. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. f thearteries of the skin is useless and dangerous. Inextensive ulceration of the leg, amputation may benecessary. Fig. 71 shows a case of acquired elephantiasis ofthe penis and scrotum in a man, aged forty, afterextirpation of the inguinal glands on both to the patient the thickening of the penisand scrotum developed gradually during some years,and caused no inconvenience. Still greater acuteswelling of the penis often developed suddenly, show-ing that it was a form o
. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. f thearteries of the skin is useless and dangerous. Inextensive ulceration of the leg, amputation may benecessary. Fig. 71 shows a case of acquired elephantiasis ofthe penis and scrotum in a man, aged forty, afterextirpation of the inguinal glands on both to the patient the thickening of the penisand scrotum developed gradually during some years,and caused no inconvenience. Still greater acuteswelling of the penis often developed suddenly, show-ing that it was a form of acquired elephantiasis whichhas been called lymphangiectatic. According to thepatient this acute swelling subsided after a few daysin bed. The thickened tissue felt soft and spongy,and appeared to consist of several lobulated growthsrather than uniform thickening. The skin was pig-mented and the scrotum covered with crusts, andthere were numerous depressions as in patient was treated by suspension, elastic pres-sure, and later on cuneiform excision. 144 V. / Bockenheimcf, Atlas. lab. Fig. 72. Ulcus cruris varicosum — Elephantiasis, Pachydermia acquisita. ULCUS CRURIS VARICOSUM {Varicose ulcer of the leg)ELEPHANTIASIS S. PACHYDERMLA ACQUISITA {Acfjuired elcphaniias-is or pachydermia)Plate LM, Fig. 72. In this case an elephantiasic thickening of thetoes has developed in connection with a varicoseulcer of the leg; which, as already explained (PlateLV), is due to connective-tissue hyperplasia of theskin resulting from lymphatic engorgement (acquiredlymphangiectatic pachydermia). The toes are enor-mously thickened, and constricted in places; thewhole foot is also enlarged, and the arch of the footis obliterated. The thickening of the foot contin-ually increased, and extended to the ankle. Frequentattacks of erysipelas aggravated the affection. At the lower third of the leg, on the inner side, isan ulcer extending over nearly the whole circum-ference of the l
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