HERPES PROGENITALIS.—A condition characterized by the sudden appearance of one or more vesicles on the balano prfeputial mucous membrane, surrounded with an erythematous area, and attended by an itching, burning pain.
The predisposing causes are catarrhal diathesis, neuroses, gout, rheumatism, and phimosis, and the exciting one is any irritation of the balanoprfeputial mucous membrane.
Symptoms. — Herpes usually appears suddenly as a cluster of vesicles sur rounded by a red areola. These vesicles, at first containing a clear serum, which later becomes cloudy, finally dry up and scab over, leaving a bright-red spot. Oc casionally the vesicles rupture, and a true ulcer results, which may become of large size when secondarily infected. Some times the .lesions are accompanied by a slight burning pain; at other times the pain is intense and neuralgic in char acter. The pain may precede the devel opment of the vesicles. The disease shows a marked tendency to recur and may occasion a polyganglionie, painless bubo.
Diagnosis.—Herpes must be distin guished from chancre, chancroid, and mucous patches. The chancre usually appears between the tenth and forty-sec ond day; it is single; painless; begins as an erosion, papule, or tubercle; and is indurated, elevated above the surface of the surrounding tissue, shows little or no secretion, and usually disappears spon taneously. Chancroid appears within five days; it may be single, but is usually multiple from autoinoculability; begins as a pustule, always ulcerates, is punched out, secretes profusely, and is often pain ful. The mucous patch is always accom panied by other manifestations of syph ilis.
Treatment.—The basis of all treatment is cleanliness. The parts should be fre quently washed with warm water, and each vesicle touched with nitrate of silver (gr. xx to and the application of such powders and lotions as are appli cable for balanoposthitis. When the pain is neuralgic, a 4-per-cent. solution of co caine or a drachm of chloral to the ounce of water may be applied. Constitutional treatment should always be directed to the correction of any existing dyscrasia. In recurrent herpes circumcision is the only means that will bring about a per manent cure.
Tuberculosis of the Penis.—Tubercu losis of the penis is an extremely rare condition. It may be periurethral, bala nopmputial, and urethral. The disease, as in other parts of the body, is charac terized by the formation of ragged, ir regular, undermined ulcers, of very slow growth, and exhibiting little or no tend ency to heal. The inguinal glands are often involved, and occasionally undergo easeous changes.
—When seen early, they should be curetted, touched with pure carbolic acid, and dressed antiseptically with iodoform. Internally, remedies should be administered to correct the existing diathesis. In later stages am putation of the organ may be necessary.
Tumors of the Penis.--Tumors of the penis may be either benign or malignant, solid or cystic.
The benign tumors include cysts (mu cous, sebaceous, or hemorrhagic), ade noma, fibroma, horns, elephantiasis, pap illomata, and vascular growths.
The malignant tumors include sar coma, carcinoma, and epithelioma. With the exception of sebaceous tumors, cysts are rare; the former may occur in any region where sebaceous glands are pres ent.
Adenoma and fibroma are exceedingly rare. Guiteras and Beck each report a case. They coincide completely with similar growths in other parts.
Horns springing from the glans have been reported by Brinton and others. They have the appearance of a nail, and when dry arc smooth and polished.
Elephantiasis usually involves the penis and scrotum, which organs may attain large size. It is but rarely seen in temperate latitudes. It may result from wounds and diseases which obstruct the lymph-channels.
The treatment of this condition is un satisfactory. Large doses of iodide of potash may be tried. Circumcision may be performed so as to remove as much of the thickened skin as possible.
Vascular growths are occasionally found along the dorsal vein and include angiomata and The treatment of benign tumors of the penis is that appropriate for like con ditions in other parts of the body: re moval when increasing in size or inter fering with function.