The vulva swells and discharges much mucus

The vulva swells and discharges much mucus

The vulva swells and discharges much mucus

At the natural period of parturition preparations are apparently made for that act. The vulva swells and discharges much mucus, the udder enlarges, the belly becomes more pendent, and the animal strains more or less. No progress is made, however; there is not even opening of the neck of the womb, and after a time the symptoms subside. The mare usually refuses the male, yet there are exceptions to this rule. If the neck of the womb has been opened and putrefying changes in its contents have set in, the mare loses appetite and condition, pines, discharges an offensive matter from the generative passages, and dies of inflammation of the womb and putrid infection. In other cases there is a slow wearing out of the strength, and she finally dies of exhaustion.

Hence the latter has been born alive at the four hundredth day

Hence the latter has been born alive at the four hundredth day

Hence the latter has been born alive at the four hundredth day

The mere prolongation of gestation does not necessarily entail the death of the foal; hence the latter has been born alive at the four hundredth day. Even when the foal has perished putrefaction does not set in unless the membranes (water bags) have been ruptured and septic bacteria have been admitted to the interior of the womb. In the latter case a fetid decomposition advances rapidly, and the mare usually perishes from poisoning with the putrid matters absorbed.

Such as lack of contractile power in the womb

Such as lack of contractile power in the womb

Such as lack of contractile power in the womb

Cause. The cause may be any effective obstruction to the act of parturition, such as lack of contractile power in the womb, unduly strong (inflammatory) adhesions between the womb and the fetal membranes, wrong presentation of the fetus, contracted pelvis (from fracture or disease of the bones), or disease and induration of the neck of the womb.

Prolonged Retention of The Fetus (Foal).

Prolonged Retention of The Fetus (Foal).

Though far less frequently than in the case of the cow, parturition may not be completed at term, and the mare, to her serious and even fatal injury, may carry the foal in the womb for a number of months. Hamon records one case in which the mare died after carrying the fetus for 17 months, and Caillier a similar result after it had been carried 22 months. In these cases the fetus retained its natural form, but in one reported by Gohier the bones only were left in the womb amid a mass of apparently purulent matter.

Paralysis.

Paralysis.

The pressure on the nerves of the pelvis is liable to cause paralysis of the hind limbs or of the nerve of sight. These are obstinate until after parturition, when they recover spontaneously, or under a course of nux vomica and (local) stimulating liniments.

Constipation.

Constipation.

This may result from compression by gravid womb, and is best corrected by a graduated allowance of boiled flaxseed.

Cramps of The Hind Limbs.

Cramps of The Hind Limbs.

The pressure of the distended womb on the nerves and blood vessels of the pelvis, besides conducing to dropsy, occasionally causes cramps of the hind limbs. The limb is raised without flexing the joints, the front of the hoof being directed toward the ground, or, the spasms occurring intermittently, the foot is kicked violently against the ground several times in rapid succession. The muscles are felt to be firm and rigid. The cramp may be promptly relieved by active rubbing or by walking the animal about, and it does not reappear after parturition.

Dropsy of The Limbs, Perineum, And Abdomen.

Dropsy of The Limbs, Perineum, And Abdomen.

The disposition to dropsy often shows itself in the hind and even in the fore limbs, around and beneath the vulva (perineum), and beneath the abdomen and chest. The affected parts are swollen and pit on pressure, but are not especially tender, and subside more or less perfectly under exercise, hand rubbing, and bandages. In obstinate cases rubbing with the following liniment may be resorted to: Compound tincture of iodin, 2 ounces; tannic acid, one-half dram; water, 10 ounces. It does not last more than a day or two after parturition.

Or the womb may close and gestation continue to the full term

Or the womb may close and gestation continue to the full term

Or the womb may close and gestation continue to the full term

Treatment consists in relieving the tension and accumulation by puncturing the fetal membrane with a cannula and trocar introduced through the neck of the womb and the withdrawal of the trocar so as to leave the cannula in situ, or the membranes may be punctured with the finger and the excess of liquid allowed to escape. This may bring on abortion, or the womb may close and gestation continue to the full term. A course of tonics (gentian root 2 drams, sulphate of iron 2 drams, daily) will do much to fortify the system and counteract further excessive effusion.

Dropsy of The Amnion.

Dropsy of The Amnion.

This differs from simple dropsy of the womb in that the fluid collects in the inner of the two water bags (that in which the foal floats) and not in the otherwise void cavity of the womb. This affection can occur only in the pregnant animal, while dropsy of the womb occurs in the unimpregnated. The blood of the pregnant mare contains an excess of water and a smaller proportion of albumen and red globules, and when this condition is still further aggravated by poor feeding and other unhygienic conditions there is developed the tendency to liquid transudation from the vessels and dropsy. As the watery condition of the blood increases with advancing pregnancy, so dropsy of the amnion is a disease of the last four or five months of gestation. The abdomen is large and pendulous, and the swelling fluctuates under pressure, though the solid body of the fetus can still be felt to strike against the hand pressed into the swelling. If the hand is introduced into the vagina, the womb is found to be tense and round, with the projecting rounded neck effaced, while the hand in the rectum will detect the rounded, swollen mass of the womb so firm and tense that the body of the fetus can not be felt within it. The mare moves weakly and unsteadily on her limbs, having difficulty in supporting the great weight, and in bad cases there may be loss of appetite, stocking (dropsy) of the hind limbs, difficult breathing, and colicky pains. The tension may lead to abortion, or a slow, laborious parturition may occur at the usual time.

Dropsy of The Womb.

Dropsy of The Womb.

This appears as a result of some disease of the walls of the womb, but has been frequently observed as the result of infection after sexual congress, and has, therefore, been confounded with pregnancy. The symptoms are those of pregnancy, but without any movements of the fetus and without the detection of any solid body in the womb when examined with the oiled hand in the rectum. At the end of four or eight months there are signs of parturition or of frequent straining to pass urine, and after a time the liquid is discharged clear and watery, or muddy, thick, and fetid. The hand introduced into the womb can detect neither fetus nor fetal membrane. If the neck of the womb closes, the liquid may accumulate a second time, or even a third, if no means are taken to disinfect it or to correct the tendency. The best resort is to remove any diseased product that may be found attached to the walls of the womb and to inject it daily with a warm solution of carbolic acid 2 drams, chlorid of zinc one-half dram, water 1 quart. A course of bitter tonics (gentian 2 drams, sulphate of iron 2 drams, daily) should be given, and a nutritious, easily digested, and slightly laxative diet allowed.

Cystic Disease of The Walls of The Womb, or Vesicular Mole.

Cystic Disease of The Walls of The Womb, or Vesicular Mole.

This condition appears to be attributable to hypertrophy (enlargement) of the villi on the inner surface of the womb, which become greatly increased in number and hollowed out internally into a series of cysts, or pouches, containing liquid. Unlike the true mole, therefore, they appear to be disease of the maternal structure of the womb rather than of the product of conception. Rodet, in a case of this kind, which had produced active labor pains, quieted the disorder with anodynes and effected a recovery. When this can not be done, attempts may be made to remove the mass with the écraseur or otherwise, following it up with antiseptic injections, as advised under the last heading.

Moles, or Anidian Monsters.

Moles, or Anidian Monsters.

These are evidently products of conception, in which the impregnated ovum has failed to develop naturally, and presents only a chaotic mass of skin, hair, bones, muscles, etc., attached to the inner surface of the womb by an umbilical cord, which is itself often shriveled and wasted. They are usually accompanied with a well-developed fetus, so that the mole may be looked upon as a twin which has undergone arrest and vitiation of development. They are expelled by the ordinary process of parturition, and usually at the same time with the normally developed offspring.

All appreciable symptoms are absent

All appreciable symptoms are absent

All appreciable symptoms are absent

All appreciable symptoms are absent, unless from the death of the fetus, or its interference with normal functions, general disorder and indications of parturition supervene. If these occur later than the natural time for parturition, they are the more significant. There may be general malaise, loss of appetite, elevated temperature, accelerated pulse, with or without distinct labor pains. Examination with the oiled hand in the rectum will reveal the womb of the natural, unimpregnated size and shape and with both horns of one size. Further exploration may detect an elastic mass apart from the womb, in the interior of which may be felt the characteristic solid body of the fetus. If the latter is still alive and can be stimulated to move, the evidence is even more perfect. The fetus may die and be carried for years, its soft structures becoming absorbed so as to leave only the bones, or by pressure it may form a fistulous opening through the abdominal walls, or less frequently through the vagina or rectum. In the latter cases the best course is to favor the expulsion of the foal and to wash out the resulting cavity with a solution of carbolic acid 1 part to water 50 parts. This may be repeated daily. When there is no spontaneous opening it is injudicious to interfere, as the danger from the retention of the fetus is less than that from septic fermentation in the enormous fetal sac when that has been opened to the air.

Extra-uterine Gestation.

Extra-uterine Gestation.

It is rare in the domestic animals to find the fetus developed elsewhere than in the womb. The exceptional forms are those in which the sperm of the male, making its way through the womb and Fallopian tubes, impregnates the ovum prior to its escape, and in which the now vitalized and growing ovum, by reason of its gradually increasing size, becomes imprisoned and fails to escape into the womb. The arrest of the ovum may be in the substance of the ovary itself (ovarian pregnancy), in the Fallopian tube (tubal pregnancy), or when by its continuous enlargement it has ruptured its envelopes so that it escapes into the cavity of the abdomen, it may become attached to any part of the serous membrane and draw its nourishment directly from that (abdominal pregnancy). In all such cases there is an increase and enlargement of the capillary blood vessels at the point to which the embryo has attached itself so as to furnish the needful nutriment for the growing offspring.

The stall of the pregnant mare should not be too narrow

The stall of the pregnant mare should not be too narrow

The stall of the pregnant mare should not be too narrow

The stall of the pregnant mare should not be too narrow, so as to cramp her when lying down or to entail violent effort in getting up, and it should not slope too much from the front backward, as this throws the weight of the uterus back on the pelvis and endangers protrusions and even abortion. Violent mental impressions are to be avoided, for though most mares are not affected thereby, yet a certain number are so profoundly impressed that peculiarities and distortions are entailed on the offspring; hence, there is wisdom shown in banishing particolored or objectionably tinted animals, and those that show deformities or faulty conformation. Hence, too, the importance of preventing prolonged, acute suffering by the pregnant mare, as certain troubles of the eyes, feet, and joints in the foals have been clearly traced to the concentration of the mother's mind on corresponding injured organs in herself. Sire and dam alike tend to reproduce their individual defects which predispose to disease, but the dam is far more liable to perpetuate the evil in her progeny which was carried while she was individually enduring severe suffering caused by such defects. Hence, an active bone spavin or ringbone, causing lameness, is more objectionable than that in which the inflammation and lameness have both passed, and an active ophthalmia is more to be feared than even an old cataract. For this reason all active diseases in the breeding mare should be soothed and abated as early as possible.

Hygiene of The Pregnant Mare.

Hygiene of The Pregnant Mare.

The pregnant mare should not be exposed to teasing by a young and ardent stallion, nor should she be overworked or fatigued, particularly under the saddle or on uneven ground. Yet exercise is beneficial to both mother and offspring, and in the absence of moderate work the breeding mare should be kept in a lot where she can take exercise at will.

The feed should be liberal, but not fattening oats, bran, sound hay, and other feeds rich in the principles which form flesh and bone being especially indicated. All aliments that tend to indigestion are to be especially avoided. Thus rank, aqueous, rapidly growing grasses and other green feed, partially ripe rye grass, millet, Hungarian grass, vetches, peas, beans, or maize are objectionable, as is overripe, fibrous, innutritious hay, or that which has been injured and rendered musty by wet, or that which is infested with smut or ergot. Feed that tends to costiveness should be avoided. Water given often, and at a temperature considerable above freezing, will avoid the dangers of indigestion and abortion which result from taking too much ice-cold water at one time. Very cold or frozen feed is objectionable in the same sense. Severe surgical operations and medicines that act violently on the womb, bowels, or kidneys are to be avoided as being liable to cause abortion. Constipation should be corrected, if possible, by bran mashes, carrots, or beets, seconded by exercise, and if a medicinal laxative is required it should be olive oil or other equally bland agent.

Duration of Pregnancy.

Duration of Pregnancy.

Mares usually go about eleven months with young, though first pregnancies often last a year. Foals have lived when born at the three hundredth day, so with others carried till the four hundredth day. With the longer pregnancies there is a greater probability of male offspring.

And pressed downward to ascertain the size and outline of the womb

And pressed downward to ascertain the size and outline of the womb

And pressed downward to ascertain the size and outline of the womb

Examination of the uterus with the oiled hand introduced into the rectum is still more satisfactory, and, if cautiously conducted, no more dangerous. The rectum must be first emptied and then the hand carried forward until it reaches the front edge of the pelvic bones below, and pressed downward to ascertain the size and outline of the womb. In the unimpregnated state the vagina and womb can be felt as a single rounded tube, dividing in front to two smaller tubes (the horns of the womb). In the pregnant mare not only the body of the womb is enlarged, but still more so one of the horns (right or left), and on compression the latter is found to contain a hard, nodular body, floating in a liquid, which in the latter half of gestation may be stimulated by gentle pressure to manifest spontaneous movements. By this method the presence of the fetus may be determined as early as the third month. If the complete, natural outline of the virgin womb can not be made out, careful examination should always be made on the right and left side for the enlarged horn and its living contents. Should there still be difficulty the mare should be placed on an inclined plane, with her hind parts lowest, and two assistants, standing on opposite sides of the body, should raise the lower part of the abdomen by a sheet passed beneath it. Finally the ear or stethoscope applied on the wall of the abdomen in front of the stifle may detect the beating of the fetal heart (one hundred and twenty-five a minute) and a blowing sound (the uterine sough), much less rapid and corresponding to the number of the pulse of the dam. It is heard most satisfactorily after the sixth or eighth month and in the absence of active rumbling of the bowels of the dam.

But an excess of iced water may prove injurious

But an excess of iced water may prove injurious

But an excess of iced water may prove injurious

From the seventh or eighth month onward the foal may be felt by the hand (palm or knuckles) pressed into the abdomen in front of the left stifle. The sudden push displaces the foal toward the opposite side of the womb, and as it floats back its hard body is felt to strike against the hand. If the pressure is maintained the movements of the live foal are felt, and especially in the morning and after a drink of cold water or during feeding. A drink of cold water will often stimulate the fetus to movements that may be seen by the eye, but an excess of iced water may prove injurious, even to the causing of abortion. Cold water dashed on the belly has a similar effect on the fetus and is equally provocative of abortion.

Though they may be entirely absent

Though they may be entirely absent

Though they may be entirely absent

Enlargement of the abdomen, especially in its lower third, with slight falling in beneath the loins and hollowness of the back are significant symptoms, though they may be entirely absent. Swelling and firmness of the udder, with the smoothing out of its wrinkles, is a suggestive sign, even though it appears only at intervals during gestation.

A steady increase in weight (1-1/2 pounds daily) about the fourth or fifth month is a useful indication of pregnancy. So is a swollen and red or bluish-red appearance of the vaginal mucous membrane.

Is an excellent indication of pregnancy

Is an excellent indication of pregnancy

Is an excellent indication of pregnancy

An unwonted gentleness and docility on the part of a previously irritable or vicious mare, and supervening on service, is an excellent indication of pregnancy, the generative instinct which caused the excitement having been satisfied.

An increase of fat, with softness and flabbiness of muscle, a loss of energy, indisposition for active work, a manifestation of laziness, indeed, and of fatigue early and easily induced, when preceded by service, will usually imply conception.

Pregnancy. Indications of Pregnancy.

Pregnancy. Indications of Pregnancy.

As the mere fact of service by the stallion does not insure pregnancy, it is important that the result should be determined to save the mare from unnecessary and dangerous work or medication when actually in foal and to obviate wasteful and needless precautions when she is not.

The cessation and nonrecurrence of the symptoms of heat (horsing) are most significant, though not an infallible, sign of conception. If the sexual excitement speedily subsides and the mare persistently refuses the stallion for a month, she is probably pregnant. In very exceptional cases a mare, though pregnant, will accept a second or third service after weeks or months, and some mares will refuse the horse persistently, though conception has not taken place, and this in spite of warm weather, good condition of the mare, and liberal feeding. The recurrence of heat in the pregnant mare is most liable to take place in hot weather. If heat merely persists an undue length of time after service, or if it reappears shortly after, in warm weather and in a comparatively idle mare, on good feeding, it is less significant, while the persistent absence of heat under such conditions may be usually accepted as proof of conception.

Is introduced through the vagina until the projecting

Is introduced through the vagina until the projecting

Is introduced through the vagina until the projecting

Spasmodic closure of the neck of the womb is common and is easily remedied in the mare by dilatation with the fingers. The hand, smeared with belladonna ointment and with the fingers drawn into the form of a cone, is introduced through the vagina until the projecting, rounded neck of the womb is felt at its anterior end. This is opened by the careful insertion of one finger at a time, until the fingers have been passed through the constricted neck into the open cavity of the womb. The introduction is made with a gentle, rotary motion, and all precipitate violence is avoided, as abrasion, laceration, or other cause of irritation is likely to interfere with the retention of the semen and consequently with impregnation. If the neck of the womb is rigid and unyielding from the induration which follows inflammation a rare condition in the mare, though common in the cow more force will be requisite, and it may even be needful to incise the neck to the depth of one-sixth of an inch in four or more opposite directions prior to forcible dilatation. The incision may be made with a probe-pointed knife, and should be done by a professional man if possible. The subsequent dilatation may be best effected by the slow expansion of sponge or seaweed tents inserted into the narrow canal. In such cases it is best to let the wounds of the neck heal before putting to horse. An imperforate hymen may be freely incised in a crucial manner until the passage will admit the human hand. An ordinary knife may be used for this purpose, and after the operation the stallion may be admitted at once or only after the wounds have healed.

So that it is only necessary here to name them as causes

So that it is only necessary here to name them as causes

So that it is only necessary here to name them as causes

Treatment. The treatment of the majority of these conditions will be found dealt with in other parts of this work, so that it is only necessary here to name them as causes. Some, however, must be specially referred to in this place. Stallions with undescended testicles are beyond the reach of medicine, and should be castrated and devoted to other uses. Indurated testicles may sometimes be remedied in the early stages by smearing with a weak iodin ointment daily for a length of time, and at the same time invigorating the system by liberal feeding and judicious work. Fatty degeneration is best met by an albuminoid diet (wheat bran, cottonseed meal, rape cake) and constant, well-regulated work. Saccharine, starchy, and fatty food (potatoes, wheat, corn, etc.) are to be specially avoided. In the mare one diseased and irritable ovary should be removed, to do away with the resulting excitability of the remainder of the generative organs. An irritable womb, with frequent straining and the ejection of a profuse secretion, may sometimes be corrected by a restricted diet and full but well-regulated work. Even fatigue will act beneficially in some such cases, hence the practice of the Arab riding his mare to exhaustion just before service. The perspiration in such case, like the action of a purgative or the abstraction of blood just before service, benefits, by rendering the blood vessels less full, by lessening secretion in the womb and elsewhere, and thus counteracting the tendency to the ejection and loss of semen. If these means are ineffectual, a full dose of camphor (2 drams) or of salicin may at times assist. Low condition and anemia demand just the opposite kind of treatment rich, nourishing, albuminoid feed, bitter tonics (gentian), sunshine, gentle exercise, liberal grooming, and supporting treatment generally are here in order.

In the mare barrenness is equally due to a variety of causes

In the mare barrenness is equally due to a variety of causes

In the mare barrenness is equally due to a variety of causes

In the mare barrenness is equally due to a variety of causes. In a number of breeding studs the proportion of sterile mares has varied from 20 to 40 per cent. It may be due to: (a) Imperfect development of the ovary and nonmaturation of ova; (b) cystic or other tumors of the ovary; (c) fatty degeneration of the ovary in very obese, pampered mares; (d) fatty degeneration of the excretory tubes of the ovaries (Fallopian tubes); (e) catarrh of the womb, with mucopurulent discharge; (f) irritable condition of the womb, with profuse secretion, straining, and ejection of the semen; (g) nervous irritability, leading to the same expulsion of the male element; (h) high condition (plethora), with profuse secretion and excitement; (i) low condition, with imperfect maturation of the ova and lack of sexual desire; (j) poor feeding, overwork, and chronic debilitating diseases, as leading to the condition just named; (k) closure of the neck of the womb, temporarily by spasm or permanently by inflammation and induration; (l) closure of the entrance to the vagina through imperforate hymen, a rare, though not unknown, condition in the mare; (m) acquired indisposition to breed, seen in old, hard-worked mares which are first put to the stallion when aged; (n) change of climate has repeatedly been followed by barrenness; (o) hybridity, which in male and female alike usually entails sterility.

Sterility.

Sterility.

Sterility may be in the male or in the female. If due to the stallion, then all the mares put to him remain barren; if the fault is in the mare, she alone fails to conceive, while other mares served by the same stallion get in foal.

In the stallion sterility may be due to the following causes: (a) Imperfect development of the testicles, as in cases in which they are retained within the abdomen; (b) inflammation of the testicles, resulting in induration; (c) fatty degeneration of the testicles, in stallions liberally fed on starchy feed and not sufficiently exercised; (d) fatty degeneration of the excretory ducts of the testicles (vasa deferentia); (e) inflammation or ulceration of these ducts; (f) inflammation or ulceration of the mucous membrane covering the penis; (g) injuries to the penis from blows (often causing paralysis); (h) warty growths on the end of the penis; (i) tumors of other kinds (largely pigmentary), affecting the testicles or penis; (j) nervous diseases which abolish the sexual appetite or that control the muscles which are essential to the act of coition; (k) azoturia with resulting weakness or paralysis of the muscles of the loins or the front of the thigh (above the stifle); (l) ossification (anchylosis) of the joints of the back or loins, which render the animal unable to rear or mount; (m) spavins, ringbones, or other painful affections of the hind limbs, the pain of which in mounting causes the animal to suddenly stop short in the act. In the first three of these only (a, b, and c) is there real sterility in the sense of the nondevelopment or imperfect development of the male vivifying element (spermatozoa). In the other examples the secretion may be imperfect in kind and amount, but as copulation is prevented it can not reach and impregnate the ovum.

Castration of The Mare.

Castration of The Mare.

Castration is a much more dangerous operation in the mare than in the females of other domesticated quadrupeds and should never be resorted to except in animals that become unmanageable on the recurrence of heat and that will not breed or that are utterly unsuited to breeding. Formerly the operation was extensively practiced in Europe, the incision being made through the flank, and a large proportion of the subjects perished. By operating through the vagina the risk can be largely obviated, as the danger of unhealthy inflammation in the wound is greatly lessened. The animal should be fixed in a trevis, with each foot fixed to a post and a sling placed under the body, or it may be thrown and put under chloroform. The manual operation demands special professional knowledge and skill, but it consists essentially in making an opening through the roof of the vagina just above the neck of the womb, then following with the hand each horn of the womb until the ovary on that side is reached and grasped between the lips of forceps and twisted off. It might be torn off by an écraseur especially constructed for the purpose. The straining that follows the operation may be checked by ounce doses of laudanum, and any risk of protrusion of the bowels may be obviated by applying the truss advised to prevent eversion of the womb. To further prevent the pressure of the abdominal contents against the vaginal wound the mare should be tied short and high for twenty-four or forty-eight hours, after which I have found it best to remove the truss and allow the privilege of lying down. Another important point is to give bran mashes and other laxative diet only, and in moderate quantity, for a fortnight, and to unload the rectum by copious injections of warm water in case impaction is imminent.

Castration by The Covered Operation.

Castration by The Covered Operation.

This is only required in case of hernia or protrusion of bowels or omentum into the sac of the scrotum, and consists in the return of the hernia and the application of the caustic clamps over the cord and inner walls of the inguinal canal, so that the walls of the latter become adherent above the clamps, the canal is obliterated, and further protrusion is hindered. For the full description of this and of the operation for hernia for geldings, see remarks on hernia.

To strangulation of unduly long cords in the external wound

To strangulation of unduly long cords in the external wound

To strangulation of unduly long cords in the external wound

Tumors on the spermatic cord. These are due to rough handling or dragging upon the cord in castration, to strangulation of unduly long cords in the external wound, to adhesion of the end of the cord to the skin, to inflammation of the cord succeeding exposure to cold or wet, or to the presence of infection (Staphylococcus botriomyces). These tumors give rise to a stiff, straddling gait, and may be felt as hard masses in the groin connected above with the cord. They may continue to grow slowly for many years until they reach a weight of 15 or 20 pounds, and contract adhesions to all surrounding parts. If disconnected from the skin and inguinal canal they may be removed in the same manner as the testicle, while if larger and firmly adherent to the skin and surrounding parts generally, they must be carefully dissected from the parts, the arteries being tied as they are reached and the cord finally torn through with an écraseur. When the cord has become swollen and indurated up into the abdomen such removal is impossible, though a partial destruction of the mass may still be attempted by passing white-hot, pointed irons upward toward the inguinal ring in the center of the thickened and indurated cord.

In these cases the treatment indicated above

In these cases the treatment indicated above

In these cases the treatment indicated above

Phymosis and paraphymosis. In cases of swelling, as above, the penis may be imprisoned within the sheath (phymosis) or protruded and swollen so that it can not be retracted into it (paraphymosis). In these cases the treatment indicated above, and especially the scarifications, will prove a useful preliminary resort. The use of astringent lotions is always desirable, and in case of the protruded penis the application of an elastic or simple linen bandage, so as to press the blood and accumulated fluid out, will enable the operator to return it.