BA.LANITIS AND POSTHITIS.—Balarti tis is an inflammation of the mucous sur face of the glans penis, and posthitis an inflammation of the mucous layer of the prepuce. As the two surfaces are usually attacked simultaneously tire term baia noposthitis is used.
The predisposing cause is a redundant or phimotic foreskin. Because of the re tained smegma and urine, the two mu cous surfaces are kept constantly moist; they become more or less macerated, of fering conditions most favorable for the development of micro-organisms. Dia betes is also said to be a predisposing cause. The exciting causes are irrita tions, abrasions, contact with endome trial discharges, and chancre, chancroid, gonorrhoea, and diphtheria.
Symptoms.—In the mild forms there is usually some burning and itching, the mucous membrane is red, somewhat thickened, and a sero-sanious pus es capes from beneath the foreskin or cov ers the surfaces as a milky secretion from which a very offensive odor is emitted. When the inflammation is more intense, superficial erosions and ulcers are seen about the corona. Croup ous and diphtheritic varieties of inflam mations have been observed, the mucous layers being covered with a membranous coating; it is closely adherent, and the attempt to strip it off is followed by hmmorrhage. Among the complications are phimosis, paraphimosis, lymphangi tis, and gangrene.
Treatment. — Balanoposthitis may be
promptly relieved by cleanliness. The prepuce should be gently retracted, the parts washed freely with Castile soap and warm water twice daily, carefully dried, and dusted with equal parts of bis muth, boric acid, and calomel. It is usu ally a good plan to interpose a piece of gauze or lint, so that the two inflamed mucous surfaces will not come in contact with each other. Some surgeons prefer lotions or washes. A small piece of cot ton is spread out over the surface of the glans penis and moistened with a solu tion of lead-water and laudanum, or with such a combination as the following:— 1 Zinci sulph., 3 grains. Plumbi acet., 6 grains. Morph. sulpb., 7 grains. Aqum, 2 fluidounces.
and the prepuce pulled forward over the glans. In the presence of erosion or ulcerations the entire mucous surface should be painted over with a solution of nitrate of silver (gr. xx to f'5'j).
When complicated by phimosis, the in flammatory oedema must be counteracted by the frequent use of hot compresses, lead-water and laudanum, and subprm putial injections. As soon as the glans can be exposed, the ordinary local treat ment as described above is indicated.
In cases of chronic balanoposthitis, or when there are frequent acute attacks, circumcision is to be recommended.