Of the PHYMOSIS.
THE Phymosis signifies no more than
such a Straitness of the Prepuce, that the
Glans cannot be denuded; which if it
becomes troublesome so as to prevent the Egress the Urine, or conceal under it Chancres, or foul Ulcers, quite out of the
Reach of Application, is to be cut open. It sometimes happens, that Children are born imperforate; in which Case, a small Puncture, dressed afterwards with a Tent, effects a Cure: but this Operation is chiefly practised in venereal Cases, in order to expose Chancres, either on the Glans or withinside the Prepuce itself: And here, if the Prepuce is not very callous and thick, a mere Incision will answer; which may be made either with the Scissars, or by slipping a Knife between the Skin and Glans to the very Extremity, and cutting it up: The last Method is more easy than that of the Scissars, but it is safer to make the Wound on one Side the Prepuce than upon the upper Part, for I have sometimes seen the great Vessels on the Dorsum Penis afford a terrible Hæmorrhage, which may be avoided by following this Rule; tho' the Prepuce remains better shaped after an Incision made in the upper Part, and therefore is to be preferred by those who understand how to take up the vessels. In Children it sometimes happens that the Prepuce becomes very much contracted; and in that Case, it is accidentally subject to slight Inflammations, which bring on some Symptoms of the Stone; but the Disorder is always removed by the Cure of the Phymosis.
If the Prepuce be very large and indurated, the Opening alone will not suffice, and it is more adviseable to take away the Callosity by Circumcision, which must be performed with a Knife; and if the Artery bleed much, it must be taken up with a small Needle and Ligature: It may be worth remarking here, that in certain Phymoses, the Prepuce becomes so thickened, and at the same time so elongated, that it resembles the Body of the Penis, and has led some into the Mistake of supposing they had cut off a Portion of the Penis itself, when it was only a monstrous Phymosis.