Impotence Support - The Ritual of Circumcision

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The Ritual of Circumcision

Moishe

2006-06-04, 8:06 am

The Ritual of Circumcision

Karen Ericksen Paige
Human Nature, pp 40-48, May 1978

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In the United States, the current medical rationale for circumcision
developed after the operation was in wide practice.

Westerners look askance at the ritual mutilations of the body performed
in exotic tribes, but they justify their own ritual mutilations as
medically appropriate. Europeans sneer at the Maasai custom of
lengthening the ear lobes, but they have their own noses bobbed and
their faces lifted. Americans are horrified at the Arunta practice of
subincision (slitting the penis on the ventral side) or the Sudanese
tradition of infibulation (excising much of the female genitals and
sewing up the vagina), but they stand with few other modern nations in
clinging to a ritual that is no less "barbaric" and no more "hygienic,"
routine circumcision.

In the United States, 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
"masturbatory insanity" - the range of mental disorders that people
believed were caused by the "polluting" practice of "self-abuse."

Nineteenth Century parents worried when babies fondled their bodies, as
this infant drawn by Mihaly Zichy (1827-1906) is doing.
Many doctors recommended circumcision as a way to prevent "masturbatory
insanity."

But circumcision warrants none of its 19th or 20th Century
justifications. It has not stopped masturbation. It has not cured
mental illness, neurotic behavior, adolescent rebellion, epilepsy,
warts, or frigidity. It does not prevent penile or cervical cancer. It
does not make a man more (or less) sexually sensitive. [NOHARMM note:
New research indicates that the foreskin is more densely nerve-laden
than the rest of the penis and that circumcised men report progressive
sensitivity loss.] It is not minor surgery either. On the contrary,
circumcision is far more risky and has far more hazardous side effects
than most people realize.

The practice developed differently in modem industrial nations than it
did in pre-industrial societies. But circumcision was no less a ritual
for all its scientific trappings.

Masturbation...was not only a religious sin but a medical problem
that caused physical and mental disease.

Masturbation had been regarded as a religious sin since Biblical times,
but in the 18th Century science took over. Onania, or the Heinous Sin
of Self-Pollution, And All Its Frightful Consequences, in Both Sexes,
Considered was published in 19 editions and sold 38,000 copies before
1750. Masturbation, the book said, was not only a religious sin but a
medical problem that caused physical and mental disease. A few years
later Samuel Tissot, a Swiss doctor, took the exclusively medical view,
arguing that the unnatural loss of semen weakened mind and body and led
to masturbatory insanity. (His book, published in 1758, was reprinted
as recently as 1905.)

Three illustrations from The Silent Friend by R. & L. Perry & Co.
(1853) showing (left to right) the "General appearance of the features
through Onanism," "The meagre appearance of the features through
Onanism," and "Spermatorrhoeal Opthalmia consequent through Onanism."
Published in: The Anxiety Makers: Some Curious Preoccupations of the
Medical Profession by Alex Comfort, Thomas Nelson & Sons/London, 1967.

Although Tissot's book sold exceptionally well for the times, it was
more than 50 years before belief in masturbatory insanity spread
throughout Europe and the United States. One indication of increasing
concern is reflected in child-rearing guides. Alice Ryerson analyzed
all such books written between 1550 and 1900 and found a steady
increase in worry about masturbation in the United States and England.
This concern began around 1750 and peaked by the last quarter of the
19th Century, when 60 percent of the books condemned the practice.

Parents looked to physicians for answers, and the physicians responded
with alacrity. Ren=E9 Spitz, who has studied their solutions, found that
treatments ranged from diet, moral exhortations, hydrotherapy, and
marriage, to such drastic measures as surgery, physical restraints,
frights, and punishment. Some doctors recommended covering the penis
with plaster of Paris, leather, or rubber; cauterization; making boys
wear chastity belts or spiked rings; and in extreme cases, castration.

Considering the alternatives, circumcision was merciful. In the 1890s,
it became a popular technique to prevent, or cure, masturbatory
insanity. In 1891 the president of the Royal college of Surgeons in
Great Britain published "On Circumcision as Preventive of
Masturbation," 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 and,
consequently, masturbation." Another physician, P.C. Remondino, added
that "circumcision is like a substantial and well-secured life annuity
"=2E..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.
Illustrations published in: The Anxiety Makers: Some Curious
Preoccupations
of the Medical Profession by Alex Comfort, Thomas Nelson & Sons/London,
1967.

Girls were spared neither parental worry about masturbation nor similar
medical solutions. Female circumcision - removal of the clitoral hood,
analogous to the foreskin of the penis, began to be recommended at this
time, but other forms of genital surgery were attempted as well,
including the removal of the entire clitoris, or clitoridectomy.

Apparently the first clitoridectomy performed in the West occurred in
1858, in England. Isaac Baker Brown published a book describing his
success at treating female masturbators with genital operations, after
which he was roundly criticised and expelled from the London
Obstetrical Society. Most evidence indicates that clitoridectomy, but
not female circumcision, was thereafter abandoned in England. No such
credit for good sense can be applied to American physicians.

By the 1890s an "Orificial Surgery Society" had been formed in the
United States, whose function it was to promote genital operations on
women and men. Its official journal advocated that any deviation from a
"normal" clitoris "requires attention." If the hood covered the
clitoris completely, the clitoris should be amputated. If the hood was
too tight, it should be slit open along one side and the wound stitched
with catgut.

The United States and England were especially fond of circumcision,
restraints, and punishments to control masturbation.

Such severe medical treatments for masturbation, for both sexes,
apparently reached their heyday between 1870 and 1904, but they
continued to be recommended in medical textbooks and by practitioners
until the 1930s. (The Orificial Surgery Society kept going until 1925.)
The United States and England were especially fond of circumcision,
restraints, and punishments to control masturbation. Between 1879 and
1904, 75 percent of the British and American medical documents studied
by Spitz recommended drastic methods, compared to 51 percent of the
documents from Germany and Austria and 55 percent of those from France
and other European countries. But after 1925 the proportion of medical
writings that favored drastic methods dropped to 25 percent in England,
America, and the rest of Europe.

Spitz traced the path of circumcision in the United States by following
the course of one classic pediatrics textbook, L.E. Holt's Diseases of
Infancy and Childhood, which went through 11 editions between 1897 and
1940. Until 1936, circumcision was recommended as a treatment for
masturbation for both sexes, and the social and mental consequences of
masturbation were discussed even in the last edition. Holt advocated
female circumcision, cauterization of the clitoris, and even blistering
of the vulva and prepuce for recalcitrant masturbators.

Several social historians today are starting to trace the rise and fall
of what has been called masturbation mania. This odd Western obsession
accompanied the transition from an agrarian to an industrial economy in
Europe and the United States between 1700 and 1914. Masturbation was
always a middle-class worry, and it must have been powerfully
threatening to warrant the prolonged attack against it. Masturbation
frightened middle-class parents because doctors said it explained why
so many young people were neurotic, disobedient, disrespectful of
parental authority, and oversexed.

Circumcision may have represented a combined effort of medicine and the
family
to defend themselves against the implacable demands and
uncertainties of the new industrial era.

In a recent article, R.P. Neuman argues that the rise of masturbation
mania was an attempt to defend the trinity of work, family, and
paternal authority against the internal tensions of the family and the
external threats of a rapidly changing economy. Parental authority was
most threatened among the rising urban middle class, where the work
ethic was strongest and sons were most likely to delay marriage.
Therefore parental control of children's sexuality was essential. The
industrial economy, unlike the family-based economic unit, undercut the
parents' power over their children because it drew them away from the
home in search of work.

I suspect that circumcision solved some of the dilemmas confronting
both middle-class families and the newly established (and not yet
entirely respectable) obstetrical and surgical professions. Parents
wanted to control the sexual impulses of their children; physicians
wanted to demonstrate and consolidate their new powers. Circumcision
may have represented a combined effort of medicine and the family to
defend themselves against the implacable demands and uncertainties of
the new industrial era.

By the end of the 1930s, about three fourths of the middle-class
families in the United States were having their sons circumcised,
compared to one fourth of lower-class families. (I estimate these
percentages from hospital statistics on ward and private patients.) As
more and more women from all social classes began to enter hospitals to
give birth, circumcision made its way across class and ethnic lines.

By the 1950s the great majority of baby boys, from rich and poor
families alike, were routinely circumcised in hospitals. One study of
the records of 18 hospitals across the nation revealed that 83 percent
of the 14,116 male infants born in 1973 had been circumcised. Among the
births financed by a California medical program during the first
quarter of 1976, 87 percent of the males were circumcised.

The question is: Why did the United States persist in circumcising
males long after the fear of masturbatory insanity declined? The only
other country in the world today that reports nearly as high a
frequency is Australia, and even there the custom is on the way out. In
England, circumcision is virtually extinct. In 1972, according to the
Hospital Inpatient Inquiry for England and Wales, less than 1 percent
of 400,000 boys under one year old had the operation (0.41 percent).
The Scandinavian countries never accepted circumcision, and most of
Europe has discontinued it. It survives where it has a religious or
cultural tradition: Israel, Arab nations, some tribes in sub-Saharan
Africa.

The question is: Why did the United States persist in circumcising
males
long after the fear of masturbatory insanity declined?

Just when the mental illness rationale for circumcision began to
decline in the 1930s, the cancer prevention rationale took its place.
This theory was launched in 1932 when A.L. Wolbarst published a
detailed article in the English medical journal Lancet. Wolbarst wanted
to show that national and religious groups that routinely practiced
circumcision had lower rates of penile cancer than groups that did not
circumcise their boys. His specific evidence is important because
physicians are still using his data to argue on behalf of circumcision.

Wolbarst gathered records from 205 American hospitals for the years
between 1925 and 1930. Of the 830 cases of cancer of the penis that
occurred during that five year period, only one patient was Jewish -
and he had not been circumcised. Wolbarst also interviewed doctors, who
reported that they had never seen a case of penile cancer among their
Jewish patients, but they had seen cases among non-Jews.

It was an impressive argument, but unfortunately it overlooked the most
elementary rules of statistics. Jews represent a very small percentage
of the population (at Wolbarst's writing, 3 percent), and penile
cancer is even rarer than that. To report numbers of cancer cases
without controlling for differences in rates of the disease and
proportion of Jews in the nation misrepresents the data.

Next Wolbarst compared the rates of penile cancer among Muslims, who
circumcise young boys, and Hindus, who do not circumcise, in four
Indian hospitals during the same time span. Only 2 percent of the cases
of penile cancer involved circumcised Muslims, though Muslims made up
21 percent of the patients in the hospitals. Wolbarst concluded that
Muslims were vastly underrepresented among penile cancer patients, and
that the reason must be the fact of their circumcision.

Again Wolbarst erred. The appropriate denominator for comparisons is
not the religious composition of hospital patients, but Hindu and
Muslim cancer rates relative to the proportion of each group in India.
Even then, the comparison between religious groups must be heavily
qualified when the groups also differ in social, economic, and
educational levels, and in their health standards and opportunities.

The carcinogenic culprit that Wolbarst implicated was smegma and other
"debris" that accumulates between the foreskin and the glans of the
penis. The sooner a boy is circumcised, Wolbarst thought, the less
chance he has of infecting himself or his partner with this dirty
substance. As Jews seem to have a lower rate of penile cancer than
Muslims, the reason must be that Jewish boys are circumcised at birth
and Muslim boys in later childhood.

No one debated a man's ability to wash the foreskin
and clean off the supposedly carcinogenic smegma, but some physicians
recommended universal circumcision as a way to protect certain
"unclean" minorities who could not be relied on to wash their penises.
..=2E.Some doctors even argued that circumcision should be done for purely
aesthetic reasons.

Wolbarst's persuasive arguments helped establish the belief that
routine circumcision for baby boys was essential to prevent cancer in
men. As time went by, other rationales were added. No one debated a
man's ability to wash the foreskin and clean off the supposedly
carcinogenic smegma, but some physicians recommended universal
circumcision as a way to protect certain "unclean" minorities who could
not be relied on to wash their penises. (The inner ear collects dirt
too, one physician later observed, but no one suggests that the
external ear should be routinely excised.)

Some doctors even argued that circumcision should be done for purely
aesthetic reasons: A penis without a foreskin, they said, is more
pleasing to the eye, neater and less likely to produce bad odors. One
physician, Willard Goodwin, wrote that "circumcision is a
beautification comparable to rhinoplasty [a nose job]," and that the
circumcised penis "appears in its flaccid state as an erect
uncircumcised organ - a beautiful instrument of precise intent."

Clearly, medical and personal motives were getting confused.
..=2E.Once established, circumcision survived on its own momentum.

Clearly, medical and personal motives were getting confused. The 1957
and 1968 editions of Benjamin Spock's Baby and Child Care advised
circumcision because it makes a boy feel "regular" (In his latest
edition, Spock changed his mind, saying that routine circumcision was
not medically necessary.) Parents continued to have their sons
circumcised so that the boys would conform to their fathers and
siblings. Once established, circumcision survived on its own momentum.

In 1970 E. Noel Preston reviewed studies done on circumcision and
cancer. His review showed, first, that the small percentage of men who
got prostate or penile cancer tend to come from lower socioeconomic
groups, for whom health care and information about disease symptoms are
less available than for the middle class. Second, the "debris" that
accumulates beneath the foreskin is not carcinogenic. In one study,
human smegma was injected into monkey vaginas once or twice a week for
three years; no cancers of the cervix or vagina developed. A similar
experiment with mice got the same results, but this time a control
group was also injected with known carcinogens that did produce vaginal
cancers.

In 1973 Milton Terris, Fitzpatrick Wilson, and James Nelson, Jr,
completed a thorough and controlled study of the role of smegma in
cervical cancer The researchers matched 172 women with three grades of
cervical infection (invasive carcinoma, carcinoma in situ, and cervical
dysplasia) with a control group of healthy women. The husbands of the
women were examined for the extent of circumcision (complete, partial,
or none) and presence or absence of smegma.

Contrary to current impression, the cancer patients and the healthy
women were equally likely to be married to circumcised men. Nor was
there any difference between the husbands of patients and the husbands
of controls in the amount of smegma under the foreskin.

Preston's review also demolished other assumptions about cancer and
circumcision. In 1964 J. T. Boyd and R. Doll found no differences in
cervical cancer rates between Jewish and non-Jewish women, and E. G.
Jones and his colleagues found no differences between women married to
circumcised men and those married to uncircumcised men. One study even
compared women whose uncircumcised husbands used a condom as a
contraceptive (thereby preventing smegma or semen from entering the
vagina and cervix) with women whose husbands never used condoms; again,
no differences in cervical cancer rates. Preston also notes that the
well-known low rate of cervical cancer among nuns, usually attributed
to their never having intercourse with uncircumcised males, fails to
consider that they do not have intercourse with circumcised males
either.

Many arguments in favor of circumcision derived from a study by Adolf
Apt, who in 1965 compared rates of prostate cancer in Sweden (where men
are not circumcised) to those in Israel (where men are). The incidence
of prostate cancer was higher in Sweden, so it seemed that lack of
circumcision was the cause. But, as Preston was first to point out, Apt
overlooked the age differences in the two countries. Prostate cancer is
a disease of older men - and there are seven times as many men over age
60 in Sweden as in Israel. Once the age difference is adjusted, Apt's
data suggest that rates of prostate cancer are higher in the
circumcised population.

In any case, prevention of a rare problem is no reason to perform
surgery on everyone.
More people die of appendicitis than get phimosis,
yet no one recommends universal appendectomy in infants as insurance.

Circumcision has been advocated for medical reasons other than cancer
prevention. Circumcision of infants is supposed to prevent the
occurrence of phimosis (narrowness of the opening of the prepuce,
preventing its being drawn back over the glans) and balanitis
(inflammation of the glans), and eliminate the dangers of a too-tight
foreskin. The incidence of each of these problems is rare, however, and
their future likelihood impossible to detect in infants. Only a small
proportion of baby boys have a fully retractable foreskin at birth; it
takes about three years before 90 percent of all boys have a
retractable foreskin. Unfortunately many doctors, observing the
unretractable foreskin of the infant, assume the child has phimosis and
recommend circumcision. In any case, prevention of a rare problem is no
reason to perform surgery on everyone. More people die of appendicitis
than get phimosis, yet no one recommends universal appendectomy in
infants as insurance.

American attitudes about sex and circumcision have undergone a dramatic
reversal. When Americans believed that sexual impulses in general, and
masturbation in particular, were harmful, circumcision was believed to
repress sexual sensation. In the last few years the prevailing opinion
has been that sexual activities, including masturbation, are
beneficial. Circumcision is now believed to enhance sexual sensation
for both sexes.

Men have debated the sexual sensitivity question for centuries.
Circumcised men think that they have the more sensitive penises;
uncircumcised men think that the constant exposure of the naked glans
to clothes and the elements toughens it. Some men think that having a
foreskin delays orgasm, giving a man more control; others think just
the opposite. This discussion is never going to be settled. Sexual
sensitivity appears to be in the mind of a man, not in his foreskin.

For women the same issue has more serious consequences. Most people are
not aware that female circumcision was ever practiced at all in the
United States. Although circumcision of the clitoris never became as
widespread a custom as circumcision of the penis, the operation is not
uncommon. Like male circumcision, the female operation continued even
after the masturbation mania subsided in the 1930s - it just changed
rationales.

In 1937 a Texas doctor, Frank Iiams, recommended female circumcision as
a way to make women more sexually responsive. Female frigidity he said,
was caused by a clitoris that was too long or too tight (the same
problems once thought to encourage masturbation). Surgical removal of
the prepuce, he said, would restore "a more happy and contented marital
life." [NOHARMM note: This persisted into the late 1950s. Read Female
Circumcision: Indications and a New Technique]

In 1973 precisely the same justification for surgery came from a New
York doctor, Leo Wollman, whose patients are referred to him by
psychoanalysts and clinical psychologists. The only complication he
reports is the formation of a hematoma (blood clot) at the place where
the incision is made to remove the foreskin. Sometimes the hematoma
grows as large as a goose egg. Wollman concedes that such a
complication may be "distressing" to the patient, but warns that
telling all women of its likelihood prior to surgery was
"psychologically inadvisable" - but legally prudent.

The issue of female circumcision has come to public attention. In 1977
a California woman brought suit against her doctor, who performed the
operation to cure her "sexual insensitivity." The medical profession is
divided on the matter, as usual. One physician who testified at the
hearing, unidentified in the newspaper accounts, said he "could see no
reason in the world why this operation had to be performed," while the
chairman of the Department of Obstetrics and Gynecology at Stanford
University Medical School said it is "a matter of judgment."

Two years ago The New York Times carried a front-page story on
unnecessary surgical practices. The Times reported that male
circumcision was the most common surgical procedure in the United
States, but there were "not untrivial" complications. The Times
understated the case.

The three most serious complications are hemorrhage, infection, and
surgical trauma. Infection of the wound, often from contact with feces
and urine, can lead to inflammation and ulceration of the penis. In one
Canadian study, Hawa Patel examined 100 circumcised infant boys and
found common, though "usually minor" complications, including
hemorrhage (35 boys), ulcers of the urethral passage (31), infection
(8), and phimosis (1). In rare instances, infections have led to
septicemia and pulmonary abscesses, causing the baby's death.

Sometimes circumcision fails because too much foreskin is pulled over
the shaft and excised, leaving a denuded shaft. Sometimes circumcisions
are incomplete. In a study of cervical cancer patients by Terris and
his colleagues, a large number of the husbands had had partial
circumcisions, in which much of the foreskin had been left.

The consequences of circumcision can be horrible. Some years ago, John
Money and Anke Ehrhardt reported a case of twin boys, one of whom had
been transformed surgically into a girl. The case has been widely cited
as an example of how social learning can turn a genetic boy into a
psychological girl. Readers of this study tend to avoid the paragraph
that tells why the operation had to be done in the first place: The
infant boy was the victim of a "mistake" during a routine circumcision.
His penis was burned off. [NOHARMM note: This is the John/Joan case in
Canada that hit the media headlines in 1997. Again, most of the media
never divulged the circumcision tragedy (until July, 1998). Instead,
they initially focused on "intersexuals" - those born with ambiguous
genitalia.]

Overall, the complication rate for routine circumcision stands at only
1 percent of all operations. Still, for every one million boys, that is
10,000 complications -including two deaths. And physicians are still
not sure about the hidden effects. The psychological and stress
consequences of early circumcision are just now coming under
investigation. Yvonne Brackbill finds that circumcised baby boys show
greater increases in heart rate in response to sounds than do girls and
uncircumcised boys. Luther Talbert and his colleagues find that after
circumcision, male babies show increased adrenal cortical hormone
levels -hormones known to increase in response to stress. And after
circumcision, I.F. Anders and R.J. Chalemian report, male babies change
their sleep patterns, staying awake for longer periods of time than
they did before the operation. Other researchers have found that male
babies, at three weeks and at three months of age, cry more and sleep
less than females, and are harder to console when they get irritable.
In short, infants are put under stress by the operation, and the
potential effects of such stress should not be ignored.

When a custom persists after its original functions have died,
it may be accorded the status of ritual.

For all of these reasons the American Pediatric Society finally
concluded in 1975 that "there are no valid medical indications for
circumcision" in infancy. But obstetricians, who generally perform the
surgery, have not endorsed this stand, and health insurance companies
are still spending some $200 million annually to pay for the $50 to $75
operation [1978 prices].

When a custom persists after its original functions have died, it may
be accorded the status of ritual. American parents and physicians no
longer cite masturbatory insanity as a reason to circumcise children,
but they have found other justifications for the ritual that they
believe in as firmly. When the same operation is variously reputed to
accomplish antithetical goals - in the case of circumcision, to repress
sexuality and to liberate it, to make the penis or clitoris less
sensitive and more sensitive - we can be sure we are dealing with
ritual, not rational thinking. It is astonishing that such a little bit
of skin carries such a great load of power.

Anthropologists and psychoanalysts have attempted many explanations of
circumcision and other forms of genital surgery in tribal cultures.
Psychoanalysts concentrate on unconscious motives, castration anxiety,
and father-son rivalry. Circumcision, they say, represents a boy's
willingness to sacrifice a part of his penis in deference to his
father's power, or the father's efforts to show his son who is boss.

The trouble with these theories is that in no society do boys
circumcise themselves, and only rarely do fathers circumcise their own
sons. The operation is almost always done by a third party: the tribal
chief, a physician, the boy's uncle, or a professional (the Jewish
mohel).

Only 23 cultures in our sample practice circumcision, and they tend to
share
a particular economy and form of social organization. ...strong
fraternal-interest groups,
related males who are united to pursue common political objectives.

Some anthropologists regard circumcision rituals as a rite of passage,
a part of manhood training. The trouble with this approach is that
across cultures, boys are circumcised at different ages: some in
infancy, some in childhood, some as adolescents. In most societies boys
are forcibly subjected to the ceremony when they are far too young to
understand the meaning of masculinity.

Circumcision was practiced in Egypt as long ago as 4000 B. C.
According to the inscription on this bas-relief from the Ankh-Mahor
tomb at Sakkara, the youth on the right accepts the surgery, but his
companion balks and must be held by the doctor's aide.

To understand the functions of circumcision, Jeffery Paige and I
studied a world-wide sample of 114 tribal societies. We asked first how
prevalent the custom is, and where it occurs. Only 23 cultures in our
sample practice circumcision, and they tend to share a particular
economy and form of social organization. These societies are all
advanced horticulturalists or nomadic pastoralists - such as the Tiv of
Nigeria or the Kazakh of Russia - that share a common political
structure. They are composed of what we call strong fraternal-interest
groups, related males who are united to pursue common political
objectives. Because of the strength of these large groups, kinsmen are
especially successful in defending property, allocating resources, and
negotiating explicit agreements over women and wealth. Women are pawns
in such societies, exchanged in kinship bargains and marriages.

For whom is the circumcision ceremony performed?

We next asked: For whom is the circumcision ceremony performed? Not for
the child, not even for the father The child is a passive participant,
according to most ethnographic accounts. The most common pattern is for
a village elder or chief to command a reluctant father to have his sons
circumcised. Among the Thonga the chief orders the ceremony for all
boys between 10 and 16, and if necessary he will use force to carry out
the command. Victor Turner, who studied the Ndembu of Zambia, observed
one wily old chief revive his flagging power over factions within his
tribe. He called for a circumcision of the warring factions' sons - and
he presided. Because the timing of the ritual varies from infancy to
adolescence, both across and within cultures, kinsmen continually fight
over who should do the operation and when. Sometimes the scheduling of
a circumcision settles a brewing feud - or escalates one.

..=2E.male circumcisions are a public demonstration by fathers to elder
kinsmen
of their loyalty to the fraternal-interest group

Evidence like this persuaded us that male circumcisions are a public
demonstration by fathers to elder kinsmen of their loyalty to the
fraternal-interest group. The greatest sign of loyalty is to entrust
one's son's reproductive ability to someone else, and it is precisely
because the ritual involves this risk that it is such a powerful
emotional symbol. (Tiv fathers laugh nervously during the ceremony,
telling the circumciser: "Easy, easy, many women will weep if you
err.")

There is a reason these societies perform ritual mutilations on the
penis, the organ of ...power,
..=2E. obedience of fathers and sons is of particular economic and
political importance.

There is a reason these societies perform ritual mutilations on the
penis, the organ of procreation and power, and not on the ear, or
finger, or elbow. In societies that practice circumcision, the
obedience of fathers and sons is of particular economic and political
importance. A father who leaves the fraternal-interest group, taking
with him the reproductive power of his sons and of his sons' sons,
represents an immense threat to the continuing ability of the group to
defend itself and its valuable resources. Among tribes that lack
fraternal-interest groups, such as the Mbuti hunter/gatherers,
individuals break off from their kin groups frequently; but the
departure of a son's family is no loss of power or wealth for the
father, since they control nothing of great value in the first place.
Only when military and political power depends on continual expansion
of males in the father's line does the departure of a son and his
reproductive assets represent a major political crisis.

Female circumcision and other genital mutilations are generally
confined
to the same types of societies that practice male circumcision.

Female circumcision and other genital mutilations are generally
confined to the same types of societies that practice male
circumcision. (Not all cultures that circumcise males also perform
genital surgery on females.) In non-Western cultures genital operations
are primarily intended to preserve a girl's virginity until marriage.
In these strong fraternal-interest groups, a bride's virginity
guarantees economic alliance and political power for her male kin, as
well as economic support and protection for the woman and her female
kin.

The ancient Hebrews had the exact form of economic and political
organization in which
male circumcision (and female virginity tests at marriage) is most
likely to occur today.

The ancient Hebrews had the exact form of economic and political
organization in which male circumcision (and female virginity tests at
marriage) is most likely to occur today. Indeed, the story of Genesis
is a story of fissions and feuds, of a growing tribe that needed unity
and the strength of its male defenders to survive in a hostile human
and ecological environment. Genesis 17 describes the bargain between
God and Abraham: "This is my covenant which ye shall keep, between me
and you and thy seed after thee; Every man child among you shall be
circumcised.... And the uncircumcised man child whose flesh of his
foreskin is not circumcised, that soul shall be cut off from his
people; he hath broken my covenant."

But the ancient Jews knew exactly what circumcision was: a loyalty
oath, a political deal.

Modern Jews often defend circumcision by arguing that the custom, like
the pork taboo, protected Jews against disease and illness whether they
were aware of it or not. But the ancient Jews knew exactly what
circumcision was: a loyalty oath, a political deal. Any Jew, even
today, who does not circumcise his sons is announcing the limitations
of his loyalty to the tribe.

---------------------------------------------------------------------------=
-----

Karen Ericksen Paige is associate professor of psychology at the
University of California at Davis. She received her Ph.D. at the
University of Michigan in 1969, where she began her studies of the
cultural and personality components of mood changes and physical
symptoms associated with the menstrual cycle. She and her husband,
Jeffery M. Paige, have just completed a four-year study of world
patterns in reproductive rituals such as circumcision and couvade.
Their book, Politics and Reproductive Ritual, will be published by the
University of California Press. Paige is continuing research on world
patterns in female puberty rites and practices associated with
premarital virginity - concentrating on the themes of honor and shame -
and she is also studying critical transition points in the life cycle
of American women and men.

---------------------------------------------------------------------------=
-----

References

Neuman, R.P. "Masturbation, Madness and the Modern Concepts of
Childhood and Adolescence" Journal of Social History, Spring 1975,
pp.1-27.

Preston, E. Noel. "Whither the Foreskin?" Journal of the American
Medical Association, vol. 213, no. 11.

Richards, M.P.M., J.F. Bernal and Yvonne Brackenbill "Early Behavioral
Difference: Gender or Circumcision?" Developmental Psychobiology, vol.
9, no. 1.

Ryerson, Alice Judson. "Medical Advice on Childrearing, 1550-1900"
Harvard Educational Review, vol. 31, no. 3.

Spitz, Ren=E9. "Authority and Masturbation: Some Remarks on a
Bibliographic Investigation" Yearbook of Psychoanalysis, vol. 9,
International Universities Press, 1953.

Terris, Milton, Fitzpatrick Wilson and James Nelson, Jr. "Relation of
Circumcision to Cancer of the Cervix" American Journal of Obstetrics
and Gynecology, vol. 117, no. 8.

Wolbarst, A.L. "Circumcision and Penile Cancer" The Lancet, January 16,
1932, pp. 150-153.

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Last updated: 06 September, 2005
=A9 1998-2002 NOHARMM. All rights reserved. Questions, or problems

Sheldon Liberman

2006-06-04, 8:06 am

Moishe wrote:
> The Ritual of Circumcision
>
> Karen Ericksen Paige
> Human Nature, pp 40-48, May 1978
>
>
> NOTE: Links with a right-facing blue arrow will take you off this
> site.
>
> In the United States, the current medical rationale for circumcision
> developed after the operation was in wide practice.
>
> Westerners look askance at the ritual mutilations of the body performed
> in exotic tribes, but they justify their own ritual mutilations as
> medically appropriate. Europeans sneer at the Maasai custom of
> lengthening the ear lobes, but they have their own noses bobbed and
> their faces lifted. Americans are horrified at the Arunta practice of
> subincision (slitting the penis on the ventral side) or the Sudanese
> tradition of infibulation (excising much of the female genitals and
> sewing up the vagina), but they stand with few other modern nations in
> clinging to a ritual that is no less "barbaric" and no more "hygienic,"
> routine circumcision.
>
> In the United States, 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
> "masturbatory insanity" - the range of mental disorders that people
> believed were caused by the "polluting" practice of "self-abuse."
>
> Nineteenth Century parents worried when babies fondled their bodies, as
> this infant drawn by Mihaly Zichy (1827-1906) is doing.
> Many doctors recommended circumcision as a way to prevent "masturbatory
> insanity."
>
>
>
> But circumcision warrants none of its 19th or 20th Century
> justifications. It has not stopped masturbation. It has not cured
> mental illness, neurotic behavior, adolescent rebellion, epilepsy,
> warts, or frigidity. It does not prevent penile or cervical cancer. It
> does not make a man more (or less) sexually sensitive. [NOHARMM note:
> New research indicates that the foreskin is more densely nerve-laden
> than the rest of the penis and that circumcised men report progressive
> sensitivity loss.] It is not minor surgery either. On the contrary,
> circumcision is far more risky and has far more hazardous side effects
> than most people realize.
>
> The practice developed differently in modem industrial nations than it
> did in pre-industrial societies. But circumcision was no less a ritual
> for all its scientific trappings.
>
> Masturbation...was not only a religious sin but a medical problem
> that caused physical and mental disease.
>
> Masturbation had been regarded as a religious sin since Biblical times,
> but in the 18th Century science took over. Onania, or the Heinous Sin
> of Self-Pollution, And All Its Frightful Consequences, in Both Sexes,
> Considered was published in 19 editions and sold 38,000 copies before
> 1750. Masturbation, the book said, was not only a religious sin but a
> medical problem that caused physical and mental disease. A few years
> later Samuel Tissot, a Swiss doctor, took the exclusively medical view,
> arguing that the unnatural loss of semen weakened mind and body and led
> to masturbatory insanity. (His book, published in 1758, was reprinted
> as recently as 1905.)
>
>
>
> Three illustrations from The Silent Friend by R. & L. Perry & Co.
> (1853) showing (left to right) the "General appearance of the features
> through Onanism," "The meagre appearance of the features through
> Onanism," and "Spermatorrhoeal Opthalmia consequent through Onanism."
> Published in: The Anxiety Makers: Some Curious Preoccupations of the
> Medical Profession by Alex Comfort, Thomas Nelson & Sons/London, 1967.
>
>
> Although Tissot's book sold exceptionally well for the times, it was
> more than 50 years before belief in masturbatory insanity spread
> throughout Europe and the United States. One indication of increasing
> concern is reflected in child-rearing guides. Alice Ryerson analyzed
> all such books written between 1550 and 1900 and found a steady
> increase in worry about masturbation in the United States and England.
> This concern began around 1750 and peaked by the last quarter of the
> 19th Century, when 60 percent of the books condemned the practice.
>
>
> Parents looked to physicians for answers, and the physicians responded
> with alacrity. Ren=E9 Spitz, who has studied their solutions, found that
> treatments ranged from diet, moral exhortations, hydrotherapy, and
> marriage, to such drastic measures as surgery, physical restraints,
> frights, and punishment. Some doctors recommended covering the penis
> with plaster of Paris, leather, or rubber; cauterization; making boys
> wear chastity belts or spiked rings; and in extreme cases, castration.
>
>
> Considering the alternatives, circumcision was merciful. In the 1890s,
> it became a popular technique to prevent, or cure, masturbatory
> insanity. In 1891 the president of the Royal college of Surgeons in
> Great Britain published "On Circumcision as Preventive of
> Masturbation," 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 and,
> consequently, masturbation." Another physician, P.C. Remondino, added
> that "circumcision is like a substantial and well-secured life annuity
> "...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.
> Illustrations published in: The Anxiety Makers: Some Curious
> Preoccupations
> of the Medical Profession by Alex Comfort, Thomas Nelson & Sons/London,
> 1967.
>
>
>
>
> Girls were spared neither parental worry about masturbation nor similar
> medical solutions. Female circumcision - removal of the clitoral hood,
> analogous to the foreskin of the penis, began to be recommended at this
> time, but other forms of genital surgery were attempted as well,
> including the removal of the entire clitoris, or clitoridectomy.
>
> Apparently the first clitoridectomy performed in the West occurred in
> 1858, in England. Isaac Baker Brown published a book describing his
> success at treating female masturbators with genital operations, after
> which he was roundly criticised and expelled from the London
> Obstetrical Society. Most evidence indicates that clitoridectomy, but
> not female circumcision, was thereafter abandoned in England. No such
> credit for good sense can be applied to American physicians.
>
> By the 1890s an "Orificial Surgery Society" had been formed in the
> United States, whose function it was to promote genital operations on
> women and men. Its official journal advocated that any deviation from a
> "normal" clitoris "requires attention." If the hood covered the
> clitoris completely, the clitoris should be amputated. If the hood was
> too tight, it should be slit open along one side and the wound stitched
> with catgut.
>
> The United States and England were especially fond of circumcision,
> restraints, and punishments to control masturbation.
>
> Such severe medical treatments for masturbation, for both sexes,
> apparently reached their heyday between 1870 and 1904, but they
> continued to be recommended in medical textbooks and by practitioners
> until the 1930s. (The Orificial Surgery Society kept going until 1925.)
> The United States and England were especially fond of circumcision,
> restraints, and punishments to control masturbation. Between 1879 and
> 1904, 75 percent of the British and American medical documents studied
> by Spitz recommended drastic methods, compared to 51 percent of the
> documents from Germany and Austria and 55 percent of those from France
> and other European countries. But after 1925 the proportion of medical
> writings that favored drastic methods dropped to 25 percent in England,
> America, and the rest of Europe.
>
> Spitz traced the path of circumcision in the United States by following
> the course of one classic pediatrics textbook, L.E. Holt's Diseases of
> Infancy and Childhood, which went through 11 editions between 1897 and
> 1940. Until 1936, circumcision was recommended as a treatment for
> masturbation for both sexes, and the social and mental consequences of
> masturbation were discussed even in the last edition. Holt advocated
> female circumcision, cauterization of the clitoris, and even blistering
> of the vulva and prepuce for recalcitrant masturbators.
>
> Several social historians today are starting to trace the rise and fall
> of what has been called masturbation mania. This odd Western obsession
> accompanied the transition from an agrarian to an industrial economy in
> Europe and the United States between 1700 and 1914. Masturbation was
> always a middle-class worry, and it must have been powerfully
> threatening to warrant the prolonged attack against it. Masturbation
> frightened middle-class parents because doctors said it explained why
> so many young people were neurotic, disobedient, disrespectful of
> parental authority, and oversexed.
>
> Circumcision may have represented a combined effort of medicine and the
> family
> to defend themselves against the implacable demands and
> uncertainties of the new industrial era.
>
> In a recent article, R.P. Neuman argues that the rise of masturbation
> mania was an attempt to defend the trinity of work, family, and
> paternal authority against the internal tensions of the family and the
> external threats of a rapidly changing economy. Parental authority was
> most threatened among the rising urban middle class, where the work
> ethic was strongest and sons were most likely to delay marriage.
> Therefore parental control of children's sexuality was essential. The
> industrial economy, unlike the family-based economic unit, undercut the
> parents' power over their children because it drew them away from the
> home in search of work.
>
> I suspect that circumcision solved some of the dilemmas confronting
> both middle-class families and the newly established (and not yet
> entirely respectable) obstetrical and surgical professions. Parents
> wanted to control the sexual impulses of their children; physicians
> wanted to demonstrate and consolidate their new powers. Circumcision
> may have represented a combined effort of medicine and the family to
> defend themselves against the implacable demands and uncertainties of
> the new industrial era.
>
> By the end of the 1930s, about three fourths of the middle-class
> families in the United States were having their sons circumcised,
> compared to one fourth of lower-class families. (I estimate these
> percentages from hospital statistics on ward and private patients.) As
> more and more women from all social classes began to enter hospitals to
> give birth, circumcision made its way across class and ethnic lines.
>
> By the 1950s the great majority of baby boys, from rich and poor
> families alike, were routinely circumcised in hospitals. One study of
> the records of 18 hospitals across the nation revealed that 83 percent
> of the 14,116 male infants born in 1973 had been circumcised. Among the
> births financed by a California medical program during the first
> quarter of 1976, 87 percent of the males were circumcised.
>
> The question is: Why did the United States persist in circumcising
> males long after the fear of masturbatory insanity declined? The only
> other country in the world today that reports nearly as high a
> frequency is Australia, and even there the custom is on the way out. In
> England, circumcision is virtually extinct. In 1972, according to the
> Hospital Inpatient Inquiry for England and Wales, less than 1 percent
> of 400,000 boys under one year old had the operation (0.41 percent).
> The Scandinavian countries never accepted circumcision, and most of
> Europe has discontinued it. It survives where it has a religious or
> cultural tradition: Israel, Arab nations, some tribes in sub-Saharan
> Africa.
>
> The question is: Why did the United States persist in circumcising
> males
> long after the fear of masturbatory insanity declined?
>
> Just when the mental illness rationale for circumcision began to
> decline in the 1930s, the cancer prevention rationale took its place.
> This theory was launched in 1932 when A.L. Wolbarst published a
> detailed article in the English medical journal Lancet. Wolbarst wanted
> to show that national and religious groups that routinely practiced
> circumcision had lower rates of penile cancer than groups that did not
> circumcise their boys. His specific evidence is important because
> physicians are still using his data to argue on behalf of circumcision.
>
> Wolbarst gathered records from 205 American hospitals for the years
> between 1925 and 1930. Of the 830 cases of cancer of the penis that
> occurred during that five year period, only one patient was Jewish -
> and he had not been circumcised. Wolbarst also interviewed doctors, who
> reported that they had never seen a case of penile cancer among their
> Jewish patients, but they had seen cases among non-Jews.
>
> It was an impressive argument, but unfortunately it overlooked the most
> elementary rules of statistics. Jews represent a very small percentage
> of the population (at Wolbarst's writing, 3 percent), and penile
> cancer is even rarer than that. To report numbers of cancer cases
> without controlling for differences in rates of the disease and
> proportion of Jews in the nation misrepresents the data.
>
> Next Wolbarst compared the rates of penile cancer among Muslims, who
> circumcise young boys, and Hindus, who do not circumcise, in four
> Indian hospitals during the same time span. Only 2 percent of the cases
> of penile cancer involved circumcised Muslims, though Muslims made up
> 21 percent of the patients in the hospitals. Wolbarst concluded that
> Muslims were vastly underrepresented among penile cancer patients, and
> that the reason must be the fact of their circumcision.
>
> Again Wolbarst erred. The appropriate denominator for comparisons is
> not the religious composition of hospital patients, but Hindu and
> Muslim cancer rates relative to the proportion of each group in India.
> Even then, the comparison between religious groups must be heavily
> qualified when the groups also differ in social, economic, and
> educational levels, and in their health standards and opportunities.
>
> The carcinogenic culprit that Wolbarst implicated was smegma and other
> "debris" that accumulates between the foreskin and the glans of the
> penis. The sooner a boy is circumcised, Wolbarst thought, the less
> chance he has of infecting himself or his partner with this dirty
> substance. As Jews seem to have a lower rate of penile cancer than
> Muslims, the reason must be that Jewish boys are circumcised at birth
> and Muslim boys in later childhood.
>
> No one debated a man's ability to wash the foreskin
> and clean off the supposedly carcinogenic smegma, but some physicians
> recommended universal circumcision as a way to protect certain
> "unclean" minorities who could not be relied on to wash their penises.
> ...Some doctors even argued that circumcision should be done for purely
> aesthetic reasons.
>
> Wolbarst's persuasive arguments helped establish the belief that
> routine circumcision for baby boys was essential to prevent cancer in
> men. As time went by, other rationales were added. No one debated a
> man's ability to wash the foreskin and clean off the supposedly
> carcinogenic smegma, but some physicians recommended universal
> circumcision as a way to protect certain "unclean" minorities who could
> not be relied on to wash their penises. (The inner ear collects dirt
> too, one physician later observed, but no one suggests that the
> external ear should be routinely excised.)
>
> Some doctors even argued that circumcision should be done for purely
> aesthetic reasons: A penis without a foreskin, they said, is more
> pleasing to the eye, neater and less likely to produce bad odors. One
> physician, Willard Goodwin, wrote that "circumcision is a
> beautification comparable to rhinoplasty [a nose job]," and that the
> circumcised penis "appears in its flaccid state as an erect
> uncircumcised organ - a beautiful instrument of precise intent."
>
> Clearly, medical and personal motives were getting confused.
> ...Once established, circumcision survived on its own momentum.
>
> Clearly, medical and personal motives were getting confused. The 1957
> and 1968 editions of Benjamin Spock's Baby and Child Care advised
> circumcision because it makes a boy feel "regular" (In his latest
> edition, Spock changed his mind, saying that routine circumcision was
> not medically necessary.) Parents continued to have their sons
> circumcised so that the boys would conform to their fathers and
> siblings. Once established, circumcision survived on its own momentum.
>
> In 1970 E. Noel Preston reviewed studies done on circumcision and
> cancer. His review showed, first, that the small percentage of men who
> got prostate or penile cancer tend to come from lower socioeconomic
> groups, for whom health care and information about disease symptoms are
> less available than for the middle class. Second, the "debris" that
> accumulates beneath the foreskin is not carcinogenic. In one study,
> human smegma was injected into monkey vaginas once or twice a week for
> three years; no cancers of the cervix or vagina developed. A similar
> experiment with mice got the same results, but this time a control
> group was also injected with known carcinogens that did produce vaginal
> cancers.
>
> In 1973 Milton Terris, Fitzpatrick Wilson, and James Nelson, Jr,
> completed a thorough and controlled study of the role of smegma in
> cervical cancer The researchers matched 172 women with three grades of
> cervical infection (invasive carcinoma, carcinoma in situ, and cervical
> dysplasia) with a control group of healthy women. The husbands of the
> women were examined for the extent of circumcision (complete, partial,
> or none) and presence or absence of smegma.
>
> Contrary to current impression, the cancer patients and the healthy
> women were equally likely to be married to circumcised men. Nor was
> there any difference between the husbands of patients and the husbands
> of controls in the amount of smegma under the foreskin.
>
> Preston's review also demolished other assumptions about cancer and
> circumcision. In 1964 J. T. Boyd and R. Doll found no differences in
> cervical cancer rates between Jewish and non-Jewish women, and E. G.
> Jones and his colleagues found no differences between women married to
> circumcised men and those married to uncircumcised men. One study even
> compared women whose uncircumcised husbands used a condom as a
> contraceptive (thereby preventing smegma or semen from entering the
> vagina and cervix) with women whose husbands never used condoms; again,
> no differences in cervical cancer rates. Preston also notes that the
> well-known low rate of cervical cancer among nuns, usually attributed
> to their never having intercourse with uncircumcised males, fails to
> consider that they do not have intercourse with circumcised males
> either.
>
> Many arguments in favor of circumcision derived from a study by Adolf
> Apt, who in 1965 compared rates of prostate cancer in Sweden (where men
> are not circumcised) to those in Israel (where men are). The incidence
> of prostate cancer was higher in Sweden, so it seemed that lack of
> circumcision was the cause. But, as Preston was first to point out, Apt
> overlooked the age differences in the two countries. Prostate cancer is
> a disease of older men - and there are seven times as many men over age
> 60 in Sweden as in Israel. Once the age difference is adjusted, Apt's
> data suggest that rates of prostate cancer are higher in the
> circumcised population.
>
> In any case, prevention of a rare problem is no reason to perform
> surgery on everyone.
> More people die of appendicitis than get phimosis,
> yet no one recommends universal appendectomy in infants as insurance.
>
> Circumcision has been advocated for medical reasons other than cancer
> prevention. Circumcision of infants is supposed to prevent the
> occurrence of phimosis (narrowness of the opening of the prepuce,
> preventing its being drawn back over the glans) and balanitis
> (inflammation of the glans), and eliminate the dangers of a too-tight
> foreskin. The incidence of each of these problems is rare, however, and
> their future likelihood impossible to detect in infants. Only a small
> proportion of baby boys have a fully retractable foreskin at birth; it
> takes about three years before 90 percent of all boys have a
> retractable foreskin. Unfortunately many doctors, observing the
> unretractable foreskin of the infant, assume the child has phimosis and
> recommend circumcision. In any case, prevention of a rare problem is no
> reason to perform surgery on everyone. More people die of appendicitis
> than get phimosis, yet no one recommends universal appendectomy in
> infants as insurance.
>
> American attitudes about sex and circumcision have undergone a dramatic
> reversal. When Americans believed that sexual impulses in general, and
> masturbation in particular, were harmful, circumcision was believed to
> repress sexual sensation. In the last few years the prevailing opinion
> has been that sexual activities, including masturbation, are
> beneficial. Circumcision is now believed to enhance sexual sensation
> for both sexes.
>
> Men have debated the sexual sensitivity question for centuries.
> Circumcised men think that they have the more sensitive penises;
> uncircumcised men think that the constant exposure of the naked glans
> to clothes and the elements toughens it. Some men think that having a
> foreskin delays orgasm, giving a man more control; others think just
> the opposite. This discussion is never going to be settled. Sexual
> sensitivity appears to be in the mind of a man, not in his foreskin.
>
> For women the same issue has more serious consequences. Most people are
> not aware that female circumcision was ever practiced at all in the
> United States. Although circumcision of the clitoris never became as
> widespread a custom as circumcision of the penis, the operation is not
> uncommon. Like male circumcision, the female operation continued even
> after the masturbation mania subsided in the 1930s - it just changed
> rationales.
>
> In 1937 a Texas doctor, Frank Iiams, recommended female circumcision as
> a way to make women more sexually responsive. Female frigidity he said,
> was caused by a clitoris that was too long or too tight (the same
> problems once thought to encourage masturbation). Surgical removal of
> the prepuce, he said, would restore "a more happy and contented marital
> life." [NOHARMM note: This persisted into the late 1950s. Read Female
> Circumcision: Indications and a New Technique]
>
> In 1973 precisely the same justification for surgery came from a New
> York doctor, Leo Wollman, whose patients are referred to him by
> psychoanalysts and clinical psychologists. The only complication he
> reports is the formation of a hematoma (blood clot) at the place where
> the incision is made to remove the foreskin. Sometimes the hematoma
> grows as large as a goose egg. Wollman concedes that such a
> complication may be "distressing" to the patient, but warns that
> telling all women of its likelihood prior to surgery was
> "psychologically inadvisable" - but legally prudent.
>
> The issue of female circumcision has come to public attention. In 1977
> a California woman brought suit against her doctor, who performed the
> operation to cure her "sexual insensitivity." The medical profession is
> divided on the matter, as usual. One physician who testified at the
> hearing, unidentified in the newspaper accounts, said he "could see no
> reason in the world why this operation had to be performed," while the
> chairman of the Department of Obstetrics and Gynecology at Stanford
> university Medical School said it is "a matter of judgment."
>
> Two years ago The New York Times carried a front-page story on
> unnecessary surgical practices. The Times reported that male
> circumcision was the most common surgical procedure in the United
> States, but there were "not untrivial" complications. The Times
> understated the case.
>
> The three most serious complications are hemorrhage, infection, and
> surgical trauma. Infection of the wound, often from contact with feces
> and urine, can lead to inflammation and ulceration of the penis. In one
> Canadian study, Hawa Patel examined 100 circumcised infant boys and
> found common, though "usually minor" complications, including
> hemorrhage (35 boys), ulcers of the urethral passage (31), infection
> (8), and phimosis (1). In rare instances, infections have led to
> septicemia and pulmonary abscesses, causing the baby's death.
>
> Sometimes circumcision fails because too much foreskin is pulled over
> the shaft and excised, leaving a denuded shaft. Sometimes circumcisions
> are incomplete. In a study of cervical cancer patients by Terris and
> his colleagues, a large number of the husbands had had partial
> circumcisions, in which much of the foreskin had been left.
>
> The consequences of circumcision can be horrible. Some years ago, John
> Money and Anke Ehrhardt reported a case of twin boys, one of whom had
> been transformed surgically into a girl. The case has been widely cited
> as an example of how social learning can turn a genetic boy into a
> psychological girl. Readers of this study tend to avoid the paragraph
> that tells why the operation had to be done in the first place: The
> infant boy was the victim of a "mistake" during a routine circumcision.
> His penis was burned off. [NOHARMM note: This is the John/Joan case in
> Canada that hit the media headlines in 1997. Again, most of the media
> never divulged the circumcision tragedy (until July, 1998). Instead,
> they initially focused on "intersexuals" - those born with ambiguous
> genitalia.]
>
> Overall, the complication rate for routine circumcision stands at only
> 1 percent of all operations. Still, for every one million boys, that is
> 10,000 complications -including two deaths. And physicians are still
> not sure about the hidden effects. The psychological and stress
> consequences of early circumcision are just now coming under
> investigation. Yvonne Brackbill finds that circumcised baby boys show
> greater increases in heart rate in response to sounds than do girls and
> uncircumcised boys. Luther Talbert and his colleagues find that after
> circumcision, male babies show increased adrenal cortical hormone
> levels -hormones known to increase in response to stress. And after
> circumcision, I.F. Anders and R.J. Chalemian report, male babies change
> their sleep patterns, staying awake for longer periods of time than
> they did before the operation. Other researchers have found that male
> babies, at three weeks and at three months of age, cry more and sleep
> less than females, and are harder to console when they get irritable.
> In short, infants are put under stress by the operation, and the
> potential effects of such stress should not be ignored.
>
> When a custom persists after its original functions have died,
> it may be accorded the status of ritual.
>
> For all of these reasons the American Pediatric Society finally
> concluded in 1975 that "there are no valid medical indications for
> circumcision" in infancy. But obstetricians, who generally perform the
> surgery, have not endorsed this stand, and health insurance companies
> are still spending some $200 million annually to pay for the $50 to $75
> operation [1978 prices].
>
> When a custom persists after its original functions have died, it may
> be accorded the status of ritual. American parents and physicians no
> longer cite masturbatory insanity as a reason to circumcise children,
> but they have found other justifications for the ritual that they
> believe in as firmly. When the same operation is variously reputed to
> accomplish antithetical goals - in the case of circumcision, to repress
> sexuality and to liberate it, to make the penis or clitoris less
> sensitive and more sensitive - we can be sure we are dealing with
> ritual, not rational thinking. It is astonishing that such a little bit
> of skin carries such a great load of power.
>
> Anthropologists and psychoanalysts have attempted many explanations of
> circumcision and other forms of genital surgery in tribal cultures.
> Psychoanalysts concentrate on unconscious motives, castration anxiety,
> and father-son rivalry. Circumcision, they say, represents a boy's
> willingness to sacrifice a part of his penis in deference to his
> father's power, or the father's efforts to show his son who is boss.
>
> The trouble with these theories is that in no society do boys
> circumcise themselves, and only rarely do fathers circumcise their own
> sons. The operation is almost always done by a third party: the tribal
> chief, a physician, the boy's uncle, or a professional (the Jewish
> mohel).
>
> Only 23 cultures in our sample practice circumcision, and they tend to
> share
> a particular economy and form of social organization. ...strong
> fraternal-interest groups,
> related males who are united to pursue common political objectives.
>
> Some anthropologists regard circumcision rituals as a rite of passage,
> a part of manhood training. The trouble with this approach is that
> across cultures, boys are circumcised at different ages: some in
> infancy, some in childhood, some as adolescents. In most societies boys
> are forcibly subjected to the ceremony when they are far too young to
> understand the meaning of masculinity.
>
>
> Circumcision was practiced in Egypt as long ago as 4000 B. C.
> According to the inscription on this bas-relief from the Ankh-Mahor
> tomb at Sakkara, the youth on the right accepts the surgery, but his
> companion balks and must be held by the doctor's aide.
>
> To understand the functions of circumcision, Jeffery Paige and I
> studied a world-wide sample of 114 tribal societies. We asked first how
> prevalent the custom is, and where it occurs. Only 23 cultures in our
> sample practice circumcision, and they tend to share a particular
> economy and form of social organization. These societies are all
> advanced horticulturalists or nomadic pastoralists - such as the Tiv of
> Nigeria or the Kazakh of Russia - that share a common political
> structure. They are composed of what we call strong fraternal-interest
> groups, related males who are united to pursue common political
> objectives. Because of the strength of these large groups, kinsmen are
> especially successful in defending property, allocating resources, and
> negotiating explicit agreements over women and wealth. Women are pawns
> in such societies, exchanged in kinship bargains and marriages.
>
> For whom is the circumcision ceremony performed?
>
> We next asked: For whom is the circumcision ceremony performed? Not for
> the child, not even for the father The child is a passive participant,
> according to most ethnographic accounts. The most common pattern is for
> a village elder or chief to command a reluctant father to have his sons
> circumcised. Among the Thonga the chief orders the ceremony for all
> boys between 10 and 16, and if necessary he will use force to carry out
> the command. Victor Turner, who studied the Ndembu of Zambia, observed
> one wily old chief revive his flagging power over factions within his
> tribe. He called for a circumcision of the warring factions' sons - and
> he presided. Because the timing of the ritual varies from infancy to
> adolescence, both across and within cultures, kinsmen continually fight
> over who should do the operation and when. Sometimes the scheduling of
> a circumcision settles a brewing feud - or escalates one.
>
> ...male circumcisions are a public demonstration by fathers to elder
> kinsmen
> of their loyalty to the fraternal-interest group
>
> Evidence like this persuaded us that male circumcisions are a public
> demonstration by fathers to elder kinsmen of their loyalty to the
> fraternal-interest group. The greatest sign of loyalty is to entrust
> one's son's reproductive ability to someone else, and it is precisely
> because the ritual involves this risk that it is such a powerful
> emotional symbol. (Tiv fathers laugh nervously during the ceremony,
> telling the circumciser: "Easy, easy, many women will weep if you
> err.")
>
> There is a reason these societies perform ritual mutilations on the
> penis, the organ of ...power,
> ... obedience of fathers and sons is of particular economic and
> political importance.
>
> There is a reason these societies perform ritual mutilations on the
> penis, the organ of procreation and power, and not on the ear, or
> finger, or elbow. In societies that practice circumcision, the
> obedience of fathers and sons is of particular economic and political
> importance. A father who leaves the fraternal-interest group, taking
> with him the reproductive power of his sons and of his sons' sons,
> represents an immense threat to the continuing ability of the group to
> defend itself and its valuable resources. Among tribes that lack
> fraternal-interest groups, such as the Mbuti hunter/gatherers,
> individuals break off from their kin groups frequently; but the
> departure of a son's family is no loss of power or wealth for the
> father, since they control nothing of great value in the first place.
> Only when military and political power depends on continual expansion
> of males in the father's line does the departure of a son and his
> reproductive assets represent a major political crisis.
>
> Female circumcision and other genital mutilations are generally
> confined
> to the same types of societies that practice male circumcision.
>
> Female circumcision and other genital mutilations are generally
> confined to the same types of societies that practice male
> circumcision. (Not all cultures that circumcise males also perform
> genital surgery on females.) In non-Western cultures genital operations
> are primarily intended to preserve a girl's virginity until marriage.
> In these strong fraternal-interest groups, a bride's virginity
> guarantees economic alliance and political power for her male kin, as
> well as economic support and protection for the woman and her female
> kin.
>
> The ancient Hebrews had the exact form of economic and political
> organization in which
> male circumcision (and female virginity tests at marriage) is most
> likely to occur today.
>
> The ancient Hebrews had the exact form of economic and political
> organization in which male circumcision (and female virginity tests at
> marriage) is most likely to occur today. Indeed, the story of Genesis
> is a story of fissions and feuds, of a growing tribe that needed unity
> and the strength of its male defenders to survive in a hostile human
> and ecological environment. Genesis 17 describes the bargain between
> God and Abraham: "This is my covenant which ye shall keep, between me
> and you and thy seed after thee; Every man child among you shall be
> circumcised.... And the uncircumcised man child whose flesh of his
> foreskin is not circumcised, that soul shall be cut off from his
> people; he hath broken my covenant."
>
> But the ancient Jews knew exactly what circumcision was: a loyalty
> oath, a political deal.
>
> Modern Jews often defend circumcision by arguing that the custom, like
> the pork taboo, protected Jews against disease and illness whether they
> were aware of it or not. But the ancient Jews knew exactly what
> circumcision was: a loyalty oath, a political deal. Any Jew, even
> today, who does not circumcise his sons is announcing the limitations
> of his loyalty to the tribe.
>
>
> -------------------------------------------------------------------------=
-------
>
> Karen Ericksen Paige is associate professor of psychology at the
> university of California at Davis. She received her Ph.D. at the
> university of Michigan in 1969, where she began her studies of the
> cultural and personality components of mood changes and physical
> symptoms associated with the menstrual cycle. She and her husband,
> Jeffery M. Paige, have just completed a four-year study of world
> patterns in reproductive rituals such as circumcision and couvade.
> Their book, Politics and Reproductive Ritual, will be published by the
> university of California Press. Paige is continuing research on world
> patterns in female puberty rites and practices associated with
> premarital virginity - concentrating on the themes of honor and shame -
> and she is also studying critical transition points in the life cycle
> of American women and men.
>
>
> -------------------------------------------------------------------------=
-------
>
> References
>
> Neuman, R.P. "Masturbation, Madness and the Modern Concepts of
> Childhood and Adolescence" Journal of Social History, Spring 1975,
> pp.1-27.
>
> Preston, E. Noel. "Whither the Foreskin?" Journal of the American
> Medical Association, vol. 213, no. 11.
>
> Richards, M.P.M., J.F. Bernal and Yvonne Brackenbill "Early Behavioral
> Difference: Gender or Circumcision?" Developmental Psychobiology, vol.
> 9, no. 1.
>
> Ryerson, Alice Judson. "Medical Advice on Childrearing, 1550-1900"
> Harvard Educational Review, vol. 31, no. 3.
>
> Spitz, Ren=E9. "Authority and Masturbation: Some Remarks on a
> Bibliographic Investigation" Yearbook of Psychoanalysis, vol. 9,
> International Universities Press, 1953.
>
> Terris, Milton, Fitzpatrick Wilson and James Nelson, Jr. "Relation of
> Circumcision to Cancer of the Cervix" American Journal of Obstetrics
> and Gynecology, vol. 117, no. 8.
>
> Wolbarst, A.L. "Circumcision and Penile Cancer" The Lancet, January 16,
> 1932, pp. 150-153.
>
> More Pages Related to Male & Female Circumcision
>
>
>
>
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No matter how much you rail against circumcision, it will never
compensate you for your own inadequate manhood. Maybe you should have
that sex change...you're already 90% there.

Don Ocean

2006-06-04, 8:06 am

I hate to burst your bubble, Moishe. But circumcision in the United
States is recommended to the parents of male babies as a method of
personal hygiene. It prevents smegma (foul smelling cheesy substance)
from building up under the foreskin. Such hygiene can be readily handled
by daily personal cleanliness, with mutilating ones male babies. There
are millions of American males that are not circumcised and that does
not make them unclean or of a faith that demands mutilization.
Pediatricians seem to like recommending it for all newborn males. It is
a quick couple of $hundred and they are off and running. Their scare
tactic is to suggest that a full foreskin male can cause cancer, Yeast
infections and a plethora of other diseases in the woman they will
eventually cohabit with. Which of course has been long ago proven to be
and old wives tale. Now you Jewish folks do what you want. If some
Charleton had trapped my folks into mutilating me as a child... As A
adult I would be looking him up and castrating him!!!! If you truly
believe in some Beneficent God or the other.. Surely you can't believe
that such God would demand that his children mutilate themselves for
some primitive pagan belief. If you must have some sacrifice.. Why not
lobotomize all of your Jewish children? It would make them happier,
easier for your leadership to control and definitely help make peace in
the world. ;-p

Moishe wrote:
> The Ritual of Circumcision
>
> Karen Ericksen Paige
> Human Nature, pp 40-48, May 1978
>
>
> NOTE: Links with a right-facing blue arrow will take you off this
> site.
>
> In the United States, the current medical rationale for circumcision
> developed after the operation was in wide practice.
>
> Westerners look askance at the ritual mutilations of the body performed
> in exotic tribes, but they justify their own ritual mutilations as
> medically appropriate. Europeans sneer at the Maasai custom of
> lengthening the ear lobes, but they have their own noses bobbed and
> their faces lifted. Americans are horrified at the Arunta practice of
> subincision (slitting the penis on the ventral side) or the Sudanese
> tradition of infibulation (excising much of the female genitals and
> sewing up the vagina), but they stand with few other modern nations in
> clinging to a ritual that is no less "barbaric" and no more "hygienic,"
> routine circumcision.
>
> In the United States, 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
> "masturbatory insanity" - the range of mental disorders that people
> believed were caused by the "polluting" practice of "self-abuse."
>
> Nineteenth Century parents worried when babies fondled their bodies, as
> this infant drawn by Mihaly Zichy (1827-1906) is doing.
> Many doctors recommended circumcision as a way to prevent "masturbatory
> insanity."
>
>
>
> But circumcision warrants none of its 19th or 20th Century
> justifications. It has not stopped masturbation. It has not cured
> mental illness, neurotic behavior, adolescent rebellion, epilepsy,
> warts, or frigidity. It does not prevent penile or cervical cancer. It
> does not make a man more (or less) sexually sensitive. [NOHARMM note:
> New research indicates that the foreskin is more densely nerve-laden
> than the rest of the penis and that circumcised men report progressive
> sensitivity loss.] It is not minor surgery either. On the contrary,
> circumcision is far more risky and has far more hazardous side effects
> than most people realize.
>
> The practice developed differently in modem industrial nations than it
> did in pre-industrial societies. But circumcision was no less a ritual
> for all its scientific trappings.
>
> Masturbation...was not only a religious sin but a medical problem
> that caused physical and mental disease.
>
> Masturbation had been regarded as a religious sin since Biblical times,
> but in the 18th Century science took over. Onania, or the Heinous Sin
> of Self-Pollution, And All Its Frightful Consequences, in Both Sexes,
> Considered was published in 19 editions and sold 38,000 copies before
> 1750. Masturbation, the book said, was not only a religious sin but a
> medical problem that caused physical and mental disease. A few years
> later Samuel Tissot, a Swiss doctor, took the exclusively medical view,
> arguing that the unnatural loss of semen weakened mind and body and led
> to masturbatory insanity. (His book, published in 1758, was reprinted
> as recently as 1905.)
>
>
>
> Three illustrations from The Silent Friend by R. & L. Perry & Co.
> (1853) showing (left to right) the "General appearance of the features
> through Onanism," "The meagre appearance of the features through
> Onanism," and "Spermatorrhoeal Opthalmia consequent through Onanism."
> Published in: The Anxiety Makers: Some Curious Preoccupations of the
> Medical Profession by Alex Comfort, Thomas Nelson & Sons/London, 1967.
>
>
> Although Tissot's book sold exceptionally well for the times, it was
> more than 50 years before belief in masturbatory insanity spread
> throughout Europe and the United States. One indication of increasing
> concern is reflected in child-rearing guides. Alice Ryerson analyzed
> all such books written between 1550 and 1900 and found a steady
> increase in worry about masturbation in the United States and England.
> This concern began around 1750 and peaked by the last quarter of the
> 19th Century, when 60 percent of the books condemned the practice.
>
>
> Parents looked to physicians for answers, and the physicians responded
> with alacrity. René Spitz, who has studied their solutions, found that
> treatments ranged from diet, moral exhortations, hydrotherapy, and
> marriage, to such drastic measures as surgery, physical restraints,
> frights, and punishment. Some doctors recommended covering the penis
> with plaster of Paris, leather, or rubber; cauterization; making boys
> wear chastity belts or spiked rings; and in extreme cases, castration.
>
>
> Considering the alternatives, circumcision was merciful. In the 1890s,
> it became a popular technique to prevent, or cure, masturbatory
> insanity. In 1891 the president of the Royal college of Surgeons in
> Great Britain published "On Circumcision as Preventive of
> Masturbation," 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 and,
> consequently, masturbation." Another physician, P.C. Remondino, added
> that "circumcision is like a substantial and well-secured life annuity
> "...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.
> Illustrations published in: The Anxiety Makers: Some Curious
> Preoccupations
> of the Medical Profession by Alex Comfort, Thomas Nelson & Sons/London,
> 1967.
>
>
>
>
> Girls were spared neither parental worry about masturbation nor similar
> medical solutions. Female circumcision - removal of the clitoral hood,
> analogous to the foreskin of the penis, began to be recommended at this
> time, but other forms of genital surgery were attempted as well,
> including the removal of the entire clitoris, or clitoridectomy.
>
> Apparently the first clitoridectomy performed in the West occurred in
> 1858, in England. Isaac Baker Brown published a book describing his
> success at treating female masturbators with genital operations, after
> which he was roundly criticised and expelled from the London
> Obstetrical Society. Most evidence indicates that clitoridectomy, but
> not female circumcision, was thereafter abandoned in England. No such
> credit for good sense can be applied to American physicians.
>
> By the 1890s an "Orificial Surgery Society" had been formed in the
> United States, whose function it was to promote genital operations on
> women and men. Its official journal advocated that any deviation from a
> "normal" clitoris "requires attention." If the hood covered the
> clitoris completely, the clitoris should be amputated. If the hood was
> too tight, it should be slit open along one side and the wound stitched
> with catgut.
>
> The United States and England were especially fond of circumcision,
> restraints, and punishments to control masturbation.
>
> Such severe medical treatments for masturbation, for both sexes,
> apparently reached their heyday between 1870 and 1904, but they
> continued to be recommended in medical textbooks and by practitioners
> until the 1930s. (The Orificial Surgery Society kept going until 1925.)
> The United States and England were especially fond of circumcision,
> restraints, and punishments to control masturbation. Between 1879 and
> 1904, 75 percent of the British and American medical documents studied
> by Spitz recommended drastic methods, compared to 51 percent of the
> documents from Germany and Austria and 55 percent of those from France
> and other European countries. But after 1925 the proportion of medical
> writings that favored drastic methods dropped to 25 percent in England,
> America, and the rest of Europe.
>
> Spitz traced the path of circumcision in the United States by following
> the course of one classic pediatrics textbook, L.E. Holt's Diseases of
> Infancy and Childhood, which went through 11 editions between 1897 and
> 1940. Until 1936, circumcision was recommended as a treatment for
> masturbation for both sexes, and the social and mental consequences of
> masturbation were discussed even in the last edition. Holt advocated
> female circumcision, cauterization of the clitoris, and even blistering
> of the vulva and prepuce for recalcitrant masturbators.
>
> Several social historians today are starting to trace the rise and fall
> of what has been called masturbation mania. This odd Western obsession
> accompanied the transition from an agrarian to an industrial economy in
> Europe and the United States between 1700 and 1914. Masturbation was
> always a middle-class worry, and it must have been powerfully
> threatening to warrant the prolonged attack against it. Masturbation
> frightened middle-class parents because doctors said it explained why
> so many young people were neurotic, disobedient, disrespectful of
> parental authority, and oversexed.
>
> Circumcision may have represented a combined effort of medicine and the
> family
> to defend themselves against the implacable demands and
> uncertainties of the new industrial era.
>
> In a recent article, R.P. Neuman argues that the rise of masturbation
> mania was an attempt to defend the trinity of work, family, and
> paternal authority against the internal tensions of the family and the
> external threats of a rapidly changing economy. Parental authority was
> most threatened among the rising urban middle class, where the work
> ethic was strongest and sons were most likely to delay marriage.
> Therefore parental control of children's sexuality was essential. The
> industrial economy, unlike the family-based economic unit, undercut the
> parents' power over their children because it drew them away from the
> home in search of work.
>
> I suspect that circumcision solved some of the dilemmas confronting
> both middle-class families and the newly established (and not yet
> entirely respectable) obstetrical and surgical professions. Parents
> wanted to control the sexual impulses of their children; physicians
> wanted to demonstrate and consolidate their new powers. Circumcision
> may have represented a combined effort of medicine and the family to
> defend themselves against the implacable demands and uncertainties of
> the new industrial era.
>
> By the end of the 1930s, about three fourths of the middle-class
> families in the United States were having their sons circumcised,
> compared to one fourth of lower-class families. (I estimate these
> percentages from hospital statistics on ward and private patients.) As
> more and more women from all social classes began to enter hospitals to
> give birth, circumcision made its way across class and ethnic lines.
>
> By the 1950s the great majority of baby boys, from rich and poor
> families alike, were routinely circumcised in hospitals. One study of
> the records of 18 hospitals across the nation revealed that 83 percent
> of the 14,116 male infants born in 1973 had been circumcised. Among the
> births financed by a California medical program during the first
> quarter of 1976, 87 percent of the males were circumcised.
>
> The question is: Why did the United States persist in circumcising
> males long after the fear of masturbatory insanity declined? The only
> other country in the world today that reports nearly as high a
> frequency is Australia, and even there the custom is on the way out. In
> England, circumcision is virtually extinct. In 1972, according to the
> Hospital Inpatient Inquiry for England and Wales, less than 1 percent
> of 400,000 boys under one year old had the operation (0.41 percent).
> The Scandinavian countries never accepted circumcision, and most of
> Europe has discontinued it. It survives where it has a religious or
> cultural tradition: Israel, Arab nations, some tribes in sub-Saharan
> Africa.
>
> The question is: Why did the United States persist in circumcising
> males
> long after the fear of masturbatory insanity declined?
>
> Just when the mental illness rationale for circumcision began to
> decline in the 1930s, the cancer prevention rationale took its place.
> This theory was launched in 1932 when A.L. Wolbarst published a
> detailed article in the English medical journal Lancet. Wolbarst wanted
> to show that national and religious groups that routinely practiced
> circumcision had lower rates of penile cancer than groups that did not
> circumcise their boys. His specific evidence is important because
> physicians are still using his data to argue on behalf of circumcision.
>
> Wolbarst gathered records from 205 American hospitals for the years
> between 1925 and 1930. Of the 830 cases of cancer of the penis that
> occurred during that five year period, only one patient was Jewish -
> and he had not been circumcised. Wolbarst also interviewed doctors, who
> reported that they had never seen a case of penile cancer among their
> Jewish patients, but they had seen cases among non-Jews.
>
> It was an impressive argument, but unfortunately it overlooked the most
> elementary rules of statistics. Jews represent a very small percentage
> of the population (at Wolbarst's writing, 3 percent), and penile
> cancer is even rarer than that. To report numbers of cancer cases
> without controlling for differences in rates of the disease and
> proportion of Jews in the nation misrepresents the data.
>
> Next Wolbarst compared the rates of penile cancer among Muslims, who
> circumcise young boys, and Hindus, who do not circumcise, in four
> Indian hospitals during the same time span. Only 2 percent of the cases
> of penile cancer involved circumcised Muslims, though Muslims made up
> 21 percent of the patients in the hospitals. Wolbarst concluded that
> Muslims were vastly underrepresented among penile cancer patients, and
> that the reason must be the fact of their circumcision.
>
> Again Wolbarst erred. The appropriate denominator for comparisons is
> not the religious composition of hospital patients, but Hindu and
> Muslim cancer rates relative to the proportion of each group in India.
> Even then, the comparison between religious groups must be heavily
> qualified when the groups also differ in social, economic, and
> educational levels, and in their health standards and opportunities.
>
> The carcinogenic culprit that Wolbarst implicated was smegma and other
> "debris" that accumulates between the foreskin and the glans of the
> penis. The sooner a boy is circumcised, Wolbarst thought, the less
> chance he has of infecting himself or his partner with this dirty
> substance. As Jews seem to have a lower rate of penile cancer than
> Muslims, the reason must be that Jewish boys are circumcised at birth
> and Muslim boys in later childhood.
>
> No one debated a man's ability to wash the foreskin
> and clean off the supposedly carcinogenic smegma, but some physicians
> recommended universal circumcision as a way to protect certain
> "unclean" minorities who could not be relied on to wash their penises.
> ...Some doctors even argued that circumcision should be done for purely
> aesthetic reasons.
>
> Wolbarst's persuasive arguments helped establish the belief that
> routine circumcision for baby boys was essential to prevent cancer in
> men. As time went by, other rationales were added. No one debated a
> man's ability to wash the foreskin and clean off the supposedly
> carcinogenic smegma, but some physicians recommended universal
> circumcision as a way to protect certain "unclean" minorities who could
> not be relied on to wash their penises. (The inner ear collects dirt
> too, one physician later observed, but no one suggests that the
> external ear should be routinely excised.)
>
> Some doctors even argued that circumcision should be done for purely
> aesthetic reasons: A penis without a foreskin, they said, is more
> pleasing to the eye, neater and less likely to produce bad odors. One
> physician, Willard Goodwin, wrote that "circumcision is a
> beautification comparable to rhinoplasty [a nose job]," and that the
> circumcised penis "appears in its flaccid state as an erect
> uncircumcised organ - a beautiful instrument of precise intent."
>
> Clearly, medical and personal motives were getting confused.
> ...Once established, circumcision survived on its own momentum.
>
> Clearly, medical and personal motives were getting confused. The 1957
> and 1968 editions of Benjamin Spock's Baby and Child Care advised
> circumcision because it makes a boy feel "regular" (In his latest
> edition, Spock changed his mind, saying that routine circumcision was
> not medically necessary.) Parents continued to have their sons
> circumcised so that the boys would conform to their fathers and
> siblings. Once established, circumcision survived on its own momentum.
>
> In 1970 E. Noel Preston reviewed studies done on circumcision and
> cancer. His review showed, first, that the small percentage of men who
> got prostate or penile cancer tend to come from lower socioeconomic
> groups, for whom health care and information about disease symptoms are
> less available than for the middle class. Second, the "debris" that
> accumulates beneath the foreskin is not carcinogenic. In one study,
> human smegma was injected into monkey vaginas once or twice a week for
> three years; no cancers of the cervix or vagina developed. A similar
> experiment with mice got the same results, but this time a control
> group was also injected with known carcinogens that did produce vaginal
> cancers.
>
> In 1973 Milton Terris, Fitzpatrick Wilson, and James Nelson, Jr,
> completed a thorough and controlled study of the role of smegma in
> cervical cancer The researchers matched 172 women with three grades of
> cervical infection (invasive carcinoma, carcinoma in situ, and cervical
> dysplasia) with a control group of healthy women. The husbands of the
> women were examined for the extent of circumcision (complete, partial,
> or none) and presence or absence of smegma.
>
> Contrary to current impression, the cancer patients and the healthy
> women were equally likely to be married to circumcised men. Nor was
> there any difference between the husbands of patients and the husbands
> of controls in the amount of smegma under the foreskin.
>
> Preston's review also demolished other assumptions about cancer and
> circumcision. In 1964 J. T. Boyd and R. Doll found no differences in
> cervical cancer rates between Jewish and non-Jewish women, and E. G.
> Jones and his colleagues found no differences between women married to
> circumcised men and those married to uncircumcised men. One study even
> compared women whose uncircumcised husbands used a condom as a
> contraceptive (thereby preventing smegma or semen from entering the
> vagina and cervix) with women whose husbands never used condoms; again,
> no differences in cervical cancer rates. Preston also notes that the
> well-known low rate of cervical cancer among nuns, usually attributed
> to their never having intercourse with uncircumcised males, fails to
> consider that they do not have intercourse with circumcised males
> either.
>
> Many arguments in favor of circumcision derived from a study by Adolf
> Apt, who in 1965 compared rates of prostate cancer in Sweden (where men
> are not circumcised) to those in Israel (where men are). The incidence
> of prostate cancer was higher in Sweden, so it seemed that lack of
> circumcision was the cause. But, as Preston was first to point out, Apt
> overlooked the age differences in the two countries. Prostate cancer is
> a disease of older men - and there are seven times as many men over age
> 60 in Sweden as in Israel. Once the age difference is adjusted, Apt's
> data suggest that rates of prostate cancer are higher in the
> circumcised population.
>
> In any case, prevention of a rare problem is no reason to perform
> surgery on everyone.
> More people die of appendicitis than get phimosis,
> yet no one recommends universal appendectomy in infants as insurance.
>
> Circumcision has been advocated for medical reasons other than cancer
> prevention. Circumcision of infants is supposed to prevent the
> occurrence of phimosis (narrowness of the opening of the prepuce,
> preventing its being drawn back over the glans) and balanitis
> (inflammation of the glans), and eliminate the dangers of a too-tight
> foreskin. The incidence of each of these problems is rare, however, and
> their future likelihood impossible to detect in infants. Only a small
> proportion of baby boys have a fully retractable foreskin at birth; it
> takes about three years before 90 percent of all boys have a
> retractable foreskin. Unfortunately many doctors, observing the
> unretractable foreskin of the infant, assume the child has phimosis and
> recommend circumcision. In any case, prevention of a rare problem is no
> reason to perform surgery on everyone. More people die of appendicitis
> than get phimosis, yet no one recommends universal appendectomy in
> infants as insurance.
>
> American attitudes about sex and circumcision have undergone a dramatic
> reversal. When Americans believed that sexual impulses in general, and
> masturbation in particular, were harmful, circumcision was believed to
> repress sexual sensation. In the last few years the prevailing opinion
> has been that sexual activities, including masturbation, are
> beneficial. Circumcision is now believed to enhance sexual sensation
> for both sexes.
>
> Men have debated the sexual sensitivity question for centuries.
> Circumcised men think that they have the more sensitive penises;
> uncircumcised men think that the constant exposure of the naked glans
> to clothes and the elements toughens it. Some men think that having a
> foreskin delays orgasm, giving a man more control; others think just
> the opposite. This discussion is never going to be settled. Sexual
> sensitivity appears to be in the mind of a man, not in his foreskin.
>
> For women the same issue has more serious consequences. Most people are
> not aware that female circumcision was ever practiced at all in the
> United States. Although circumcision of the clitoris never became as
> widespread a custom as circumcision of the penis, the operation is not
> uncommon. Like male circumcision, the female operation continued even
> after the masturbation mania subsided in the 1930s - it just changed
> rationales.
>
> In 1937 a Texas doctor, Frank Iiams, recommended female circumcision as
> a way to make women more sexually responsive. Female frigidity he said,
> was caused by a clitoris that was too long or too tight (the same
> problems once thought to encourage masturbation). Surgical removal of
> the prepuce, he said, would restore "a more happy and contented marital
> life." [NOHARMM note: This persisted into the late 1950s. Read Female
> Circumcision: Indications and a New Technique]
>
> In 1973 precisely the same justification for surgery came from a New
> York doctor, Leo Wollman, whose patients are referred to him by
> psychoanalysts and clinical psychologists. The only complication he
> reports is the formation of a hematoma (blood clot) at the place where
> the incision is made to remove the foreskin. Sometimes the hematoma
> grows as large as a goose egg. Wollman concedes that such a
> complication may be "distressing" to the patient, but warns that
> telling all women of its likelihood prior to surgery was
> "psychologically inadvisable" - but legally prudent.
>
> The issue of female circumcision has come to public attention. In 1977
> a California woman brought suit against her doctor, who performed the
> operation to cure her "sexual insensitivity." The medical profession is
> divided on the matter, as usual. One physician who testified at the
> hearing, unidentified in the newspaper accounts, said he "could see no
> reason in the world why this operation had to be performed," while the
> chairman of the Department of Obstetrics and Gynecology at Stanford
> university Medical School said it is "a matter of judgment."
>
> Two years ago The New York Times carried a front-page story on
> unnecessary surgical practices. The Times reported that male
> circumcision was the most common surgical procedure in the United
> States, but there were "not untrivial" complications. The Times
> understated the case.
>
> The three most serious complications are hemorrhage, infection, and
> surgical trauma. Infection of the wound, often from contact with feces
> and urine, can lead to inflammation and ulceration of the penis. In one
> Canadian study, Hawa Patel examined 100 circumcised infant boys and
> found common, though "usually minor" complications, including
> hemorrhage (35 boys), ulcers of the urethral passage (31), infection
> (8), and phimosis (1). In rare instances, infections have led to
> septicemia and pulmonary abscesses, causing the baby's death.
>
> Sometimes circumcision fails because too much foreskin is pulled over
> the shaft and excised, leaving a denuded shaft. Sometimes circumcisions
> are incomplete. In a study of cervical cancer patients by Terris and
> his colleagues, a large number of the husbands had had partial
> circumcisions, in which much of the foreskin had been left.
>
> The consequences of circumcision can be horrible. Some years ago, John
> Money and Anke Ehrhardt reported a case of twin boys, one of whom had
> been transformed surgically into a girl. The case has been widely cited
> as an example of how social learning can turn a genetic boy into a
> psychological girl. Readers of this study tend to avoid the paragraph
> that tells why the operation had to be done in the first place: The
> infant boy was the victim of a "mistake" during a routine circumcision.
> His penis was burned off. [NOHARMM note: This is the John/Joan case in
> Canada that hit the media headlines in 1997. Again, most of the media
> never divulged the circumcision tragedy (until July, 1998). Instead,
> they initially focused on "intersexuals" - those born with ambiguous
> genitalia.]
>
> Overall, the complication rate for routine circumcision stands at only
> 1 percent of all operations. Still, for every one million boys, that is
> 10,000 complications -including two deaths. And physicians are still
> not sure about the hidden effects. The psychological and stress
> consequences of early circumcision are just now coming under
> investigation. Yvonne Brackbill finds that circumcised baby boys show
> greater increases in heart rate in response to sounds than do girls and
> uncircumcised boys. Luther Talbert and his colleagues find that after
> circumcision, male babies show increased adrenal cortical hormone
> levels -hormones known to increase in response to stress. And after
> circumcision, I.F. Anders and R.J. Chalemian report, male babies change
> their sleep patterns, staying awake for longer periods of time than
> they did before the operation. Other researchers have found that male
> babies, at three weeks and at three months of age, cry more and sleep
> less than females, and are harder to console when they get irritable.
> In short, infants are put under stress by the operation, and the
> potential effects of such stress should not be ignored.
>
> When a custom persists after its original functions have died,
> it may be accorded the status of ritual.
>
> For all of these reasons the American Pediatric Society finally
> concluded in 1975 that "there are no valid medical indications for
> circumcision" in infancy. But obstetricians, who generally perform the
> surgery, have not endorsed this stand, and health insurance companies
> are still spending some $200 million annually to pay for the $50 to $75
> operation [1978 prices].
>
> When a custom persists after its original functions have died, it may
> be accorded the status of ritual. American parents and physicians no
> longer cite masturbatory insanity as a reason to circumcise children,
> but they have found other justifications for the ritual that they
> believe in as firmly. When the same operation is variously reputed to
> accomplish antithetical goals - in the case of circumcision, to repress
> sexuality and to liberate it, to make the penis or clitoris less
> sensitive and more sensitive - we can be sure we are dealing with
> ritual, not rational thinking. It is astonishing that such a little bit
> of skin carries such a great load of power.
>
> Anthropologists and psychoanalysts have attempted many explanations of
> circumcision and other forms of genital surgery in tribal cultures.
> Psychoanalysts concentrate on unconscious motives, castration anxiety,
> and father-son rivalry. Circumcision, they say, represents a boy's
> willingness to sacrifice a part of his penis in deference to his
> father's power, or the father's efforts to show his son who is boss.
>
> The trouble with these theories is that in no society do boys
> circumcise themselves, and only rarely do fathers circumcise their own
> sons. The operation is almost always done by a third party: the tribal
> chief, a physician, the boy's uncle, or a professional (the Jewish
> mohel).
>
> Only 23 cultures in our sample practice circumcision, and they tend to
> share
> a particular economy and form of social organization. ...strong
> fraternal-interest groups,
> related males who are united to pursue common political objectives.
>
> Some anthropologists regard circumcision rituals as a rite of passage,
> a part of manhood training. The trouble with this approach is that
> across cultures, boys are circumcised at different ages: some in
> infancy, some in childhood, some as adolescents. In most societies boys
> are forcibly subjected to the ceremony when they are far too young to
> understand the meaning of masculinity.
>
>
> Circumcision was practiced in Egypt as long ago as 4000 B. C.
> According to the inscription on this bas-relief from the Ankh-Mahor
> tomb at Sakkara, the youth on the right accepts the surgery, but his
> companion balks and must be held by the doctor's aide.
>
> To understand the functions of circumcision, Jeffery Paige and I
> studied a world-wide sample of 114 tribal societies. We asked first how
> prevalent the custom is, and where it occurs. Only 23 cultures in our
> sample practice circumcision, and they tend to share a particular
> economy and form of social organization. These societies are all
> advanced horticulturalists or nomadic pastoralists - such as the Tiv of
> Nigeria or the Kazakh of Russia - that share a common political
> structure. They are composed of what we call strong fraternal-interest
> groups, related males who are united to pursue common political
> objectives. Because of the strength of these large groups, kinsmen are
> especially successful in defending property, allocating resources, and
> negotiating explicit agreements over women and wealth. Women are pawns
> in such societies, exchanged in kinship bargains and marriages.
>
> For whom is the circumcision ceremony performed?
>
> We next asked: For whom is the circumcision ceremony performed? Not for
> the child, not even for the father The child is a passive participant,
> according to most ethnographic accounts. The most common pattern is for
> a village elder or chief to command a reluctant father to have his sons
> circumcised. Among the Thonga the chief orders the ceremony for all
> boys between 10 and 16, and if necessary he will use force to carry out
> the command. Victor Turner, who studied the Ndembu of Zambia, observed
> one wily old chief revive his flagging power over factions within his
> tribe. He called for a circumcision of the warring factions' sons - and
> he presided. Because the timing of the ritual varies from infancy to
> adolescence, both across and within cultures, kinsmen continually fight
> over who should do the operation and when. Sometimes the scheduling of
> a circumcision settles a brewing feud - or escalates one.
>
> ...male circumcisions are a public demonstration by fathers to elder
> kinsmen
> of their loyalty to the fraternal-interest group
>
> Evidence like this persuaded us that male circumcisions are a public
> demonstration by fathers to elder kinsmen of their loyalty to the
> fraternal-interest group. The greatest sign of loyalty is to entrust
> one's son's reproductive ability to someone else, and it is precisely
> because the ritual involves this risk that it is such a powerful
> emotional symbol. (Tiv fathers laugh nervously during the ceremony,
> telling the circumciser: "Easy, easy, many women will weep if you
> err.")
>
> There is a reason these societies perform ritual mutilations on the
> penis, the organ of ...power,
> ... obedience of fathers and sons is of particular economic and
> political importance.
>
> There is a reason these societies perform ritual mutilations on the
> penis