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A Short History of Circumcision in North America:
In the Physicians' Own Words

The following quotes, culled from the medical literature, in the physicians' own words, allow us to trace the history of the medical profession's view of circumcision with great accuracy. Since the circumcision problem has always been greater in the United States, the estimated figures for the circumcision rate in urban centers are given for that country only and serve to illustrate the effect that debate in the medical literature can have on the general population.

1860: .001% of the North Eastern urban American male population circumcised

In cases of masturbation we must, I believe, break the habit by inducing such a condition of the parts as will cause too much local suffering to allow of the practice being continued. For this purpose, if the prepuce is long, we may circumcise the male patient with present and probably with future advantage; the operation, too, should not be performed under chloroform, so that the pain experienced may be associated with the habit we wish to eradicate.

[Athol A.W. Johnson. On An Injurious Habit Occasionally Met with in Infancy and Early Childhood. Lancet 1860;1:344-345.]

 

1871: 1% of the North Eastern urban American male population circumcised

I refer to masturbation as one of the effects of a long prepuce; not that this vice is entirely absent in those who have undergone circumcision, though I never saw an instance in a Jewish child of very tender years, except as the result of association with children whose covered glans have naturally impelled them to the habit.

[M.J. Moses. The Value of Circumcision as a Hygienic and Therapeutic Measure. New York Medical Journal 1871;14:368-374.]

 

1887: 10% of the North Eastern urban American male population circumcised

Hip trouble is from falling down, an accident that children with tight foreskins are especially liable to owing to the weakening of the muscles produced by the condition of the genitals.

[Lewis A. Sayer. Circumcision For The Cure of Enuresis. Journal of the American Medical Association 1887;7:631-633.]

 

There can be no doubt of [masturbation's] injurious effect, and of the proneness to practice it on the part of children with defective brains. Circumcision should always be practiced. It may be necessary to make the genitals so sore by blistering fluids that pain results from attempts to rub the parts.

[Angel Money. Treatment Of Disease In Children. Philadelphia: P. Blakiston. 1887:421.]

 

1888: 15% of the North Eastern urban American male population circumcised

A remedy [for masturbation] which is almost always successful in small boys is circumcision...The operation should be performed by a surgeon without administering an anaesthetic, as the pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment...

[John Harvey Kellogg. Plain Facts for Old and Young. Burlington, Iowa: F. Segner & Co. 1888:295.]

 

In consequence of circumcision the epithelial covering of the glans becomes dry, hard, less liable to excoriation and inflammation, and less pervious to venereal viruses. The sensibility of the glans is diminished, but not sufficiently to interfere with the copulative function of the organ or to constitute an objection...It is well authenticated that the foreskin...is a fruitful cause of the habit of masturbation in children... I conclude that the foreskin is detrimental to health, and that circumcision is a wise measure of hygiene.

[Jefferson C. Crossland. The Hygiene of Circumcision. New York Medical Journal 1891;53:484-485]

 

Measures more radical than circumcision would, if public opinion permitted their adoption, be a true kindness to many patients of both sexes.

[Jonathan Hutchinson. On Circumcision as Preventive of Masturbation. Archives of Surgery 1891;2:267-268]

 

In all cases in which male children are suffering nerve tension, confirmed derangement of the digestive organs, restlessness, irritability, and other disturbances of the nervous system, even to chorea, convulsions, and paralysis, or where through nerve waste the nutritive facilities of the general system are below par and structural diseases are occurring circumcision should be considered as among the lines of treatment to be pursued.

[Charles E. Fisher. A Hand-Book On The Diseases of Children And Their Homeopathic Treatment. Chicago: Medical Century Co. 1895:875.]

 

1895: 15% of the North Eastern urban American male population circumcised

In all cases of masturbation circumcision is undoubtedly the physicians' closest friend and ally...To obtain the best results one must cut away enough skin and mucous membrane to rather put it on the stretch when erections come later. There must be no play in the skin after the wound has thoroughly healed, but it must fit tightly over the penis, for should there be any play the patient will be found to readily resume his practice, not begrudging the time and extra energy required to produce the orgasm. It is true, however, that the longer it takes to have an orgasm, the less frequently it will be attempted, consequently the greater the benefit gained...The younger the patient operated upon the more pronounced the benefit, though occasionally we find patients who were circumcised before puberty that require a resection of the skin, as it has grown loose and pliant after that epoch.

[E. J. Spratling. Masturbation in the Adult. Medical Record 1895;24:442-443.]

 

Local indications for circumcision: Hygienic, phimosis, paraphimosis, redundancy (where the prepuce more than covers the glans). adhesions, papillomata, eczema (acute and chronic), oedema, chancre, chancroid, cicatrices, inflammatory thickening, elephantiasis, naevus, epithelioma, gangrene, tuberculosis, preputial calculi, hip-joint disease, hernia. Systemic indications: Onanism, seminal emissions, enuresis, dysuria, retention, general nervousness, impotence, convulsions, hystero-epilepsy.

[George F. Shrady. Circumscisus. Medical Record 1896;49:430]

 

The prepuce is an important factor in the production of phthisis [tuberculosis]. This can be proven by the immunity of the Jewish race from tubercular affections.

[S.G.A. Brown. A Plea for Circumcision. Medical World 1897;15:124-125.]

 

Circumcision should be done if phimosis exists, and even where it is not, the moral effect of the operation is sometimes of very great benefit.

[Emmett L. Holt. The Diseases Of Infancy And Childhood. New York: D. Appleton. 1897:696-698.]

 

Clarence B. was addicted to the secret vice practiced among boys. I performed an orificial operation, consisting of circumcision...He needed the rightful punishment of cutting pains after his illicit pleasures.

[N. Bergman. Report of a Few Cases of Circumcision. Journal of Orificial Surgery 1898;7:249-251.]

 

Not infrequently marital unhappiness would be better relieved by circumcising the husband than by suing for divorce...

[A.W. Taylor. Circumcision - Its Moral and Physical Necessities and Advantages. Medical Record 1899;56:174.]

 

1900: 25% of the North Eastern urban American male population circumcised

Finally, circumcision probably tends to increase the power of sexual control. The only physiological advantage which the prepuce can be supposed to confer is that of maintaining the penis in a condition susceptible to more acute sensation than would otherwise exist. It may increase the pleasure of coition and the impulse to it: but these are advantages which in the present state of society can well be spared. If in their loss increase in sexual control should result, one should be thankful.

[Jonathan Hutchinson. On the Advantages of Circumcision. Medical News 1900;77:707-708.]

 

It has been urged as an argument against the universal adoption of circumcision that the removal of the protective covering of the glans tends to dull the sensibility of that exquisitely sensitive structure and thereby diminishes sexual appetite and the pleasurable effects of coitus. Granted that this be true, my answer is that, whatever may have been the case in days gone by, sensuality in our time needs neither whip nor spur, but would be all the better for a little more judicious use of curb and bearing-rein.

[E. Harding Freeland. Circumcision as a Preventive of Syphilis and Other Disorders. Lancet 1900;2:1869-1871.]

 

Another advantage of circumcision...is the lessened liability to masturbation. A long foreskin is irritating per se, as it necessitates more manipulation of the parts in bathing...This leads the child to handle the parts, and as a rule, pleasurable sensations are elicited from the extremely sensitive mucous membrane, with resultant manipulation and masturbation. The exposure of the glans penis following circumcision...lessens the sensitiveness of the organ...It therefore lies with the physicians, the family adviser in affairs hygienic and medical, to urge its acceptance.

[Ernest G. Mark. Circumcision. American Practitioner and News 1901;31:121-126.]

 

Frequent micturition, loss of flesh, convulsions, phosphatic calculus, hernia, nervous exhaustion, dyspepsia, diarrhea, proplapse of rectum, balanitis, acute phimosis and masturbation are all conditions induced by the constricted long prepuce, and all to be rapidly remedied by the simple operation of circumcision.

[H.G.H. Naylor. A Plea for Early Circumcision. Pediatrics 1901;12:231.]

 

I have repeatedly seen such cases as convulsions, constant crying in infants, simulated hip joint diseases, backwardness in studies, enuresis, marasmus, muscular inco-ordination, paralysis, masturbation, neurasthenia, and even epilepsy, cured or greatly benefited by the proper performance of circumcision.

[W.G. Steele. Importance of Circumcision. Medical World 1902;20:518-519.]

 

1903

Boys ought to be circumcised -- the permanent and tempting invitation to masturbation in the form of the foreskin being removed in their early infancy, before sexual feelings are experienced, and the vicious counsel of other boys is received... There is some reason, then, and excuse as well, why boys should be boys, endowed as they are with anatomical conditions, as well as traits, calculated to lead them astray.

[Brandsford Lewis. A Plain Talk on Matters Pertaining to Genito-Urinary Anatomy, Physiology and Diseases (Part 1). American Journal of Dermatology and Genito-Urinary Diseases 1903;7:201-209.]

 

1912: 35% of the North Eastern urban American male population circumcised

The little sufferer lay in his mother's lap. The dropsy...had taken the form of hydrocephalus...I then circumcised the child...The head diminished in size and in two weeks the condition of hydrocephalus had disappeared and the child was once more dismissed as cured...

[E.H. Pratt. Orificial Surgery: Its Philosophy Application and Technique. Ed. B.E. Dawson. Newark: Physicians Drug News Co. 1912:396-398.]

 

Circumcision promotes cleanliness, prevents disease, and by reducing oversensitiveness of the parts tends to relieve sexual irritability, thus correcting any tendency which may exist to improper manipulations of the genital organs and the consequent acquirement of evil sexual habits, such as masturbation.

[G. Frank. Lydston. Sex Hygiene for the Male. Chicago: Riverton Press. 1912:159.]

 

It is generally accepted that irritation derived from a tight prepuce may be followed by nervous phenomena, among these being convulsions and epilepsy. It is therefore not at all improbably that in many infants who die in convulsions the real cause of death is a long or tight prepuce. The foreskin is a frequent factor in the causation of masturbation...Circumcision offers a diminished tendency to masturbation, nocturnal pollutions, convulsions and other nervous results of local irritation. It is the moral duty of every physician to encourage circumcision in the young...

[Abraham L. Wolbarst. Universal Circumcision. Journal of the American Medical Association 1914;62:92-97.]

 

Circumcision not only reduces the irritability of the child's penis, but also the so-called passion of which so many married men are so extremely proud, to the detriment of their wives and their married life. Many youthful rapes could be prevented, many separations, and divorces also, and many an unhappy marriage improved if this unnatural passion was cut down by a timely circumcision.

[L.W. Wuesthoff. Benefits of Circumcision. Medical World 1915;33:434.]

 

The prepuce is one of the great factors in causing masturbation in boys...Here is the dilemma we are in: If we do not teach the growing boy to pull the prepuce back and cleanse the glans there is the danger of smegma collecting and of adhesions and ulcerations forming, which in their turn will cause irritation likely to lead to masturbation. If we do teach the boy to pull the prepuce back and cleanse his glans, that handling alone is sufficient gradually and almost without the boy's knowledge to initiate him into the habit of masturbation... Therefore, off with the prepuce!

[William J Robinson. Circumcision and Masturbation. Medical World 1915;33:390.]

 

1920: 50% of the North Eastern urban American male population circumcised

Circumcision is an excellent thing to do; it helps to prevent hernia due to straining, and later it helps in preventing masturbation. The ordinary schoolboy is not taught to keep himself clean, and if he is taught he thinks too much about the matter.

[I. Solomons. For and Against Circumcision. British Medical Journal 1920;1:768.]

 

Phimosis may be a predisposing cause of masturbation in some cases...Hemorrhage following circumcision at birth cannot be considered seriously as a contraindication. Meatal ulcer due to ammoniacal diapers in the circumcised is not a contraindication... Routine circumcision at birth is warranted.

[Editor. Routine Circumcision at Birth? Journal of the American Medical Association 1928;91:201.]

 

1935: 55% of the North Eastern urban American male population circumcised

I suggest that all male children should be circumcised. This is "against nature," but that is exactly the reason why it should be done. Nature intends that the adolescent male shall copulate as often and as promiscuously as possible, and to that end covers the sensitive glans so that it shall be ever ready to receive stimuli. Civilization, on the contrary, requires chastity, and the glans of the circumcised rapidly assumes a leathery texture less sensitive than skin. Thus the adolescent has his attention drawn to his penis much less often. I am convinced that masturbation is much less common in the circumcised. With these considerations in view it does not seem apt to argue that "God knows best how to make little boys.

[R.W. Cockshut. Circumcision. British Medical Journal. 1935;2:764.]

 

[Routine Circumcision] does not necessitate handling of the penis by the child himself and therefore does not focus the male's attention on his own genitals. Masturbation is considered less likely.

[Alan F. Guttmacher. Should The Baby Circumcised? Parents' Magazine 1941;16:26, 76-78.]

 

...[W]e do feel that there are many excellent reasons for routinely circumcising the male...Circumcision will reduce the incidence of onanism. ...Circumcision will increase the male libido.... Longevity, immunity to nearly all physical and mental illness, increased physical vigor, etc., are all attributed to this practice... In addition to the aforementioned reasons for doing the operation, we shall list several reasons to support immediate circumcision. ... Convenience: Under the present regime the obstetrician finishes his episiotomy, walks across the hall and circumcises the infant, and is finished with the whole business. Stimulation of the baby: Frequently following a general anesthetic the newborn is depressed and various stimulants are employed; circumcision unfailingly produces and excellent response in a sleepy baby.

[Richard L. Miller. Donald C. Snyder. Immediate Circumcision of the Newborn Male. American Journal of Obstetrics and Gynecology 1953;65:1-11.]

 

Malnutrition, epistaxis, convulsions, night terrors, chorea, and epilepsy have all been reflexly attributed to phimosis. Parents readily recognize the importance of local cleanliness and genital hygiene in their children and are usually ready to adopt measures which may avert masturbation. Circumcision is usually advised on these grounds.

[Meredith F. Campbell. The Male Genital Tract and the Female Urethra. in: Campbell's Urology. vol. 2. Philadelphia: W.B. Saunders Company. 1970:1836.]

 

1971: 90% of the North Eastern urban American male population circumcised

There are no valid medical indications for circumcision in the neonatal period.

[Committee On Fetus And Newborn. Standards and Recommendations for Hospital Care of Newborn Infants, 5th Ed. Evanston: American Academy of Pediatrics. 1971:110.]

 

1994: 60% of the North Eastern urban American male population circumcised

Circumcision causes pain, trauma, and a permanent loss of protective and erogenous tissue...Removing normal, healthy, functioning tissue for no medical reason has ethical implications: circumcision violates the United Nations' Universal Declaration of Human Rights (Article 5) and the United Nations' Convention on the Rights of the Child (Article 13).

[Leo Sorger. To AGOC: Stop Circumcisions. OB.GYN. News 1994;29:8 (November 1) ]

 

Despite the obviously irrational cruelty of circumcision, the profit incentive in American medical practice is unlikely to allow science or human rights principles to interrupt the highly lucrative American circumcision industry. It is now time for European medical associations loudly to condemn the North American medical community for participating in and profiting from what is by any standard a senseless and barbaric sexual mutilation of innocent children.

[Paul M. Fleiss. Circumcision. Lancet 1995;345:927.]

 

I really wish people would stop discussing circumcision in such an emotional way and look at it objectively. I will continue to do circumcision unless it is outlawed (and even then I shall probably continue to do it in my surgery).

[Peter J. Sullivan. Circumcision: Be Rational about the Benefits. Australian Medicine (October 2, 1995):6.]

 

Attempts to legitimize Bronze Age blood rituals under the guise of modern medicine are unethical. One of the social functions of medicine is to free humankind from harmful and useless customs and to encourage science-based medical and social practices...Attempts to justify the forced circumcision of nonconsenting individuals in the name of medicine must fail or risk further discredit and disgrace to modern American medical practice.

[Paul. M. Fleiss. More on Circumcision. Clinical Pediatrics 1995;34:623-624.]

 

It cannot be ethical for a doctor to amputate normal tissue from a normal child.

[John P. Warren et al. Circumcision of Children. British Medical Journal 1996;312:377.]


Note: Circumcision rates derived from: Wallerstein, E. Circumcision: an American Health Fallacy. New York: Springer. 1980. p. 214-217.

It is important to note that these rates reflect circumcision rates of males born in urban American hospitals in New York City, Philadelphia, and other major North Eastern cities. The majority of the American populace has traditionally been rural rather than urban. Wallerstein's rates do not reflect a national average. Throughout most of the Nineteenth Century and early to mid-20th Century, neonatal circumcision in the rest of the United States was nearly non-existent.

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