But, taken as a whole, when considered in its relation to onanism, nocturnal enuresis, preputial calculus, syphilis, cancer, and a lot of nervous and other ailments, or induced abnormal physical conditions, we can really conclude that the days of the prepuce are past and gone, that it has outlived its usefulness, and that those whom a religious or civil ordinance or custom happily makes them rid of it are people to be greatly envied. As Sancho Panza remarked, "God bless the man who invented sleep," so we may well join in blessing the inventor of circumcision, as an event that has saved some parts of the human family from much ill and suffering.
Phimosis is an ancient attendant on our inheritance of the prepuce, we being, in fact, born with it; this is the rule. There are, however, exceptions to this rule, which, singularly enough, are found to be hereditary. The writer has met with a number of such instances, and they have always been found to have been family traits. Within the past year, after attending a confinement, his attention was called to the child by the nurse, who thought that the child was deformed; the nurse, singularly enough, never having seen a natural-looking glans penis in all her life, was astonished at the size and appearance of the member. On examination, the organ showed a complete absence of prepuce. On inquiry, the father and another son, born more than twenty years previously,--this comprising every male member of the family,--were found to have been thus born, with the glans fully exposed. The family is now residing in San Diego, and is naturally one of more than superior physical health and intelligence. I saw another family similarly affected in the north of France, and of individual cases, without knowing the history of the rest of the family, I have seen a large number. As the prepuce can be observed in every stage of disappearance among mixed races, it would seem that in time it would disappear altogether. Its effectual absence in so many cases evidently belongs to some evolutionary process, and shows beyond question that nature does not insist on its presence either as a necessity or as an ornament.
The word or term "phimosis" is derived from two Greek roots, signifying "string" and "to tighten," or "to tie with a string." Galen, from its signification, accepted the word, and from him it has been transmitted through the different epochs of medicine down to our own times. In virtue of its etymological significance, it was formerly applied to any stenosis or closure of duct or aperture, but at present the term is used simply to denote that constriction that affects the prepuce, and which prevents the glans from being passed through the preputial orifice. Phimosis is said to be congenital or natural and acquired. The first of these is the common lot of all, as a rule, and with some it remains so throughout life. As babyhood advances in boyhood and boyhood into youth, the prepuce gradually becomes lax and distensible, and in proportion to the existence of these conditions it also loses in its length. Where, however, the distal end persists in its constricted condition it is drawn forward as the penis increases in bulk.