When the penis of an infant is in a state of erection the operation of circumcision can be more easily performed and the dressing more efficiently applied. The manipulation of the organ necessary to grasp the prepuce is generally sufficient to stimulate the increased blood supply requisite for an erection. The skin of the penis does not share with the rest of the organ, a greater amount of blood during this state. It stretches by its own elasticity. All the arteries and veins of the penis run in the deep structures previously alluded to, so that circumcision, in an infant at any rate, can never wound a blood vessel. The _Frænum is freely supplied with blood_, and if cut will produce troublesome hæmorrhage, but a circumcision in no way interferes with this part. [Illustration] CHAPTER V. _Technique of Operation._ A good light is essential for the performance of circumcision. The instruments required are as follows:-- 1) _Knife_ of steel, to be made of one piece of metal without joints, crevices or any ornamentation whatsoever. The handle should be stout enough to permit a firm grasp upon it. The blade should be about 5 inches in length and fully half inch in width. 2) _Shield._ This is a metal plate with a centre slit, the edges of which are made to grasp the prepuce at the level of the amputation. The Shield protects both the glans penis and the scrotum from injury by the knife. 3) _Scissors._ These are required occasionally to cut through the mucous membrane. They should be of the pattern known as the “_blunt pointed_.” When it is evident that the mucous membrane is very adherent to the glans, the separation of these two structures may be effected by the use of a _Probe_. This is a thin metal rod which is easily inserted under the mucous membrane and swept round the glans so as to break through the adhesions. The person who is to hold the infant, is seated on a chair with his feet on the side rail of a second chair so as to keep the knees raised. The latter must be kept close together. A firm pillow is placed on the knees and the infant is laid thereon facing the Mohel. When the necessary clothing has been loosened, the thighs and knees are bent up completely (flexed) and then the thighs are in addition rotated outwards, and kept in this position by the hands of the individual holding the infant. The clothes should be displaced behind the buttocks of the infant so as to raise the part. The antiseptic preparations described in Chapter iii. having been carried out, the operation is performed according to the following stages.