place from 
