Pubic bone

“ The penis can then be shelled out, the prepuce being first cut through around the corona glandis. If lateral flaps can be formed of sound skin they are then dissected up. The perineal and pubic incisions are now deepened and, assistants holding the testes and penis well out of the way, the neck of the tumour is cut through close to the perineum and pubes. Gaping vessels are all carefully ligatured, redundant tunica vaginalis—if hydroceles be present—being excised. ”

“ Lithotomy above the Pubes, or the High Operation.—In cases where, from the known size of the stone, or from the deformity of the bones of the pelvis, it is impossible that the stone can be extracted entire in the usual manner; in cases where the prostate is very much enlarged, or where there is any real or supposed likelihood of inflammation of the neck of the bladder, the supra-pubic operation may be warrantable. Its performance is easy, it does not involve any wound of the peritoneum if properly performed, and there is no risk of hæmorrhage. ”

“ The urethral aperture of the triangular ligament appears removed at this distance below the pubic symphysis, and that portion of the canal which lies behind the ligament, and ascends obliquely backwards and upwards to the vesical orifice on a level with the symphysis pubis in the adult should be remembered, as varying both in direction and length in individuals of the extremes of age. In the young, this variation is owing to the usual high position of the bladder in the pelvis, whilst in the old it may be caused by an enlarged state of the prostate. ”

“ Owing to the inclination of the pelvis, the base of the sacrum is nearly 4 in higher than the upper border of the pubic symphysis. The female pelvis is distinguished from the male by certain sexual characters. The bones are more slender, the ridges and processes for muscular attachment more feeble, the breadth and capacity greater, the depth less, giving the greater breadth to the hips of a woman ; the inlet more nearly circular, the pubic arch wider, the distance between the tuberosities greater, and the aceta- bulum smaller in the female than in the male. ”

“ But to name this great pelvic bone was a difficulty with me. I was under the impression that its broad, smoothly expanded surface might be best compared with that of an ischium [3] or pubis, and that this would be more suited to the broad depressed body (as I supposed it to be) of such a huge creature, than, by accepting it as an ilium, to admit the beast to have been narrow in the rear, like a bird, with the plane of the bone not much inclined from the vertical. ”

“ With people that have been circumcized, the skin must be detached behind the crown of the gland. This operation is not very painful as the prepuce being loosened, you can draw it with the hand back to the pubis without any loss of blood.
Then the loosened integument is drawn once more over and beyond the gland. This done the verge is dipped frequently into cold water, and then covered with a plaster, which has a strong tendency to minimize inflammation. As soon as it is quite free from inflammation, the verge is to be bandaged from the pubis to the annular incision ”

“ So small is the line of separation described between these herniae by the ligament, that this (so to express the idea) stands in the character of an arch, which, at the same time, supports an aqueduct (the inguinal canal) and spans a road (the femoral sheath.) The femoral arch, A I, Fig. 1, Plate 43, extends between the anterior superior iliac spinous process and the pubic spine. It connects the aponeurosis of the external oblique muscle, D d, Fig. 2, Plate 44, with F, the fascia lata. Immediately above and below its pubic extremity appear the external ring and the saphenous opening. ”

“ The finger will enter a quantity of brick-dust coloured pus in the cellular substance around the bladder, and if considerable force has been used in the extraction of the stone, will readily find its way towards the wound in the perineum; the barrier between the adipose structure of the perineum and the reticular texture of the pelvis being broken down, the suppurative inflammation spreads rapidly along the latter, and may be traced in some cases, between the peritoneum and abdominal muscles, as high as the umbilicus ”

“ The prostate gland, V, surrounds its neck, and occupies a position behind and below the pubic arch, D, and in front of the rectum, W. The gland, V, being of a rounded form and dense structure, can be felt in this situation by the finger, passed upwards through the bowel. The prostate is suspended from the back of the pubic arch by the anterior true ligament of the bladder, and at its forepart, where the membranous portion of the urethra commences, this passes through the deep perinæal fascia, X. The anterior fibres of the levator ani muscle embrace the prostate on both its sides. ”

“ The ova may be seen attached to the hair-shafts.
It infests adults chiefly, being in many instances probably contracted through sexual intercourse.
Is the pediculus pubis found upon any other part of the body?
Yes. Although its favorite habitat is the region of the pubes, it [Pg 276] may, in exceptional instances, also infest the axillæ, the sternal region of the male, the beard, eyebrows, and even the eyelashes.
State the diagnostic characters of pediculosis pubis. ”

“ The first step is to make an incision in the upper part of the scrotum, the direction in which it is to be carried being toward the symphysis pubis. When the hernial sac is reached the staff is introduced into the slit and pushed upward between the wall of the sac and the fleshy part of the penis, the flat side of the instrument being kept uppermost, as it is upon this surface that the cutting with the scalpel or the razor is to be done. After the end of the staff has been pushed well upward the flesh of the scrotum is to be divided upon the flat surface of this instrument ”

“ The physiological purpose of the pubic hair is to prevent irritation of the genital organs by the sweat that would otherwise run down upon them, and to protect the skin from direct friction during the act of copulation.
The labia majora in women during the menacme are usually strongly developed, their outer surface is hairy; in parous women we almost invariably observe small or even large lacerations of the frænulum pudendi or fourchette, in front of the posterior commissure of the vulva. ”

“ There being four varieties of it, according to Leonides; three of them occur in men and one in women. In men, sometimes about the perineum and sometimes about the middle of the scrotum, there is the appearance of a female pudendum with hair; and in addition to these there is a third variety, in which the discharge of urine takes place at the scrotum as from a female pudendum. In women there is often found above the pudendum and in the situation of the pubes the appearance of a man’s privy parts, there being three bodies projecting there, one like a penis, and two like testicles. ”

“ And if the penis is pressed between the finger and thumb, matter or pus exudes. As the inflammatory stage commences, the formation of pus is increased, which changes from a thin to a thick yellow color, accompanied by a severe scalding on making water. The inflammation increases up to the fifth day, often causing such pain, on urinating, that the patient is tortured severely. When the disease reaches its height, the erections become somewhat painful, when the discharge may be streaked with blood. ”

“ The growth of the denser pubic hair begins with the appearance of hairs along the middle of the mons Veneris and at the margins of the labia majora. Early sexual development is commonly indicated by an early and thick growth of the pubic hair. ”

“ In all cases it is situated above the centre of a man’s height. It is a vulgar error to say that when a man lies with legs and arms outstretched, and a circle is drawn round him, the umbilicus lies in the centre of it. This central point is in most persons just above the pubes.
In very corpulent persons two deep transverse furrows run across the abdomen. One runs across the navel and completely conceals it. The other is lower down, just above the fat of the pubes. In tapping the bladder above the pubes in such a case, the trochar should be introduced where this line intersects the linea alba. ”

“ The penis can stand any amount of forcing backward; it stands this in cancer or hypertrophy of the prepuce, or in the inflammatory thickenings that precede gangrene of the prepuce, in any extended degree; becoming, for the time being, more or less atrophied. As has been shown by Lisfranc, the penis can be made nearly to disappear into the pubes ”

“ During convalescence they ought to use rubefacients, and natural baths in a cold state. Cases occurring from a wound of the spine, from a fall and dislocation of a vertebra, if there be a concurrence of fatal symptoms, it is impossible to remedy. If the penis is paralysed, we must apply the remedies recommended for the bladder to the same parts, and also to the groin; and medicines which excite to erections ought also to be used. Milk, cheese, and the other cakes are improper, likewise lettuces and the other pot-herbs. ”

“ Of a violent inflammation of the penis, which had originated in unclean intercourse with a beast, with a coruncle, or knot, constricting the urethra, cured in a manner to the last degree empirical and cruel. The penis being laid on a rough stone, the Physician suddenly when the patient was not expecting it, struck it as heavily as ever he could with his doubled fist, so that the stoppage and ulcer might burst. This case has a smack of the Venereal disease about it; and might serve as an argument for those who hold that this disease was known to the Ancients as well. ”

“ The superficial fascia of the hypogastrium, the scrotum, and the perinaeum forming a continuous membrane, and being adherent to the several parts above noticed, may be regarded as a general double sac, which isolates the inguino-perinæal region from the femoral and anal regions, and hence it happens that when the urethra becomes ruptured, the urine which is extravasated in the perinaeum, is allowed to pass over the scrotum and the abdomen, involving these parts in consequent inflammation, whilst the thighs and anal space are exempt. ”

“ This masculine form of the pubic hair is by no means common in women; according to Lombroso it is met with more frequently in Italian women than in those belonging to other European nations. In most women, the thick hairy covering of the mons Veneris is sharply limited above by the curved line that indicates the upper margin of the eminence, whereas in men a strip of hair usually passes up from the mons pubis to the umbilicus. ”

“ In like manner, if the sore become spreading, or otherwise malignant, we must suit the applications to the state of it. When the ulcer is freed from inflammation we may loose the dressings, and use diachylon plaster to the groins and bottom of the belly. During the whole time of the treatment, the thighs must be bound together, which contributes to the cure with the other remedies. If the stone, being small, fall into the penis, and cannot be voided with the urine, we may draw the prepuce strongly forwards, and bind it at the extremity of the glans. ”

“ If then the man be standing erect we give orders to the assistants standing behind to press with their hands and push downwards the swelling to the pubes. Then taking a sharp-pointed knife or lancet, if the dropsy is among the intestines, in the perpendicular line of the navel, and about three fingers’ breadth distance from it we divide the hypogastrium as far as the peritoneum. But if the liver be primarily affected we must make our incision on the left side of the navel ”

“ He must know the form and size of the bones of a woman, how large a hole the three bones of the pelvis make, for the reason that the child's head will soon come through that hole. He must know a normal head cannot come through a pelvis that has been crushed in so much as to bring the pubis within one and one-half to two and one-half inches of the sacrum. ”