This, as we have seen, is an almost necessary consequence of the operation, the swelling making its appearance a short time after the alteration is accomplished. It usually first affects the parts immediately around the edges of the wound, and spreads forwards and upwards in such a manner that the entire scrotum and sheath become the seat of it. It is somewhat warm, tense, and slightly painful. If there is no increase beyond these limits, there is no occasion for alarm, as by exercise, fomentations, and scarifications, with the administration of diuretics, it ordinarily subsides. But if it continues to increase, and extends upwards and backwards, involving the inside of the thighs and the perineum, loses its character of heat and soreness, to become cold and painless, crepitating under pressure, we must prepare to encounter the most severe of all complications, that of gangrene, requiring the most prompt and vigorous treatment, as we shall presently see. It may also happen that even while retaining the characteristics of healthy œdema, it may assume such dimensions that the penis becomes so involved that phymosis and paraphymosis may supervene, to add to the other complications. These, however, are not serious sequelæ, as by proper care, with fomentations or scarifications, and the use of a suspensory bandage, they may be readily overcome. GANGRENE. This accident may be looked for from the fourth to the eighth day, manifesting itself not only by the extent which the œdema of the scrotal region assumes, and by its characteristics of coldness, loss of sensibility, and crepitant feeling, but by the fœtid odor proceeding from the wound, and by a change in the character, or the disappearance of the suppuration, which is succeeded by a sanious, bloody and offensive discharge. To this series of symptoms are to be added a marked increase of the general disturbance, manifested by increased thirst, anorexia, fœtid mouth, change of color in the mucous membrane to a livid hue, increase of pulse, with weakening, increased respiration, temperature at first elevated and then diminished, and after five or six days a final termination in the death of the patient. The progress of this complication is so rapid, and the chances of recovery are so few, that the necessity for prompt treatment becomes at once obvious. All the diseased and mortified parts must be removed at once, and means instantly employed to prevent the absorption of gangrenous matter. Friction with ammoniacal and turpentine liniments must be used over the swelling; the parts must be subjected to the actual cautery at white heat, and disinfecting agents of all kinds must be freely used, as chloride of lime, carbolic acid, and permanganate of potash, while internal treatment must immediately be instituted by the administration of stimulants and antiseptics in the form of ammonia and phenic acid, or its preparations. ABSCESSES.