AMPUTATION OP By Bamlet "VV. Assistant
Surgeon,
THE PENIS.
Switzek, F.R.C.S.I.,
6th Punjab
Infantry ;
Civil
Surgeon,
Kohat.
lad about 14 years of age, an inhabitant of Koorm, of Cabul, presented himself at the Kohat Dispensary on the 29th December, 1867. Ho had travelled a long distance in search of relief, and was most anxious to submit to anything that would remove the loathsome disease from which he suffered?progressive elephantiasis of the penis.
Jaffer,
in the
a
kingdom
History.?Three years ago he first felt his urine smart him severely when being voided. Shortly after he noticed an eruption on the penis and scrotum, which itched greatly. He at seems to have done nothing for it, and the disease went on, first slowly, then more rapidly, and during the last six months the organ increased so much in size and weight, in proportion to his age and stature, that it became truly burdensome, from the dragging sensation which the mass caused to the spermatic cords and loins.
On examination, the penis was found to be greatly enlarged, hard and cartilaginous to the touch, and contorted on itself; the prepuce thickened, and contracted into phymosis over a withered glans, an ichorous discharge welling out; the circumference at the largest part was seven inches, and the length four and a half inches. The diseased and thickened tissue extended to the root of the penis at the pubis, and was continued below on to the The organ could never be of any use for procreative scrotum. purposes, and the lad and his friends wished it removed. Accordingly, on the 31st December, kindly assisted by Dr. A. P. Holmes, (the boy being under chloroform,) I guarded the abdomen and scrotum with the thin blades of a bullet forceps, and swept the diseased mass away with a long amputating knife, as close to the symphisis as I possibly could Half a second was sufficient to do this, and to grasp the wound and control the spouting arteries, five of which required ligatures, the two of the corpus carernosuni being rather troublesome to secure. A female silver catheter was inserted into the patulous urethra; the wound dressed with wet lint, and secured by a T bandage. About an ounce of blood was lost. What was removed weighed seven ounces and three drachms. r The next day the wound was glazed over, and urine had freely The boy bad a good night's rust, and was very hungry. All went on well uutil the morning of the 3rd, when a good deal of inflammation was present, and the scrotum was much swollen, but there was no pain ; a clean tongue and quiet pulse. In order that it should be properly done, 1 fomented the parts myself with warm water for half an hour, and applied six leeches to the pubis. This checked the tendency to inflammation ; and on the 4th he The wound to be dressed with strong solution was much better. of permanganate of potash, and the scrotum supported on a pillow'. The lad eats well, and complains of nothing. Dowels freely open without medicine. 6th.?All inflammation subsided, and wound granulating healthily.
passed.
No further notes of the progress of the lad to recovery are necessary. The ligatures did not separate until the and the wound was wholly cicatrised on the 31st January, when he was discharged.
fifteenth*day,
Ilis appearance was of course one of great mutilation, but, from bis age and the probability of his never having known sexual desire, it is likely tie has not yet realized the extent of his misfortune. The penis and scrotum are continuous, there to being nothing represent the situation of the penis, but a small cicatrix and the opening of the urethra. He was furnished with a No. 9 bougie, and directed to the orifice pass it through
occasionally. Mr. Teal, of London, Las recommended that, after the performance of this operation, a bistoury should be made to divide the
end of the urethra into four parts, and that the mucous membrane and skin be brought together by sutures. The object to be attained is a patulous condition of the mouth, and the prevention of redundant skill overlapping. To me the proceeding appears difficult and unnecessary, if the skin is well drawn lorward before the knife is applied, no skin will be left in excels. The introduction of the catheter for two hours each day during the cure will effectually prevent contraction. 1 'll" penis has been put in spirits, and forwarded to the (JuratJi of the Medical
College Museum, Calcutta. Koiiat, February,
1808.
Surgeon,
THE PENIS.
Switzek, F.R.C.S.I.,
6th Punjab
Infantry ;
Civil
Surgeon,
Kohat.
lad about 14 years of age, an inhabitant of Koorm, of Cabul, presented himself at the Kohat Dispensary on the 29th December, 1867. Ho had travelled a long distance in search of relief, and was most anxious to submit to anything that would remove the loathsome disease from which he suffered?progressive elephantiasis of the penis.
Jaffer,
in the
a
kingdom
History.?Three years ago he first felt his urine smart him severely when being voided. Shortly after he noticed an eruption on the penis and scrotum, which itched greatly. He at seems to have done nothing for it, and the disease went on, first slowly, then more rapidly, and during the last six months the organ increased so much in size and weight, in proportion to his age and stature, that it became truly burdensome, from the dragging sensation which the mass caused to the spermatic cords and loins.
On examination, the penis was found to be greatly enlarged, hard and cartilaginous to the touch, and contorted on itself; the prepuce thickened, and contracted into phymosis over a withered glans, an ichorous discharge welling out; the circumference at the largest part was seven inches, and the length four and a half inches. The diseased and thickened tissue extended to the root of the penis at the pubis, and was continued below on to the The organ could never be of any use for procreative scrotum. purposes, and the lad and his friends wished it removed. Accordingly, on the 31st December, kindly assisted by Dr. A. P. Holmes, (the boy being under chloroform,) I guarded the abdomen and scrotum with the thin blades of a bullet forceps, and swept the diseased mass away with a long amputating knife, as close to the symphisis as I possibly could Half a second was sufficient to do this, and to grasp the wound and control the spouting arteries, five of which required ligatures, the two of the corpus carernosuni being rather troublesome to secure. A female silver catheter was inserted into the patulous urethra; the wound dressed with wet lint, and secured by a T bandage. About an ounce of blood was lost. What was removed weighed seven ounces and three drachms. r The next day the wound was glazed over, and urine had freely The boy bad a good night's rust, and was very hungry. All went on well uutil the morning of the 3rd, when a good deal of inflammation was present, and the scrotum was much swollen, but there was no pain ; a clean tongue and quiet pulse. In order that it should be properly done, 1 fomented the parts myself with warm water for half an hour, and applied six leeches to the pubis. This checked the tendency to inflammation ; and on the 4th he The wound to be dressed with strong solution was much better. of permanganate of potash, and the scrotum supported on a pillow'. The lad eats well, and complains of nothing. Dowels freely open without medicine. 6th.?All inflammation subsided, and wound granulating healthily.
passed.
No further notes of the progress of the lad to recovery are necessary. The ligatures did not separate until the and the wound was wholly cicatrised on the 31st January, when he was discharged.
fifteenth*day,
Ilis appearance was of course one of great mutilation, but, from bis age and the probability of his never having known sexual desire, it is likely tie has not yet realized the extent of his misfortune. The penis and scrotum are continuous, there to being nothing represent the situation of the penis, but a small cicatrix and the opening of the urethra. He was furnished with a No. 9 bougie, and directed to the orifice pass it through
occasionally. Mr. Teal, of London, Las recommended that, after the performance of this operation, a bistoury should be made to divide the
end of the urethra into four parts, and that the mucous membrane and skin be brought together by sutures. The object to be attained is a patulous condition of the mouth, and the prevention of redundant skill overlapping. To me the proceeding appears difficult and unnecessary, if the skin is well drawn lorward before the knife is applied, no skin will be left in excels. The introduction of the catheter for two hours each day during the cure will effectually prevent contraction. 1 'll" penis has been put in spirits, and forwarded to the (JuratJi of the Medical
College Museum, Calcutta. Koiiat, February,
1808.
