forceps, on either side of the median line, and both layers slit up between them with sharp scissors to within about one eighth inch of the point of re- flexion — from the angle of this incision the prepuce is trimmed away on each side, parallel with the corona glandis, the frenal portion being reserved to the last. (It will not infrequently be found neces- sary to shell out the glans from an adherent pre- puce, like a hazelnut, but this is seldom difficult. In cases of Price Levitra Walmart long standing, I have found the inner layer thickened and infiltrated, resembling leather, but this condition disappears in from one to two weeks.) If the frenal artery has been cut, it is now ligated with No. 00 catgut, and the cut edges of the two layers united in the median line, dorsally and ven- trally, by No. i catgut sutures, .which serve as guides for the approximation Price Levitra Walmart of the tissues laterally. A suture is then placed on each side, the ends of the four sutures being left long, and two additional sutures introduced on each side. Undue tension must be avoided in tying these sutures. The field is now sponged off with the bichloride solution, and the catheter carefully loosened. Usually there Price Levitra Walmart is practically no hasmorrhage, but should :iny occur, it Price Levitra Walmart is easily controlled by extra sutures. A narrow strip of borated gauze is laid over the suture line, overlapping at the ends, and tied in place bv the ends of the four sutures, left long for the purpose. The penis is wrapped with a sterile gauze bandage, the meatus and part of the glans being left uncovered, and the patient ordered to re- main quiet, although I have had them return to hard work Price Levitra Walmart immediately after the operation, with no bad results. It may be well to keep the patient on bromides for two or three days, as erections are somewhat painful. With this technique, I have always had rapid and perfect healing, and my patients have been absolute- ly satisfied with the results of the operation. Dr. Charles A. Covcll, of Syracuse, N. Y.. says: Aside from the surgical necessity in certain dis- eases, circumcision should be performed on all male children. It prevents masturbation in early life. and later lessens the danger of infection. A general anaesthetic should first be administered. As the time of the operation is short, only a few moments at the most, chloroform is preferable, un- less coptraindicated. It should, however, be given by a thoroughly competent physician. The danger limit in this operation is very close to the line where sensibility ceases. In my early practice, I often had a nurse or a medical student give the anaesthetic. and it was a very usual happening for me, to have to defer the operation while I performed artificial respiration on the patient. While the anaesthetic is being given, cleanse the parts thoroughly with soap and water, and if the prepuce can be retracted and the glans exposed, all adhesions are broken up, the secretions back of the corona removed, and tlie inner side of the prepuce and the glands washed. The adhesions are best re- moved at this or Price Levitra Walmart any other stage of the operation by carefully pulling the layers apart with the fingers. The bleeding Price Levitra Walmart if any is controlled by apply- ing hot water. The instant that the sensibility of the skin is lost, make a scratch on the skin with a scalpel on the dorsum of the penis, slightly anterior to where the corona shows through the skin. This scratch serves as a Price Levitra Walmart guide, and indicates the exact point to which the cut skin will retract, after amputation. Draw the skin forward and clasp w-ith a long pair of dressing forceps in such a way that the scratch comes even with the anterior edge of the blades. Dressing forceps are better than the self locking forceps, as they do not damage the tissues, and are held in the left hand of the operator, while all the tissue in front of them is cut off with scissors. Re- lease the forceps when the skin retracts, leaving the mucous layer covering the glans like a hood. Pass a grooved director under this layer, and slit along the dorsum with scissors back to within an eighth of an inch of the cut skin, thus making a flap on Price Levitra Walmart each side. If the prepuce was not retracted in the first cleansing, now loosen all adhesions and cleanse with hot water. Seize the flaps separately with dressing forceps, and with scissors cut them off fol- lowing the line of the Price Levitra Walmart cut skin, leaving an eighth to a quarter of an inch Price Levitra Walmart of loose tissue, removing part of the frenum or not according to the excessive length of tissue. If the frenal artery spurts tie it with fine catgut. Insert four stitches of medium sized gut, one on top, one at the frenum, and one on either side mid- way betv\-een the other two, tie and leave the ends six inches long. These are usually sufficient to ap- proximate all cut edges. If not, insert a few fine gut stitches as necessary, tic, and cut the ends off short. Now take a piece of gauze tape, either plain ster- ile or of iodoform, personally I prefer the iodoform, three quarters of an inch wide and ten inches long. Fold in the edgPrice Levitra Walmart the suture on one side. Tie the suture over the tape. Carry the gauze over the cut skin edges so as to enfold and cover them Price Levitra Walmart to the frenum and tie the suture over the gauze tape at that point in Price Levitra Walmart the same wav, then up the other side, and cross the two ends of the tape between the ends of the suture at the top, tie, and cut off all ends short. Be careful not to draw the gauze too tight, but leave a little loop between each suture to allow for swelling. No other dressing- is needed. The patient can Price Levitra Walmart urinate with frecdiini, without in any way soiling the dressing. Price Levitra Walmart All ih.e parts are protected and Price Levitra Walmart the dressing has never to be changed. In about ten days the skin is healed and the sutures are absorbed. If the dressing should adhere in places it may be loosened bv Price Levitra Walmart the application of hydrogen peroxide. CORRESPONDENCE.