On account of the straining required to urinate, prolapsus ani, hernia, and hydrocele of the cord sometimes develop. Symptoms may arise from preputial adhesions, as well as phimosis. Frequent or difficult micturition, nocturnal incontinence, priapism, pruritus, and masturbation may develop out of the irritation, as well as nervous manifestations, such as insomnia and night terrors. The condition should be recognized and corrected in infancy. If the adhesions are dense, an incision can be made down the dorsum of the prepuce, the tissue forcibly separated from the glans, and the flaps cut off. Stitches may be required. In other cases circumcision may be necessary. =Paraphimosis.=—When a prepuce with a small orifice is forcibly retracted over the glans, it occasionally happens that it cannot be pulled forward again. If allowed to remain this way, the parts will swell, and the penis become strangulated as if with a ligature. The danger arises from the stoppage of the circulation, which may be followed by ulceration and gangrene. Reduction must be brought about by manipulation, if possible, but where this fails, the constricting band must be cut through and sedative applications used. =Balanitis= is inflammation of the prepuce from the decomposition of smegma, which collects under a tight foreskin. The condition is quickly relieved by cleanliness and a few applications of vaseline or zinc oxide ointment. Circumcision should not be done until the inflammation has subsided. =Circumcision=, either as a physical necessity or as a religious rite, is frequently performed. The nurse prepares a table with sterile linen, a basin with antiseptic solution and sponges, sterile towel, and sterile vaseline, with a roll of gauze bandage an inch wide. The object of the operation is to remove the prepuce and leave the glans exposed. The instruments needed are a pair of sharp scissors, a pair of dissecting forceps, two pairs of artery forceps, small, full curved needles, and fine catgut. The nurse gives the child some gauze to suck, which has been soaked in brandy and sugar-water, brandy one dram to an ounce of water. Then taking her place at the child’s head, she flexes the thighs back upon the abdomen, and widely separates them. The field of operation is thoroughly washed with soap and warm water, the prepuce is then retracted and the smegma wiped away. Then the body and limbs should be covered with clean linen, except the penis, or a sterile towel may be used with a hole in it through which the penis is drawn. The redundant tissue is removed and fine catgut sutures put in. The operation being completed, the wound is covered with sterile vaseline and wrapped with a sterile gauze bandage, leaving the end of the glans exposed. [Illustration: Fig. 128.—Hydrocephalus. (Bumm.)]