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It is usually taught that a great variety of causes is concerned in producing enuresis. It is said to be due to a partial asphyxia during sleep from adenoid vegetation. It is said to be caused by phimosis, and to be cured by circumcision. It is said that the urine is often too acid and so irritating that the bladder refuses to retain it for the usual length of time.
In concealed chancres with phimosis, the sac of the prepuce should be slit up along the dorsum to admit of the ointment being applied. If phagedæna occurs, the prepuce must be slit open along the dorsum, or if sloughing, cut away, and the patient should have frequent sitz baths of weak sublimate lotion.
+157+. As circumcision is often performed shortly before marriage it has been suggested that its object is to increase procreative power by preventing phimosis. The opinion that such is its effect, though it has no scientific support, has been and is held by not a few persons.
Baly mentions a case of epilepsy occasioned by irritation in the socket of a tooth. Webber reports a case of epilepsy due to phimosis and to irritation from a tooth. Beardsley speaks of an attempt at strangulation that produced epilepsy. Brown-Sequard records an instance produced by injury to the sciatic nerve. Doyle gives an account of the production of epilepsy from protracted bathing in a pond.
In one case 22 small stones were removed, and in the other a single calculus weighing one ounce 110 grains. Congenital phimosis is said to be very common among the natives of Solomon Islands. In September, 1695, Bernard removed two stones from the meatus urinarius of a man, after a lodgment of twenty years. Block mentions a similar case, in which the lodgment had lasted twenty-eight years.
Circumcision is practiced in nearly every portion of the world, and by various races, sometimes being a civil as well as a religious custom. Its use in surgery is too well known to be discussed here. It might be mentioned, however, that Rake of Trinidad, has performed circumcision 16 times, usually for phimosis due to leprous tuberculation of the prepuce.
Had my father been asking after the amputation of the tail of a puppy-dog he could not have done it in a more careless air: the system which Dr. Slop had laid down, to treat the accident by, no way allowed of such a mode of enquiry. He sat down. Pray, Sir, quoth my uncle Toby, in a manner which could not go unanswered, in what condition is the boy? 'Twill end in a phimosis, replied Dr. Slop.
The incomplete or irregular development is more frequent, but most common is excessive development of the prepuce, constituting phimosis, when there is abnormal adherence with the glans. Instances of phimosis, being quite common, will be passed without special mention. Deficient or absent prepuce has been observed by Blasius, Marcellus Donatus, and Gilibert.
At the orifice of the prepuce the primary lesion assumes the form of multiple linear ulcers or fissures, and as each of these is attended with infiltration, the prepuce cannot be pulled back a condition known as syphilitic phimosis.
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