In this case the difficulty was evidently both the result of mechanical pressure and reflex irritation. A somewhat similar case as to its results is given by Dr. Sayre, to whom the case was reported by Dr. A. R. Mott, Jr., of Randall's Island, in January of 1880: "John English, aged 46, native of England, widower, clerk; admitted to workhouse hospital. Patient had been at work for a week as a prisoner; on the 23d of December was noticed to be restless and uneasy, and finally, in the evening, he fell from his bunk in a fit. During the next forty-eight hours he had several convulsions, and during the intervals lay in a semi-comatose condition, showing no consciousness except to stir a limb when pinched. Pulse, 120; temperature, 1011/2 deg.; respiration, 18. Swallowed nothing, and passed faeces in bed. Continued in this condition until December 25th (temperature having fallen to 100 deg.), when a string was discovered passed twice around the penis behind corona and tied, the long prepuce serving to conceal it from observation. While not sufficiently tight to occlude the urethral canal, still a firm, indurated band remained after the string was cut, and did not disappear for four or five days. "Within one hour after the removal of the string the man sat up and asked for milk, and from this time remained perfectly well (was under observation for three months). He declared that he remembered nothing that had taken place during the past three days; had never had fits, denied venereal diseases, was moderately addicted to drink, but had led a 'virtuous life since the death of his wife, two years before.'" The following case in the practice of Dr. F. J. Wirthington, of Livermore, Pa., was also reported to Dr. Sayre: "When the child was born, he was considered the biggest and finest boy that had been born in the community for a long time, until, when he was about two and a-half years old, and being sick, a doctor was called in, who told them that their child was paralyzed, the paralysis being in his lower extremities, and who treated him with the usual nerve-tonic and with electricity. Notwithstanding all this, the boy went steadily down, and the paralysis continued until he was seen by Dr. Wirthington. The child was then unable to walk; on examination, the prepuce was found to be adherent almost all the way around the glans penis. Behind the corona was a solid cake of sebaceous matter. The case was promptly operated upon, and, although the previous attendant had not found any cause to account for the paralysis, a rapid recovery took place, the boy being able to walk even before the complete cicatrization of the wound, and was soon the picture of health."