Pedicel

“ When a hydrocele is found to be congenital, it must be at once obvious that to inject irritating fluids into the tunica vaginalis (the radical cure) is inadmissible. In an adult, free from all structural disease, and in whom a congenital hydrocele is occasioned by the gravitation of the ordinary serous secretion of the peritonaeum, a cure may be effected by causing the obliteration of the serous spermatic canal by the pressure of a truss. When a congenital hydrocele happens in an infant in whom the testicle, 5, Fig. ”

“ He also reports the case of a distinguished musician who, by reason of hypospadias, had never impregnated his wife, and had resorted to injections of semen with a favorable result. This latter case seems hardly warranted when we consider that men afflicted with hypospadias and epispadias have become fathers. Percy gives the instance of a gentleman whom he had known for some time, whose urethra terminated a little below the frenum, as in other persons, but whose glans bulged quite prominently beyond it, rendering urination in the forward direction impossible. ”

“ ON PEDICATION SO much for copulation in the normal way. We will now discuss another mode of pleasure,—that due to introduction of the member into the anus. A man who exercises his member in the anus, be it of a man or a woman, pedicates; he is called a pederast, pedicon, drawk [20] , and the other party, who allows himself to be invaded in that way, is called the patient, cinaedus, catamite [21] , minion, effeminate; if adult or worn out, he is named exolete. ”

“ No sooner has the development of the first of these reached a certain degree of completeness than others are formed in similar fashion. The first part of the invagination takes place, by which the future head comes to lie within the brood-capsule and the pedicle is no longer hollow but solid (e) ; the suckers and hooks are, however, still invaginated, and remain so for a considerable period. Seeing that the interior of the brood-capsule is lined with cuticle, it corresponds to the outside of the parent cyst, and hence is probably the representative of a previous invagination. ”

“ Nurses sometimes stroke or tickle a child's genitals in order to put an end to a screaming fit. But in some cases--and these are more numerous than is commonly supposed--nursemaids do this under the impulse of their own lustful feelings. Such actions are not necessarily the outcome of a perverse sexual impulse, although they may be due to such an impulse in the form of paedophilia, as I shall have to explain in detail when I come to describe that perversion. Frequently the offenders are not in the least aware of the danger of what they are doing, and do it merely in sport. ”

“ Another ingenious modification, sometimes useful in a short narrow pedicle, is to tie it as close to the cyst as possible, bring the ligature out at the wound, and then with a strong harelip needle transfix the pedicle, along with both sides of the wound, just below the ligature.
When the pedicle is excessively broad and stout, it should be transfixed by strong needles and double threads in various places, and thus tied in several portions. Absence of the pedicle greatly adds to the danger in any given case. ”

“ A man was spoken of in both France and Germany a who passed for many years as a female. He had a cleft scrotum and hypospadias, which caused the deception. Sleeping with another servant for three years, he constantly had sexual congress with her during this period, and finally impregnated her. It was supposed in this case that the posterior wall of the vagina supplied the deficiency of the lower boundary of the urethra, forming a complete channel for the semen to proceed through. ”

“ The infected child should sleep by herself, and utmost care must be exercised in preventing her fingers from first touching the itching vulva and then placing them to the eyes or to the mother's eyes. A vulva pad must be worn as long as the disease lasts. The physician will give you the proper medicines to be used in these cases, and if no physician is within reach, you are perfectly safe in dropping into the spread apart vulva a few drops of twenty-per-cent argyrol and then applying the vulva pad. After each treatment the hands of the mother or nurse must be most rigidly cleansed. ”

“ Whether the seduction be the work of other children or of adults, the child thus led astray is likely subsequently to induce artificially as often as possible the agreeable sensations with which it has now been made acquainted, more especially in view of the fact that in children the imitative impulse is far more strongly developed than it is in adults, in whom imitative inclinations are counteracted by numerous inhibitions. What is true of seduction is true also of the various affections of the genital organs which induce an impulse to scratch, such as eczema, prurigo, urticaria, &c. ”

“ It appears that here the children were in the habit of swinging on a chain suspended between two pillars, and that the watchers waited to catch a glimpse of the children's genital organs, or merely of their bare legs, when their petticoats flew up occasionally in the act of swinging. Many pædophiles become sexually excited at the mere sight of children sympathetic to them. In other cases, by no means rare, men experience sexual excitement whenever they see a little girl with short petticoats ”

“ The surgical interest of this disease lies in the fact that it is frequently complicated by pain and swelling of the testis, œdema of the scrotum, and occasionally by a urethral discharge, and atrophy of the testis has been observed after such an attack. In females there is sometimes pain in the ovary, tenderness and swelling of the mamma, and a vaginal discharge. ”

“ Sometimes, in other cases, the foreskin becomes inflamed, offensive secretions may form about the end of the penis, etc. All such disorders should be submitted to a judicious physician at once, to avoid irritations which might result in a tendency to sexual excitement—a calamity truly deplorable to the young. The idea which some writers advance—that a long prepuce (or foreskin) often proves an exciting cause of troublesome sensations to the boy, is certainly erroneous. ”

“ Surgeons know that sarcoceles, hydroceles by effusion, varicoceles and all the diseases of the testicles are as rare before the period of puberty, when nutrition only is going on in these glands, as they are common in the subsequent years.
It appears that it is the mucous glands which are then the most commonly affected and are consequently in the greatest activity. The lachrymal glands are also very frequently in action. The infant weeps more often than the adult; we might say that all the passions which agitate this age have but one uniform mode of expression, and this mode is weeping. ”

“ In other cases the child may be seen handling his genital organs, either openly or beneath his clothing. Often, in the absence of manual stimulation, the child adopts some other means of stimulating his genital organs. Thus, in girls the legs will be crossed, and the thighs rubbed lightly each against the other. In other cases, both in boys and in girls, the child will lean against a piece of furniture in what appears to be a perfectly innocent manner; but in reality pressure is being exercised on the genital organs, it may be by the corner of a table, it may be by the back of a chair ”

“ If he has practiced the habit only in a very limited way, so that he is not suffering from any bad consequences, postponement of marriage is not necessary.
What should a young man do when he discovers that he has varicocele?—The approach of this disease is first noticed by a dilation of the cord leading to the epididymis of the left testis. When the veins become full of impure blood and feel like a handful of tangled earthworms and the left gland becomes painfully tender and begins to become much reduced in size, then the individual has a real case of varicocele. ”

“ She thus takes the opportunity of investigating the boy's penis to find out how it works, etc., in order to satisfy her curiosity. I know of a case in which a nurse in a fashionable London Square garden used to collect all the boys and girls (gentlemen's children) in a summer-house when it grew dark, and, turning up her petticoats, invite all the boys to look at and feel her vulva, and also incite the older boys of 12 or 14 to have coitus with her. Girls are afraid of pregnancy, so do not allow an adult penis to operate. I think people should take on a far higher class of nurses, than they do. ”

“ It will not always be your fault if the baby's navel is not small and flat when you are leaving your case, but you will always be blamed for it, if it is not. Notice carefully every morning when you bathe the child if there is any umbilical protrusion, and report it without delay to your doctor, if there is any, no matter how slight. This is not, however, the place to treat of umbilical hernia, and we will go on with the washing, If the child's skin is very tender, chafing easily, wash with castile soap suds, rinse and dry carefully, after every time he urinates, as well as when you bathe him. ”

“ Before introducing these, he will generally find it necessary to ligature a small artery on each side of the penis, and one or two in the frænum. The best dressing in children will be some simple ointment, such as boracic acid ointment, or the glans may be simply smeared with a little vaseline. After every act of micturition the parts should be well sponged with boracic acid lotion or Condy's fluid and water. 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. ”

“ When a piece of healthy tissue is removed from the body and immersed in a sterile solution, and absolutely isolated from the atmosphere, decomposition is indefinitely postponed, but as soon as unsterilized air is allowed access to it, putrefactive changes ensue. The pedicle after ovariotomy is in an air-tight chamber, and if the tissues included by the ligature are healthy, and the silk employed for the purpose is absolutely aseptic, this pedicle, when returned into the abdomen, resembles the piece of tissue isolated from contact with the atmosphere. ”

“ In the child, however, we sometimes find the symptoms produced by difficulty in making water owing to the length of the prepuce and the extreme narrowness of its orifice, which may even be scarcely large enough to admit the head of a pin. This congenital phimosis is, I may add, not an infrequent occasion of incontinence of urine in children, and is also an exciting cause of the habit of masturbation, owing to the discomfort and irritation which it constantly keeps up. ”

“ Nevertheless, there may arise, in connection with the operation of venesection, a number of questions which are quite likely to puzzle an inexperienced physician and perhaps lead him into error. For example, infants and old people possess as a rule diminished vigor, and the woman who is about to be confined needs all her strength for the period following delivery, both for herself and for the nourishing of the child. ”

“ The testicles, thus suspended, have two coats, one adhering closely, and the other loosely surrounding the former—between the two, a lubricating fluid is secreted, whereby the various movements of the body are permitted [16] without injury; it is between these coats that water is secreted occasionally, constituting the disease known as hydrocele. The closely fitting coat is termed from its whiteness and density Tunica Albuginea—the other Tunica Vaginalis. These coverings are formed of that extensive membrane in the abdomen called the Peritonœum. ”

“ During the first period of childhood, that is to say, up to the end of the seventh year of life, the occurrence of manifestations of the sexual impulse must arouse suspicions of the existence of a congenital morbid predisposition. But as regards the phenomena of detumescence, which are confined to the peripheral genital organs, we must make an exception to this rule if they do not appear spontaneously, but result either from local inflammatory or other morbid changes, or from deliberate seduction of the child to the performance of sexual manipulations ”

“ Afterwards, Antyllus uses sutures and the treatment for recent wounds; but the moderns have recourse to what is called the incarnative mode of treatment. If the testicle is found in a state of putrefaction, or otherwise diseased, the vessels which pass along with the cremaster are to be separately inclosed in a ligature, the cremaster cut, and the testicle removed. And when there are two hernias we may operate in the same manner twice, directing the incisions on both sides at the parts of the scrotum about the loins. ”

“ Pustular eruptions upon the scalp, especially posteriorly, should always arouse a suspicion of pediculosis. The possibility of the pediculosis being secondary to eczema must not be forgotten.
What is the treatment of pediculosis capitis?
Treatment consists in the application of some remedy destructive to the pediculi and their ova. Crude petroleum is effective, one or two thorough applications over night being usually sufficient ”

“ It is a disease incident to every period of life, but more commonly met with in grown persons. The ordinary formation of hydrocele is unattended with pain; and the patient [70] accidentally discovers the existence of the swelling, but oftentimes not until it has attained a considerable magnitude. The tumor, when large, produces an unsightly appearance, and forms a hindrance to sexual intercourse, from the integuments of the penis being involved therein, and thereby preventing a perfect erection of that organ. The disease may appear to originate spontaneously ”