As a rule, simple hypertrophic disease of the penile integument does not interfere with the sexual functions of the male organ after its removal; it being susceptible of complete removal in exaggerated cases, even without touching the body of the organ. There are exceptions to this rule, however, when even this otherwise non-malignant disease may entail the loss of all the genitals. In the London _Lancet_ of July 11, 1846, at page 46, there is a record of a remarkable case of this nature reported by F. H. Brett, Esq., F.R.C.S. The case was that of a locksmith of forty years of age, who was naturally much phimosed. The penis was enormously enlarged, as well as the scrotum, which was more or less ulcerated and full of sinuses filled with a serous pus; some six months prior to the final operation, a part of the prepuce was removed to facilitate urination, but the whole mass had to be subsequently removed, including the whole of the skin of the penis and the scrotum, the testicles having been carefully dissected out and recovered with some skin flap. In this case the disease was believed to have originated from a perineal fistula. The pathological investigation in the case, however, by Mr. Quekett, who submitted the mass to a microscopical examination, confirmed Mr. Brett in his original opinion that the disease had the same pathological conditions as the similar disease found in India, where it originates from local inflammatory causes. In this case the preputial irritation was, in all probability, the precursor of the conditions that led to the perineal fistula, the patient having had a stricture for some twelve years. Mr. Brett states that the man had been abandoned by his wife on account of his previous sexual disability, and on account, as well, of his having been incapacitated from following any vocation. After the operation all his functions were restored and his organs were sound. Nelaton records a case reported by Wadd, in 1817, of an African negro so affected, whose penis measured fourteen inches in length and twelve and a half inches in circumference; also the case reported by Gibert, of Hospital St. Louis, of a subject "with a penis the size of a mule's."