Circumcision

Customs of Central Asians. Circumcision. Photograph shows a group of men seated on the ground near a small boy who is being circumcised. Album print. Illus. in: Turkestanskii al’bom, chast’ etnograficheskaia, 1871-1872, part 2, vol. 1, pl. 71. Batga [sic] buri translated from Persian as circumcision. Photo credit: Unknown – Library of Congress, Public Domain, Wikipedia Commons

 

There is a huge amount of information regarding the history of circumcision, dates which are way before the Bible was written; the Bible has many references to circumcision. Vast historical references include religious and social customs as well as superstitions and taboos, in addition to medical evidence. There is only room here for just a glimpse of the medical point of view.

 

Sir John Hutchinson MD – Photo credit: Unknown; Wikipedia Commons

 

 

Jonathan Hutchinson (1828-1913), an eminent English physician was the first prominent medical advocate for circumcision. Hutchinson’s activity in the cause of scientific surgery and in advancing the study of the natural sciences was unwearying. He published more than 1,200 medical articles and also produced the quarterly Archives of Surgery from 1890 to 1900, being its only contributor. His lectures on neuropathogenesis, gout, leprosy, diseases of the tongue, etc., were full of original observation; but his principal work was connected with the study of syphilis, on which he became the first living authority. He was the first to describe his triad of medical signs for congenital syphilis: notched incisor teeth, labyrinthine deafness and interstitial keratitis, which was very useful for providing a firm diagnosis long before the Treponema pallidum or the Wassermann test were discovered. Hutchinson was the founder of the Medical Graduates’ College and Polyclinic; and both in his native town of Selby and at Haslemere, Surrey, he started educational museums for popular instruction in natural history. He published several volumes on his own subjects and was given an Hon. LL.D degree by both the University of Glasgow and University of Cambridge. He received a knighthood in 1908.

 

In 1855, Hutchinson published a study in which he compared the rate of contraction of venereal disease amongst the gentile and Jewish population of London. His study appeared to demonstrate that circumcised men were significantly less vulnerable to venereal diseases. In fact, a 2006 systematic review concluded that the evidence strongly indicates that circumcised men are at lower risk of chancroid and syphilis. Clearly, Dr. Hutchinson was ahead of his time. Hutchinson also became a notable leader in the campaign for medical circumcision for the next fifty years, publishing A Plea for Circumcision. in the British Medical Journal (1890). In that article, he contended that,“the foreskin constitutes a harbor for filth, and is a constant source of irritation. It conduces to [self eroticism], and adds to the difficulties of continence. It increases the risk of syphilis in early life, and of cancer in the aged. In an 1893 article, On circumcision as a preventive of self-eroticism, he wrote: I am inclined to believe that circumcision may often accomplish much, both in breaking the habit as an immediate result, and in diminishing the temptation to it subsequently.“

 

Nathaniel Heckford, a pediatrician at the East London Hospital for Children, wrote Circumcision as a Remedial Measure in Certain Cases of Epilepsy, Chorea, etc. (1865), in which he argued that circumcision acted as an effective remedial measure in the prevention of certain cases of epilepsy and chorea. These increasingly common medical beliefs were even applied to females. The controversial obstetrical surgeon Isaac Baker Brown founded the London Surgical Home for Women in 1858, where he worked on advancing surgical procedures. In 1866, Baker Brown described the use of clitoridectomy, as a cure for several conditions, including epilepsy, catalepsy and mania, which he attributed to self-stimulation. In On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females, he gave a 70% success rate using this treatment. However, during 1866, Baker Brown began to receive negative feedback from within the medical profession from doctors who questioned the validity of Baker Brown’s claims of success. An article appeared in The London Times, which was favorable towards Baker Brown’s work but suggested that Baker Brown had treated women of unsound mind. He was also accused of performing procedures without the consent or knowledge of his patients or their families. In 1867 he was expelled from the Obstetrical Society of London for carrying out the operations without consent. Baker Brown’s ideas were more accepted in the United States, where, from the 1860s, the operation was being used to cure hysteria, and in young girls what was called rebellion or unfeminine aggression“.

 

Lewis Sayre, New York orthopedic surgeon, became a prominent advocate for circumcision in America. In 1870, he examined a five-year-old boy who was unable to straighten his legs, and whose condition had so far defied treatment. Upon noting that the boy’s genitals were inflamed, Sayre hypothesized that chronic irritation of the boy’s foreskin had paralyzed his knees via reflex neurosis. Sayre circumcised the boy, and within a few weeks, he recovered from his paralysis. After several additional incidents in which circumcision also appeared effective in treating paralyzed joints, Sayre began to promote circumcision as a powerful orthopedic remedy. Sayre’s prominence within the medical profession allowed him to reach a wide audience. As more practitioners tried circumcision as a treatment for otherwise intractable medical conditions, sometimes achieving positive results, the list of ailments reputed to be treatable through circumcision grew. By the 1890s, hernia, bladder infections, kidney stones, insomnia, chronic indigestion, rheumatism, epilepsy, asthma, bedwetting, Bright’s disease, erectile dysfunction, syphilis, insanity, and skin cancer had all been linked to the foreskin, and many physicians advocated universal circumcision as a preventive health measure.

 

Specific medical arguments aside, several hypotheses have been raised in explaining the public’s acceptance of infant circumcision as preventive medicine. The success of the germ theory of disease had not only enabled physicians to combat many of the postoperative complications of surgery, but had made the wider public deeply suspicious of dirt and bodily secretions. Accordingly, the smegma that collects under the foreskin was viewed as unhealthy, and circumcision readily accepted as good hygiene. In this Victorian climate, circumcision could be employed as a means of discouraging self-stimulation. All About the Baby, a popular parenting book of the 1890s, recommended infant circumcision for precisely this purpose. As hospitals proliferated in urban areas, childbirth, at least among the upper and middle classes, was increasingly under the care of physicians in hospitals rather than with midwives in the home. It has been suggested that once a critical mass of infants were being circumcised in the hospital, circumcision became a class marker of those wealthy enough to afford a hospital birth.

 

During the same time period, circumcision was becoming easier to perform. William Stewart Halsted’s 1885 discovery of hypodermic cocaine as a local anesthetic made it easier for doctors without expertise in the use of chloroform and other general anesthetics to perform minor surgeries. Also, several mechanically aided circumcision techniques, forerunners of modern clamp-based circumcision methods, were first published in the medical literature of the 1890s, allowing surgeons to perform circumcisions more safely and successfully. By the 1920s, advances in the understanding of disease had undermined much of the original medical basis for preventive circumcision. Doctors continued to promote it, however, as good penile hygiene and as a preventive for a handful of conditions such as: balanitis, phimosis, and cancer.

 

By 2014 the American Academy of Pediatrics found that the health benefits of newborn male circumcision outweigh the risks

 

Circumcision in English-speaking countries arose in a climate of antiquated, negative attitudes towards relationships. In her 1978 article The Ritual of Circumcision, Karen Erickson Paige writes: The current medical rationale for circumcision developed after the operation was in wide practice. The original reason for the surgical removal of the foreskin, or prepuce, was to control ‘insanity’ – the range of mental disorders that people believed were caused by the polluting’ practice of self-abuse.“

 

Editor’s note: Page is pointing out, how hard it is to believe that anyone could have such outrageous ideas, completely lacking in any scientific evidence and so harshly punitive.

 

Self-abuse was a term commonly used to describe self-stimulation in the 19th century. According to Paige, treatments ranged from diet, moral exhortations, hydrotherapy, and marriage, to such drastic measures as surgery, physical restraints, frights, and punishment. Some doctors recommended using plaster of Paris, leather, or rubber; cauterization; making boys wear chastity belts or spiked rings; and in extreme cases, castration. Paige details how circumcision became popular as a remedy:

 

In the 1890s, it became a popular technique to prevent, or cure, insanity. In 1891 the president of the Royal College of Surgeons of England published On Circumcision as a Preventive, and two years later another British doctor wrote Circumcision: Its Advantages and How to Perform It, which listed the reasons for removing the vestigial prepuce. Evidently the foreskin could cause nocturnal incontinence, hysteria, epilepsy, and irritation that might give rise to erotic stimulation. Another physician, P.C. Remondino, added that circumcision is like a substantial and well-secured life annuity as it insures better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor bills. No wonder it became a popular remedy.

 

One of the leading advocates of circumcision was John Harvey Kellogg. He advocated the consumption of Kellogg’s corn flakes as a remedy, and he believed that circumcision would be an effective way to eliminate stimulation in males.

 

Editor’s note: Talk about plain old Puritanical meanness can hardly believe some of this, but it’s true. Eighteenth and Nineteenth Century solutions: Covering the organs with a cage had been practiced with entire success. A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. The operation should be performed by a surgeon without administering an anesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. The soreness which continues for several weeks interrupts the practice, and if it had not previously become too firmly fixed, it may be forgotten and not resumed. If any attempt is made to watch the child, he should be so carefully surrounded by vigilance that he cannot possibly transgress without detection. If he is only partially watched, he soon learns to elude observation, and thus the effect is only to make him cunning in his vice.

 

Robert Darby (2003), writing in the Medical Journal of Australia, noted that some 19th-century circumcision advocates – and their opponents – believed that the foreskin was highly erotic and sensitive:

 

In the 19th century the role of the foreskin in erotic sensation was well understood by physicians who wanted to cut it off precisely because they considered it the major factor leading boys to self-stimulation. The Victorian physician and venerealologist William Acton (1814-1875) damned it as a source of serious mischief, and most of his contemporaries concurred. Both opponents and supporters of circumcision agreed that the significant role the foreskin played in responses was the main reason why it should be either left in place or removed. William Hammond, a Professor of Mind in New York in the late 19th century, commented that circumcision, when performed in early life, generally lessens the voluptuous sensations of intimacy, and both he and Acton considered the foreskin necessary for optimal reproductive function, especially in old age. Jonathan Hutchinson, English surgeon and pathologist (1828-1913), and many others, thought this was the main reason why it should be excised.

 

Born in the United Kingdom during the late-nineteenth century, John Maynard Keynes and his brother Geoffrey, were both circumcised in boyhood due to parents’ concern about their habits. Mainstream pediatric manuals continued to recommend circumcision as a deterrent until the 1950s.

 

Wikipedia; http://www.nytimes.com/1997/04/02/us/study-is-adding-to-doubts-about-circumcision.html

 

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