Note 104 — Chapter XXIII · Reflex Neuroses and the Prepuce.

I have often performed dilatation where, for some reason, either the timidity of the parents or the health of the child seemed to contraindicate any more radical procedure. It is customary to advise mothers or the nurses to retract the skin daily, but even after a good dilatation I have found as sudden a recontraction, and even in the majority of cases, where daily drawing back the skin might have been practicable, the cries and struggles of the child are a positive prohibition to these instructions being carried out; it is not once in ten times that it can be carried out. I have seen two very annoying cases of paraphimosis resulting from this procedure, the struggles of the child having prevented the return of the prepuce to its proper place, and the violent crying and sobbing of the child having assisted to congest the organ.