Note 101 — Chapter XXI · The Prepuce and Gangrene of the Penis.

I have now under my care a poor consumptive who has all the appearance of having always been as virtuous as Joseph, but who, unlike Joseph, has from infancy had as a constant companion a long, miserable, smegmanous, and annoying prepuce. The young man has an œdema which first affected his feet, but one day, owing to the irritation of a slight balanitis, the prepuce swelled at once; it proceeded through the penis integument to the scrotum; the penis itself retracted, leaving the integument and scrotum to assume a translucent, puffy, cork-screw appearance and attitude; from its labyrinthic passage the urine slowly dribbles during urination in a scalding stream. In addition to the physical sufferings, he is tormented by the knowledge that his friends attribute all his disease and troubles—since the occurence of the penile œdema—to the fact that his earlier manhood must have been indiscreet, as well as sinful. The laity cannot connect any penile, scrotal, or testicular disease with anything except venereal disease; and if the physician attempts to explain matters, they simply look upon it as the good-natured and well-intentioned efforts of the doctor to deceive them and to cover up the shortcomings of some frail mortal. Many a poor fellow has to leave this world under a cloud of mistrust and a bad odor of past deviltry to which he is not entitled, and suffer all this in addition to all his physical ills, owing to his having been ornamented through life with an annoying prepuce,—the luckless heritage of having been born a Christian. Columbus in chains moralizing on the ingratitude of this world is nothing to the poor invalid with a swollen prepuce, innocently acquired, silently “cussing” the ignorance of his relatives and friends.