2 10 240 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> The following letter from Dr V. Raveenthiran in the Journal of Pediatric Surgery replies to the speculations of a certain Steven Moreton on the supposed “hygienic” or “health” origins of non-therapeutic circumcision. Dr. Moreton has placed many contentious arguments regarding circumcision. I agree with him that tracing the origins of this ancient procedure is not an easy task; however, the exercise is not completely irrelevant to modern medical practice. Circumcision is the only surgical operation that is either passionately patronized or vehemently condemned — not only by laity but also by medical practitioners [1]. Influence of lobbying groups is such that even the medical literature is more often distorted [2] as it is evident from frequent reversal of policy recommendations by professional bodies such as American Academy of Pediatrics [3]. Dichotomized circumcision politics, which potentially affects millions of children, can be better understood only by studying its historical evolution. Historically several hypotheses have been proposed regarding the origins and purpose of circumcision [1,4–8]. They include: (1) Religious sacrifice in fulfillment of the covenant with God; (2) Tribal rite of passage into adulthood; (3) Demonstration of leadership qualities such as courage and endurance of pain which are prerequisite of being elected as chieftains; (4) Deterrent of premature indulgence into procreative life; (5) Superstitious act of ensuring or enhancing virility and fertility; (6) Measure of personal hygiene in xeric environments; (7) Symbol of social status (paradoxically both nobility and slavery); (8) Symbolic emasculation – either humiliating or punitive – of war prisoners and slaves; (9) Mark of clan identification especially during exodus and riots; (10) Aesthetic procedure to enhance men's sexual attractiveness; (11) Imitation of a leader's malformation (aposthia) by his followers; (12) Modifier of sexual pleasure (paradoxically both enhancer and suppressor); (13) Dissuader of masturbation and sexual perversions; (14) Magical repellent of demons that were believed to dwell in preputial sac; (15) Castration substitute employed by jealous fathers to discourage sons from having incestuous affair with mothers; (16) Indigenous technique of creating gender awareness and masculine identity; (17) Superstitious act of separating males from androgynous child and (18) Method of oath taking by men enrolled to guard a particular primitive society. To the aforementioned long list, Moreton adds “his own theory” of ‘prophylactic origins of circumcision’. It is nothing new but a plagiarized version of an archaic concept that was originally expressed by Herodotus when he first saw circumcised Egyptians in circa 450 BCE. Since then this speculation has been repeated in many avatars — the latest of which claims that circumcision was originally intended to avoid irritation of desert sand accumulating underneath the foreskin [9]. However, Darby exposed the fallacies of hygiene theory and firmly laid it to rest [10,11]. Rhetoric on protective health benefits of circumcision has only camouflaged over time to match unconquered diseases of the given era. For example in late 19th century, when infectious and neurological diseases were poorly understood, Merrill Ricketts claimed circumcision to prevent or cure paralysis, neurasthenia, eczema, elephantiasis, tuberculosis, enuresis, impotence, epilepsy, hysteria and even acne [1,12,13]. Although all of them are now disproved, devotees of circumcision have not abandoned the worship; but simply moved on to build newer altars. They now claim circumcision to be preventive of penile cancer, sexually transmitted infections including HIV, cervical carcinoma, and urinary tract infection. Surprisingly, these misleading claims are often included in medical textbooks. It is now emerging that evidences for these claims are scant, invalid, weak and distorted [1–3]. As we snigger today at the impossible list of Merrill Ricketts, so will our successors chuckle at contemporary claims of hygiene and prophylaxis. From Merrill Ricketts to Moreton, misconception of foreskin hygiene is perpetuated by the dogma wherein the smegma is vilified as an irritant. It defies logic as to how a physiological secretion of body can be harmful [1]. Myths surrounding smegma have long been dispelled [14] and hence Moreton is trying to resurrect a buried lie. Moreton got his anthropological lessons wrong when he stated that this operation must have been adopted by primitive men on seeing the health benefits enjoyed by an occasional child born without prepuce (aposthia). It is widely acknowledged that primitive societies did not consider malformed children as human beings. Even minor anomalies were considered a bad omen and such babies were either killed or allowed to die by abandoning in wilderness [15]. Therefore a child born with aposthia in prehistoric times was unlikely to have survived long enough to demonstrate the benefits of preputial absence. I maintained that prehistoric men of paleolithic era were unlikely to have inflicted self-injuries as it would have been a survival disadvantage. I also cited Taves’ experiment wherein circumcision was hypothesized to increase glans friction during intromission. Moreton refutes both these assertions by citing tribal rituals and clinical studies finding infrequent coital injuries in circumcised men. Moreton appears to have mistaken ‘prehistoric men’ for ‘tribal men’ and ‘penile intromission’ for ‘sexual intercourse’. For example, intromission is just the act of inserting the penis into the vagina while intercourse is the full range of act that culminates in orgasm (Oxford English Dictionary). Circumcision certainly makes intromission unpleasant which is why it was projected as masturbation dissuader. Sexual pleasure and coital injuries are determined not only by the status of circumcision but by many other factors such as degree of vaginal lubrication, force of pelvic thrust, coexisting diseases, genital malformations, psychological inclination of partners and coital posture. Unfortunately none of the studies cited by Moreton take all these covariables into consideration. Further, an equally good number of “robust” studies published in high impact journals indicate that coital injuries and impaired sexual pleasure are more frequent in circumcised men [16–19]. This is what I dismiss as dichotomized literature. Moreton asks for more evidences of circumcision originating as a punishment or humiliation of war prisoners. They are plenty to fill an entire issue of the Journal of Pediatric Surgery; suffice I mention a few of them. Diodorus Siculus (circa 100 BC) in his magnum opus Bibliotheca Historica described a bas-relief seen in the Tomb of Ozymandyas (Hellenized name of Rameses II) [20]. The sculpture, probably commemorating the King's victory in the Battle of Kadesh (circa. 1274 BC), was said to depict chain-bound war prisoners registered by a royal scribe in preparation for amputation of right hand or ‘private parts’. A pile of these excised organs was also seen in the foreground [5]. A more explicit description is found in the Old Testament. Saul wanted to avenge both David and Philistines. Hatching a cleaver plan, he asked David to bring 100 foreskins of philistines as dowry to marry his daughter Michal; And David brought 200 of them and took her hands in wedlock (Samuel 18:25–27). In another story, when Shechemraped Jacob’s daughter Dinah, her enraged brothers deceitfully circumcised all their enemies and humiliatingly killed them while they were still recovering from the sore (Genesis 34:1–31). Forced circumcision of enemies is also well documented as late as in British India. The theory of punitive origin of circumcision is of some practical importance. I have observed that circumcision is more often promoted and defended by those who have undergone the procedure themselves [21]. Psychologically this appears to be a phenomenon of re-enacting the shame and trauma suffered during childhood [22]. In circumcised adults, I have seen this shame being sublimated into pride at some point of life. Perplexed by this paradox I looked into the history. Now, I could see the ‘shame’ in the punishment of captured enemies and the ‘pride’ in the sacrificial rites of Osiris cult. Osiris himself being punished by emasculation and its symbolic emulation by his followers could be the connecting links between the contrasting emotions of shame and pride. Finally, I wonder if Dr. Moreton's communication suffers from serious conflicts of interest (COI) as he is the editor and contributor of a blog ‘promoting circumcision’. Certainly, I have no prejudice in exploring and writing the history of circumcision V. Raveenthiran Department of Pediatric Surgery, SRM Medical College, 200, Fifth Street, Viduthalai Nagar, Kovilambakkam, Chennai 600117, India References [1] Gollaher DL. Circumcision: a history of the world's most controversial surgery. New York: Basic Books; 2000. [2] Boyle GJ, Hill G. Circumcision-generated emotions bias medical literature. BJU Int 2012;109:E11. [3] Frisch M, Aigrain Y, Barauskas V, et al. Cultural bias in the AAP's 2012 technical report and policy statement on male circumcision. Pediatrics 2013;131:796–800. [4] Friedman DM. A mind of its own: a cultural history of the penis. London: Robert Hale; 2001. [5] Remondino PC. Theories as to the origin of circumcision. History of circumcision from the earliest times to the present. London: FA Davis; 1891. p. 28–33. [6] Amin Ud Din M. Aposthia — a motive of circumcision origin. Iran J Public Health 2012;41:84. [7] Charles W. Motives for male circumcision among preliterate and literate peoples. J Sex Res 1966;2:69–88. [8] Kaicher DC, Swan KG. A cut above: circumcision as an ancient status symbol. Urology 2010;76:18–20. [9] Hutson JM. Circumcision: a surgeon's perspective. J Med Ethics 2004;30:238–40. [10] Darby R. The riddle of the sands: circumcision, history, and myth. N Z Med J 2005; 118:U1564. [11] Darby R. A surgical temptation: the demonization of the foreskin and the rise of circumcision in Great Britain. University of Chicago Press; 2005. [12] Ricketts BM. The last fifty of a series of two hundred circumcisions. N Y Med J 1894; 59:431–2. [13] Anonymous. Circumcision for the relief of acne. Hospital (Lond) 1902;31:339. [14] Van Howe RS, Hodges FM. The carcinogenicity of smegma: debunking a myth. J Eur Acad Dermatol Venereol 2006;20:1046–54. [15] Nun L. Neonaticide, infanticide and filicide. Israel: BN Publications; 2017. [16] Bronselaer GA, Schober JM, Meyer-Bahlburg HF, et al. Male circumcision decreases penile sensitivity as measured in a large cohort. BJU Int 2013;111:820–7. [17] Masood S, Patel HR, Himpson RC, et al. Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly? Urol Int 2005;75:62–6. [18] Fink KS, Carson CC, De Vellis RF. Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction. J Urol 2002; 167:2113–6. [19] Boyle GJ. Circumcision of infants and children: short-term trauma and long-term psychosexual harm. Adv Sex Med 2015;5:22–38. [20] Diodorus Siculus. Bibliotheca Historica (English translation); vol 1, sec 48:2. Available from http://penelope.uchicago.edu/Thayer/E/Roman/Texts/Diodorus_Siculus/1C*.html, Accessed date: 30 September 2018. [21] Muller AJ. To cut or not to cut? Personal factors influence primary care physicians’ position on elective circumcision. J Men's Health 2010;7:227–32. [22] van der Kolk BA. The compulsion to repeat the trauma. Re-enactment, revictimization, and masochism. Psychiatr Clin North Am 1989;12:389–411. Source V. Raveenthiran. <a href="https://www.jpedsurg.org/article/S0022-3468(18)30664-X/fulltext" rel="noopener" target="_blank">Reply to letter to the Editor: Tracing the origins of circumcision</a>. Journal of Pediatric Surgery, early view, 2018 </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Cultural/religious/ritual circumcision not related to hygienic or other practical considerations darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> Over the last hundred years or so, a remarkably strong movement against circumcision among Jewish people has emerged. This development may surprise people, but it is a logical development of the modernisation and integration that began in the early nineteenth century, as European Jews were freed from the ghettos and joined the mainstream of modern life. In the process they naturally questioned many ancient observances and practices. Such questioning is also an expression of commitment to human rights, going back to the European Enlightenment of the eighteenth century (the <a href="https://en.wikipedia.org/wiki/Declaration_of_the_Rights_of_Man_and_of_the_Citizen">Declaration of the Rights of Man and Citizen</a>), strengthened by the <a href="http://www.arclaw.org/arc_human_rights_table/">Universal Declaration of Human Rights</a> just after the Second World War. The principles developed here asserted an individual’s right to freedom, autonomy, and personal rights, of which the most basic was control over his or her own body. Given their own sad history of discrimination and persecution Jewish people have naturally been at the forefront of campaigns for human rights in many areas other than freedom of religion. This critical trend also derives from new historical information about the origin of circumcision (male and female) in Egypt and Africa, scientific discoveries about the damage caused by circumcision, and a desire on the part of individuals to observe a higher level of spiritual ethics. This movement to question and often reject circumcision includes Jewish Rabbis, scholars, parents, intellectuals and educators, both in the United States and in Israel itself. In the United States, especially, Jewish people are so prominent in the general anti-circumcision and child protection movements that the controversy over circumcision is sometimes seen as a debate internal to the Jewish community. That would be a mistake: human rights are enjoyed by all humans, simply by virtue of their birth. The Jewish people’s long experience of, and heroic resistance to, persecution and discrimination has naturally made them particularly sensitive to human rights issues, so it comes as no surprise to see the most thoughtful members of the community having doubts about a practice that is increasingly seen as unconscionable denial of individual autonomy and personal choice - in short, a violation of those same rights that Jewish people invoke when defending their own religious freedom and cultural/personal identity. <h2>Increasing opposition to circumcision in Israel</h2> As worldwide opposition to routine circumcision grows, increasing numbers of Jewish people in Israel are deciding not to circumcise their sons. A well-researched article in the newspaper Haaretz (June 2013) reports the results of a survey conducted in 2006 which found that while nearly 5 per cent of respondents had not circumcised, fully a third (33 per cent) of parents would have preferred not to circumcise; they were persuaded by fear of social pressure. The greatest anxiety is about the reaction of relatives, especially grandparents - who usually get over their shock once they see their grandson and realise how beautiful he is. For example, Ido (an uncircumcised Jerusalem resident) told Haaretz that his paternal grandmother “did not stop crying from the moment she heard that her grandson was not going to be circumcised − until the first time she saw him and was enchanted by him. After that, he says, the subject never came up again.” Further evidence of the changing tide of sentiment are the increasing numbers of opinion pieces in Israeli newspapers criticising and rejecting circumcision, such as Uri Misgiv, who challenges the connection between circumcision and Judaism, declares his opposition to the cutting of children’s genitals on ethical and human rights grounds, and wonders why “people without any religious faith anxiously keep track of every heartbeat of their infant in the womb, run with him to the monitor, sonogram and every possible pregnancy test, guard him carefully from the moment of his birth – and then hasten to cut his sexual organ.” Also of significance is an editorial in Haaretz which stated firmly that “individual rights take precedence over religious customs”. The editorial was referring to a case in which an Israeli religious (rabbinical) court ordered a woman to have her boy circumcised and fined her for refusing; criticising the court’s decision, the editorial rejected forced circumcision and asserted the primacy of personal autonomy. <h3>Israeli writer challenges link between Judaism and circumcision</h3> The idea that Judaism is inextricably linked to circumcision must be challenged and corrected. When my beloved son was born I didn’t circumcise him. It was an easy and natural step, which I saw as an expression of my existence as a free man. I’m opposed to circumcision, and also have reservations about the use of the term “brit milah” (“covenant of circumcision”). It involves cutting the infant’s sexual organ, and I am opposed to the cutting of the sexual organs of boys and girls. Until now, I have naturally focused my efforts at persuasion on the population of secular parents. After all, it’s quite strange that people without any religious faith anxiously keep track of every heartbeat of their infant in the womb, run with him to the monitor, sonogram and every possible pregnancy test, guard him carefully from the moment of his birth – and then hasten to cut his sexual organ. It is relatively easy to reject the two reasons for continuing to practice circumcision that are common among the secular community. First, the health-related hygienic reason is relevant for other times or other continents, and in any case it should be confronted by a medical reason which is usually not reported: The percentage of accidents and mishaps in circumcisions is significant. Quite a large percentage of newborns who are hospitalized arrive with injuries and infections resulting from circumcision. Also, as opposed to refraining from making the cut, circumcision is an irreversible process, liable to cause irreversible damage. Second, the “social” reason is gradually declining on its own with the welcome spread of refraining from circumcision – and in any case is quite hard to understand. (Recently I encountered two separate cases of lesbian couples who brought a baby into the world together and decided to cut his sexual organ in order to “prevent him from being different.”) Recently, though, I realized that maybe the secular community should be left in peace. After all, at least the “secular circumcision” is frequently performed by a surgeon, with anesthesia. The “Jewish circumcision,” however, is performed by a mohel who is not necessarily a doctor, and always without anesthesia. This is an invasive and brutal act – abuse of a helpless infant, which I am certain will be outlawed in the future. In effect, there are two acts: Cutting the foreskin, and retracting it from the membrane that separates it from the glans, sometimes with a knife and sometimes with a fingernail. These are tissues that are full of nerves; it’s no wonder the victims scream. Sometimes, traditional circumcision also includes a third act by the mohel – sucking the injured organ until blood is drawn. Regarding this primitive ritual, Avi Shilon wrote in Haaretz ("Circumcision: A good trick for preserving Jewish identity," Dec. 25) that “a society cannot exist without symbols.” Rabbi Rafi Feuerstein wrote on Ynet that “parents who refrained from this small operation forced their children to be uprooted from the most basic symbol of their identity.” And Naftali Bennett, the economy and religious services minister, rejected the very existence of the discussion, declaring: “Friends, since the circumcision of our forefather Abraham, this is the strongest tie connecting the Jewish people to its Creator and itself … Make no mistake, this campaign is not motivated by compassion or enlightenment … only the desire to see a state of all its citizens, neutered of Judaism.” Strange. According to Jewish law, a Jew is someone born to a Jewish mother and, according to a more progressive approach, anyone who sees himself as belonging to the Jewish people. There were periods and communities in Jewish history in which circumcision was not practiced – from the days of ancient Egypt up to the Communist bloc. Moses was opposed to circumcision and didn’t circumcise his son, and the Children of Israel crossed the Jordan into Canaan uncircumcised. Circumcision does not determine that a person is Jewish, and non-circumcision does not determine that a person is not Jewish. So to come and claim that the preservation of Jewish identity rises and falls with the cutting of the sexual organs of infants? That this is the most basic symbol that guarantees the survival of Jewish society? That this is the strongest tie connecting the Jewish people to itself and its God? More than faith? More than the Torah and the Ten Commandments? More than the State of Israel and the Land of Israel? In light of such groundless claims, both religious and nonreligious Jews should start asking themselves questions. Source: <a href="http://www.haaretz.com/opinion/.premium-1.566724">Uri Misgav, Let’s talk about circumcision</a>. Haaretz, 2 January 2014. <h3>Israel newspaper rejects forced circumcision, asserts primacy of individual rights</h3> Civil courts need to send an important message that individual rights take precedence over religious customs, however widespread they are. Elinor's baby son was born with a medical problem, so he couldn’t be circumcised after eight days. During the time that elapsed, Elinor learned what the circumcision procedure actually entails, “and I realized that I couldn’t do that to my son. He’s perfect just as he is.” She claims the baby’s father was a party to this decision. But when the two began discussing their divorce in a rabbinical court, the father demanded that the mother be forced to have their son circumcised, as reported by Netta Ahituv on November 26. In an unprecedented decision, the rabbinical court ordered Elinor to circumcise her son against her will, and ruled that for every day for which she refuses to carry out the procedure, she will have to pay a fine of NIS 500. In response to the appeal she submitted to the Rabbinical Court of Appeals, the rabbinical judges wrote that “Removing the foreskin prepares the spiritual soul to receive the yoke of the kingdom of heaven and to learn God’s Torah and His commandments.” Another explanation they gave for rejecting the appeal related to the public battles against circumcision in Europe and the United States. “The Israeli public sees this as another expression of anti-Semitism, which must be fought,” they wrote. Alongside these embarrassing arguments, they claimed that “The commandment of circumcision is the covenant God made with His chosen people.” But circumcision is first and foremost a surgical operation performed on the body of a baby who is under his parents’ care. The fact that this operation is “performed on every Jewish boy,” to quote the rabbinical judges, doesn’t justify their conclusion that “When one parent demands this, the other parent cannot stay his hand.” The question of whether a baby should be circumcised should not be decided by a rabbinical court at all, but by his parents. If the parents cannot resolve their disagreement, reason actually mandates refraining from this irreversible operation, and letting the child decide for himself when he grows up. It is hoped that the High Court of Justice, which will soon be asked to decide this case, will overturn the rabbinical court’s decision. The justices will thereby send an important message that in Israel, individual rights take precedence over religious customs, however widespread they are. Source: <a href="http://www.haaretz.com/opinion/1.560811">No to forced circumcision.</a> Haaretz Editorial, 29 November 2013 <h3>More Israeli parents decide not to circumcise</h3> When their first child, a son, was born 11 years ago, it was clear to Eran Sadeh, now 42, and his partner, Maya, 40, that he would be circumcised. “We arranged it with a mohel [ritual circumciser] and then I started to look for information and references about the man on the Internet,” says Eran, a former lawyer-turned-computer instructor in a software company. But while surfing the Web, he came across a world of information about circumcision. “For the first time in my life I learned what’s cut, how it’s cut and what the risks are. I didn’t have a clue until then. The word was just another check mark on the list of tasks related to the birth. I treated it almost as a bureaucratic process. But the new information I came across shook me, and I knew I wasn’t capable of inflicting that on my son.” Eran Sadeh is not alone. In the past decade, increasing numbers of Jewish parents in Israel have decided not to have their sons circumcised. They hardly constitute a majority, but today, in contrast to the past, many Israelis are considering this idea. An informal online survey conducted in 2006 by the Israeli parenting portal Mamy found that of 1,418 parents of boys, 4.8 percent did not have them circumcised. The reasons given: 1.6 percent were not Jews; 2 percent objected to disfiguring the body; and 1.2 percent refrained because the act is painful. The survey also found that nearly a third of the parents would prefer to forgo circumcision but nevertheless have it done for social reasons (16.6 per cent), health reasons (10.4 per cent) and because it is important for the grandparents (2.1 per cent)‏. ... Among those in the latter group are Eran and Maya Sadeh, who live in the north of the country. They say that the most shocking piece of information they came across about circumcision, and the one that influenced them most deeply was the view of Maimonides on the subject ‏(see Circumcision in Judaism below‏). The great 13th century physician and philosopher “accorded emasculating justification to circumcision,” Eran Sadeh says. “He maintained explicitly that it is done in order to affect male sexuality and reduce the pleasure of the sex act. For me, that connected with female circumcision and shocked me. I immediately read up on the physiological aspects and understood that what Maimonides said is correct: Circumcision affects the functioning of the genital organ in sexual relations. “I connected that with my legal knowledge about human rights and understood that it’s wrong from that point of view as well. You take a person in the most vulnerable and helpless condition and amputate part of his body. Maimonides talks about that, too. Circumcision is performed when the infant is eight days old, because the bond between the parent and the child is not yet very strong and the parent is capable of inflicting this on his son. It is a gross violation of human rights, perpetrated by none other than the child’s parents, those who are responsible for protecting him.” Source: Netta Ahiuv, <a href="http://www.haaretz.com/weekend/magazine/even-in-israel-more-and-more-parents-choose-not-to-circumcise-their-sons-1.436421">Even in Israel, more and more parents choose not to circumcise their sons.</a> Haaretz Weekend Magazine, 14 June 2013. Accessing articles in Haaretz may require registration: it's free and fast. <h2> <a id="Schonfeld" name="Schonfeld"></a>Circumcision – defending the indefensible</h2> By screening my TV documentary 'It’s a Boy!' for European parliamentarians I aim to help shore up their commitment to protection of children’s right to physical integrity. I am a Jewish filmmaker and I have been invited by the Council of Europe to its Parliamentary Assembly next week. By screening my television documentary It’s a Boy! for European parliamentarians I aim to help shore up their commitment to protection of children’s right to physical integrity – a key step toward ending ritual circumcision of boys. Yet there is a struggle underway. Israeli Knesset members have orchestrated moves to reverse progress and protect the ancient custom instead of protecting children from harm. That’s why remarks quoted by MK Nachman Shai defamed me in this newspaper this week. Shai insinuated that the documentary, celebrated for its depiction of parental remorse over circumcision, was made by an enemy of the Jewish state. Never mind that I have lifelong deep ties to Israel evidenced in several acclaimed films, an ad hominem attack has been levelled without a shred of evidence for it. But will thinking people therefore shun an authoritative film? Those who would hope so demonstrate the poverty of their argument in favor of a cruel birth rite. In Strasbourg, my film will show the hidden casualties of circumcision – bleeding infants rushed into hospital, infected babies in intensive care, permanent deformities of young boys, and deaths. It will show mothers and fathers, Jewish, Muslim and African, full of sorrow and remorse for what they inflicted on their offspring. And I will refer to my experience as a Jewish father, the story I tell here. From a very young age attending Jewish schools my personal preoccupation was the Jewish thirst for justice and our empathy for suffering. Tsa’ar ba’alei chayim, the Jewish injunction to heed the distress of living beings, became the wellspring of the filmmaking I’m most proud of, including films about Israeli society, its past, present and future. When my wife and I were trying for our first baby, for a worryingly long time it wasn’t happening. But eventually we brought into our home a tiny lad with a wide-eyed look, a soft gurgling presence, and he brought out more gentleness than I knew I had in me. Until the calls started coming through. Have you fixed who will do the deed? When is the circumcision? But slicing away a body part from a healthy baby seemed to me neither natural nor inevitable, and I worried about him suffering. After several weeks of ignoring the messages, they became insistent. You do know your mother is dying of cancer? Get it done. The counsel from relatives was it’s harmless, it’s healthy, it’s just a few seconds. The doctor assured us the liquid anaesthetic he applied to the foreskin would make the procedure pain-free. The nurse spread our boy’s limbs and gripped them tightly. He started bawling. A frenzy of bawling. No-one had ever restrained him like this. There was a shriek. High-pitched, prolonged, unlike any sound I’d heard from him before. An instrument was attached to our son’s penis, and with each manipulation our child let out more shrieks. And then when the cutting edge was pressed through his flesh we heard a twisting, animal-like groaning and he writhed and grimaced as though something truly awful was being done to him. And then it was over. But it wasn’t over. The instruments were wielded again for “neatening the cut” and then “dressing the wound” – steps usually done out of sight of parents and celebrants. Our boy had a new kind of voice which rose up hoarsely at each contact with his genitals. At home, the wide-eyed look and soft gurgling were gone. Instead there was a helpless being with a raw wound to be re-bandaged repeatedly. For two days and nights he was writhing and crying. It had not been pain-free. It had not been a few seconds. It had been a betrayal of our son, and of ourselves. Only much later did I learn from a consultant paediatric anaesthetist how a baby’s pain is likely to be greater than an adult’s with the same procedure. If anaesthetics are injected, the procedure can be almost pain-free, but anaesthetic injections entail risks for a baby, and afterward while the wound heals protracted pain is inevitable. I learned that no matter who performs circumcisions, significant complications can threaten a child’s survival or his future experience of life; bleeding, infection and deformities are one-in-50 events by conservative estimates. And each year there are deaths. How many? It’s impossible to know because no-one is counting, and such deaths are sometimes attributed to heart failure or other causes less controversial than circumcision. Had I known such facts earlier, my son would have remained intact, as is the case with increasing numbers of Jewish boys today, including thousands in Israel. What of the health benefits claimed? A very slight reduction in the extremely rare condition of penile cancer is cited. The circumcision of grown men in Africa is credited with a reduction in HIV transmission in that region, but is not a serious justification for circumcising babies and young boys in Europe or Israel. A decrease in frequency of urinary tract infections (UTIs) in babies – that is vaunted as the statistically significant benefit from circumcision. But the same result can be achieved by soap and water, and in any case UTIs are readily treatable with antibiotics. Parents like me know from our remorse that it was wrong to make such an irreversible, painful and dangerous decision for our children. We owed our children protection, and we owe it to our communities not to be silenced when we have erred as parents. But the fear of being cast out from our tribes remains an intense pressure. Fear cows individuals who wish to dissent publicly. Fear cows parents who want to reject circumcision. That’s why boys from all backgrounds need the protection of the rule of law – secular law – wherever they may live. The necessity for this now in Israel is obvious. To deprive children of Jewish and Muslim descent in any country of full legal protection because of their lineage amounts to a most perverse kind of prejudice against those children. As for any attempt by real anti-Semites to latch onto this issue, that would be denounced publicly. But then real anti-Semites are not usually the people keen to protect Jewish children from harm, and real anti-Semites would probably like nothing better than continuance of a practice that stokes anti-Jewish feelings and for generation after generation inflicts suffering on Jewish boys. Children’s right to physical integrity should be what Israeli parliamentarians defend – rather than a brutal anachronism. <a href="http://www.itsaboythefilm.com/" rel="noopener" target="_blank">The author produced and directed It’s a Boy!</a> Source: Victor S. Schonfeld, <a href="http://www.jpost.com/Opinion/Op-Ed-Contributors/Circumcision-defending-the-indefensible-339081">Circumcision – defending the indefensible.</a> Jerusalem Post, 22 January 2014. <h2>Jewish anti-circumcision resources</h2> Jewish Voices – Many Jews Question Circumcision <a href="http://intactnews.org/node/104/1311886091/jewish-voices-current-judaic-movement-end-circumcision-part-1">Jewish Voices: The Current Judaic Movement to End Circumcision: Part 1</a> http://intactnews.org/node/104/1311886091/jewish-voices-current-judaic-movement-end-circumcision-part-1 <a href="http://intactnews.org/node/105/1311886372/jewish-voices-current-judaic-movement-end-circumcision-part-2" rel="noopener" target="_blank">Jewish Voices: The Current Judaic Movement to End Circumcision: Part 2</a> http://intactnews.org/node/105/1311886372/jewish-voices-current-judaic-movement-end-circumcision-part-2 <a href="http://intactnews.org/node/112/1313862929/jewish-voices-current-judaic-movement-end-circumcision-part-3" rel="noopener" target="_blank">Jewish Voices: The Current Judaic Movement to End Circumcision: Part 3</a> http://intactnews.org/node/112/1313862929/jewish-voices-current-judaic-movement-end-circumcision-part-3 <a href="http://salem-news.com/articles/august212011/jewish-circumcision-nw.php" rel="noopener" target="_blank">Jewish Parents are Trading Circumcision for Peaceful Covenant Ceremonies</a> http://salem-news.com/articles/august212011/jewish-circumcision-nw.php <a href="http://intactnews.org/node/103/1311885181/jews-speak-out-favor-banning-circumcision-minors" rel="noopener" target="_blank">Jews Speak Out in Favor of Banning Circumcision on Minors</a> http://intactnews.org/node/103/1311885181/jews-speak-out-favor-banning-circumcision-minors Peaceful Ceremonies: Brit B’lee Milah, Bris Shalom, Brit Hyiam, Brit Chayim, Brit Ben <a href="http://www.nocirc.org/religion/Naming_ceremony.php" rel="noopener" target="_blank">Brit B’lee Milah (Covenant Without Cutting) Ceremony</a> http://www.nocirc.org/religion/Naming_ceremony.php <a href="http://www.nocircofmi.org/BrisShalom.htm" rel="noopener" target="_blank">Bris Shalom Ceremony by Norm Cohen</a> http://www.nocircofmi.org/BrisShalom.htm <a href="http://www.interfaithfamily.com/life_cycle/pregnancy_and_birth_ceremonies/Sample_Non-Cutting_Naming_Ceremony_1.shtml" rel="noopener" target="_blank">Sample Non-Cutting Naming Ceremony #1</a> http://www.interfaithfamily.com/life_cycle/pregnancy_and_birth_ceremonies/Sample_Non-Cutting_Naming_Ceremony_1.shtml <a href="http://www.interfaithfamily.com/life_cycle/pregnancy_and_birth_ceremonies/Sample_Non-Cutting_Naming_Ceremony_2.shtml" rel="noopener" target="_blank">Sample Non-Cutting Naming Ceremony #2</a> http://www.interfaithfamily.com/life_cycle/pregnancy_and_birth_ceremonies/Sample_Non-Cutting_Naming_Ceremony_2.shtml <a href="http://www.veryveryfine.com/imported-20101215221410/2010/12/29/the-naming.html" rel="noopener" target="_blank">The Naming at Very, Very Fine</a> http://www.veryveryfine.com/imported-20101215221410/2010/12/29/the-naming.html <a href="http://www.beyondthebris.com/2011/07/brit-shalom-alternative-naming-ceremony.html" rel="noopener" target="_blank">Brit Shalom: An Alternative Naming Ceremony by Mark D. Reiss, MD</a> http://www.beyondthebris.com/2011/07/brit-shalom-alternative-naming-ceremony.html Jewish Religious and Historical Perspectives <a href="http://www.noharmm.org/rationaljew.htm">Being rational about circumcision and Jewish observance by Moshe Rothenberg, MSW</a> http://www.noharmm.org/rationaljew.htm <a href="http://www.beyondthebris.com/2011/07/defying-convention-interview-with_27.html" rel="noopener" target="_blank">Defying Convention: An Interview With Miriam Pollack</a> http://www.beyondthebris.com/2011/07/defying-convention-interview-with_27.html <a href="http://www.rabbinathan.com/writings/circum.shtml" rel="noopener" target="_blank">One Rabbis’ Thoughts on Circumcision by Rabbi Nathan Segal</a> http://www.rabbinathan.com/writings/circum.shtml <a href="http://www.beyondthebris.com/2011/07/eli-ungar-sargon-debates-kosher-sex.html" rel="noopener" target="_blank">Eli Ungar-Sargon Debates Rabbi Shmuley Boteach on the Moral Problems of Circumcision</a> http://www.beyondthebris.com/2011/07/eli-ungar-sargon-debates-kosher-sex.html <a href="http://vadimcherny.org/judaism/how_judaic_circumcision.htm" rel="noopener" target="_blank">Israeli Linguist Vadim Cherny: How Judaic is circumcision?</a> http://vadimcherny.org/judaism/how_judaic_circumcision.htm <a href="http://hyphen.bravehost.com/QuestioningMilah.htm" rel="noopener" target="_blank">Brit Milah : Inconsistent with Jewish Ethics? By D.A. Huffman-Paren</a>t http://hyphen.bravehost.com/QuestioningMilah.htm <a href="http://www.circumstitions.com/Jewish.html" rel="noopener" target="_blank">A Case for Bris without Milah</a> http://www.circumstitions.com/Jewish.html <a href="http://www.cirp.org/library/cultural/goodman1999/" rel="noopener" target="_blank">An Alternative Perspective by Jenny Goodman, MD</a> http://www.cirp.org/library/cultural/goodman1999/ <a href="http://www.cutthefilm.com/Cut_Website/Home.html" rel="noopener" target="_blank">Cut: Slicing Through the Myths of Circumcision – A Film by Eli Ungar-Sargon</a> http://www.cutthefilm.com/Cut_Website/Home.html <a href="http://lisabravermoss.com/uploads/Challenging_the_Circumcision_Myth.pdf">Jerusalem Post: Challenging the Circumcision Myth by Jan Jaben-Eilon [PDF]</a> http://lisabravermoss.com/uploads/Challenging_the_Circumcision_Myth.pdf Jewish Parents – Mothers Voices <a href="http://www.unassistedchildbirth.com/miscarticles/circarticle.html" rel="noopener" target="_blank">Laura Shanley: A Jewish Woman Rejects Circumcision</a> http://www.unassistedchildbirth.com/miscarticles/circarticle.html <a href="http://mothering.com/health/my-son-the-little-jew-with-a-foreskin" rel="noopener" target="_blank">My Son: The Little Jew with a Foreskin by Stacey Greenberg, Mothering Magazine</a> http://mothering.com/health/my-son-the-little-jew-with-a-foreskin <a href="http://www.beyondthebris.com/2011/04/lucking-into-bris-shalom.html" rel="noopener" target="_blank">Lucking Into Bris Shalom by Sarah Rockwell</a> http://www.beyondthebris.com/2011/04/lucking-into-bris-shalom.html <a href="http://www.beyondthebris.com/2011/05/how-cut-saved-my-sons-foreskin-movie.html" rel="noopener" target="_blank">How “Cut” Saved My Son’s Foreskin: A Movie Review by Diane Targovnik</a> http://www.beyondthebris.com/2011/05/how-cut-saved-my-sons-foreskin-movie.html <a href="http://blogs.evtrib.com/spirituallife/2006/08/31/jewish-mom-circumcision-spiritually-wounds-breaks-bonds-and-trust/" rel="noopener" target="_blank">Jewish mom: Circumcision spiritually wounds, breaks bonds and trust</a> http://blogs.evtrib.com/spirituallife/2006/08/31/jewish-mom-circumcision-spiritually-wounds-breaks-bonds-and-trust/ Jewish Parents – Fathers Voices <a href="http://www.cirp.org/pages/cultural/kimmel1/" rel="noopener" target="_blank">The Kindest Un-Cut Feminism, Judaism, and My Son’s Foreskin, by Professor Michael S. Kimmel</a> http://www.cirp.org/pages/cultural/kimmel1/ <a href="http://www.nocirc.org/symposia/second/rothenberg.html" rel="noopener" target="_blank">Ending Circumcision in the Jewish Community? by Moshe Rothenberg, MSW</a> http://www.nocirc.org/symposia/second/rothenberg.html Men’s Voices <a href="http://www.beyondthebris.com/2011/06/to-mohel-who-cut-me.html" rel="noopener" target="_blank">To the Mohel Who Cut Me by Shea Levy</a> http://www.beyondthebris.com/2011/06/to-mohel-who-cut-me.html <a href="http://www.beyondthebris.com/2011/06/on-circumcision-authority-and.html" rel="noopener" target="_blank">On Circumcision, Authority, and the Perpetuation of Abuse by Jonathan Friedman</a> http://www.beyondthebris.com/2011/06/on-circumcision-authority-and.html <a href="http://www.beyondthebris.com/2011/03/howard-stern-jewish-intactivist.html" rel="noopener" target="_blank">Howard Stern: Jewish Intactivist by Rebecca Wald, JD</a> http://www.beyondthebris.com/2011/03/howard-stern-jewish-intactivist.html Women’s Voices <a href="http://www.noharmm.org/pollack.htm" rel="noopener" target="_blank">Circumcision: A Jewish Feminist Perspective by Miriam Pollack</a> http://www.noharmm.org/pollack.htm <a href="http://www.tikkun.org/nextgen/circumcision-identity-gender-and-power" rel="noopener" target="_blank">Circumcision: Identity, Gender, and Power by Miriam Pollack</a> http://www.tikkun.org/nextgen/circumcision-identity-gender-and-power Circumcision Referendums and Legal Issues <a href="https://www.forward.com/articles/137577/">Outlawing Circumcision: Good for the Jews? by Eliyahu Ungar-Sargon</a> http://www.forward.com/articles/137577/ Jews Speak in Favor of Banning Circumcision on Minors <a href="http://intactnews.org/node/103/1311885181/jews-speak-out-favor-banning-circumcision-minors">http://intactnews.org/node/103/1311885181/jews-speak-out-favor-banning-circumcision-minors</a> <a href="http://thejewishreporter.com/2011/06/02/questioning-circumcision/" rel="noopener" target="_blank">Questioning Circumcision: Op/Ed by Rebecca Wald, JD., The Jewish Reporter</a> http://thejewishreporter.com/2011/06/02/questioning-circumcision/ <a href="http://www.sandfordborins.com/2011/06/09/the-circumcision-referendum-a-liberal-jewish-perspective/" rel="noopener" target="_blank">The Circumcision Referendum: A Liberal Jewish Perspective by Sandford Borins, PhD</a> http://www.sandfordborins.com/2011/06/09/the-circumcision-referendum-a-liberal-jewish-perspective/ <a href="http://www.rebeccasteinfeld.com/publications" rel="noopener" target="_blank">Jewish Journal: Circumcision critic has Board links</a> http://www.rebeccasteinfeld.com/publications Jewish Groups for Genital Integrity <a href="http://www.beyondthebris.com/" rel="noopener" target="_blank">Beyond the Bris: Jewish Parenting Blog</a> http://www.beyondthebris.com/ <a href="http://www.jewsagainstcircumcision.org/" rel="noopener" target="_blank">Jews Against Circumcision</a> http://www.jewsagainstcircumcision.org/ <a href="http://www.jewsfortherightsofthechild.org/" rel="noopener" target="_blank">Jews for the Rights of the Child</a> http://www.jewsfortherightsofthechild.org/ <a href="http://www.circumstitions.com/Jewish-shalom.html" rel="noopener" target="_blank">Bris Shalom Officiants by Mark D. Reiss, MD</a> http://www.circumstitions.com/Jewish-shalom.html <a href="http://www.jewishcircumcision.org/" rel="noopener" target="_blank">Questioning Circumcision: A Jewish Perspective by Ron Goldman, PhD</a> http://www.jewishcircumcision.org Israeli Groups for Genital Integrity <a href="http://www.kahal.org/" rel="noopener" target="_blank">Kahal: Giving Up Brit Milah</a> http://www.kahal.org/ <a href="http://www.britmila.org.il/" rel="noopener" target="_blank">Intact Son: the Israeli Association Against Genital Mutilation</a> http://www.britmila.org.il/ <a href="http://www.gonnen.org/" rel="noopener" target="_blank">Gonnen: Protect the Child</a> http://www.gonnen.org/ <a href="http://www.beofen-tv.co.il/circumcision/main.html" rel="noopener" target="_blank">Af-Mila: Israeli Intactivist</a> http://www.beofen-tv.co.il/circumcision/main.html </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Jewish voices against circumcision getting stronger darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> As the demand for democracy and individual rights spreads from the developed world to the Middle East and Asia, more people are taking up the cry that bodily integrity - an entitlement implied in the Universal Declaration of Human Rights - applies to all parts of the body. Progressive Jewish people, especially in the United States, have been abandoning circumcision for many years, but until recently few people from a Muslim background dared to question the practice. That silence is now well and truly broken. <h2>Circumcision or genital mutilation</h2> by Jahanshah Rashidian Circumcision, or for non-believers “genital mutilation”, is one of the most ancient rituals still practised in some societies. Historical background of this old ritual, as to when, who, and why it started is not precisely known. The practice varies from region to region and from epoch to epoch in its total or partial removal of the foreskin /clitoris for both sexes. Circumcision, in its different forms, is practised in a big part of the world. The Jews were the first to adapt it as a sign of religiosity; it is mentioned in the Old Testament as a religious ritual and preserved its practice into our times. Circumcision was banned by the ancient Romans and Greeks considering it as an act of barbarity. Also the early Christians took a strong stand against it. Despite many modern anti-circumcision movements especially for the female one, circumcision for both sexes is practised worldwide in the Islamic societies, in some old tribes in Africa, in some native tribes of Australia and since 19th century, occasionally, in the USA. Benefits of circumcision are believed to maintain genital organs in hygienic conditions for male whereas it is practised to reduce the sexual lust for female. Removal of a functional, sensitive, healthy, and normal foreskin or clitoris with many nerve fibres, nerve endings, strictly speaking is a genital mutilation. Medically speaking, it has no relevant healthy benefits that can objectively be used to justify its practice. And as such, this heritage of passed rituals violates the principles of modern morality and the very principles of sciences. Our universal law respects parent’s “ownership rights” over their children to protect them, namely to the extent where all their decisions should normally be in the child’s benefits. The contrast to this however appears when they have no right by abusing constitutional guarantees of freedom of religion to inculcate a particular religion or ritual practice into their children. A child’s right to maintain the integrity of his/her healthy body should not be violated by any religion. Some businesslike or religious doctors, as modern circumcisers, cut off a functional healthy and normal part of human body, a business or religious treatment which is in contradiction to their professional morality. This is akin to remove an eyelid which protects the eye or to cut off a finger of a child as a pseudo-healthy treatment. Circumcision would have died out long ago, along with leeching, skull-drilling, and castration if it were frankly motivated by purely medical reasons. The fact is that the “reasons” were later invented and stereotyped to justify the ritual act of circumcision. Pseudo- intellectuals of religious industry have been long brainwashing innocent people to blindly practise such rituals. Religious mission is to avoid rising general awareness about the scientific, reasonable, and beneficial reasons, and in this light, much has been cooked up about the nonessential ritual of circumcision. The advisability given about circumcision, contrary to immunisation, is merely rooted in cultural customs, religious and social myths, but not in therapeutic treatments. The foreskin protects the glands of sexual organs. Thus the foreskin is an essential part of human sexual anatomy. The foreskin is a sensitive and functional organ with a rich concentration of blood vessels and nerve endings to keep the glands soft, moist, and sensitive. The psychological studies have proved that all individuals, regardless religion or gender, who have genital cutting imposed upon them as non-consenting children, bear different degrees of physical, sexual, and emotional wounding. The cutting is mostly the first painful and bloody trauma for a child. Many people from circumcising cultures can attest to the harm this practice inflicted on them. Religious and cultural influence reinforces denial of these consequences and makes it, with all means, taboo for people to dare talking openly about their harm. The fact that religious pressure forces people to adapt to and cope with this wounding or to remain silent, does not justify the wounding anymore. No medical evidence about the effectiveness of this wounding in reducing the risk of contracting HIV/AIDS or considerable effectiveness of penile cancer or genital diseases has been really proved. Only periodical speculations, which are mostly loaded with religiosity, justify this practice. No health organisation in the world currently accepts circumcision as a preventive procedure and advocates its practice for both sexes; even if female circumcision is in some areas absent, it is immorally perverse to excuse one cruelty by invoking a worse one. The genitals of both sexes, as the products of evolution, should be left intact. Since 1996 female circumcision has been considered violence against women in the US and thus has become illegal, but the “civilised world” ignores the practice of it in many circumcising cultures. In Egypt, a US alley, more than 90% of women are victims of female circumcision. The legitimisation of this painful and barbaric act, which can rarely be imagined without shuddering or being sick, is mentioned in a Hadith reported by Umm’Atiyya: “A female circumciser in Madineh was told by the Prophet of Islam, “When you circumcise, do not cut a big part of clitoris as that is better for a woman and more desirable for her husband.” The narration, ignoring the image of pain and sufferance, is one of the fundamental religious sources, allowing not only circumcision of boys (Khitan), but also circumcision of girls (Khafd) in Islam. For less conservative Islamic scholars, the narration is a “modest” reason that only the outer part of the clitoris should be cut off and not as is done in some other African Muslim countries cutting off all the clitoris. Cutting away a part or a young girl’s entire clitoris is a ritual practice in parts of Islamic Africa. However, even the “modest” image of such a removal of the prepuce of a young girl’s clitoris seems still odious enough to call it a barbaric maiming of innocent girls. It practically is to inflict a despoiling of ability to enjoy sexuality. It means that sex for women is not so much more than procreative act. Beside the idea of reducing all of the female extra-marital affairs, another dominant idea of female circumcision has been claimed to diminish the risk of rape. As such, the entire clitoris is cut off. The tissue are then sewn together, leaving a narrow hole for the flow of urine or menstrual blood (a second procedure is necessary to allow the sexual intercourse). This typical patriarchal and misogynous idea does not consider the male rapist as the main culprit, but implicitly the female uncircumcised victim! Degree of brutality of female circumcision brought some of the Islamic scholars to modify their judgement about performance of its practice, arguing that female circumcision has been regarded by the Prophet as an act of merit, not as an obligation. This is the why that female circumcision is less practised than male circumcision in the Islamic societies. Circumcision however is not mentioned in the Koran and has been initially inspired as an act of purification (Taharah/Taharat) for both sexes. This has been referred by a narration from the Prophet who classifies circumcision as one of the five acts of Fitrah (purification), namely shaving the public hair, trimming the moustaches, clipping the nails, plucking the armpit hairs. Circumcision was imposed on Iranians through the Islamic invasion in 7th century. (The pre-Islamic Iranians, Zoroastrians, were not circumcised). Circumcision for both sexes, along with female infanticide, was old tribal traditions practised by the primitive patriarchal pagans in Arabian; the advanced culture of Persians did not adopt such atrocious rituals. Islam adopted the circumcision and changed its status into an Islamic ritual. And as such, it was imposed upon the conquered territories, including Iran. Female circumcision, apart from some cases in southern areas and Kurdistan, is not practised in Iran, but the Shiite sect considers male circumcision obligatory and tends to lean the extreme side on the issue. Associated with a typical ceremony (Khatneh Soorun), a reminder of a sacrificial ceremony, the Islamic circumcision is in perfect harmony with the feast of the sacrifice in Islam. Circumcision in Sharia is an order to cut the skin that covers the male genital and /or to cut the upper end of the skin that covers the clitoris on the female genital part. It has been considered by Islamic scholars that circumcision is compulsory act on both males and females. Sacrifice like cannibalism and infanticide is older than all the main monotheist religions. It has been an act of worship. Human / animal sacrifice was a routine ritual ceremony, in which young human victims were killed to please their gods or spirits. In exchange for the wanton sacrifice, the human victims were baptised martyrs and were promised holly rewards like the paradise in the next world. The human victim was not only offered to satisfy the gods and consequently the group, but as a martyr, became a promoted status of sacred. This concept of divine victim is very similar to the concept of martyrdom in Shiite traditions. At the early ancient cultures human /animal sacrifice was a routine ritual in times of natural disaster; even for the rise of the sun a person would be sacrificed. Human sacrifice or mutilation still happens today as in underground practice in some traditional religions in some cultures in South Africa. The occasions of human sacrifice and human mutilations are associated with some ritual ceremonies. In ancient Egypt, as brutal as widow-burial, the ceremonial and sacrificial circumcision, for both sexes, was practised to please their god of fertility. In ancient Mesopotamian there were festivities in which the genital organ of a young boy was brutally cut off and was offered to the goddess of fertility. Some scholars believe that all of the monotheists Prophets were born circumcised, while some others claim that Prophet Abraham was the first to practise (self) circumcision to please God.” No need to mention that today’s judgement about such an act of “pleasing” can be reduced to the rank of pathology. Another aspect of circumcision besides the purification and the sacrificial character, can be regarded as an act of punishment (a means of humiliating to mark captured enemies and slaves, or as a patriarchal means was in its origin an injury to the mother reducing her authority over her child). The punishment which religiously often means a ritual purification is attributed to tone down sexual pleasure. Human sexuality has been seen in many primitive cultures as immoral and impure and thus needs ritual purification. Circumcision, in this case, was the obvious way to “purify” the believers. In this light, sex with an uncircumcised man is not allowed for a Muslim woman. Considering the case of the Abraham’s self-circumcision, to be believed or not, reflexes that a very important combined factor of circumcision is to be self-injury. This is a pathological practice to relieve overwhelming emotional tension. It can be practised from a little common cut of skin to the collective practice of self-flagellation or self-stabbing in the Shiite mourning rituals. As witnessed in the period of mourning month of “Moharam”, self-injury in Shiite is widely practised. In this case, the practice is usually a symbolic act to connect the individual to the group of believers. Some practices like piercing and tattoos, or in this case circumcision, are also socially preconditioned. These practices are done to identify with a particular group, religion, and collective identity. So, the social respect of collective practice can turn into a practice of self-injury like circumcision, and its harm is socially justified for the members of that society. The self-injury in its ritual practice often focuses on the sexual organs and can be regarded as a copy mechanism for the origin of circumcision. To conclude my article and my purpose, I point out the following traits: <ul> <li>Circumcision, an old practice, has no clear references concerning its history, motive and origin.</li> <li>Circumcision is a ritual practice of primitive cultures and can be rooted in the factors of sexual punishment, ritual sacrifice and self-injury.</li> <li>Circumcision has no preventive or medical benefits.</li> <li>Circumcision, as an act of genital mutilation for both sexes, cannot morally be permitted.</li> </ul> <a href="http://www.mideastyouth.com/2010/03/26/circumcision-or-genital-mutilation/" rel="noopener" target="_blank">Original source with comments from readers</a> <a href="http://www.agoravox.com/comment/article/circumcision-or-genital-mutliation-11414" rel="noopener" target="_blank">Or at the author’s blog</a> Jahanshah Rashidian is an Iranian-born German and a freelance writer in several languages (Persian, German, French, and English). He is not affiliated to any political entities. He writes on democracy, human rights, and secularism. <a href="http://www.agoravox.com/auteur/jahanshah-rashidian" rel="noopener" target="_blank">See his blog here</a> </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Iranian human rights activist criticises circumcision darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> Leonard B. Glick. Marked in Your Flesh: Circumcision from Ancient Judea to Modern America. New York: Oxford University Press, 2005. xiv + 370 pp. $30.00 (cloth), ISBN 978-0-19-517674-2. Reviewed by Emily Wentzell (Department of Anthropology, University of Michigan)â€¨ <a href="http://www.h-net.org/reviews/showrev.php?id=11858">Published on H-Histsex (June, 2006)</a> <h3>A Genealogy of Male Infant Circumcision</h3> In his wide-ranging exploration of the religious history, medicalization, and current North American practice of infant male circumcision, Leonard Glick, a retired professor of anthropology, makes a case against the practice by denaturalizing it. While Glick briefly argues directly against infant circumcision at the beginning and end of the book, his central goal is to cause readers to question the unquestioning acceptance of circumcision as a medically advisable act, and, for Jewish readers, to problematize the practice as a straightforward and harmless marker of religious identity. Tracing a path from the original Jewish circumcision, the Biblical story of God's covenant with Abraham, to portrayals of circumcision as recent as Seinfeld, Glick explores the historically shifting social meanings and material consequences of circumcision as a Jewish ritual practice; turns to medical literature to discuss the clinical adoption of circumcision as a secular surgery; and provides an overview of current American debates about the medical value and religious meanings of the practice. Glick argues that this focus on Jewish circumcision is a prerequisite for a study of modern American circumcision, since the doctors who promoted medical circumcision deliberately borrowed the Jewish ritual practice, and the Jewish religious discourse about circumcision continues to coexist with the medical dialogue. Since this work covers so much ground and thus could be useful as a reference for scholars interested in a variety of time periods and topics, I shall provide an overview of the contents of each chapter as well as a discussion of the work as a whole. The first portion of the book deals with the history of infant male circumcision from its Biblical inception to modernity. Chapter 1 covers the religious and social meanings of circumcision from the advent of Temple Judaism around 500 B.C.E. to the Hellenic world of the first century C.E. Here, Glick first discusses the earliest ritual significance of circumcision in Judea, relying on a rich variety of early religious texts and secondary sources to map the web of meanings that the practice may have held, in order to explain why the ritual removal of infant male foreskins developed. Glick then addresses the social consequences of circumcision in the Greco-Roman world (using examples such as excerpts from Roman satire and historical accounts of the attempts by Jewish gymnasium-goers to re-stretch their foreskins) to argue that circumcision functioned as an often-derided ethnic marker. Finally, Glick discusses Gentile attitudes toward circumcision as a religious act, as shown in the rhetorical efforts by Philo (first century) to link Jewish circumcision with fertility, physical and spiritual cleanliness, and the diminishment of sexual pleasure. <h4>Greeks, Romans and Europeans</h4> This chapter exemplifies the way that each portion of the book addresses broad temporal, topical, and geographical spans. This breadth enables Glick to cover a specific genealogy of circumcision in its entirety, flexibly moving throughout space and time to pause at points of particular significance or for which there is especially rich historical information. While this technique enables a great breadth of information to be brought into the history of circumcision, at times it may cause readers to lose their bearings or to feel that, while they have been given the information necessary to understand an event or actor's role in the history of circumcision, they cannot understand it in its own specific context. At points in this wide-ranging history, the reader may therefore feel that depth is sacrificed for breadth. However, Glick employs this strategy in order to present a particular history that will enable him to make a statement about modern circumcision that can have real-world consequences, and the decision to seek historical breadth is thus appropriate for his goals. Chapter 2 covers the Christian rejection of circumcision, focusing on the ways in which debates about the practice were implicated in larger disagreements among early Christian theologians about the relationship of Christianity to Judaism. Separation of the two was achieved in part by the eventual Christian rejection of physical circumcision in favor of a concept of spiritual circumcision and derision of ritual focus on the flesh. Glick then discusses Roman opposition to politically threatening Jewish proselytism in the second to fourth centuries C.E., and the resulting juridical sanctions placed on the act of circumcision. Next, he outlines the rise of Rabbinic Judaism, focusing on the codification of circumcision in the Mishnah and Talmud, to show how the creation of these texts altered the physical practice of circumcision (calling for the removal of significantly more penile tissue), and cast the rite as central to the very idea of humanity in Rabbinical thought. Addressing the practice and public perception of circumcision in Europe, chapters 3 and 4 cover the development and significance of European circumcision rituals and Gentile reactions to the practice. Glick argues that circumcision became a key marker of Jewishness in medieval Europe, and he discusses the social significance of various aspects of the circumcision rite, many of which persist today. In the context of increasing stigmatization of Jews due to economic changes in the eleventh and twelfth centuries, Glick analyzes the writings of figures such as Peter Abelard, Martin Luther, and Benedictus de Spinoza on circumcision as emblematic of differing ways of thinking about Jewishness in their particular historical and social locations. Glick then discusses the social and sometimes juridical impact of popular stories told in twelfth-through-fifteenth-century Europe about Jewish kidnapping, circumcision, and murder of Christian boys, and their supposed use of Gentile blood in religious practice, including circumcision. Chapter 4 concludes with a discussion of the discourse on the barbarity of circumcision that was employed to overturn an Act enabling the naturalization (and thus economic advancement) of British Jews in 1753. <h4>Jewish critics of circumcision</h4> Glick separates the book into two sections, stating that the work's "pivot" point occurs in chapter 5, with the advent of modernity in the mid-nineteenth century, and a reform movement within Judaism that enabled some revaluation of circumcision as a necessary and appropriately modern practice. Here, Glick seeks to show both how circumcision persisted, and how the persistence of circumcision was remarkable in the face of such change. The latter is a difficult point to argue, as it requires a demonstration that circumcision was and is counterintuitive in its social and historical contexts. While this argument gives the story of circumcision a political framing appropriate to Glick's project of questioning the modern necessity of the practice, his historical analysis of the specific ways in which circumcision did persist, both as a religious and then as a secularized medical procedure, is much stronger than his discussion of the strangeness of this occurrence. Glick effectively shows that circumcision remained a marker of Jewish identity that even the most radical reformers were loath to challenge, and he traces the complex links between religious ritual and medical circumcision that enabled popularizing of the practice as a secularized medical procedure in North America and Britain. There were several outspoken critics of circumcision among nineteenth-century German Jews, including the remarkable Abraham Geiger and Samuel Holdheim, who argued that the practice should be entirely dropped, but they did not succeed in convincing more than a few individuals in their community. Glick demonstrates that religious and medical reforms, such as early state public health activities, combined not to eliminate, but to medicalize circumcision--for example, by calling for the medical training or licensing of practitioners of the rite. Chapter 6 details the pro-circumcision bent of doctors in Victorian and early-twentieth-century America, as an astonishing range of maladies, from chronic masturbation to paralysis, were attributed to the sexual stimulation and supposed dirtiness of the foreskin. Glick writes that doctors took up circumcision as a weapon against both disease and immorality, and that Jewish doctors further supported the medicalization of the practice by arguing that doctors, not mohels (ritual circumcisers), should perform the operation. <h4>Medicalization of ritual circumcision</h4> Glick further discusses the medicalization of circumcision in chapter 7, presenting medical discourse about the health benefits of the procedure from 1910 to the present. He argues that during this period circumcision became viewed as a preventative health procedure, thought to ward off the most feared diseases of the early and late twentieth century--cancer, syphilis and HIV/AIDS. Glick focuses on discussions of the health benefits of circumcision in the medical literature, detailing the arguments of the highest profile participants in this discourse, evaluating the legitimacy of their case, and contexualizing them with biographical information about their popularizers, including consideration of the effect of their religious beliefs on their advocacy for or rejection of circumcision. Glick also discusses the often-fraught statements that medical governing bodies, such as the American Academy of Pediatrics, have made about the validity of the practice, and he grounds this discussion in material medical practice with a brief history of the development and use of the clamps now commonly employed in medical circumcision procedures. This chapter provides an excellent topography of the key figures in twentieth-century American debates about the medical value of circumcision, and demonstrates that their arguments continue to shape medical ideas about, and the practice of, this surgery. In the final chapters of the book, Glick addresses modern American discussions and representations of circumcision. Seeking again to show the persistence of circumcision as counterintuitive, he presents a somewhat paradoxical argument--that circumcision, through medicalization, has lost its meaning as a Jewish practice, and that this loss of meaning makes it anachronistic for secular Jews to continue viewing the practice as central to Jewish identity. However, the evidence he presents in chapter 8--accounts from Orthodox, Reform, and Humanistic Jews about their struggles with certain ethical aspects of circumcision that usually conclude by reaffirming that the practice is the key to Jewish identity, as well as Jewish books on baby care and text from Mohels's web sites--tends rather to demonstrate that circumcision has retained strong meaning for Jews, despite its medicalization and its adoption by non-Jews. <h4>The American media</h4> Chapter 9 provides an overview of representations of circumcision in American popular media, discussing selected texts from Jewish periodicals, children's books dealing with the circumcision of a sibling, feminist discussions of circumcision as a patriarchal practice, fiction by Jewish authors, sitcoms such as Seinfeld and Sex in the City, and jokes. While all the chapters move selectively between key texts, events, and actors over a broad spatial and temporal range to provide a wider picture of the genealogy of circumcision, this chapter is the least successful, as it seems to cover texts chosen for their accessibility rather than their cultural significance, while the discussion of the texts is sometimes more descriptive than analytic. In the epilogue, Glick lays out his political stance against circumcision. He argues that the validity of circumcision boils down to two questions: whether the practice is medically effective, and whether parents have the right to alter a child's healthy body so significantly without the child's consent. Glick's previous argument about the medicalization of circumcision sheds ample light on his first question; his historicization of medical discourse of circumcision frames it as social text rather than presentation of biological fact, making his historically grounded discussions of the invalidation of claims for the health benefits of medical circumcision very convincing. However, the second question is hurriedly contextualized in a discussion of human rights that ignores long-standing critiques of the concept as inherently Western and individualistic.[1] While Glick makes passing references to discussions about female circumcision (in this case, unproblematically discussing activist critiques without noting that some feminists have argued that this type of activism is culturally imperialistic) and to male circumcision rites in religions like Islam, he does not fully develop these links.[2] Further developing these connections would have enriched the analysis of modern portrayals of and discussions about circumcision practices. Glick also uses his case that circumcision has lost religious significance to argue against the necessity for Jews to circumcise their male infants; but again, this argument is muddied by the evidence he has presented that circumcision remains a culturally salient practice. If elements of Glick's final argument against circumcision are not fully developed, however, it is because in large part his project is an historical one, geared toward detailing the development of Jewish and then medical circumcision in order to present it as a historically and socially located practice that can be questioned by modern practitioners. The great strength of the book is its thorough yet wide-ranging genealogy of infant male circumcision. While other in-depth scholarship has increased our knowledge of the medicalization of circumcision, Glick's work sets this phase of circumcision's history into a broader historical and social context; further, his rich discussion of the original meanings of the Jewish practice fills a gap in the literature on circumcision.[3] In short, Glick's project is to provide a complete history of circumcision, ranging across place, time, and the divide between religion and medicine, in order to enable individuals to make better-informed choices about whether they will participate in the practice, and this he ably achieves. <h4>Notes</h4> [1]. For a discussion of this and the opposing point of view in relation to female circumcision, see Alison T. Slack, "Female Circumcision: A Critical Appraisal," Human Rights Quarterly 10 (1988): pp. 437-486. [2]. Ellen Gruenbaum, The Female Circumcision Controversy: An Anthropological Perspective (Philadelphia: University of Pennsylvania Press, 2001). [3]. For discussions of the medicalization of circumcision, see Frederick Hodges, "A Short History of the Institutionalization of Involuntary Sexual Mutilation in the United States," in Sexual Mutilations: A Human Tragedy, ed. George C. Denniston and Marilyn Milos (New York: Plenum Press, 1997); David L. Gollaher, Circumcision: A History of the World's Most Controversial Surgery (New York: Basic Books, 2000); and Robert Darby, A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain (Chicago: University of Chicago Press, 2005). <h3>Response by Leonard Glick</h3> The following response by Leonard Glick was posted to the <a href="http://www.h-net.org/~histsex/" rel="noopener" target="_blank">H-Histsex discussion list </a>on 13 July 2006 I thank Emily Wentzell for the most generous and informative review that my book, Marked in Your Flesh has yet received. In fact, her critique of one major argument provides an opportunity for what might be helpful amplification. Although appreciating my "historical analysis" of Jewish circumcision, she found unpersuasive my argument that the practice "was and is counterintuitive in its social and historical contexts." The paradoxical quality of that unterintuitive behavior is especially evident in the contemporary American context, and it is to that point in particular that I want to address this reply. Continuing not only to accept but even to vigorously defend circumcision is indeed counterintuitive for most Jewish Americans, since its original religious significance--as the legacy of an immutable covenant between God and Abraham--has little or no valence for those who do not accept myth as history or biblical texts as obligatory guides for contemporary life. That is indeed a puzzling feature of the modern history of this supremely puzzling practice. I think we can begin to untangle the knot by recognizing that Judaism is what I call a "localized religion" (in this case localized to a single people, not to a single place)--fundamentally different from the two definitively world or "universalist" religions, Christianity and Islam, but akin (perhaps surprisingly) to those of Native American peoples or distinct ethnic groups of Asia and Africa, whose religions are inseparable from specific localized identities. For example, just as one could not convert to the Hopi religion without somehow becoming a Hopi, one cannot convert to Judaism without becoming a Jew. This conflation between religious and ethnic identity is a source of confusion for non-Jews, some of whom cannot understand how a person who does not practice Judaism (the religion) can still claim to be Jewish. The answer is that in modern Western culture, with its emphasis on individual choice and responsibility, abandonment of the formal ritual requirements of traditional Judaism need not constitute denial of Jewish ethnic identity. (Note that many now identify themselves as "secular Jews," but no one can be a "secular Christian.") Here, I suggest, is the source of what Wentzell identified as "counterintuitive": If circumcision (like many other ritual practices) no longer has its original symbolic power as a religious act, why do so many Jews insist that if they abandon it, the result will be disappearance of the Jewish people? To phrase this differently, if the more rigorous ritual requirements of the Jewish religion (kosher food regulations, strict Sabbath observance, and much more) are no longer essential components of modern Jewish life, why has circumcision, the most anachronistic of ritual practices, been elevated to the role of single, indispensable guarantor of ethnic survival? The mystery deepens when we recognize two additional complications. First, infant circumcision is still widely accepted as an American medical practice, and even today more than 55 per cent of all American male infants are circumcised at or soon after birth. Moreover, since hospital operations are essentially identical in result to those performed by mohels (i.e., radical removal of the entire foreskin), ritually circumcised Jewish American males have penises altered in a manner indistinguishable from those of their Gentile neighbors. Second, according to religious doctrine the only valid circumcision is a ritual operation performed by a mohel on the eighth postnatal day. But many, possibly most, Jewish parents now choose hospital circumcision by a physician--a practice having no religious significance whatever--partly because other American infants are being circumcised in the hospitals, but also in the paradoxically contradictory belief that foreskin removal in itself distinguishes the boy as Jewish. The bottom line: in America circumcised genitals do not mark Jewish identity. So one major question--why, then, does circumcision still receive such resolute endorsement by Jewish Americans?--is more readily asked than answered, and much of the argument in my book implicitly acknowledges that. One can only speculate: Is this because circumcision is a single day's act performed on an uncomprehending infant, while other ritual regulations require a lifetime of burdensome daily observance by adults? Or is it perhaps because the dramatic, primordial quality of the event--a sacrificial blood offering, if one accepts the obligatory texts accompanying the rite--distinguishes circumcision from such comparatively mundane practices as dietary observances? Or is it simply that, with so much else abandoned, most Jews (even the "secular" nonbelievers) are unwilling to relinquish this beleaguered relic of pre-modern Judaism--even when performed in a manner contradictory to religious law? One of my goals in Marked in Your Flesh was to show that even those Jews who are most determined to defend circumcision are troubled by a remarkable degree of anxiety, ambivalence, and even downright confusion. My purpose in quoting various contemporary texts--books for prospective Jewish parents, books for girls who ask why there is a rite of initiation for boys alone, fiction, television sitcoms, and so on--was to convey the floundering quality of many conventional explanations and justifications. Nearly all the quoted selections are by Jewish authors--not by my intention, but determined by the fact that, despite the controversial nature of all circumcision, it is Jewish Americans who are by far the most sensitive to any challenge to the practice. Will infant circumcision maintain its hold on Jewish Americans as the overall American circumcision rate continues to decline? Until now it has been relatively easy to accept foreskin removal as a widely approved American custom--avoiding the obvious question of how this practice can guarantee the survival of a specifically Jewish identity in a nation of circumcised men! But as more and more Americans come to understand that infant circumcision is medically unjustifiable and indeed harmful, the general rate will continue its downward slide; and as that happens, more and more Jewish American parents will have to ask themselves whether circumcising their sons is wise or necessary. When that time comes, Ms. Wentzell and I may both be able to answer the ultimate question: Why must genitals be cut to define anyoneÂ¹s social identity? </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Review: Marked in your flesh (2006) darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h3>Circumcision no barrier to HIV infection</h3> Whatever the US media may claim, there are increasing reports that AIDS is making rapid headway in the Middle East â€“ that is, among Moslem populations where most of the males are circumcised. A recent report by Nicholas Eberstadt and Laura M. Kelly in the US journal Foreign Policy suggests that denial of the problem, failure to take action, repressive attitudes to sexuality and lack of attention to counselling in safe sex practices are more important factors in the spread of the disease than normal (or even abnormal) human anatomy. <h4>THE MUSLIM FACE OF AIDS</h4> On a cold December evening in the southern Iranian city of Kerman, the stars blazed overhead as a father took his son's life. Enraged, and with an axe in hand, the head of a prominent Iranian family chopped his child to pieces for bringing shame upon his relatives. The son's crime? Contracting HIV, the virus that causes AIDS. In a country where, in some parts, nearly 60 percent of HIVâ€“positive citizens take their own lives within the first year of their diagnosis, the 23-year-old son faced little chance of acceptance, even from his family. That tragic story is just one of the many being told as the deadly contagion unfolds across the massive Islamic expanse, from Morocco to the Philippines. In the years immediately ahead, the AIDS pandemic will exact a grim toll on a number of vulnerable populations with volatile polities â€“ places unlikely to cope with the significant social stresses and economic burdens that AIDS can cause. Officially, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates the total HIV population of North Africa, the Middle East, and predominantly Muslim Asia at nearly 1 million people today. At the end of 2003, UNAIDS estimated that up to 420,000 people in Mali, 180,000 in Indonesia, 150,000 in Pakistan, and 61,000 in Iran had HIV/AIDS. Those numbers, however, are severely understated. UNAIDS figures depend upon surveillance data; thus a lack of information can be taken as a lack of infection. UNAIDS data on the number of people living with HIV/AIDS are completely missing for Afghanistan, Turkey, and Somalia, all countries with large at-risk populations. Moreover, UNAIDS' HIV estimates are determined by conferring with local governments, and politicians who do not wish to allocate domestic resources to HIV/AIDS programs (or to deter foreign investors) can downplay its reach or simply refuse to admit its presence. Although the prevalence rates of Muslim infections may seem small when compared with the tragedy that is unfolding in southern Africa, they stand in sharp contrast to official estimates that suggest no disease at all. An instructive tale for the Muslim world lies in the differing responses to HIV/AIDS in Thailand and South Africa. In the early 1990s, both countries had an official national prevalence of between 2 and 3 percent. Thailand embarked on an aggressive antiâ€“HIV campaign that reached all sectors of society. AIDS education programs were delivered in schools as well as in brothels, and senior political leaders delivered AIDS-prevention messages as a part of almost every public address. As a result of this campaign, HIV rates remained low throughout the 1990s. By comparison, South Africa did little to halt the spread of HIV until the dawn of this millennium and now has the nightmarish task of controlling a disease that already infects nearly a quarter of its adult population. The Muslim world now must decide if it will replicate Thailand's relative success, or follow South Africa's deadly path. <h4>It Couldn't Happen Here</h4> The first cases of HIV in the region were officially recorded in Bahrain, Qatar, Iran, and several other Muslim states in the midâ€“1980s. Despite identifying the disease early on, many countries still have not launched treatment or public health education programs to prevent its further spread. One major reason for this lack of action has been assumptions that premarital sex, adultery, prostitution, homosexuality, and intravenous drug use do not occur in the Muslim world, or happen so infrequently that the risk of the disease gaining a foothold in these countries is low. In 1995, for example, Indonesia's Council of Ulemas urged that condoms only be sold to married couples with prescriptions from general practitioners. It was felt that strong religious convictions would prevent people from having extramarital sex. Members of the international public health community, for their part, have not only seemed to accept the presumptions behind those arguments but on occasion have also espoused them. As recently as February, an official in Pakistan's National AIDS Control Programme asserted that HIV prevalence was lower in Pakistan than in other countries thanks largely to "better social and Islamic values." Islamic culture and Muslim beliefs, unfortunately, are not sufficient to inoculate populations against the spread of HIV. The trajectory of the virus in predominantly Muslim regions of the sub-Sahara proves this point. In Nigeria, 6 to 10 percent of adults are infected, and between 10 to 18 percent of adults in Ethiopia are HIV-positive. Both are countries in which fully half of the people practice some form of Islam. Although the HIV epidemic in Muslim Africa should have sounded a wake-up call to other Islamic communities, few Islamic authorities north of the Sahara seem to have heard the alarm. For all the diversity within the more than 1 billion-strong Muslim world â€“ from Albania and Turkey in Europe, across Northern Africa and through the Persian Gulf, and to Malaysia and Indonesia in South Asia â€“ a couple of common features have kept its efforts to combat the disease frozen in time. One is that there is no prescribed separation of faith and state in many Islamic countries today: The Koran is consulted not only as a religious text but also as a source of law, a guide to statecraft, and an arbiter of social behavior. Although such reliance on the Koran may help leaders envision an ideal human society (one with low rates of drug abuse, prostitution, and other types of crime), it also often keeps them from providing civic assistance to counter real social problems. Another common factor that contributes to a slow response to HIV/AIDS is the relative absence of firmly rooted or functional democratic systems in many Muslim countries. Citizens of these countries simply do not expect their governments to provide social services to mitigate the impact of HIV/AIDS. Taken together, these two tendencies â€“ political primacy of the Koran and weak or absent democracy â€“ have cost Muslim leaders valuable time in the fight against the epidemic. <h4>Tackling the Taboo</h4> Although many Muslim leaders have done little to control HIV/AIDS other than deport the foreigners that they blame for the disease, a handful of leaders have acknowledged their epidemics and are working diligently to find ways to control infections. One of the Muslim governments that does seem to be responding to its gathering HIV problem is, surprisingly, "axis of evil" member Iran. Although the social stigma associated with the disease remains quite severe â€“ until 2001, workers could be fired from their jobs for being HIV-positive, and throughout 2002, doctors and hospitals could refuse to treat AIDS patients â€“ recent government actions paint a more promising picture. Iran's President Mohammad Khatami and his administration have been very forthcoming about the extent of the epidemic and the urgent need to control the further spread of the disease. HIV education is now offered as a standard part of the health curriculum in many Iranian public schools, and lectures about how to prevent the disease are also given to couples who apply for marriage licenses. Perhaps surprising, given the Iranian regime's strict conservative reputation, needle-exchange programs also have been offered in high drug-use areas of Tehran, and syringes are now sold over the counter in many pharmacies. Hopefully, the incoming administration will continue HIV education and prevention efforts. Yet, spread of the disease among prostitutes and their clients remains a challenge for Iran. Officials are not even sure how many commercial sex workers there are, and estimates range from 30,000 to more than 300,000. Creating social welfare programs and communicating alternative, safer behaviors for poor or troubled women and girls could reduce the number of prostitutes and levels of transmission in this difficult-to-reach group, thus preventing the further spread into the general population. Another Muslim society has seen considerable progress in HIV education and prevention efforts within gay and bisexual networks and commercial sex circles. In Bangladesh, recent surveys have found that knowledge of HIV and its transmission is low among both male and female sex workers, and efforts to increase condom use are under way around the country. Since 1997, the Bandhu Social Welfare Society has provided safer-sex promotion activities for more than 76,000 homosexual and bisexual men. Some officials hope to expand this successful non-governmental organization from six cities where anti-HIV and anti-STD education and prevention are offered to a national program. The Bangladeshis have also successfully experimented with awareness programs in the social and religious center of each community: the mosque. Because imams play an important role in shaping values, training them to educate people to the dangers of HIV seems natural. With assistance from the Islamic Foundation, the Islamic Medical Mission, and the United Nations Development Programme, thousands of religious leaders â€“ including some women â€“ are now trained to deliver anti-HIV and anti-STD educational and prevention messages. Unfortunately, the efforts of Iran and Bangladesh far outpace those of other Muslim countries. Little or no surveillance data are available on the disease in many countries with significant higher-risk populations of intravenous drug users â€“ Afghanistan and Iraq among them. Saudi Arabia and other states in the Persian Gulf have only recently begun to admit that they have a small but persistent domestic locus of infection after decades of blaming foreigners for the disease. <h4>Guarding the Faithful</h4> A look at the latest UNAIDS update for Muslim nation statistics is telling for its lack of information: a handful of cases here, empty columns there. But all these blank pages cannot mask the toll AIDS is taking, and will take, on the Muslim world. If Muslim societies are to respond effectively to their own stillâ€“gathering domestic HIV epidemics, they must begin mounting aggressive HIV/AIDS surveillance programs. To control the epidemic, sweeping legislative and social changes are also required. Following the example of Iran, conservative and fundamentalist regimes must harness their religious piety to deal with this urgent social need. In addition to teaching safer behaviors to higherâ€“risk groups, social messages can be crafted to teach people that they can still be good Muslims and care for those infected with this disease. Counsellors for an Egyptian hotline encourage callers to accept acquaintances and family members with AIDS by reminding them of the relationships they shared before the diagnosis. By stressing similarities between the infected and the nonâ€“infected, the counsellors encourage greater social acceptance of the disease. In the Muslim world, as everywhere else, battling HIV/AIDS is in part a women's issue. Islamic women must refuse to be infected and die in silence. They must embrace the fight against this disease at all levels of society. Married women must talk to their husbands who work as remittance laborers overseas and urge them to avoid extramarital sexual contact (or use condoms if they do stray). HIV/AIDS education and control efforts could also become part of each citizen's zakat, or charity giving. In nations that use taxes as part of their zakat, some portion of the contributions could establish AIDS awareness and treatment programs. Helping Muslim societies confront their own HIV/AIDS problem might actually become an avenue of positive engagement for the United States â€“ in regions where America could stand to improve its image. Domestic or international, anti-AIDS action for the Muslim world must be planned and implemented soon. Unchecked, HIV/AIDS will continue to spread through Muslim countries â€“ destroying families and deepening poverty â€“ until it has ruined the very fabric of these societies. Muslim countries must acknowledge that contemporary societal ills are serious domestic issues, but also that modern public health and scientific measures can help them conquer this disease. And those of us in the West must respect the fundamental fact that socially conservative societies will adapt to some issues but will not necessarily buy what we mean by "modernity" wholesale. Islamic countries are at a crossroads. They can choose to act slowly and mount only superficial education and prevention programs. Or they can choose to confront this killer virus that threatens their community of believers. After a shaky start, the formidable powers of national religious leaders can be harnessed to educate people to protect themselves. Most important, these countries have to reach out to their most vulnerable â€“ to the people who are most at risk â€“ to stop the continued spread of the disease. If they don't, AIDS will exact an even greater toll among the faithful. Nicholas Eberstadt is the Henry Wendt Scholar in Political Economy at the American Enterprise Institute. Laura M. Kelley is the principal author of the U.S. National Intelligence Council's 2002 study, The Next Wave of HIV/AIDS: Nigeria, Ethiopia, Russia, India, and China. <a href="http://www.frontpagemag.com/Articles/ReadArticle.asp?ID=18641">The Muslim Face of AIDS</a> By Nicholas Eberstadt and Laura M. Kelley Foreign Policy, July 7, 2005 </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource AIDS now a threat in Middle East (2005) darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h1>Medical history and medical practice:</h1> <h2>Three persistent myths about the foreskin</h2> “we are all apt to accept a historical myth where we cannot rely on historical knowledge. Where history is lacking, mythology takes its place, and those who disdain history are among the foremost victims of mythology.” — Owsei Temkin (1) <h3>Abstract</h3> Although many nineteenth century misconceptions about the foreskin have been dispelled since Douglas Gairdner showed that infantile phimosis was not an abnormality, other old ideas have proved more persistent. Three of these are the proposition that ritual or religious circumcision arose as a hygiene measure; the view of the foreskin as a “cesspool”; and the assertion that circumcision makes no difference to sexual response. It is suggested that the first idea should be dismissed as a myth; that the second is a reflection of religious ideology and medical misunderstanding; and that the third is contradicted by centuries of medical opinion and has been seriously questioned by modern research. * * * * * * * Although much progress has been made since 1949 in dispelling nineteenth century myths about the male foreskin (for example, that infantile phimosis was a pathological abnormality (2), that circumcised men were immune to syphilis (3, 4), and that circumcised boys did not masturbate), other myths have proved more persistent. Among these are the idea that ritual circumcision as practised by certain tribal peoples arose as a hygiene or sanitary measure, particularly as a precaution against sand or dust in desert environments (5); the description of the foreskin as a “harbour for filth” or “cesspool”; and the assertion that the removal of the foreskin makes no difference to sexual function. <h3> <a id="origin" name="origin"></a>1. Origins of ritual circumcision</h3> There is no evidence that ritual or religious circumcision first arose as a hygiene measure. Many primitive cultures carried out a variety of mutilating procedures on different parts of the body, including the genitals of both boys and girls, but the origins and rationale of these practices are obscure and contested, as are the environmental conditions prevailing when and where such customs emerged. Past societies also practised cannibalism, human sacrifice, infanticide, widow-burial, foot-binding and many other traditions not endorsed today. It is a delusion of Marxist anthropology to assume that traditional rites must have a materialist and rational explanation; modern anthropology recognises that such customs emerge from the belief structure or cosmology of the cultures which produced them and do not necessarily have practical significance. Many conflicting theories have been advanced to account for the rise of ritual operations on the male and female genitals (6-8), among which are the following: <ul> <li>a propitiatory sacrifice or sign of submission to a deity, probably a milder form of a ritual which began as outright human sacrifice;</li> <li>an offering to the god or goddess of fertility to ensure children;</li> <li>a mark of tribal identification;</li> <li>a rite of passage from childhood to adult responsibility;</li> <li>(in the case of boys circumcised at puberty) the imposition of adult and tribal authority at a time when youthful rebellion might be expected;</li> <li>a fertility rite, aimed at giving men the power of procreation by making them shed blood from their genitals like women;</li> <li>an attempt to emphasise feminine or masculine characteristics in girls and boys by removing the parts of the genitals (clitoris and foreskin) believed to resemble the genitals of the other sex;</li> <li>a means of humiliating and marking defeated enemies and slaves. </li> </ul> The only point of agreement among proponents of the various theories is that a pragmatic aim like hygiene had nothing to do with it. In the days before aseptic surgery, any cutting of flesh was about the least hygienic thing anybody could do, carrying a high risk of bleeding, infection and death. Travelling in Iraq in the 1930s the English doctor Wilfred Thesiger reported that Arab boys undergoing circumcision: sometimes took two months to recover, suffering great pain in the meanwhile. One young man came to me for treatment ten days after his circumcision, and … the stench made me retch. His entire penis, his scrotum and the inside of his thighs were a suppurating mess from which the skin was sloughing away, the pus trickling down his legs (9). None of the ancient cultures which practised circumcision have traditionally claimed that the ritual was introduced as a hygiene measure: African tribes, Arabs, Jews, Moslems and Australian Aboriginals explain it different ways, but divine command, tribal identification, social role, family obligation, respect for ancestors and promotion of chastity figure prominently (10, 11). It was only in the late nineteenth century, when mass circumcision was being introduced for “health” reasons, that doctors sought legitimacy for the new procedure by claiming continuity with the distant past and attempting to explain the origins of circumcision in terms of their own hygienic agenda (12). As a Dr Davidson put it in 1889, “a nation like the Jews, whose ideas of sanitation were so far advanced … adopted the practice as much for its substantial benefits to health as out of regard to religious ceremonial” (13). Moslems enjoying less respect at that time, and little being known about them, the Jews were the preferred model. Nobody has ever suggested that circumcision as performed by the Aboriginals had a hygienic rationale, nor that their custom of knocking out teeth during initiation ceremonies was a precaution against the inconvenience of tooth decay in later life. Many of the cultures which practised male circumcision also enforced various forms of female genital mutilation (14, 15), but western doctors today are horrified by this sort of surgery, do not seek evidence that it might be beneficial to women’s health and do not suggest that it originated as a means of preventing sand from irritating the clitoral hood or labia. It was a different story in the 1850s and 60s, and it remains different in the cultures which continue to practise female circumcision. In the 1850s and 60s many English doctors believed that clitoridectomy was as valuable as male circumcision in treating nervous diseases like epilepsy, hysteria and masturbation (as well as their sequelae in madness) and pushed the therapy on women with little attempt to gain consent (16, 17). Egyptian and other Islamic physicians today insist on the hygienic value of female circumcision as a preventive of both organic disease and sexual promiscuity (18). <h3> <a id="filth" name="filth"></a>2. The foreskin as a "harbour of filth"</h3> The notion of the foreskin as inherently dirty and disease-promoting has been revived in recent times by several advocates of routine circumcision. The American G.N. Weiss states that “over the millennia the male’s preputial cavity has acted as a cesspool for infectious agents transmitting disease” (19), while Australia’s Brian Morris quotes both this remark and a reference by the Brisbane GP Terry Russell to “pathogenic organisms multiplying in the warm, moist environment under the prepuce”. Morris adds that the “stench” of the foreskin means that uncircumcised men need three showers a day (20). The origins of these scientifically baseless assertions lie partly in ancient Judaic theology, which designated many natural phenomena as unclean in a spiritual or religious sense, and partly in the late nineteenth century century’s limited understanding of epidemiology. Bacteriological causation of disease was not fully understood at that time, visible “filth” alone was thought to be capable of generating disease (21), and neither the anatomy nor the functions of the foreskin had been studied. In the 1890s another advocate of universal circumcision, Jonathan Hutchinson (one of England’s most distinguished surgeons), described the foreskin as a “harbour for filth” (22). Modern research, however, has shown these beliefs to be without foundation: far from being unhygienic, the infant foreskin promotes the cleanliness of the penis by acting as a valve to let urine out while blocking the entry of foreign matter. It also protects the glans from dirt and abrasion and keeps it moist in much the same way as the eyelid lubricates the eye. In adults the sub-preputial moisture is not merely harmless, but is a useful moisturiser and may have anti-bacterial and anti-fungal properties (23-26). <h3> <a id="pleasure" name="pleasure"></a>3. Functions and value of the foreskin</h3> A striking omission from many discussions of the risks and benefits of circumcision is a consideration of the value of the foreskin and the corresponding disadvantages of being obliged to live without one. Much of the past argument as to the health benefits of circumcision has rested on the assumption that the foreskin was useless flap of skin, with the result that the loss of this complex and versatile structure was never factored into such cost-benefit analyses of the procedure as have been attempted. Most have these have ignored the value of the lost tissue and focused exclusively on the additional risks of the operation (bleeding, infection etc). If the foreskin performs valuable functions, or even if it is no more than a desirable adornment, the equation changes sharply: even if circumcision offered real health benefits, they must be set against the costs of losing that part of the body. Although most medical discussions ignore it (5), there is a vast medical literature on the significance of the foreskin, stretching from the ancient Greeks, who regarded the foreskin as the most beautiful part of the male genitals, to the contemporary Canadian and New Zealand researchers who have identified the complex innervation of the penis, the frenular delta and the ridged bands of the foreskin, as well as its relevance to the experience of female partners (27-30). In the Graeco-Roman world doctors considered the foreskin so important that they devised treatments to lengthen those which did not provide generous coverage of the glans (31). During the Renaissance the centrality of the foreskin to male sexual function and the pleasure of both partners was recognised by Berengario da Carpi (32), Gabriele Falloppio (33) and William Harvey (34). In the eighteenth century male folklore held that the foreskin was “the best of your property” (35), and a similar outlook was expressed in popular sex manuals like Aristotle’s Master-Piece (36) and by physicians such as Robert James (37) and John Hunter, who also appreciated the importance of the foreskin in providing the slack tissue needed to accommodate erection: The prepuce is … a doubling of the skin of the penis when not erected … by which provision the glans is covered and preserved when not necessary to be used, whereby its feelings are probably more acute. When the penis becomes erect it in general fills the whole skin, by which the doubling forming the prepuce in the non-erect state is unfolded, and is employed in covering the body of the penis (38). There is a puzzle in the fact that while circumcision advocates today assure parents that circumcision makes no difference to the experience of sex, their counterparts a century ago insisted that it made a major difference and that this was the most important reason for doing it. In the nineteenth century the erotic role of the foreskin was well understood by surgeons, who wanted to cut it off precisely because its tactile responsiveness (“irritability”, as they complained) was a major factor leading boys to masturbation: William Acton damned the foreskin as “a source of serious mischief” (39), and most of his contemporaries concurred (40, 41). Both opponents and supporters of circumcision agreed that the significant role the foreskin played in sexual response was the main reason why it should be left in place or removed. In the USA William Hammond commented that “circumcision, when performed in early life, generally lessens the voluptuous sensations of sexual intercourse”, and that even those who had it done later reported that “the operation had very decidedly diminished the voluptuous feelings afterwards experienced” (42). Both he and Acton considered the foreskin necessary for optimal sexual function, especially in old age. Jonathan Hutchinson, an ardent supporter of universal infant circumcision, thought this was the most important reason why it should be excised: The only physiological advantage which the prepuce … confer[s] is … 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 … we can well be spared. If in their loss increase in sexual control should result, one should be thankful (43). Similar comments were made by dozens of British and American medical men from the 1840s to the 1930s. In 1874 a correspondent to the Lancet signing himself “a Jewish surgeon” stated that “the removal of the prepuce reduces to an extraordinary degree the sensitiveness of the glans penis” and expressed his belief that “the intention of the rite was to enhance and advance as far as possible the chastity of the race by blunting mechanically the sensibility of the organ of sexual appetite” (44). In this view he was following the great Jewish physician and philosopher Maimonides, who had written that the reason for circumcision was “the desire to bring about a decrease in sexual intercourse and a weakening of the organ” (45). In 1915 a doctor in the USA similarly commented: 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 (46). The phrasing used by many made it clear that a word like hygienic had a moral as well as a physical connotation. In his article “The hygiene of circumcision”, another US physician stressed the value of the operation in diminishing the sensibility of the penis and discouraging masturbation (47). In his book Sex hygiene for the male (1912), G. Frank Lydston wrote: Circumcision promotes cleanliness, prevents disease, and by reducing over-sensitiveness 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 [sic] of evil sexual habits, such as masturbation (48). A modern American physician who had himself circumcised in the 1970s was so pleased with the result that he wrote an article urging everybody else to have it done, but even he acknowledged the loss of sexual sensation: The change in sensation during intercourse a few weeks later was surprising. The sharp pleasurable sensation was noticeably lessened, as it is when topical anaesthetics are used to delay ejaculation. … The overpowering erotic sensation has been dulled, and with it some of the immediate pleasurable sensation. Initial excitement has decreased. … [When fully erect the penis presents] a smooth shaft with a piston-in-cylinder-like action during coition. Friction and therefore sensation are diminished (49). It is difficult to put numbers on so subjective an experience as sexual satisfaction, but the research of Cold and Taylor has provided scientific confirmation of the eighteenth century folklore that a man’s foreskin was “the best of your property”. Valentine left a hostage to fortune which merits the attention of doctors and parents today. Regardless of the disease prevention/risk of harm calculus, “If it [the foreskin] does have a function, its routine removal in newborns cannot be justified. Perhaps the foreskin does have a rationale that has been ignored or not recognised” (50). <h3>Conclusion</h3> As much as recognising the rationale, it is a matter of remembering the medical knowledge already accumulated before the masturbation phobia of the nineteenth century and the circumcision mania of the twentieth century consigned it to the archives. Referring to the sorry results of forgetting the cure for scurvy discovered by John Woodall in the 1630s, Sir Geoffrey Keynes remarks that it was an example of “how easily important facts may be forgotten through failure to consult the history of medicine” (51). If researchers today paid more attention to medical history they might be saved from errors like the myth of desert hygiene and find themselves able to make a stronger case that optimal male health and happiness required doctors to protect the foreskin instead of seeking excuses to destroy it. <a id="refs" name="refs"></a>References 1. Temkin O. “The usefulness of medical history for medicine”, in The double face of Janus and other essays, Baltimore, Johns Hopkins University Press, 1977, 68-100, here 69 2. Gairdner D. “The fate of the foreskin: A study of circumcision”, British Medical Journal, 24 December 1949, 1433-7 3. Gilman S. Freud, race and gender, Princeton University Press, 1993, ch. 2 4. Darby R. “Where doctors differ: The debate on circumcision as a preventive of syphilis 1855-1914”, Social History of Medicine, March 2003 (forthcoming) 5. Paediatric and Child Health Division, Royal Australasian College of Physicians, Policy statement on circumcision, RACP, Sydney, September 2002: http://www.racp.edu.au/hpu/paed/circumcision/index.htm 6. Gollaher D.L. Circumcision: A history of the world’s most controversial surgery, New York, Basic Books, 2000, ch. 3 7. Loeb E.M. “The blood sacrifice complex”, in Memoirs of the American Anthropological Association, No. 23, 1923, repr. New York, Kraus Reprint, 1974 8. Ngxamngxa A.N.N. “The function of circumcision among the Xhosa-spe tribes in historical perspective”, in E.J. de Jager (ed.), Man: Anthropological essays presented to O.F. Raum, Capetown, Struik, 1971, 183-204 9. Thesiger W. The marsh Arabs, London 1964, 101-2 10. Hoffman L.W. Covenant of blood: Circumcision and gender in rabbinic Judaism, University of Chicago Press, 1996 11. Aldeeb Abu-Sahlieh S.A. Male and female circumcision among Jews, Christians and Muslims: Religious, medical, social and legal debate, Warren PA, Shangri-La Publications (Marco Polo Monographs, No. 5), 2001 12. Remondino P.C. History of circumcision from the earliest times to the present: Moral and physical reasons for its performance, Philadelphia and London, F.A. Davis, 1891 13. Davidson A. “Genital irritation in boys”, The Practitioner (London), Vol. 42, 1889, 350-56, here 356 14. Roles N.C. “Tribal surgery in East Africa during the XIXth century: Part 1 – Ritual operations”, East African Medical Journal, Vol. 43, 1966, 579-94 15. Scheper-Hughes N. “Virgin territory: The male discovers the clitoris”, Medical Anthropology Quarterly, Vol. 5, 1991, 25-8 16. Moscucci O. “Clitoridectomy, circumcision and the politics of sexual pleasure in mid-Victorian Britain”, in Andrew H. Miller and James Eli Adams (eds), Sexualities in Victorian Britain, Bloomington, Indiana University Press, 1996 17. Fleming J.B. “Clitoridectomy: The disastrous downfall of Isaac Baker Brown FRCS (1867)”, Journal of Obstetrics and Gynaecology of the British Empire, Vol. 67, 1960, 1017-34 18. Gollaher D.L. Circumcision: A history of the world’s most controversial surgery, New York, Basic Books, 2000, ch. 8 19. Weiss G.N. “Prophylactic neonatal surgery and infectious diseases”, Pediatric Infectious Diseases Journal, Vol. 16, 1997, 727-34 20. Morris B. In favour of circumcision, Sydney, New South Wales University Press, 1999, 30 21. Worboys M. Spreading germs: Disease theories and medical practice in Britain 1865-1900, Cambridge University Press, 2000 22. Hutchinson J. “A plea for circumcision”, Archives of Surgery, Vol. 2, 1890, 15 23. Van Howe R.S. “Circumcision and infectious diseases revisited”, Pediatric Infectious Diseases Journal, Vol. 17, 1998, 1-6 24. Fleiss P, Hodges F, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Inf 1998;74:364-367 25. Prakash [sic, Parkash] S, Raghuram R, Venkatesan, et al. Sub-preputial wetness - Its nature. Ann Nat Med Sci (India) 1982; 18(3): 109-112 26. Lee-Huang S, Huang PL, Sun Y, et al. Lysozyme and RNases as anti-HIV components in beta-core preparations of human chorionic gonadotropin. Proc Natl Acad Sci USA 1999;96(6):2678-81 27. Taylor J.R. Lockwood A.P. and Taylor A.J. “The prepuce: Specialised mucosa of the penis and its loss to circumcision”, British Journal of Urology, Vol. 77, 1996, 291-5 28. Cold C.J. and Taylor J.R. “The prepuce”, BJU International, Vol. 83, Supplement 1, January 1999, 34–44 29. Cold C.J. and McGrath K.A. “Anatomy and histology of the penile and clitoral prepuce in primates: Evolutionary perspective of specialised sensory tissue of the external genitalia”, in George C. Denniston, Frederick Hodges and Marilyn Milos (eds), Male and female circumcision: Medical, legal and ethical considerations in pediatric practice, New York, Kluwer Academic/Plenum Publishers, 1999 30. O’Hara K. and O’Hara J. “The effect of male circumcision on the sexual enjoyment of the female partner”, BJU International 1999;83 Suppl 1, 79-84. 31. Hodges, F. “The ideal prepuce in Ancient Greece and Rome: Male genital aesthetics and their relation to lipodermos, circumcision, foreskin restoration and the Kinodesme”, Bulletin of the History of Medicine, Vol. 75, 2001, pp. 375-405 32. da Carpi, Jacopo Berengario. A short introduction to anatomy, translated by L.R. Lind, University of Chicago Press, 1959, 72-3 33. Quoted in Alex Comfort, The anxiety makers: Some curious preoccupations of the medical profession, London, Nelson, 1967, 17; and in Thomas Laqueur, Making sex: Body and gender from the Greeks to Freud, Cambridge, Mass., Harvard University Press, 1991, 271, fn. 75 34. Harvey, W. The anatomical lectures of William Harvey, ed. and trans Gweneth Whitteridge, Edinburgh, E. & S. Livingstone, 1964, 213 35. Wolper, R.S. “Circumcision as polemic in the Jew Bill of 1753: The cutter cut?”, Eighteenth Century Life, Vol. 7, 1982, 24-36 36. Aristotle’s complete masterpiece, in three parts, displaying the secrets of nature in the generation of man, London, 1749, facsimile reprint, New York, Garland, 1986, 13 37. James R. A medicinal dictionary: including physic, surgery, anatomy, chymistry, and botany, in all their branches relative to medicine, 3 vols, London, 1743-45, Vol. II, entry for “Generatio” 38. Hunter J. A treatise on the venereal disease, London 1786, 221 39. Acton W. The functions and disorders of the reproductive organs in childhood, youth, adult age and advanced life, 3rd London edition, Philadelphia, Lindsay and Blakiston, 1865, 22 40. Parsons G.P. “Equal treatment for all: American medical remedies for male sexual problems, 1850-1900”, Journal of the History of Medicine, Vol. 32, 1977, 55-71 41. Darby R. “Circumcision as a preventive of masturbation: A review of the secondary historical literature”, Journal of Social History, Spring 2003, forthcoming 42. Hammond W.A. Sexual impotence in the male and female, Detroit, 1887, facsimile reprint, New York, Arno, 1974, 272-3 43. Hutchinson J. “The advantages of circumcision”, Medical Review, Vol. 3, 1900, 641-2 44. “Circumcision”, Lancet, 12 December 1874, 856 45. Moses Maimonides. Guide for the perplexed, trans. M. Friedlander, New York, Dover Publications, 1956, 378 46. Wuesthoff L.W. “Benefits of circumcision”, Medical World, Vol. 33, 1915, 434 47. Crossland J.C. “The hygiene of circumcision”, New York Medical Journal, Vol. 53, 1891, 484-5 48. Wolbarst A. “Universal circumcision as a sanitary measure”, Journal of the American Medical Association, Vol. 62, 1914, 95 (cited) 49. Valentine R.J. “Adult circumcision: A personal report”, Medical Aspects of Human Sexuality, Vol. 8, January 1974, 31-42, 48, here 32-3 50. Valentine R.J. “Adult circumcision: A personal report”, Medical Aspects of Human Sexuality, Vol. 8, January 1974, 32-3 51. Keynes G. The gates of memory, Oxford, Clarendon Press, 1981, 360 NOTE: This paper was originally written in 2002. A shorter version was published in the Medical Journal of Australia as "<a href="http://www.mja.com.au/public/issues/178_04_170203/contents_170203.html">Medical history and medical practice: Persistent myths about the foreskin</a>", Medical Journal of Australia, Vol. 178, 17 February 2003. </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Origins of ritual circumcision darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> A Plague of Paradoxes: AIDS, Culture and Demography in Northern Tanzania. By Philip W. Setel. Chicago and London: Chicago University Press, 1999, 308 pp Reviewed by Robert Darby [1] Archives of Sexual Behavior, Vol. 34, No. 6, December 2005, pp. 707â€“714 Introduction How a disease afflicting thousands of homosexual men and intravenous drug users in developed nations became an epidemic affecting millions of heterosexual men and women in Africa is one of the great puzzles of epidemiology. In hindsight it will probably eclipse the centuries-long debate over whether syphilis and gonorrhoea were different diseases or phases of the same one. It may well be seen to have elicited many of the same explanatory efforts, moral judgements and therapeutic or preventive responses as the syphilis epidemic of the eighteenth and nineteenth centuries; then, as with AIDS today, many schools of thought contended, some stressing behavioural, some socio-economic, some micro-biological, some moral and some anatomical factors. [2] Philip Setel's aim in this richly textured and illuminating study is to historicise the impact of AIDS in a region of Tanzania â€“ to move away from a narrow focus on virus particles, receptor cells and body parts, and to consider the broad social and human environment which has enabled the disease to exercise the effects it has. He thus seeks to explain both why its spread has been so fast and so terrible and to illustrate the ways in which it has been perceived and experienced by Tanzanian men and women. While not denying the centrality of sexuality in the process, Setel insists that it is mediated by its social context: "AIDS in Kilimanjaro has been an outgrowth of culture, history, demography and political economy. ... It has been a disorder of social reproduction that emerged through the intersection of HIV with people engaged in a conscious struggle with forces both impinging on and internal to their cultural worlds. Sexuality ... has been framed as an outcome of socio-cultural change in productive and reproductive regimes." (p. 236) The region studied is occupied by the Chagga people, living in the north of Tanzania, on the slopes of Mt Kilimanjaro, near the border with Kenya. The main town in the area is Moshi. Among the paradoxes which give the book its title, Setel notes that contemporary sexual ideologies (lamenting the immorality or bad character of modern youth) have been based on nostalgia for a vanishing demographic system. He emphasises that "traditional" Chagga culture was not static, but constantly evolving under internal and external influences, such as other ethnic groups, Arab slave traders, and of course European colonialism. The latter brought new diseases, but also new economic opportunities, such as coffee, cultivation of which transformed the vegetable plots traditionally farmed by Chagga families. Rapid population growth led to massive emigration from the region after World War II, especially of young single men, who naturally sought sexual contacts wherever they went, but who were not able to marry until they had accumulated the resources needed to buy a wife (the bridewealth). [3] From its earliest appearance, HIV was associated with mobile men, especially itinerant businessmen (often just petty traders), whose proliferation in the 1980s was itself a sign of structural changes in the world economy, Tanzania's failed development strategies and shrinking economic options in other areas. The disease spread fast. In 1992 Kilimanjaro was listed as the seventh most severely affected region, with 134.2 cases per 100,000; in 1994 the fifth; and in 1997 the third. In 1991 over 70 per cent of self-identified prostitutes tested sero-positive. Setel points out that these figures are not confirmed by the lower level of sero-prevalence measured among blood donors, suggesting either that AIDS detection in the region is more thorough than elsewhere in Tanzania, or (more probably) that many infected people are returning home to die. A welcome focus of the book is its stress on women's experience. Setel points out that the high level of HIV infection among women is an effect of both their economic and social subordination as much as of their sexuality. He particularly mentions female poverty and economic insecurity, leading many into various forms of prostitution; their dislocation from cultural institutions which could protect them from unwanted advances from husbands or former lovers; and their general lack of rights and subordination to male power. As in Victorian England, the double standard on sexuality morality is strongly in evidence: one man made no apology for his own fondness for screwing around, yet criticised the looseness of contemporary youth and insisted that any future wife be a virgin. It is this moral environment, far more than their expense, which explains the low level of condom use in the region. Even though many women knew about them and wanted their protection, as respectful wives they could not make the suggestion to their husband; yet men did not want to put them on because they were uncomfortable and reduced sensation. On top of that, the local Christian churches preached against their use, and other opponents spread the rumour that they had actually been impregnated with HIV. Not that condoms alone are the answer: as Brooke Schoepf has argued, "Failure to recognise the economic causes of prostitution, to address the structural causes of under-development, poverty and joblessness, builds resentment ... and resistance to advice such as the need for condoms" (quoted, p. 237). The lesson is that any program to combat AIDS in Tanzania must also aim to raise the social status and economic security of women. "African sexuality"? Setel is critical of accounts which identify "African sexuality" as the main culprit in the spread of HIV, agreeing with Schoepf that it is not sexuality per se which is the problem, but "situations of risk produced by intersections of biology, political economy and culture". He points out that there is no such thing as "African sexuality" and that such explanations can easily stereotype Africans as being unusually randy and promiscuous, as well as more generously endowed â€“ a trope with a long history in envious European discourse. Yet his own study does bring out very clearly that traditional, no less than modern, Tanzanian culture was marked by a high level of sexual activity (promiscuity by any other name), involving sexual liaisons soon after puberty, multiple partners at any one time, various forms of polygyny and polyandry and more casual relationships in adulthood, a strong preference for vaginal intercourse over other (safer) forms of enjoyment, and a high valuation placed on fertility. A successful man wanted to advertise the fact by having as many children by as many women (both wives and "girlfriends") as possible, and that meant a lot of unprotected fucking. A carpenter in Moshi regretted that the saddest effect of AIDS had been to lessen the amount of fun people could have: "AIDS has ruined their way of life. The greatest achievement here is sex. Our way of life has been very seriously affected. Even with one girl there is not much fun. You need to have several to have a good time. ... Life has become very miserable". (p. 179) It hardly needs pointing out, as all studies of HIV have shown, that frequent unprotected sex with multiple partners is the most important risk factor for infection. As Setel himself writes, "where there has been historically low condom use, poor treatment of STDs, and a general preference for penetrative vaginal sex ... multipartner sexuality among some can be statistically related to increased risk of being infected with HIV." (p. 201) Circumcision not a significant factor There is no comfort here for the small band of researchers from circumcising cultures who are seeking to prove that the male foreskin is the decisive factor in the high incidence of AIDS in the Third World, supposedly because it is uniquely vulnerable to penetration by the virus. Given the pre-existing ubiquity of both male and female circumcision in Africa, it seems an eccentric argument, and it is a sign of the cultural bias of such researchers that they make no attempt to suggest that, or to test whether, female circumcision might be the key factor â€“ that the labia or clitoral hood might as treacherous a pair of Trojan horses as the prepuce. [4] It is certainly not an issue in Kilimanjaro, where both boys and girls are circumcised as part of a complex sequence of initiation rites at puberty. His foreskin gone, the former boy is visibly different and now both subject to adult responsibilities and entitled to adult privileges, such as the right to seek sexual opportunities and economic advancement in the village. Initiation for girls used to involve excision of both the labia minora and the clitoris, but now appears to involve only the latter: whatever the details, the adjustment likewise marks their transition from girl to woman, with attendant rights and responsibilities. There is no suggestion in this book that circumcision or lack of it could have anything to do with the prevalence of HIV among males, though one man interviewed asserted that the discontinuation of female circumcision was a factor in rising rates of both immorality and HIV infection: "This is all because Chagga culture has been polluted and mixed with European ways. ... In the past there was initiation and puberty training. Men learned their age sets and women were circumcised. ... The youth of today are tied up in the profligacy of the disco, bearing children out of marriage, and so on". (pp. 59-60) It is the sort of conservative lament for lost virtue common to all societies in the throes of change. A Plague of Paradoxes demonstrates the value of an anthropological approach to the question which is generating more literature each year than anybody could read in a lifetime: how to explain, and thus contain, the high incidence of HIV infection in Africa, so much worse than anywhere else. Several types of theory have been proposed, variously emphasising genetic susceptibility, patterns of sexual behaviour, iatrogenic misadventure (non-sterile medical procedures), failure to institute effective programs or to do so in time, and even anatomical variables, such as male and, to a lesser extent, female circumcision. Setel's argument is that any mono-causal account is missing the point, and that explanations (and thus effective control strategies) are to be sought in the peculiar combination of social, demographic, economic, cultural and behavioural evolution in each African region. Such an approach requires a lot more than just the counting of foreskin-free penises or herpes lesions which has become fashionable in some medical circles. He shows clearly, and often in moving detail, how demographic patterns, social change, economic need, cultural understandings, sexual behaviour and medical responses created an environment in which HIV was sure to thrive. Tanzanian sexual practices (frequent unprotected intercourse with multiple partners) would have been enough on its own to ensure the spread of the virus (as it was among homosexual communities in the USA), but it is these broader factors, coupled with the tardy response to the problem by medical authorities [5] and limited resources, as a consequence of poverty, when they did, which explains why the epidemic has had such a devastating impact on the lives of African people. References and notes 1. Visiting Fellow, School of Social Sciences, Australian National University, Canberra, ACT 0200, Australia 2. Peter Baldwin, Contagion and the State in Europe, Cambridge University Press, 1999, ch. 5; Robert Darby, "Where doctors differ: The debate on circumcision as a protection against syphilis, 1855-1914", Social History of Medicine, Vol. 16, 2003, pp. 57-78 3. A remarkably similar situation in Victorian England was blamed for the proliferation of prostitution and consequent high level of syphilis and other venereal diseases. 4. It is only a few doctors from Moslem countries practising female circumcision and some conservative Africans who assert that failure to be circumcised makes women more vulnerable to infection and that the operation is therefore a valuable prophylactic. While western researchers on this issue have generally seen female circumcision as a means of spreading AIDS, they have, rather inconsistently, seen male circumcision as a means of stopping it. 5. The first HIV cases were noticed in 1984, the first death in Moshi was in 1986, but it was not until "the early 1990s" that meaningful preventive programs were in place. Such a delay gave the virus an enormous head start in which to establish itself throughout the population. This situation contrasts with countries such as Australia and Britain, where the response was rapid, moralism was avoided, and effective education programs stressing safe sex were developed with the full involvement of, and thus acceptance by, the at-risk communities. That such an approach is working in Africa is suggested by David Moore and Robert Hogg, <a href="http://www.cirp.org/library/disease/HIV/moore1/" rel="noopener" target="_blank">"Trends in antenatal human immunodeficiency virus prevalence in western Kenya and eastern Uganda: Evidence of differences in health policies?"</a>, International Journal of Epidemiology, Vol. 33, 2004, pp. 1-7 <h3>Update 2006: Toronto AIDS conference refuses to embrace circumcision as miracle prophylactic</h3> While the huge AIDS conference in Toronto in August 2006 produced the familiar calls, from the usual suspects, for mass male circumcision as the great surgical hope against HIV in underdeveloped countries, the conference as a whole remained sceptical of this approach and did not endorse Mr Gates' stress on this strategy. Although his keynote speech and a few papers advocating circumcision received disproportionate publicity, most of the conference focused on the need for education, encouragement of safe sex, the development of topical applications and the empowerment of women. This was the most valuable suggestion in Mr Gates' presentation, since it is the subordinate position of women in many traditional cultures which prevents them from refusing sexual advances, or insisting on condoms or safe sex when they consent. There were even papers on the irrelevance of circumcision and the importance of condoms, regretting the fashionable stress on the former and the incomprehensible neglect of the latter. They pointed out that it was irrational to promote a risky and harmful surgical operation such as circumcision, offering at most a 60 per cent reduction in risk, clinically shown to be effective over only 20 months, in the much-hyped study by Bertran Auvert, the extravagant claims of which have been criticised by <a href="http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030078" rel="noopener" target="_blank">Michel Garenne</a> at the Pasteur Institute. Consistent condom use provided 90 per cent protection over a person's lifetime. <a href="http://www.circumstitions.com/HIV-SA.html" rel="noopener" target="_blank">A thoughtful critique of Auvert</a> <a href="http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030078" rel="noopener" target="_blank">Michel Garenne paper</a> <a href="http://www.circinfo.org/news.html" rel="noopener" target="_blank">Condoms the best defence</a> <a href="http://www.populationaction.org/resources/publications/condomscount/data.htm" rel="noopener" target="_blank">Further information on condom use in underdeveloped countries</a> <h3>Circumcision not so protective after all</h3> Male Circumcision May Not Protect Against HIV Infection: Paper by Dr Vinod Mishra, Presented at AIDS 2006 By Danny Kucharsky TORONTO, CANADA -- August 17, 2006 -- HIV prevalence is not necessarily lower in populations that have higher male circumcision rates, according to findings from a study of African countries presented here at the 16th International AIDS Conference (AIDS 2006). The study, which examined the association between male circumcision and HIV infection in 8 Sub-Saharan African countries, contradicts the findings of previous research and the opinion of several prominent personalities active in the fight against AIDS, such as former US President Bill Clinton. While several studies have indicated that male circumcision has a protective effect against sexually transmitted infections (STI), including HIV infection, the evidence is inconclusive, said investigator Dr. Vinod Mishra, director of research, <a href="http://www.orcmacro.com/whatsnew.aspx" rel="noopener" target="_blank">ORC Macro, Calverton, Maryland</a>. "We're just questioning that push," he said of the optimism displayed by Clinton and others. The study used demographic findings from recent demographic and health surveys in Burkina Faso, Cameroon, Ghana, Kenya, Lesotho and Malawi, and AIDS indicator surveys from Tanzania and Uganda. The surveys were conducted from 2003 to 2005 and sample sizes ranged from 3,300 men in Lesotho to 10,000 men in Uganda. In survey fieldwork in each country, men aged 15 to 59 gave blood for anonymous HIV testing. Information on circumcision status and on STI/STI symptoms was based on men's responses to questions in survey interviews. Prevalence of male circumcision ranged from a high of 96% in Ghana to a low of 21% in Malawi. Among the other countries, circumcision rates were 84% in Kenya, 89% in Burkina Faso and 25% in Uganda. HIV prevalence was markedly lower among circumcised than uncircumcised men only in Kenya (11.5% among uncircumcised men vs. 3.1% among circumcised men). A small protective effect of male circumcision was also seen in Burkina Faso (2.9% vs. 1.7%, respectively) and Uganda (5.5% vs. 3.7%). In the other countries, there was either no difference in HIV rates between circumcised and uncircumcised men or circumcised men were more likely to be HIV-positive than uncircumcised men. For example, in Lesotho, HIV was seen in 23.4% of circumcised men compared to 15.4% of uncircumcised men. "If anything, the correlation [between circumcision and HIV infection] goes the other way," in most of the countries studied, Dr. Mishra said during his presentation on August 15th. When adjusted for sociodemographic and behavioral factors, a small protective effect was observed in 6 of the 8 countries, but it was not statistically significant in any country, Dr. Mishra said. In Kenya, and to a lesser extent, in Ghana, Malawi, Tanzania and Uganda, circumcised men were less likely than uncircumcised men to report having had an STI or STI symptoms in the 12-month period prior to the survey (2.1% vs. 5.4%, respectively). The relationship was reversed in Cameroon (8.0% vs. 2.5%) and Lesotho (12.1% vs. 7.5%). With other factors controlled, male circumcision had some protective effect in 5 of the 8 countries, but the effect was statistically significant only in Tanzania. In addition, "circumcised men tend to have more lifetime sex partners, so there's some [high-risk] behaviors that go with circumcision status," he said. A study limitation is that it was based on self-reported information on circumcision status and STI/STI symptoms. It also lacks data on age at circumcision and degree of circumcision, which might influence susceptibility to HIV infection. However, Dr. Mishra said the study is consistent with other research that has failed to find a protective effect of male circumcision on HIV and STIs. Dr Vinod Mishra, "Is Male Circumcision Protective of HIV Infection?" (Conference abstract TUPE04010 <a href="http://www.docguide.com/news/content.nsf/news/852571020057CCF6852571CD005207D9" rel="noopener" target="_blank">http://www.docguide.com/news/content.nsf/news/852571020057CCF6852571CD005207D9</a> <a href="http://www.orcmacro.com/whatsnew.aspx" rel="noopener" target="_blank">http://www.orcmacro.com/whatsnew.aspx</a> <h3>Wot, no condoms</h3> Condoms Still Out in the Cold at Toronto AIDS Conference: Emerging Prevention Technologies Take Centre Stage, Proven Condom Given Short Shrift 16 August 2006 TORONTO, Canada â€” "Prevention" and "new technologies" are the buzzwords at the XVI International AIDS Conference in Toronto, but UNFPA, the United Nations Population Fund, is calling attention to the fact that millions of people still lack access to the most basic and available preventive method of allâ€”the male and female condom. The Conference, which has attracted 25,000 scientists, activists and policymakers from all over the world, marks the first time the international community has seized upon prevention as the most cost-effective and sustainable response to the global pandemic. Keynote speakers former United States President William Clinton and Microsoft co-founder Bill Gates both emphasized the need for female-controlled methods, such as microbicides to halt the virus's spreadâ€”particularly among young women and girls who now make up the fastest growing proportion of the newly infected. The potential of vaccines and male circumcision to slow transmission rates have also grabbed the lion's share of attention. Steve Kraus, Chief of the HIV Branch of UNFPA, asserts that, while discussions around new prevention technologies represent an important step in the evolution of the global HIV response, all of them are still years away from becoming widely available. "People are getting infected now," he says. "While we applaud discussion and research into new technologies, we are still not using what we have available today. The condom already exists and it hasn't been delivered. It works and represents the best tool we have in the fight against HIV/AIDS," says Dr. Kraus. Today, an estimated 8 to 10 billion condoms are being used in low-and middle-income countries. This represents only half of the total need. In sub-Saharan Africa, where HIV prevalence is highest, African males have access to only 10 condoms on averageâ€”per year. While female condom distribution is increasing, the total market share remains woefully lowâ€”at only 0.3 per centâ€”despite rising demand in high-prevalence settings such as Zimbabwe and Malawi. To meet increased demand, UNAIDS estimates, resources will have to double from about $320 million a year today to between $500 million and $630 million by 2015. SOURCE: <a href="http://www.unfpa.org/news/news.cfm?ID=842" rel="noopener" target="_blank">http://www.unfpa.org/news/news.cfm?ID=842</a> UNFPA, the <a href="http://www.unfpa.org/" rel="noopener" target="_blank">United Nations Population Fund</a>, is an international development agency that promotes the right of every woman, man and child to enjoy a life of health and equal opportunity. UNFPA supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect. Contact information: Patricia Leidl Toronto Cell Phone: +1 917-535-9508 Email: leidl (AT) unfpa.org Abubakar Dungus New York Tel. +1 (212) 297-5031 Email: dungus (AT) unfpa.org </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource AIDS and society in Tanzania (2000s) darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h4>James Bruce puzzles over male and female circumcision in Africa</h4> During the course of his explorations to discover the source of the Nile in 1768-73, the Scottish traveller James Bruce observed the circumcision practices of the Ethiopians. He also sought to explain them historically with reference to both contemporary natural history and the Old Testament narrative. <h3>The customs of the Ethiopians</h3> I have already said, that the Agaazi, the predecessors of those people that settled in Tigre from the mountains of Habab, were shepherds adjoining the Red Sea; that they speak the language Geez, and are the only people in Abyssinia in possession of letters; that these are all circumcised, both men and women. The former term, as applied to men, is commonly known to every one the least acquainted with the Jewish history. The latter is, as far as I know, a rite merely Gentile, although in Africa, at least that part adjoining to Egypt and the Red Sea, it is much more known and more universally practised than the other. This I shall call excision, that I may express this uncommon operation by as decent a word as possible. The Falasha likewise submit to both. These nations, however they agree in their rite, differ in their accounts of the time they received this ceremony, as well as in the manner of performing it. The Abyssinians of Tigre say, that they received it from Ishmael's family and his descendants, with whom they were early connected in their trading voyages. [1] They say also, the queen of Saba, and all the women of that coast, had suffered excision at he usual time of life, before puberty, and before her journey to Jerusalem. [2] The Falasha again declare, that their circumcision was that commonly practised at Jerusalem in the time of Solomon, and in use among them when they left Palestine, and came into Abyssinia. The circumcision of the Abyssinians is performed with a sharp knife, or razor. There is no laceration with the nails, no formula or repetition of words, nor any religious ceremony at the time of the operation, nor is it done at any particular age, and generally it is a woman that is the surgeon. The Falasha say, they perform it sometimes with the edge of a sharp stone; sometimes with a knife or razor, and at other times with the nails of their fingers; and for this purpose they have the nails of their little fingers of an immoderate length: at the time of the operation the priest chants a hymn, or verse, importing, "Blessed art thou, O Lord, who hast ordained circumcision!" This is performed on the eighth day, and is a religious rite, according to the first institution by God to Abraham. The Abyssinians pretend theirs is not so; and, being pressed for the reason, they tell you it is because Christ and the apostles were circumcised, tho' they do not hold it necessary to salvation. But it is the objection they constantly make against eating out of the same plate, or drinking out of the same cup with strangers, that they are uncircumcised, while, with the Egyptians or the Cophts, though equally strangers, they make no such difficulty. In the time of the Jesuits, when the Roman Catholic religion was abolished, and liberty given to them to return to their old worship, their priests proclaimed a general circumcision; [3] and the populace, in the first days of their fury, or triumph, murdered many Catholics, by stabbing them with a lance in that part, as they met them, repeating in derision the Jewish hymn, or ejaculation, "Blessed is the Lord that hath ordained circumcision!" so that, I believe, their indifference in this article is rather owing to not being contradicted; just as they are careless abut every other part of religion, unless such as have been revived in their minds by disputes with the Jesuits, and kept up since in part among their clergy. But none of them pretend that circumcision arises from necessity of any kind, or from any obstruction or impediment to procreation, or that it becomes necessary for cleanliness, or from the heat of climate. None of these reasons, constantly alledged in Europe, [4] are ever to be heard here, nor do I believe they have the smallest foundation any where; and this, I think, should weigh strongly in favour of the account scripture gives of it. Examining the origin of this ceremony, independent of this revelation, I will never believe that any man, or nations of men, rashly submitted to a disgraceful, sometimes dangerous, and always painful operation, unless there had been proposed, as a consequence, some reward for submitting to, or some punishment for refusing it, which balanced in their minds the pain and danger, as well as disgrace, of that operation. All the inhabitants of the globe agree in considering it shameful to expose that part of their body, even to men; and in the east, where, from climate, you are allowed, and from respect to your superiors, the generality of men are forced to go naked, all agree in covering their waist, which is called their nakedness, though it is really only part of their body that is covered. We see even that there was a curse attended the mere seeing that part of the body of a parent, and not instantly throwing a covering over it. (Gen. chap. ix. ver. 22) I do not propose discussing at large the arguments for or against the time of the beginning to circumcise. The scripture has given such an account of it, that, when weighed with the promise so exactly kept to the end, seems to me to be a very rational one. But, considering all revelation out of the question, I think there is no room to institute any free or fair inquiry. I give no pre-eminence to Moses nor his writings. I suppose him a profane author; but, till those that argue against his account, and maintain circumcision was earlier than Abraham, shall shew me another profane writer as old as Moses, as near the time they say it began as Moses was to the time of Abraham, I will not argue with them in support of Moses against Herodotus, [5] nor discuss who Herodotus's Phenecians, and who his Egyptians were that circumcised. Herdotus knew not Abraham nor Moses, and, compared to their days, he is but as yesterday. Those Phenecians and Egyptians might, for anything he knew at the time, have received circumcision from Abraham or Ishmael, or some of their posterity, as the Abysinians or Ethiopians, whom he refers to, actually say they did, which Herodotus did not know, it is plain, though he mentions they were circumcised. This tradition of the Abyssinians merits some consideration from what they say of it themselves, that they were, in the earliest time, circumcised before they left their native country and settled in Tigre. From this they derive no honour, nor do they pretend to any. It would have been otherwise, if the aera fixed upon had been the reign of Menilek, son of Solomon, when they first embraced Judaism under a monarch. This would have made a much more brilliant epoch in their history, whilst it was probable that they adopted circumcision under the countenance of Azarias, the son of Zadok, the high priest, and the representatives of the twelve tribes who came with him at that time from Jerusalem. It seems to me very extraordinary, that, if circumcision was originally a Jewish invention, all those nations to the south should be absolutely ignorant of it, while others to the northward were so early acquainted with it; for none of those nation up the Nile (excepting the Shepherds) either knew or practise it to this day; though, ever since the 1400th year before Christ, they have been in the closest connection with the Jews. This would rather make me believe, that the rite of circumcision went northward from the plain of Mamre, for it certainly made no progress southward from Egypt. We see it obtained in Arabia, by Zipporah, Moses's wife, circumcising her son upon their return to Egypt. (Exod. chap. iv. ver. 25) Her great anxiety to have that operation immediately performed, shews that hers was a Judaical circumcision; there was no sin that attended the omission of the operation in Egypt, but God had said to Abraham, "The soul that is not circumcised shall be cut off from Israel." (Gen. chap. xvii. ver. 14) [6] The Tcherat Agows, who live between Lasta and Begemder, in an exceedingly fertile country, are not circumcised; and, therefore, if this nation left Palestine upon Joshua passing Jordan, circumcision was not known there, for the Agows to this day are not circumcised. The same may be said of the Agows of Damot, who are settled at the head of the Nile. It will be seen by the two specimens of their different languages that they are different nations, as I have alledged. Next to these are the Gafat, in a plain open country, who do not use circumcision; none of them were ever converted to Judaism, and but a few of them to Christianity. The next are the people of Amhara who did not use circumcision , at least few of them, till after the massacre of the princes by Judith in the year 900, when the remaining princes of the line of Solomon fled to Shoa, and the court was established there. The last of these nations that I shall mention are the Galla, who are not circumcised; of this nation we have said enough. On the north, a black, woolly-headed nation, called the Shangalla, already mentioned, bounds Abyssinia, and serves like a string to the bow made by these nations of Galla. Who they are we know perfectly, being the Cushite Troglodytes of Sofala, Saba, Axum and Meroe; shut up, as I have already mentioned, in those caves, the first habitations of their more polished ancestors. Neither do these circumcise, though they immediately bordered upon Egypt, while the Cushite, adjoining to the peninsula of Africa certainly did. As then so many nations contiguous to Egypt never received circumcision from it, it seems an invincible argument, that this was no endemical rite or custom among the Egyptians, and I have before observed, that it was of no use to this nation, as the reasons mentioned by Philo, [7] and the rest, of cleanliness and climate, are absolute dreams, and now, exploded; and that they are so is plain, because, otherwise, the nations more to the southward would have adopted it, as they have universally done another custom, which I shall presently speak of. Circumcision, then, having no natural cause or advantage, being in itself repugnant to man's nature and extremely painful, if not dangerous, it could never originate in man's mind wantonly and out of free will. It might have done so indeed from imitation, but with Abraham it had a cause, as God was to make his private family in a few years numerous, like the sands of the sea. This mark, which separated them from all the world, was an easy way to show whether the promise was fulfilled or not. They were going to take possession of a land where circumcision was not known, and this showed them their enemy distinct from their own people. And it would be the grossest absurdity to send Samson to bring, as tokens of the slain, so many fore-skins or prepuces of the Philistines, if, as Herodotus says, the Philistines had cut off their prepuces a thousand years before. I must here take notice that this custom, filthy and barbarous as it is, has been adopted by the Abyssinians of Tigre, who have always been circumcised, from a knowledge that the nations about them were not circumcised at all. It is true that they do not content themselves with the fore-skin, and I doubt very much if this was not the case with the Jews likewise. On the contrary, in place of the foreskin they cut the whole away, scrotum and all, and bring this to their superiors, as a token they have killed an enemy. Although it then appears tat the nations which had Egypt between Abraham and them, that is, were to the southward, did not follow the Egyptians in the rite of circumcision, yet in another, of excision, they all concurred. Strabo says, the Egyptians circumcised both men and women, like the Jews. (Lib. xvii, p. 950) [8] I will not pretend to say that any such operation ever did obtain among Jewish women, as scripture is silent upon it.; and indeed it is nowhere ever pretended to have been a religious rite, but to be introduced from necessity, to avoid a deformity which nature has subjected particular people to, in particular climates and countries. We perceive among the brutes, that nature creating the animal with the same limbs or members all the world over, does yet indulge itself in a variety, in the proportion of such limbs or members. Some are remarkable for the size of their heads, some for the breadth and bigness of the tail, some for the length of their legs, and some or the size of their horns. There is a district in Abyssinia, within the perpetual rains, where cows, of no greater size than ours, have horns, each of which would contain as much water as the ordinary water pail used in England does; and I remember on the frontiers of Sennar, near the River Dender, to have seen a herd of many hundred cows, every one of which had the apparent construction of their parts almost similar with that of the bull; so that for a considerable time, I was persuaded that these were oxen, their udders being very small, until I had seen them milked. This particular appearance, or unnecessary appendage, at first made me believe that I had found the real cause of circumcision from analogy, but, upon information, this did not hold. It is however otherwise in the excision of women. From climate, or some other cause, a certain disproportion is found generally to prevail among them. And, as the population of a country has in every age been considered as an object worthy of attention, men have endeavoured to remedy this deformity by the amputation of the redundancy. All the Egyptians, therefore, the Arabians, and nations to the south of Africa, the Abyssinians, Gallas, Agows, Gafats, and Gongas, make their children undergo this operation, at no fixed time indeed, but always before they are marriageable. When the Roman Catholic priests first settled in Egypt, they did not neglect supporting their mission by temporal advantages, and small presents given to needy people their proselytes; but mistaking this excision of the Coptish women for a ceremony performed upon Judaical principles, they forbade, upon pain of excommunication, that excision should be performed upon the children of parents who had become Catholics. The converts obeyed, the children grew up, and arrived at puberty; but the consequences of having obeyed the interdict were, that the man found, by chusing a wife among the Catholic Cophts, he subjected himself to a very disagreeable inconveniency, to which he had conceived an unconquerable aversion, and therefore he married a heretical wife, free from this objection, and with her he lapsed into heresy. The missionaries therefore finding it impossible that ever their congregation could increase, and that this accident did frustrate all their labours, laid their case before the College of Cardinals de propaganda fide, at Rome. These took it up as a matter of moment, which it really was, and sent over visitors, skilled in surgery fairly to report upon the case as it stood; and they, on their return, declared, that the heat of the climate, or some other natural cause, did, in that particular nation, invariably alter the formation so as to make a difference from what was ordinary in the sex of other countries, and that this difference did occasion a disgust, which must impede the consequences for which matrimony was instituted. The college, upon this report, ordered that a declaration, being first made by the patient and her parents that it was not done from Judaical intention, but because it disappointed the ends of marriage, "Si modo matrimonii fructus impediret id omnino tollendum effet:" that the imperfection was, by all manner of means, to be removed; so that the Catholics as well as the Cophts, in Egypt, undergo excision ever since. This is done with a knife, or razor, by women generally when the child is about eight years old. (The reader will observe, by the obscurity of this passage, that it is with reluctance I have been determined to mention it at all; but as it is an historical fact, which as had material consequences, I have thought it not allowable to omit it altogether. Any naturalist, wishing for more particular information, may consult the French copy.) James Bruce of Kinnaird, Travels to discover the source of the Nile, in the years 1768, 1769, 1770, 1771, 1772 and 1773 (6 vols, Dublin: printed by William Porter, 1790-91), Vol. 3, pp. 670-80 <h3>Commentary</h3> This is a fascinating discussion, full of doubts and uncertainty, in which Bruce grapples honestly with and tries to reconcile two glaring contradictions. First there is the contradiction between his Western horror at the "disgrace" of an unnatural practice like circumcision and the fact that these Ethiopians did it to both girls and boys. Secondly there is the contradiction between their own explanations for the rite and the account of the origin of circumcision among the Jews given in Genesis. Bruce's arguments are unclear in places, but he seems to accept the biblical account of the origin of circumcision among the Jews, and to infer that any other places that practised male circumcision must have copied it from them. In this viewpoint, it is interesting to note, he was at variance with much Enlightenment opinion, which tended to discount biblical narratives as fictional or metaphorical, and to seek naturalistic explanations for (apparently) religious customs; in his Philosophical Dictionary, Voltaire insisted that the Jews learned circumcision from the Egyptians. But circumcision of females was a different matter. Dismissing Strabo's claim, Bruce takes the absence of any reference to female circumcision in the scriptures as proof that it was not practised by the Jews and, therefore, that it did not have a religious origin at all. How then did a custom so bizarre ever arise? Here Bruce returns to the environmental argument common in the late eighteenth century and usually applied to circumcision in both men and women: that the heat of the desert or tropics caused the foreskin and clitoris or labia to grow to such a length that health was endangered and procreation impeded. Bruce rejected this explanation for male circumcision, noting that the Abyssinians made no such claims, but accepted it in the case of female circumcision, since no other explanation â€“ and certainly not a religious one â€“ seemed to be available. <h3>NOTES</h3> 1. In his pamphlet, The early spread of circumcision (London 1846), George Rose also sought to defend the biblical account against both the remarks of Herodotus and the naturalistic explanations that were emerging from the new science of anthropology. He realised that militant Islam had spread circumcision throughout south Asia, but explained its existence elsewhere or in places where it antedated the Moslem conquests as a result of the influence of Arab traders before the time of Mohammed. As the descendants of Abraham's son Ishmael, they had been circumcised at the age of 13, also explaining why so many African and other tribes performed the operation at puberty. 2. It is not clear whether Bruce means Sheba, the legendary visit of whose queen to King Solomon was immortalised in the extravagant opera by G.W.F. Handel, first performed in 1749. Insofar as Sheba was real place, it is supposed to have been in south-west Arabia (today's Yemen), not Ethiopia. Whether there was ever a queen in that ultra-male chauvinist part of the world, however, seems as unlikely as the story that she visited the equally doubtful Solomon â€“ though Handel's mincing overture makes the legend as convincing as it ever could be. The biblical texts are I Kings, 10:1-13, and II Chronicles, 9:1-12. 3. The Abyssinian rebellion against the Catholics was described by Edward Gibbon, whose account concludes: "Basilides expelled the Latin patriarch, and restored to the wishes of the nation the faith and discipline of Egypt. The Monophysite churches resounded with a song of triumph, "that the sheep of Aethiopia were now delivered from the hyaenas of the West", and the gates of that solitary realm were for ever shut against the arts, the science, and the fanaticism of Europe." (The decline and fall of the Roman Empire, chap. 47) 4. For example, by Georges-Louis Buffon and Edward Gibbon, who wrote "Of all the systems of Christianity, that of Abyssinia is the only one which still adheres to the Mosaic rites. ... Circumcision had been practised by the most ancient Aethiopians, from motives of health and cleanliness, which seem to be explained in the Recherches Philosophiques sur les Americains, tom. ii, p. 117. (Decline and fall, chap. 15, fn. 25) Gibbon also wrote that on the incorporation of the Abyssinian church into the Roman Catholic, by the Catholic Patriarch of Aethiopia, Alphonso Mendez, in 1632, the Ethiopian Christians were required to give up Jewish customs and their connections with Alexandria. He continued: "He [Mendez] condemned the ancient practice of circumcision, which health rather than superstition had first invented in the climate of Aethiopia." And he added in a footnote: <div>"I am aware how tender is the question of circumcision. Yet I will affirm, 1. That the Aethiopians have a physical reason for the circumcision of males, and even of females (Recherches Philosophiques sur les Americains, tom. ii). 2. That it was practised in Aethiopia long before the introduction of Judaism or Christianity (Herodot. 1.ii.c.104; Marsham, Canon Chron. p. 72-3). "Infantes circumcident ob consuetudinem non ob Judaismum", says Gregory the Abyssinian priest (apud. Fabric. Lux Christiana, p. 720). Yet, in the heat of the dispute, the Portuguese were sometimes branded with the name of uncircumcised (La Corze, p. 80; Ludolph. Hist. and Comment. 1.iii.c.1" (Decline and fall, chap. 47, and fn. 160).</div> There had been an earlier attempt to unite the Coptic with the Latin church, in the fifteenth century, when the Council of Florence issued the Bull of union with the Copts, which banned circumcision outright: <div>It [the Catholic Church] firmly believes, professes and teaches that the legal prescriptions of the old Testament or the Mosaic law, which are divided into ceremonies, holy sacrifices and sacraments, because they were instituted to signify something in the future, although they were adequate for the divine cult of that age, once our lord Jesus Christ who was signified by them had come, came to an end and the sacraments of the new Testament had their beginning. Whoever, after the passion, places his hope in the legal prescriptions and submits himself to them as necessary for salvation and as if faith in Christ without them could not save, sins mortally. It does not deny that from Christ's passion until the promulgation of the gospel they could have been retained, provided they were in no way believed to be necessary for salvation. But it asserts that after the promulgation of the gospel they cannot be observed without loss of eternal salvation. Therefore it denounces all who after that time observe circumcision, the Sabbath and other legal prescriptions as strangers to the faith of Christ and unable to share in eternal salvation, unless they recoil at some time from these errors. Therefore it strictly orders all who glory in the name of Christian, not to practise circumcision either before or after baptism, since whether or not they place their hope in it, it cannot possibly be observed without loss of eternal salvation.</div> <a href="http://www.ewtn.com/library/councils/florence.htm#5" rel="noopener" target="_blank">Bull of Union with the Copts, Council of Florence, Session 11, 1442</a> 5. For 1500 years or so, the brief comments made by Herodotus (born c.490 BC) in his Histories were just about the sum total of western knowledge about circumcision, and they remain the strongest evidence that the Egyptians practised it. The two passages are as follows: <div>The Egyptians themselves, in their manners and customs seem to have reversed the ordinary practices of mankind. ... They practise circumcision, while men of other nations â€“ except those who have learnt from Egypt â€“ leave their private parts as nature made them. ... They are religious to excess beyond any other nations in the world. [For example] ... they circumcise themselves for cleanliness' sake, preferring to be clean rather than comely.</div> Herodotus, The histories, trans. Aubrey de Selincourt, revd. John Marincola (Penguin Classics, 2003), Book I, 35-38, pp. 109-10 <div>The Colchians, the Egyptians and the Ethiopians are the only races which from ancient times have practised circumcision. The Phoenecians and the Syrians of Palestine themselves admit that they learned the practice from Egypt, and the Syrians who live near the rivers Thermodon and Parthenius, as well as their neighbours the Macronians, say that they learnt it only a short time ago from the Colchians. No other nations use circumcision, and all these are without doubt following the Egyptian lead. As between the Egyptians and the Ethiopians, I cannot say which learned from the other, for the custom is evidently a very ancient one; but I have no doubt that the other nations adopted it as a result of their intercourse with Egypt, and in this belief I am strongly supported by the fact that Phoenecians who have contact with Greece drop the Egyptian usage, and allow their children to go uncircumcised.</div> Book II, 104, pp. 134-5 What is interesting about the comments on the Egyptians is Herodotus' stress on their perversity, and in the second passage it is curious that he does not mention the Jews. Herodotus is by no means reliable as a reporter, however, and there is great doubt as to whether the Egyptians practised circumcision generally, as a requirement for priests, or at all; and, if they did, at what periods of their 2000-plus year history. (There is a vast literature on this question; for a start, see <a href="http://www.cirp.org/library/history/hodges2/" rel="noopener" target="_blank">Frederick Hodges, The ideal prepuce</a>.) As for the Colchians and Macronians , nobody quite knows who they were. According to Herodotus, the Colchians lived at the eastern end of the Back Sea, and were supposed to be the descendants of an army sent abroad by the pharaoh Sesostris. If so, it is hard to see how they could have influenced the customs of the Syrians, living far away on the Mediterranean coast. Colchis was also the place from which Jason fetched the Golden Fleece, in the myth of the Argonauts, but there is no indication in that narrative that the locals were circumcised. Edward Gibbon wrote that by the eighteenth century "not a vestige can be found of the art, the knowledge, or the navigation of the ancient Colchians", and that the rite of circumcision was practised "only by the Mahometans of the Euxine" (Decline and fall, chap. 42) Colchis seems to have been more of a Shangri-La than a real society, a location where the ancient and later worlds could site their fantasies of fearsome otherness. In the eighteenth century it became the home of the terrifying but instructive Mingrelians, a people so removed from western morality that, although professing Christianity, they "bury their children alive without scruple", as John Locke reminded those who thought that Christian values were innate in the mind (Essay concerning human understanding, 1690). Gibbon could not resist adding a report that a Mingrelian ambassador once arrived in Constantinople with a retinue of 200 persons, but ate them day by day until only a secretary and two valets were left (Decline and fall, chap. 42, fn. 74) 6. I can't quite follow Bruce's geographical logic here. 7. Philo was an influential Jewish, but Greek-speaking, intellectual who lived in Alexandria from c.15 BC to 50 CE. He was noted for his symbolic interpretations of the books of Moses, but also for his defence of Jewish customs such as circumcision against both Graeco-Roman critics and Hellenising Jews, who thought that such barbarities ought to be abandoned, now that the world was civilized. In defence of circumcision Philo named six advantages, none of which had anything to do with divine command or ethnic identity: (1) That it prevents a particular kind of "serious and malignant" carbuncle on the penis; (2) that it ensures "the complete cleanliness of the body"; (3) so that "this circumcised part have a certain similarity to the heart, for both organs serve to procreate"; (4 â€“ the most important) to ensure numerous offspring; (5) "the excision of pleasures which bewitch the mind. For since among the love-lures of pleasure the palm is held by the mating of man and woman, the legislators thought good to dock the organ which ministers to such intercourse, thus making circumcision the figure of the excision of excessive and superfluous pleasure, not only of one pleasure, but of all the other pleasures signified by one, and that the most imperious"; (6) "that a man should know himself and banish from the soul the grievous malady of conceit". (Philo of Alexandria, Of the special laws, Book I (ii), in Works of Philo, trans. F.H. Colson (Loeb Classical Library, 1937), Vol. VII, p. 104-5) How little the arguments of circumcision advocates have changed in two millennia! The big difference is the last two points: no crusader for circumcision these days would dare to suggest that the operation harmed the penis in any way or reduced a male's capacity for sexual sensation, nor that it would chasten and purge him of conceit. It is not surprising, then, that Philo is not a pro-circumcision authority whom they are fond of citing. 8. The Greek geographer Strabo (late 1st Century BCE) stated: "One of the customs most zealously observed among the Egyptians is this, that they rear every child that is born, and circumcise the males, and excise the females, as is also customary among the Jews, who are also Egyptian in origin"; and similarly of the Ethiopians: "they are mutilated in their sexual organs, and the women are excised in the Jewish manner". For a fascinating discussion of this obscure question, see Shaye J.D. Cohen, "Why aren't Jewish women circumcised?", in Maria Wyke (ed.), Gender and the body in the ancient Mediterranean (London: Blackwell, 1998) </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The mysterious Abyssinians (1768-1773) darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h3>Medical history and medical practice</h3> <h3>Introduction</h3> Although many nineteenth century misconceptions about the foreskin have been dispelled since Douglas Gairdner showed that infantile phimosis was not an abnormality, other old ideas have proved more persistent. Three of these are the proposition that ritual or religious circumcision arose as a hygiene measure; the view of the foreskin as a "cesspool"; and the assertion that circumcision makes no difference to sexual response. It is suggested that the first idea should be dismissed as a myth; that the second is a reflection of religious ideology and medical misunderstanding; and that the third is contradicted by centuries of medical opinion and has been seriously questioned by modern research. * * * * * * * * Although much progress has been made since 1949 in dispelling nineteenth century myths about the male foreskin (for example, that infantile phimosis was a pathological abnormality (2), that circumcised men were immune to syphilis (3, 4), and that circumcised boys did not masturbate), other myths have proved more persistent. Among these are the idea that ritual circumcision as practised by certain tribal peoples arose as a hygiene or sanitary measure, particularly as a precaution against sand or dust in desert environments (5); the description of the foreskin as a "harbour for filth" or "cesspool"; and the assertion that the removal of the foreskin makes no difference to sexual function. There is no evidence that ritual or religious circumcision first arose as a hygiene measure. Many primitive cultures carried out a variety of mutilating procedures on different parts of the body, including the genitals of both boys and girls, but the origins and rationale of these practices are obscure and contested, as are the environmental conditions prevailing when and where such customs emerged. Past societies also practised cannibalism, human sacrifice, infanticide, widow-burial, foot-binding and many other traditions not endorsed today. It is a delusion of Marxist anthropology to assume that traditional rites must have a materialist and rational explanation; modern anthropology recognises that such customs emerge from the belief structure or cosmology of the cultures which produced them and do not necessarily have practical significance. Many conflicting theories have been advanced to account for the rise of ritual operations on the male and female genitals (6-8), among which are the following: <ul> <li>a propitiatory sacrifice or sign of submission to a deity, probably a milder form of a ritual which began as outright human sacrifice;</li> <li>an offering to the god or goddess of fertility to ensure children;</li> <li>a mark of tribal identification;</li> <li>a rite of passage from childhood to adult responsibility;</li> <li>(in the case of boys circumcised at puberty) the imposition of adult and tribal authority at a time when youthful rebellion might be expected;</li> <li>a fertility rite, aimed at giving men the power of procreation by making them shed blood from their genitals like women;</li> <li>an attempt to emphasise feminine or masculine characteristics in girls and boys by removing the parts of the genitals (clitoris and foreskin) believed to resemble the genitals of the other sex;</li> <li>a means of humiliating and marking defeated enemies and slaves.</li> </ul> The only point of agreement among proponents of the various theories is that a pragmatic aim like hygiene had nothing to do with it. In the days before aseptic surgery, any cutting of flesh was about the least hygienic thing anybody could do, carrying a high risk of bleeding, infection and death. Travelling in Iraq in the 1930s the English doctor Wilfred Thesiger reported that Arab boys undergoing circumcision: sometimes took two months to recover, suffering great pain in the meanwhile. One young man came to me for treatment ten days after his circumcision, and ... the stench made me retch. His entire penis, his scrotum and the inside of his thighs were a suppurating mess from which the skin was sloughing away, the pus trickling down his legs (9). None of the ancient cultures which practised circumcision have traditionally claimed that the ritual was introduced as a hygiene measure: African tribes, Arabs, Jews, Moslems and Australian Aboriginals explain it different ways, but divine command, tribal identification, social role, family obligation, respect for ancestors and promotion of chastity figure prominently (10, 11). It was only in the late nineteenth century, when mass circumcision was being introduced for "health" reasons, that doctors sought legitimacy for the new procedure by claiming continuity with the distant past and attempting to explain the origins of circumcision in terms of their own hygienic agenda (12). As a Dr Davidson put it in 1889, "a nation like the Jews, whose ideas of sanitation were so far advanced ... adopted the practice as much for its substantial benefits to health as out of regard to religious ceremonial" (13). Moslems enjoying less respect at that time, and little being known about them, the Jews were the preferred model. Nobody has ever suggested that circumcision as performed by the Aboriginals had a hygienic rationale, nor that their custom of knocking out teeth during initiation ceremonies was a precaution against the inconvenience of tooth decay in later life. Many of the cultures which practised male circumcision also enforced various forms of female genital mutilation (14, 15), but western doctors today are horrified by this sort of surgery, do not seek evidence that it might be beneficial to women's health and do not suggest that it originated as a means of preventing sand from irritating the clitoral hood or labia. It was a different story in the 1850s and 60s, and it remains different in the cultures which continue to practise female circumcision. In the 1850s and 60s many English doctors believed that clitoridectomy was as valuable as male circumcision in treating nervous diseases like epilepsy, hysteria and masturbation (as well as their sequelae in madness) and pushed the therapy on women with little attempt to gain consent (16, 17). Egyptian and other Islamic physicians today insist on the hygienic value of female circumcision as a preventive of both organic disease and sexual promiscuity (18). The notion of the foreskin as inherently dirty and disease-promoting has been revived in recent times by several advocates of routine circumcision. The American G.N. Weiss states that "over the millennia the male's preputial cavity has acted as a cesspool for infectious agents transmitting disease" (19), while Australia's Brian Morris quotes both this remark and a reference by the Brisbane GP Terry Russell to "pathogenic organisms multiplying in the warm, moist environment under the prepuce". Morris adds that the "stench" of the foreskin means that uncircumcised men need three showers a day (20). The origins of these scientifically baseless assertions lie partly in ancient Judaic theology, which designated many natural phenomena as unclean in a spiritual or religious sense, and partly in the late nineteenth century century's limited understanding of epidemiology. Bacteriological causation of disease was not fully understood at that time, visible "filth" alone was thought to be capable of generating disease (21), and neither the anatomy nor the functions of the foreskin had been studied. In the 1890s another advocate of universal circumcision, Jonathan Hutchinson (one of England's most distinguished surgeons), described the foreskin as a "harbour for filth" (22). Modern research, however, has shown these beliefs to be without foundation: far from being unhygienic, the infant foreskin promotes the cleanliness of the penis by acting as a valve to let urine out while blocking the entry of foreign matter. It also protects the glans from dirt and abrasion and keeps it moist in much the same way as the eyelid lubricates the eye. In adults the sub-preputial moisture is not merely harmless, but is a useful moisturiser and may have anti-bacterial and anti-fungal properties (23-26). A striking omission from many discussions of the risks and benefits of circumcision is a consideration of the value of the foreskin and the corresponding disadvantages of being obliged to live without one. Much of the past argument as to the health benefits of circumcision has rested on the assumption that the foreskin was useless flap of skin, with the result that the loss of this complex and versatile structure was never factored into such cost-benefit analyses of the procedure as have been attempted. Most have these have ignored the value of the lost tissue and focused exclusively on the additional risks of the operation (bleeding, infection etc). If the foreskin performs valuable functions, or even if it is no more than a desirable adornment, the equation changes sharply: even if circumcision offered real health benefits, they must be set against the costs of losing that part of the body. Although most medical discussions ignore it (5), there is a vast medical literature on the significance of the foreskin, stretching from the ancient Greeks, who regarded the foreskin as the most beautiful part of the male genitals, to the contemporary Canadian and New Zealand researchers who have identified the complex innervation of the penis, the frenular delta and the ridged bands of the foreskin, as well as its relevance to the experience of female partners (27-30). In the Greek and Roman world doctors considered the foreskin so important that they devised treatments to lengthen those which did not provide generous coverage of the glans (31). During the Renaissance the centrality of the foreskin to male sexual function and the pleasure of both partners was recognised by Berengario da Carpi (32), Gabriele Falloppio (33) and William Harvey (34). In the eighteenth century male folklore held that the foreskin was "the best of your property" (35), and a similar outlook was expressed in popular sex manuals like Aristotle's Master-Piece (36) and by physicians such as Robert James (37) and John Hunter, who also appreciated the importance of the foreskin in providing the slack tissue needed to accommodate erection: The prepuce is ... a doubling of the skin of the penis when not erected ... by which provision the glans is covered and preserved when not necessary to be used, whereby its feelings are probably more acute. When the penis becomes erect it in general fills the whole skin, by which the doubling forming the prepuce in the non-erect state is unfolded, and is employed in covering the body of the penis (38). There is a puzzle in the fact that while circumcision advocates today assure parents that circumcision makes no difference to the experience of sex, their counterparts a century ago insisted that it made a major difference and that this was the most important reason for doing it. In the nineteenth century the erotic role of the foreskin was well understood by surgeons, who wanted to cut it off precisely because its tactile responsiveness ("irritability", as they complained) was a major factor leading boys to masturbation: William Acton damned the foreskin as "a source of serious mischief" (39), and most of his contemporaries concurred (40, 41). Both opponents and supporters of circumcision agreed that the significant role the foreskin played in sexual response was the main reason why it should be left in place or removed. In the USA William Hammond commented that "circumcision, when performed in early life, generally lessens the voluptuous sensations of sexual intercourse", and that even those who had it done later reported that "the operation had very decidedly diminished the voluptuous feelings afterwards experienced" (42). Both he and Acton considered the foreskin necessary for optimal sexual function, especially in old age. Jonathan Hutchinson, an ardent supporter of universal infant circumcision, thought this was the most important reason why it should be excised: The only physiological advantage which the prepuce ... confer[s] is ... 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 ... we can well be spared. If in their loss increase in sexual control should result, one should be thankful (43). Similar comments were made by dozens of British and American medical men from the 1840s to the 1930s. In 1874 a correspondent to the Lancet signing himself "a Jewish surgeon" stated that "the removal of the prepuce reduces to an extraordinary degree the sensitiveness of the glans penis" and expressed his belief that "the intention of the rite was to enhance and advance as far as possible the chastity of the race by blunting mechanically the sensibility of the organ of sexual appetite" (44). In this view he was following the great Jewish physician and philosopher Maimonides, who had written that the reason for circumcision was "the desire to bring about a decrease in sexual intercourse and a weakening of the organ" (45). In 1915 a doctor in the USA similarly commented: 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 (46). The phrasing used by many made it clear that a word like hygienic had a moral as well as a physical connotation. In his article "The hygiene of circumcision", another US physician stressed the value of the operation in diminishing the sensibility of the penis and discouraging masturbation (47). In his book Sex hygiene for the male (1912), G. Frank Lydston wrote: Circumcision promotes cleanliness, prevents disease, and by reducing over-sensitiveness 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 [sic] of evil sexual habits, such as masturbation (48). A modern American physician who had himself circumcised in the 1970s was so pleased with the result that he wrote an article urging everybody else to have it done, but even he acknowledged the loss of sexual sensation: The change in sensation during intercourse a few weeks later was surprising. The sharp pleasurable sensation was noticeably lessened, as it is when topical anaesthetics are used to delay ejaculation. ... The overpowering erotic sensation has been dulled, and with it some of the immediate pleasurable sensation. Initial excitement has decreased. ... [When fully erect the penis presents] a smooth shaft with a piston-in-cylinder-like action during coition. Friction and therefore sensation are diminished (49). It is difficult to put numbers on so subjective an experience as sexual satisfaction, but the research of Cold and Taylor has provided scientific confirmation of the eighteenth century folklore that a man's foreskin was "the best of your property". Valentine left a hostage to fortune which merits the attention of doctors and parents today. Regardless of the disease prevention/risk of harm calculus, "If it [the foreskin] does have a function, its routine removal in newborns cannot be justified. Perhaps the foreskin does have a rationale that has been ignored or not recognised" (50). As much as recognising the rationale, it is a matter of remembering the medical knowledge already accumulated before the masturbation phobia of the nineteenth century and the circumcision mania of the twentieth century consigned it to the archives. Referring to the sorry results of forgetting the cure for scurvy discovered by John Woodall in the 1630s, Sir Geoffrey Keynes remarks that it was an example of "how easily important facts may be forgotten through failure to consult the history of medicine" (51). If researchers today paid more attention to medical history they might be saved from errors like the myth of desert hygiene and find themselves able to make a stronger case that optimal male health and happiness required doctors to protect the foreskin instead of seeking excuses to destroy it. <h3>References</h3> 1. Temkin O. "The usefulness of medical history for medicine", in The double face of Janus and other essays, Baltimore, Johns Hopkins University Press, 1977, 68-100, here 69 2. Gairdner D. "The fate of the foreskin: A study of circumcision", British Medical Journal, 24 December 1949, 1433-7 3. Gilman S. Freud, race and gender, Princeton University Press, 1993, ch. 2 4. Darby R. "Where doctors differ: The debate on circumcision as a preventive of syphilis 1855-1914", Social History of Medicine, March 2003 (forthcoming) 5. Paediatric and Child Health Division, Royal Australasian College of Physicians, Policy statement on circumcision, RACP, Sydney, September 2002: http://www.racp.edu.au/hpu/paed/circumcision/index.htm 6. Gollaher D.L. Circumcision: A history of the world's most controversial surgery, New York, Basic Books, 2000, ch. 3 7. Loeb E.M. "The blood sacrifice complex", in Memoirs of the American Anthropological Association, No. 23, 1923, repr. New York, Kraus Reprint, 1974 8. Ngxamngxa A.N.N. "The function of circumcision among the Xhosa-spe tribes in historical perspective", in E.J. de Jager (ed.), Man: Anthropological essays presented to O.F. Raum, Capetown, Struik, 1971, 183-204 9. Thesiger W. The marsh Arabs, London 1964, 101-2 10. Hoffman L.W. Covenant of blood: Circumcision and gender in rabbinic Judaism, University of Chicago Press, 1996 11. Aldeeb Abu-Sahlieh S.A. Male and female circumcision among Jews, Christians and Muslims: Religious, medical, social and legal debate, Warren PA, Shangri-La Publications (Marco Polo Monographs, No. 5), 2001 12. Remondino P.C. History of circumcision from the earliest times to the present: Moral and physical reasons for its performance, Philadelphia and London, F.A. Davis, 1891 13. Davidson A. "Genital irritation in boys", The Practitioner (London), Vol. 42, 1889, 350-56, here 356 14. Roles N.C. "Tribal surgery in East Africa during the XIXth century: Part 1 â€“ Ritual operations", East African Medical Journal, Vol. 43, 1966, 579-94 15. Scheper-Hughes N. "Virgin territory: The male discovers the clitoris", Medical Anthropology Quarterly, Vol. 5, 1991, 25-8 16. Moscucci O. "Clitoridectomy, circumcision and the politics of sexual pleasure in mid-Victorian Britain", in Andrew H. Miller and James Eli Adams (eds), Sexualities in Victorian Britain, Bloomington, Indiana University Press, 1996 17. Fleming J.B. "Clitoridectomy: The disastrous downfall of Isaac Baker Brown FRCS (1867)", Journal of Obstetrics and Gynaecology of the British Empire, Vol. 67, 1960, 1017-34 18. Gollaher D.L. Circumcision: A history of the world's most controversial surgery, New York, Basic Books, 2000, ch. 8 19. Weiss G.N. "Prophylactic neonatal surgery and infectious diseases", Pediatric Infectious Diseases Journal, Vol. 16, 1997, 727-34 20. Morris B. In favour of circumcision, Sydney, New South Wales University Press, 1999, 30 21. Worboys M. Spreading germs: Disease theories and medical practice in Britain 1865-1900, Cambridge University Press, 2000 22. Hutchinson J. "A plea for circumcision", Archives of Surgery, Vol. 2, 1890, 15 23. Van Howe R.S. "Circumcision and infectious diseases revisited", Pediatric Infectious Diseases Journal, Vol. 17, 1998, 1-6 24. Fleiss P, Hodges F, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Inf 1998;74:364-367 25. Prakash [sic, Parkash] S, Raghuram R, Venkatesan, et al. Sub-preputial wetness - Its nature. Ann Nat Med Sci (India) 1982; 18(3): 109-112 26. Lee-Huang S, Huang PL, Sun Y, et al. Lysozyme and RNases as anti-HIV components in beta-core preparations of human chorionic gonadotropin. Proc Natl Acad Sci USA 1999;96(6):2678-81 27. Taylor J.R. Lockwood A.P. and Taylor A.J. "The prepuce: Specialised mucosa of the penis and its loss to circumcision", British Journal of Urology, Vol. 77, 1996, 291-5 28. Cold C.J. and Taylor J.R. "The prepuce", BJU International, Vol. 83, Supplement 1, January 1999, 34â€“44 29. Cold C.J. and McGrath K.A. "Anatomy and histology of the penile and clitoral prepuce in primates: Evolutionary perspective of specialised sensory tissue of the external genitalia", in George C. Denniston, Frederick Hodges and Marilyn Milos (eds), Male and female circumcision: Medical, legal and ethical considerations in pediatric practice, New York, Kluwer Academic/Plenum Publishers, 1999 30. O'Hara K. and O'Hara J. "The effect of male circumcision on the sexual enjoyment of the female partner", BJU International 1999;83 Suppl 1, 79-84. 31. Hodges, F. "The ideal prepuce in Ancient Greece and Rome: Male genital aesthetics and their relation to lipodermos, circumcision, foreskin restoration and the Kinodesme", Bulletin of the History of Medicine, Vol. 75, 2001, pp. 375-405 32. da Carpi, Jacopo Berengario. A short introduction to anatomy, translated by L.R. Lind, University of Chicago Press, 1959, 72-3 33. Quoted in Alex Comfort, The anxiety makers: Some curious preoccupations of the medical profession, London, Nelson, 1967, 17; and in Thomas Laqueur, Making sex: Body and gender from the Greeks to Freud, Cambridge, Mass., Harvard University Press, 1991, 271, fn. 75 34. Harvey, W. The anatomical lectures of William Harvey, ed. and trans Gweneth Whitteridge, Edinburgh, E. & S. Livingstone, 1964, 213 35. Wolper, R.S. "Circumcision as polemic in the Jew Bill of 1753: The cutter cut?", Eighteenth Century Life, Vol. 7, 1982, 24-36 36. Aristotle's complete masterpiece, in three parts, displaying the secrets of nature in the generation of man, London, 1749, facsimile reprint, New York, Garland, 1986, 13 37. James R. A medicinal dictionary: including physic, surgery, anatomy, chymistry, and botany, in all their branches relative to medicine, 3 vols, London, 1743-45, Vol. II, entry for "Generatio" 38. Hunter J. A treatise on the venereal disease, London 1786, 221 39. Acton W. The functions and disorders of the reproductive organs in childhood, youth, adult age and advanced life, 3rd London edition, Philadelphia, Lindsay and Blakiston, 1865, 22 40. Parsons G.P. "Equal treatment for all: American medical remedies for male sexual problems, 1850-1900", Journal of the History of Medicine, Vol. 32, 1977, 55-71 41. Darby R. "Circumcision as a preventive of masturbation: A review of the secondary historical literature", Journal of Social History, Vol. 36, Spring 2003 42. Hammond W.A. Sexual impotence in the male and female, Detroit, 1887, facsimile reprint, New York, Arno, 1974, 272-3 43. Hutchinson J. "The advantages of circumcision", Medical Review, Vol. 3, 1900, 641-2 44. "Circumcision", Lancet, 12 December 1874, 856 45. Moses Maimonides. Guide for the perplexed, trans. M. Friedlander, New York, Dover Publications, 1956, 378 46. Wuesthoff L.W. "Benefits of circumcision", Medical World, Vol. 33, 1915, 434 47. Crossland J.C. "The hygiene of circumcision", New York Medical Journal, Vol. 53, 1891, 484-5 48. Wolbarst A. "Universal circumcision as a sanitary measure", Journal of the American Medical Association, Vol. 62, 1914, 95 (cited) 49. Valentine R.J. "Adult circumcision: A personal report", Medical Aspects of Human Sexuality, Vol. 8, January 1974, 31-42, 48, here 32-3 50. Valentine R.J. "Adult circumcision: A personal report", Medical Aspects of Human Sexuality, Vol. 8, January 1974, 32-3 51. Keynes G. The gates of memory, Oxford, Clarendon Press, 1981, 360 </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Three persistent myths about the foreskin darby Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Robert Darby Subject The topic of the resource Circumcision history Description An account of the resource Archive of the work published by Robert Darby Creator An entity primarily responsible for making the resource Robert Darby Source A related resource from which the described resource is derived circinfo.org historyofcircumcsion.org Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Text Any textual data included in the document <div class="intro" id="intro"> <h3>Sand: A persistent myth about circumcision</h3> "We are all apt to accept a historical myth where we cannot rely on historical knowledge. Where history is lacking, mythology takes its place, and those who disdain history are among the foremost victims of mythology." â€” Owsei Temkin [1] <h3>Abstract</h3> Although many nineteenth century misconceptions about the foreskin have been dispelled since Douglas Gairdner showed that infantile phimosis was not a congenital abnormality, other old ideas have proved more persistent. One of the most ubiquitous is the proposition that ritual or religious circumcision arose as a hygiene or sanitary measure; and the related idea that troops serving in the Middle East during the Second World War were subject to such severe epidemics of balanitis that mass circumcision was necessary. Both these myths should be firmly laid to rest. * * * * * * * * One of the strangest arguments offered for male circumcision is that amputation of the foreskin protects the penis, and more especially the glans, from irritation by sand. This idea is certainly counter-intuitive. Common sense suggests quite the opposite scenario: that the foreskin guards the penis, particularly the glans and the vulnerable urinary opening, from any such irritation by shielding them from dust, sand and other forms of dirt. This function seems all the more likely in boys before puberty, when the foreskin is usually long, tight and less frequently retracted. Yet the claim appears regularly in serious medical journals, both as an explanation for the ancient origin of ritual circumcision in tribal societies, and as a medical justification for its performance in the twentieth century. In a recent article on the ethics of circumcising male minors, J.M. Hutson asserted that circumcision was "likely to have arisen as an early public health measure for preventing recurrent balanitis, caused by sand accumulating under the foreskin." [2] He provided no reference for this suggestion, but it is possible that he was copying a similar claim from the policy statement on circumcision issued by the Royal Australasian College of Physicians in 2002: "Circumcision of males has been undertaken for religious and cultural reasons for many thousands of years. It probably originated as a hygienic measure in communities living in hot, dusty and dry environments." [3] Again, no citation was offered, and not surprisingly, for it would be very hard to find reliable evidence that ritual or religious circumcision arose as a health measure. <h4>Mutilating procedures common</h4> Many primitive cultures carried out various mutilating procedures on different parts of the body, including the genitals of both boys and girls, but the origins and rationale of these practices are obscure and contested, as are the environmental conditions prevailing when such customs emerged. Such societies also practised human sacrifice, widow-burial, foot-binding, scarification, tattooing, piercing, infibulation, head or nose shaping, tooth evulsion and many other traditions not seen as health-giving today. The idea that the mutilations carried out by savage cultures must have a utilitarian basis emerged in the eighteenth century, when Enlightenment thinkers sought naturalistic explanations for phenomena formerly regarded as miracles or attributed to the will of the Deity. Denis Diderot embodied this trend when he suggested that infibulation of women in some tribal societies originated as a birth control measure and only later became sanctioned as a divinely ordained precept. [4] It is, however, a functionalist delusion which Mary Douglas has called "medical materialism" to assume that traditional rites must have a rational basis; modern anthropology recognises that such customs emerge from the belief structure or cosmology of the cultures which produced them and do not necessarily have utilitarian significance. [5] Many conflicting theories have been advanced to account for ritual operations on the male and female genitals, among which are the following: <ul> <li>a propitiatory sacrifice or sign of submission to a deity, probably a milder form of a ritual which began as outright human sacrifice;</li> <li>an offering to the god or goddess of fertility to ensure children;</li> <li>a mark of tribal identification;</li> <li>a rite of passage from childhood to adult responsibility;</li> <li>(in the case of boys circumcised at puberty) the imposition of adult and tribal authority at a time when youthful rebellion might be expected;</li> <li>a fertility rite, aimed at giving men the power of procreation by making them shed blood from their genitals like women;</li> <li>an attempt to emphasise feminine or masculine characteristics in girls and boys by removing the parts of the genitals (clitoris and foreskin) believed to resemble the genitals of the other sex;</li> <li>a means of humiliating and marking defeated enemies and slaves. [6]</li> </ul> <h4>Circumcison seen as risky and dangerous</h4> The only point of agreement among proponents of the numerous theories is that a practical objective such as health had nothing to do with it, and the reason is obvious: in the days before aseptic surgery, any cutting of flesh was about the least hygienic thing anybody could do, carrying a high risk of bleeding, infection and death. Among most of the traditional (tribal) societies that practise it as an initiation or transition ritual, circumcision is regarded as a dangerous business, testing the boy's courage and manliness, but carrying severe risks. Among the Tiv people of central Nigeria, the father's role is to protect his son from the numerous spiritual dangers attending the operation and to do what he can to mitigate the threats to his health and well-being. There is an account of one Tiv ceremony in which the father played an active but supporting role, standing beside his son during the operation, urging stoicism during the cutting and reassuring him that he could bear it like a man. Later he asked frantically if somebody could do something to stop the bleeding, since the boy was haemorrhaging seriously and was losing consciousness. Among the Mongo (middle Congo), the father is responsible for washing the post-circumcision wound and caring for the boy after the operation. It is believed that if he does not remain continent until the wound is healed, it is likely to become seriously infected. Among Riffians of Morocco, the circumcision operation is regarded as very dangerous, meaning that the parents are keen to obtain the services of a skilled operator, always hard to find. The anthropologist Carleton Coon described an unsuccessful operation during which the practitioner severed the end of the glans along with the foreskin; the child died seven days later from the loss of blood. This outcome was not regarded as something that had to be stoically borne and forgotten, however: only the intervention of the local sheik prevented the enraged father from killing the circumciser on the spot, and the latter's family was required to pay $500 blood money to stop the boy's family from seeking vengeance. Among the Ndembu people of Zambia the father stands behind the circumciser with an axe, ready to deal him a fatal blow if he should injure the boy. Karen and Jeffery Page, The Politics of Reproductive Ritual (Berkeley: University of California Press, 1081), pp. 153-4 Travelling in Iraq in the 1930s the English doctor Wilfred Thesiger reported that Arab boys undergoing circumcision: sometimes took two months to recover, suffering great pain in the meanwhile. One young man came to me for treatment ten days after his circumcision, and ... the stench made me retch. His entire penis, his scrotum and the inside of his thighs were a suppurating mess from which the skin was sloughing away, the pus trickling down his legs. [7] Sand under his foreskin, assuming it could get in and then prove impossible to remove, would seem far preferable to this fate. Even today, in the age of antibiotics, <a href="http://www.historyofcircumcision.net./templates/pages/ritual_circumcision_in_south_africa.html" rel="noopener" target="_blank">scores of South African teenagers die</a> in consequence of their traditional bush circumcision ordeal. [8] <h4>Cultural reasons for circumcision</h4> It is significant that none of the ancient cultures which practised circumcision have traditionally claimed that the ritual was introduced as a sanitary measure. African tribes, Arabs, Jews, Moslems and Australian Aboriginals explain it different ways, but divine command, tribal identification, social role, family obligation, respect for ancestors and promotion of self control figure prominently. Jewish authorities make no mention of hygiene, let alone sand, but place stress on the religious significance of circumcision: it is an outward sign of the Covenant between God and his people. [9] In The Jewish Rite of Circumcision (c. 1885), Dr Asher Asher added that there was also a moral and a political dimension, but that these were secondary. Following Philo and Maimonides, Asher stated that the moral purpose of circumcision was "to diminish the carnal appetite of mankind", and remind a Jewish man that to carry out his high mission he must begin by surrendering all sensuality, licentiousness, lasciviousness; it is the first step in the process whereby that which we possess in common with the brute is eliminated. ... The seal of the Covenant which God has stamped into our flesh is â€“ chastity. The political reason was to give Jewish men "some unmistakeable sign whereby to recognise each other; a sign of such a nature that no stranger can ... impose himself on them as one of themselves". [10] Recent research has suggested that circumcision did not become established among the Jewish people until about 500 BC, well into historical times, and that the motives had more to do with the preservation of cultural distinctiveness than promoting physical health; it was only then that the verses on circumcision were added to Genesis. [11] It is hard to imagine Jewish men in Victorian London exposing their penis to validate their bona fides as co-religionists, but such a prominent mark would be highly significant in places where people normally go about naked. In these societies circumcision has much the same significance as an age card or driver's licence. The Kaguru of east-central Tanzania explain circumcision (practised at puberty on both boys and girls) in terms of enhancing gender differentiation and social control. They consider the uncircumcised penis unclean because its moistness makes men resemble women, whose wet and regularly bleeding genitals are considered polluting. At the same time, initiation enables the older men to impress the young with "the need for conformity to traditional values and beliefs, and ... the superior knowledge and authority of elder males." The circumcision ritual among the Kaguru and many other east African peoples, writes the anthropologist T.O. Beidelman, is "a cultural cosmetic that expresses the socio-economic reality of power rooted in elders' ability to monopolize both ... information and access to women and property". [12] Unlike the story about sand, there does seems to be some continuity between the primitive and the modern here: witness the insistence of so many American fathers that their sons' penises must look like just theirs. <h4>Fantasies of Victorian medical men</h4> It was only in the late nineteenth century, when mass circumcision was being introduced for such vital "health" reasons as control of masturbation, that doctors sought legitimacy for the new procedure by claiming continuity with the distant past and attempting to explain the origins of circumcision in terms of their own hygienic agenda. One of the first English surgeons to make the connection was James Copland, who introduced the idea that "the neglect of circumcision in Christian countries" was a common cause of masturbation, and praised the descendants of Abraham and the "followers of Mahomet" for perpetuating "an enduring and healthy race" as one of the "beneficial results of circumcision". He was convinced that "the abrogation of this rite among Christians has been injurious to them, in religious, in moral, in physical, and in sanitory [sic] and constitutional points of view, â€“ that circumcision is a most salutary rite." [13] This theme was taken up by the sanitarians in the public health movement, such as W.H. Corfield, who praised "the laws of Moses" for anticipating the sanitary provisions of his own day, and singled out circumcision as one of the most salutary regulations that was ever imposed on a people, especially in an eastern country, where the ... necessity of scrupulous personal cleanliness is so much increased. ... What wisdom was shown by Moses, and by Mahomet in later times, in retaining this wholesome custom as a religious rite, and thereby securing its perpetuation. It was to the observance of such practices that many nineteenth century writers on hygiene attributed "the singular immunity of the Jewish race in the midst of fearfully fatal epidemics". [14] This "immunity" was a major theme of epidemiological debate in the late nineteenth century, prefiguring the attempts in our own day to prove that African tribes which practise (male) circumcision have lower rates of HIV infection than those which do not. [15] As the enthusiasm grew, other medical men put forward even more fanciful suggestions. Dr Arthur Dampier-Bennett believed that circumcision was invented as a treatment for epilepsy. There was, he thought, evidence that "in all primitive peoples there is a peculiar tendency to epilepsy", which might be caused by cerebral pressure or "local irritation" such as that generated by a tight foreskin. He had treated "epileptiform convulsions" in a four-year old boy by excising his "remarkably long and adherent" prepuce, and he thus considered it "more than likely that, amongst wild tribes ... it has been discovered that a pacifying result follows ... the operation". [16] James Allen argued that circumcision came into existence as a preventive of parasitic infections such as schistosomiasis, [17] while (Sir) John Bland-Sutton insisted that the main purpose of circumcision was to ensure fertility: "it was to ensure fruitful coitus in order that the seed of Abraham should multiply according to the Covenant. A long foreskin is a recognised hindrance to convenient coitus". [18] Since Moslems enjoyed less respect at that time, and less was known about them, it was Jewish custom which provided Victorian surgeons with the preferred model. Nobody has ever suggested that circumcision as performed by Australian Aboriginals had a hygienic rationale, nor that their custom of knocking out teeth during initiation ceremonies was a precaution against the inconvenience of tooth decay in adult life. <h4>Female genital mutilation</h4> It is usually forgotten by those who accept the sanitary origins of circumcision that many of the tribal cultures which practised male circumcision also enforced various forms of <a href="http://www.historyofcircumcision.net./templates/pages/fgm_and_circumcision_problems_of_definition.html" rel="noopener" target="_blank">female genital mutilation</a>. Western doctors today are horrified by this sort of surgery, do not seek evidence that it might be beneficial to women's health and do not suggest that it originated as a means of preventing sand from getting under the clitoral hood or labia and irritating the vagina or the vulva. It was a different story in the mid-nineteenth century, when many doctors assumed with W.F. Daniell that female circumcision as practised by savage cultures "constituted no unimportant branch of medical hygiene" and that further research would reveal "the use and purport of this singular custom". [19] In the 1850s and 60s many English doctors believed that clitoridectomy was as valuable as male circumcision in treating nervous diseases like epilepsy, hysteria and masturbation (as well as their sequelae in madness) and pushed the therapy on women with little attempt to gain consent. [20] Many Egyptian and other Islamic physicians today insist on the hygienic value of female circumcision as a preventive of both organic disease and sexual promiscuity. [21] <h4>Secrets of World War II</h4> Just-so stories about the ancient past are perhaps of merely academic interest, but the threat of sand has also been advanced as a justification for the circumcision of normal western men in the twentieth century. Professor Hutson further claimed that when Australian soldiers were stationed in the Middle East during the first and second world wars "the incidence of recurrent balanitis caused by sand under the foreskin reached 'epidemic' proportions, leading to large numbers of soldiers requiring circumcision". On this occasion there is a reference: to a "personal communication" from A.M. Hutson in 1974. [22] We are not given details of this, but one assumes it is a wartime anecdote told by his father or an uncle. Further support could have been obtained from Spencer Beasley, one of the authors of the RACP Policy Statement, who similarly claimed that "the fashion for circumcision [in New Zealand] began in World War II in North Africa where soldiers often went days without showers and inflammation of the foreskin from sand was the most common cause of absenteeism from the front line". [23] This seems doubtful. At a time when the desert resounded to the din of tank battles such as that fought at El Alamein, it is unlikely that the most common sight in the medics' tent were men with inflamed penises. Nor does history support Professor Beasley's statement that neonatal circumcision became routine only after the Second World War. The practice had in fact become common in the 1930s, [24] following the pattern observed in Australia in the 1910s, [25] and in Britain in the 1890s, when circumcision of male infants and boys was widely enforced as a preventive of "congenital phimosis", masturbation, syphilis, epilepsy, hip joint disease, bed wetting, pimples and minor disorders too numerous to mention. [26] It is time that the "sand myth" was laid firmly to rest. Common sense tells us that in the North African combat theatre surgical resources were limited, and already fully committed to treating, first, the wounded, and secondly serious illnesses; army medics in those desperate times were not scratching around for work. On top of that, the omnipresence of desert dust would dictate that surgical procedures be kept to a minimum, since dust in wounds would have far more serious effects than it could ever have under the foreskin. These intuitions are confirmed by the official war histories. If there had been an "epidemic" of balanitis, one would expect it to have left some sign in the records and to have been noticed by the official historians, yet none of the many medical volumes published by Britain, Australia and New Zealand so much as mentions it. <h4>Official medical histories do not mention circumcision</h4> The British History of the Second World War identifies the main medical problems in the Middle East and North Africa as hepatitis, diarrhoea, dysentery, tonsillitis, accidental injuries, burns, malaria, sandfly fever and "desert sores". The last sound promising, but no location is specified, and the condition was not treated surgically. [27, 28] Neither sand nor balanitis are among the "clinical problems of war" discussed by Allan Walker in Australia's official history, though acne gets a couple of pages, and "desert sores" turn out to be small sores arising from cuts, grazes and insect bites which became infected with either Staph or Streptococcus. [29] The menace of the foreskin also seems to have escaped his attention in the volume devoted to medical issues in the Middle East and North Africa. As among the British troops, the main health problems encountered were gastric diseases such as diarrhoea, dysentery and hepatitis. These certainly emphasised the need for hygiene, but not specifically of the penis; it referred to the construction of latrines, correct toilet procedures and the control of flies. Interestingly enough, Walker remarks that "conjunctivitis was remarkably uncommon, in spite of dust and glare and paucity of convenience for washing": if the blowing sand was rarely able to inflame the exposed and vulnerable eyeball, it seems highly unlikely that it could do much to harm to the concealed and (in uncircumcised men) well protected glans penis. [30] The New Zealand history similarly states that skin inflammations were a hazard of desert warfare, and that they were exacerbated by fine sand, but it makes no mention of the foreskin as a problem site, nor of circumcision as a treatment, and goes on to comment that every effort was made to minimise cuts to the skin, and to avoid surgery unless it was "urgent or else offered the prospect of permanent relief of symptoms sufficient to enable men to be retained in useful employment overseas." [31, 32] In none of the thousands of pages contained in these volumes do the words balanitis, circumcision or foreskin make a single appearance. <h4>An urban myth</h4> Because the sand myth has never been seriously argued for or substantiated, nobody has regarded it as sufficiently important to warrant refutation. As a result it continues to enjoy a subterranean existence as a kind of medical urban myth, popping up in surprising places with odd variations. [33-35] One of the most peculiar is the claim by a correspondent in the Journal of the Royal Society of Medicine that "a German surgeon" had told him that Africa Corps troops had "suffered in the same way", and had similarly been circumcised. [36] Although the writer conceded that the recommendation was "understandably unofficial", the idea that a German under the rule of Nazism would have submitted to an operation which could have identified him as a Jew, or that anybody in authority would have recommended such a course, is preposterous. To check this point, Mr Hugh Young wrote to Manfred Rommel, son of the German commander, whose courteous reply concluded: "I have never heard that soldiers in the Africa Corps were circumcised. The veterans I could contact have not either". [37] Even Aaron Fink, long-time crusader for universal neonatal circumcision, and originator of the idea that circumcision was a "natural condom", and thus the perfect prophylactic against HIV-AIDS, [38] admitted that protection against desert sand was probably not the main reason for the adoption of circumcision by the Arabs and Jews. But he went on to make the even more extraordinary suggestion that troops serving in the Arctic ought to be compulsorily circumcised so as to avoid frostbite. [39] One admires the logic, but wonders why Fink regarded frostbite on the glans or penis shaft as preferable to frostbite on the foreskin, which â€“ with its rich blood supply â€“ must provide the definite "health benefit" of insulating the rest of the penis from extremes of cold. Given the frequency with which advocates of routine circumcision appeal to ancient tribal wisdom, one would think that Fink might have noticed that neither the Laplanders, nor the natives of northern Siberia, nor the Eskimos (at least in their original state), who ought to know about such matters, have ever practised circumcision. A similar error in logic was made by Victorian advocates of circumcision as a preventive of syphilis: observing that the primary chancre was often on the prepuce, they concluded that its amputation in advance would confer a high degree of immunity to the disease, forgetting that the "venereal poison" would then get access to the body through the next layer of skin it encountered. [40] The fact that these myths, stories and failures of clear thinking crop up so often is a sad indication that the intellectual quality of much of the debate about circumcision is lower than the subject demands. <h3>References</h3> 1. Temkin O. The usefulness of medical history for medicine. The double face of Janus and other essays. Baltimore: Johns Hopkins University Press 1977: 69 2. Hutson JM. Circumcision: A surgeon's perspective. J Med Ethics 2004; 30: 238 3. Paediatrics & Child Health Division, Royal Australasian College of Physicians, <a href="http://www.racp.edu.au/hpu/paed/circumcision/summary.htm" rel="noopener" target="_blank">Routine Circumcision of Normal Male Infants and Boys: Policy Statement</a>, Sydney, October 2002. 4. Diderot D. Supplement to Bougainville's voyage. Michel Feher (ed.), The libertine reader: Eroticism and the Enlightenment in eighteenth century France. New York: Zone Books 1997: 79 5. Douglas M. Purity and danger: An analysis of the concepts of pollution and taboo. Harmondsworth: Penguin 1970: ch. 3 6. Gollaher D. Circumcision: A history of the world's most controversial surgery. New York: Basic Books 2000: ch. 3; 7. Thesiger W. The marsh Arabs. London: Longmans 1964: 101-2 8. Editorial. <a href="http://www.historyofcircumcision.net./templates/pages/ritual_circumcision_in_south_africa.html" rel="noopener" target="_blank">Astonishing indifference to deaths due to botched ritual circumcision</a>. South African Medical Journal 2003; 93: n.p. (No. 8, August) 9. Weiss C. A worldwide survey of the current practice of Milah (ritual circumcision). Jewish Social Studies 1962; 24: 30-48 10. Asher A. The Jewish rite of circumcision. London n.d. [c. 1885]: 1-10 11. Hoffman L. Covenant of blood: Circumcision and gender in rabbinic Judaism. Chicago: Chicago University Press, 1996 12. Beidelman TO. The cool knife: Imagery of gender, sexuality and moral education in Kaguru initiation ritual. Washington: Smithsonian Institution Press, 1997: 117-19 13. Copland J. Pollution. Dictionary of practical medicine. 4 vols. London: Longmans 1844-58: III, 442, 445 14. Corfield WH. Introductory lecture on hygiene and public health. Br Med J 1870; 1: 617-18 15. Darby RJL. Where doctors differ: The debate on circumcision as a protection against syphilis, 1855-1914. Soc Hist Med 2003; 16: 57-78 16. Dampier-Bennett G. The origin of circumcision. Br Med J 1907; 2: 243-4 17. Allen J. Bilharzia haemotoba and circumcision. Lancet 1909; 1: 1317-20 18. Bland-Sutton J. Circumcision as a rite and as a surgical operation. Br Med J 1907; 1: 1409 19. Daniell WF. On the circumcision of females in western Africa. London Medical Gazette 1847; NS 5: 374-8 20. Moscucci O. Clitoridectomy, circumcision and the politics of sexual pleasure in mid-Victorian Britain. Andrew H. Miller and James Eli Adams (eds), Sexualities in Victorian Britain. Bloomington: Indiana University Press 1996 21. Gollaher D. Circumcision: A history of the world's most controversial surgery. New York: Basic Books 2000: ch. 8 22. Hutson JM. Circumcision: A surgeon's perspective. J Med Ethics 2004; 30: 238 23. <a href="http://www.cirp.org/news/dominionpost08-30-02/" rel="noopener" target="_blank">Dominion Post</a><a href="http://www.cirp.org/news/dominionpost08-30-02/">, Wellington, NZ,</a> 30 August 2002: 1 24. McGrath K. and Young H. A review of circumcision in New Zealand. Denniston GC, Hodges F and Milos M (eds), Understanding circumcision A multi-disciplinary approach to a multi-dimensional problem London and New York: Kluwer Academic and Plenum Press 2001: 129-46 25. Darby RJL. A source of serious mischief: The demonisation of the foreskin and the rise of preventive circumcision in Australia. Denniston GC, Hodges F and Milos M (eds), Understanding circumcision A multi-disciplinary approach to a multi-dimensional problem London and New York: Kluwer Academic and Plenum Press 2001: 153-98 26. Dunsmuir WD and Gordon EM. The history of circumcision. BJU International 1999; 83, Suppl. 1: 1-12 27. Crew FAE. The army medical services. 2 vols. London: HM Stationery Office 1956-7: I, 243-52; II, 251. 28. Cope Z. Surgery. London: HM Stationery Office 1953 29. Walker A. Clinical problems of war. Canberra: Australian War Memorial 1952: 619-23 30. Walker A. Middle East and Far East. Canberra: Australian War Memorial 1953: 384-5; 223 31. Stout TDM. War surgery and medicine. Wellington: Department of Internal Affairs 1954 32. Stout TDM. New Zealand medical services in Middle East and Italy. Wellington: Department of Internal Affairs 1956 33. Speert H. Circumcision of the newborn: An appraisal of its present status. Obstetrics and Gynecology 1953; 2: 164-72; here 165 34. Rosner F. Circumcision: An attempt at a clearer understanding. NY State J Med 1966; 66: 2919-22; here 2920 35. Gardner M. Mind the sand. New Scientist, 22 January 2000: 50-51 36. Gardner AMN. Circumcision and sand. J R Soc Med 1991; 84: 387 37. <a href="http://www.circumstitions.com/sand.html" rel="noopener" target="_blank">Manfred Rommel to Hugh Young, 15 October 2002</a> 38. Fink A. Newborn circumcision as a long-term strategy for AIDS prevention. J R Soc Med 1989; 82: 695 39. Fink A. Circumcision and sand. J R Soc Med 1991; 84: 696 40. Darby RJL. Where doctors differ: The debate on circumcision as a protection against syphilis, 1855-1914. Soc Hist Med 2003; 16: 57-78 </div> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource The riddle of the sands darby