The Barbarity of Circumcision as a Remedy for Congenital AbnormalitySnow, Herbert
Philosophy
The Barbarity of Circumcision as a Remedy for Congenital Abnormality
Snow, Herbert
Circumcision; Penis -- Abnormalities
In the adult, union by first
intention may often be obtained by a dry dressing of iodoform-wool
thickly covered with collodion, so as to protect it from the urine.
This may be left unchanged for four or five days. _There is usually
a good deal of swelling of the mucous membrane about the frænum,
and some solid oedema usually remains for some weeks after the
operation._ This gradually subsides, and a linear cicatrix
remains, which causes the patient no inconvenience....
_The chief points to be attended to in the performance of this
operation, and on which its after-success is most dependent,
are_--1. That too much skin be not removed; 2. That the mucous
membrane be slit up to the base of the glans; 3. That too much of
it be not removed; 4. That all bleeding vessels be tied with catgut
ligatures, which must be cut short; 5. That the mucous membrane be
well turned back, so as to cover the gap left by the retracted
skin; 6. That all sutures be of catgut, which will be absorbed, and
thus save the pain of taking them out.
The _modus operandi_ of different surgeons varies in particular details,
usually of a slight and unimportant character. The pithy description
contained in Maunders _Operative Surgery_ may be appropriately quoted:
The extremity of the foreskin being seized with forceps is drawn
well forwards; the whole prepuce is embraced with the blades of
dressing-forceps, immediately anterior to the _glans penis_, and
cut off in front of the latter instrument. As soon as the forceps
are removed, the skin will become retracted, leaving the mucous
membrane still about the glans; this is slit up longitudinally as
far as the corona, when it may be turned back, and its edge will
come into apposition with the circular wound in the skin. The
operation is now complete; but in the adult it will be well to
introduce a few interrupted sutures.
The prepuce has sometimes been _slit up longitudinally on a director_.
Although well suited to cases of adventitious phimosis in the adult, the
method is in no way adapted to the congenital form, and has never found
general favour with the medical profession. It has no advantages over
circumcision; although retaining the prepuce, it still leaves the glans
largely uncovered; and the sharp corners of the divided skin, unless
trimmed and rounded off, produce a very unsightly after-appearance.
Public-domain text, read in full here on John Shaqi.
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