Buy Generic Levitra From India Online | OVERNIGHT Delivery!

corona, leaving a forceps holding each side. Then with the scissors the skin and mucous membrane is sheared from the back of the dorsal slit to the point held by the forceps on the frenum, and the same procedure repeated on the other side. A few, very fine, plain catgut sutures are required to control the oozing, and to keep the skin and mucous membrane in perfect apposition. In a small penis a continuous suture may be started on each side of the frenum and continued to the dorsum, but must be tied separately. If the penis is of fair size Buy Generic Levitra From India Online this is not advisable, as swelling may make the suture too tight. If adhesions have formed be- tween the glans and its covering they must be teased away by gauze or a Buy Generic Levitra From India Online probe until any SLCretion back of the corona can be liberated. The wound should be well dusted with zinc stearate. which protects it from moisture and is soothing as well. Over this should be applied a gauze and adhesive dressing, and the exposed portion of Buy Generic Levitra From India Online the glan.^ will protected with petrolatum or zinc oxide ointment, so the urine will drop ofif without soiling the band- age. Unless the bandage becomes badly soiled it will not Buy Generic Levitra From India Online need changing for three or four days, in which case the edges have united. Circumcision in adults can be painlessly and suc- cessfully performed imder local anjesthesia, and general anresthesia should be used only when de- manded by. the patient. After a vigorous cleansing of the parts with soap and water, the foreskin should be well pulled up and a rubber band applied to the penis to lessen the circulation. The foreskin is then infiltrated with a two or four per cent, co- caine solution with a small amount of adrenalin added-. The corona is located and the needle in- serted about one fourth of an inch anterior to it on the dorsmn of the penis. .As soon as the point of the needle is buried begin infiltrating, and by direct- ing the point of the needle toward the tip of the frenum and infiltrating ahead of the needle Buy Generic Levitra From India Online point the part can be infiltrated with one insertion of the ncrdle tor each side. \\'ithdraw the needle and on reinserting it to inject the other side it should be inserted in the infiltrated area and directed toward the tip of the frenum on the opposite side until that side is infiltrated. A forceps or clamp should then be applied at an angle corresponding to the slope of the glans and in Buy Generic Levitra From India Online such a manner as to leave the skin long enough to cover the corona, then the ex- cess is trimmed off with scissors. The clamp is removed and the mucous membrane held by two forceps and split along the dorsum well back to the corona. If it is sensitive it should be infiltrated as the skin and then trimmed to correspond with the curve of the corona to the frenum. Interrupted sutures of small, plain catgut should be applied beginning on each side of the frenum, and all bleeding vessels controlled by these same sutures that coapt the skin and mucous membrane. There is very little bleeding if the cuts are Buy Generic Levitra From India Online made with scissors, as the crushing closes all except the largest vessels, and in ligating them the knot should be left exposed, otherwise hcalmg will be delayed at that point. The wound should be dressed dry with zinc stear- ate or some similar dusting powder that will shed the water and Buy Generic Levitra From India Online at Buy Generic Levitra From India Online the same time feel smooth and com- fortable to the patient. The glans should be cov- ered with zinc oxide ointment or petrolatum to pre- vent chafing as it rubs against the clothing. The patient should stand with the feet wide apart and urinate straight downward, so as to not wet or soil the dressing, which may be left on for several days. If there is a chancroid on the foreskin to be taken ofif, it must be thoroughly cauterized with carbolic acid and alcohol, and the part then washed well with bichloride solution i in 10,000 before the in- cision is made, and the dressing in these cases must be changed daily, and any reappearance of the in- fection in the wound thoroughly cauterized and dusted with boric acid powder. Dr. H. C. Kiiicaid, of Hitulington, IF. I'a., ob- serves: In performing a circumcision, I find the o])era- tion simpler (and therefore results better) without the use of any of the numerous "phimosis clamps" on the market, and, except in young children or excessively nervous adults, I have found cocaine an;esthesia preferable to general. With the patient recumbent, and with my hands carefully disinfected (so far as possible), the penis is thoroughly washed with green soap and aseptic gauze sponges, the prepuce being retracted, and its inner layer, the glans, and sulcus receiving atten- tion, and all smegma being removed. It will some- times be found necessary to slit the prepuce before it can be retracted. This preliminary scrubbing is followed by a washing with a i in 1,000 bichloride solution. It is not necessary, during this prepara- tion, for the hands to come in contact with the pa- tient's skin. The penis is now wrapped in moist sterile gauze, the hands redisinfected, and two ster- ile towels arranged over the patient's abdomen and legs, above and below^ the penis, thus .giving a wide aseptic field. .\ gum catheter, previously sterilized by boiling with the instnunents, is now lied about the base of the penis. This must be cnrcfnllv done to avoid altering the relations n{ the parts, lie- 230 OCR READERS DISCUiSIOXS. ginning on the dorsum, the skin just posterior to the intended Hne of incision is infiltrated with a two per cent, cocaine solution, the infiltration being marked by a succession of wheals. The inner sur- face of the prepuce is anaesthetized by the simple application of the solution, and loss of sensation is usually complete in about five minutes, during which time the penis is kept covered with a sterile towel, and the surgeon's hands may again be dis- infected. The foreskin is now grasped, with a haemostatic