Note of a Successful Case of Extirpation of Penis for Cancer

aspect, however, the growth has not quite reached the root of the organ and the pubic skin is free. The testicles are unaffected, and the glands of the groin are not enlarged. Oil the following day the patient was put under the influence of chloroform, and, kindly assisted by Surgn.-Lt.-Col. Fawcett, and Suvgn.-Lieut. Mitter, i.m.s., I completely ire^moved the organ by the method advocated by Mr. Gould. The patient was put in the lithotomy position, and an attempt made to pass a sound; but the urethral orifice could not be discovered owing to the friable and distorted condition of the parts due to the presence of the cauliflower excrescences. The scrotum -was then split in the middle line along the whole length of the raphe ; and the corpus spongiosum after being isolated by careful dissection was divided transversely far back, just sufficient length of the tube being left to allow of it beingbrought out on to the periuteum. The crura were?then detached from the pubic and ischial rami by the aid of the knife and rasparatory, and the original incision was next prolonged around the root of the penis above, going well, up 011 to the pubes and giving the growth awide margin. The suspensory ligament was cut through, and the whole penis removed en masse^ with a wide strip of scrotum which had been included in the racquet-shaped incision above> described. Considerable difficulty was'experi-; enced in securing the internal pudic arteries as. they emerged from the triangular ligament on account of the density and tight Stretching of that structure, and the haemorrhage was only! arrested after detaching a portion of the ligament ? from the sides of the arch and so relaxing it.; The urethra was now slit up for a short distance