Surgery; its theory and practice . , inflammationsometimes simulatinggonorrhoea, adhesion ofthe glans to the prepuce,or even as age advancesthe formation of an epi-thelioma. The treatmentmay be considered underthe head of i, circujn-cision ; 2, slitting the pre-puce; and 3, dilatation ofthe preputial orifice. 1. Circumcision.—Lay hold of the prepuce transversely witha pair of polypus forceps, on a level with the corona (Fig. 355) ;let the glans slip back, close the forceps, and shave off the prepucein front of them with a clean sweep of the knife, llemove theforceps, slit up the mucous lining
Surgery; its theory and practice . , inflammationsometimes simulatinggonorrhoea, adhesion ofthe glans to the prepuce,or even as age advancesthe formation of an epi-thelioma. The treatmentmay be considered underthe head of i, circujn-cision ; 2, slitting the pre-puce; and 3, dilatation ofthe preputial orifice. 1. Circumcision.—Lay hold of the prepuce transversely witha pair of polypus forceps, on a level with the corona (Fig. 355) ;let the glans slip back, close the forceps, and shave off the prepucein front of them with a clean sweep of the knife, llemove theforceps, slit up the mucous lining of the prepuce in the middleHne quite back to the corona, break down any adhesions betweenthe prepuce and glans, wash away the secretion, twist or tie anyspurting vessels, and stitch the flaps of mucous membrane to theskin with interrupted horse-hair or catgut sutures. Dress withboracic lint or iodoform gauze. 2. Slitting the prepuce may be done with scissors, or with acurved bistoury guided by a director, introduced between the. Seizing the prepuce preparatory to the operation ofcircumcision. (Bryants Surgerj-.) 73© DISE.\SES OF REGIONS. glans and prepuce. In either case the mucous membrane shouldbe united to the skin-flaps by fine sutures after twisting and tyingany bleeding vessels. Care should be taken not to pass the di-rector into the meatus, and to ensure that the mucous membraneis slit quite back to the corona. 3. Dilatation of the prepuce may be accomplished in slight casesby a daily endeavor to draw back the contracted prepuce over theglans. It may also be done by the preputial dilator, or by forcibleseparation of the blades of the dressing forceps, though suchmeans are not often successful. Primary venereal sores or chancres.—Two chief varieties ofvenereal sore or chancre occur, the syphilitic or infecting, and thelocal contagious or non-infecting. Either of these may be accom-panied by sloughing or phagedaena, and is then spoken of assloughing and phagedaenic s
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectsurgery, bookyear1896
