A manual of syphilis and the venereal diseases, . the prepuce. If soft chancre be present, 318 SYPHILIS AND THE VENEREAL DISEASES. any freshly cut surfaces are certain to become gangrene has begun in any part, pressure should berelieved by incisions, hot fomentations should be applied,and the patient should be kept quiet in bed. Quinineand tonics should be given to meet the indications ofeach case. In adults, congenital phimosis and phimosis due tothickening of the tissues or to cicatricial contractionshould be treated by circumcision. a short prepuce becomes infl
A manual of syphilis and the venereal diseases, . the prepuce. If soft chancre be present, 318 SYPHILIS AND THE VENEREAL DISEASES. any freshly cut surfaces are certain to become gangrene has begun in any part, pressure should berelieved by incisions, hot fomentations should be applied,and the patient should be kept quiet in bed. Quinineand tonics should be given to meet the indications ofeach case. In adults, congenital phimosis and phimosis due tothickening of the tissues or to cicatricial contractionshould be treated by circumcision. a short prepuce becomes inflamed and cedema-tous, it is apt to roll back of the glans, where it rapidlybecomes more swollen and infiltrated until it cannotbe returned to its normal position. This form of para-phimosis is usually mild in type. A more serious formoften occurs where a longer prepuce with a narrowopening, especially if rendered yet narrower by inflam-mation, is slipped back of the glans. This may occur incoitus or in cleansing the glans, but is most frequently. Fig. 12.—Paraphimosis (Cullerier). found complicating hard or soft chancres or other localdisorder. The retraction may be the result of excessiveswelling, of accident, or of failure to return the prepuceover the glans after local treatment and dressing. Symptoms.—In spontaneous paraphimosis due to in-flammation of a short prepuce the most prominentsymptom is the mass of swollen and cedematous tissue PARAPHIMOSIS. 3 19 back of the glans. The swelling is often irregular inform, larger below than above, and is usually soft, puffy,or doughy. The glans is but slightly if at all affected,and subjective symptoms are wanting. If the conditionis allowed to persist, the infiltration of the tissues mayincrease until the swelling becomes tense, white, andglistening. In such cases the glans becomes more orless swollen and darkened in hue, showing an interferencewith circulation. Strangulation rarely follows. When a long prepuce with a tight ope
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