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730 applied. A fibrous dressing next the raw surfaces is troublesome, as it sticks to the wound and is painful and difficult to remove. The dressing should be massive, well padded, and kept in place by an eight-tailed bandage secured in front and behind to a strap round the waist, a hole being cut in front for the penis to emerge. The large wound generally does well. Skin grafting should be practised freely and early, especially round the root of the penis.

Mortality from operation.—The mortality from these formidable-looking operations, if they are carefully

Fig. 123.—Elephantiasis of labia majora. (After Nuñez.)

done, is small, and need not exceed 5 per cent. The results are very satisfactory, as a rule, the functions of the organs being retained or restored.

Elephantiasis of the arms.—This is comparatively rare. Allowing for the differences between the upper and lower extremities as regards gravitation of fluids, the symptoms and pathology of elephantiasis of the arm are the same as those of elephantiasis of the legs. Beyond the judicious employment of massage and elastic bandaging, little can be done in the way of treatment.

Elephantiasis of the vulva and mammæ.—Elephantiasis of the vulva (Figs. 123, 124) and mammæ (Fig. 125) is still rarer. Where growth has