1 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"> <h2>Australia</h2> <h3>A new Britannia in another world</h3> When Australia was first settled by the British the only form of circumcision on the continent was practised as a male initiation ritual by a limited number of Aboriginal nations in Arnhem Land and the desert areas of what is now the Northern Territory and parts of Western and South Australia. The first reports of such customs were greeted with horrified incredulity; in his study Prehistoric Times (1865), Sir John Lubbock listed the operation among a number of "horrible rites" practised by these peoples, and cited it as evidence of their remoteness from civilization. The additional exercise known as subincision found in some tribes - slitting the underside of the penis - he found so shocking and incredible that he reported the gory details in Latin. These rites had no influence on white practice, and little was known about them until the investigations of Baldwin Spencer and other anthropologists around the turn of the century. Attitudes to circumcision changed sharply at the same time. However deeply British doctors might despise the backwardness of these savages, they found themselves in agreement with them on one sensitive point: that boys should indeed have their foreskins removed, but preferably in infancy or boyhood rather than at puberty, and for moral and health rather than social and customary reasons. In Australia the rise of circumcision followed the British example, but the practice endured longer and affected a greater proportion of boys. Since most doctors were British, were educated in Britain or received their medical training in Australia from British teachers, it is not surprising that they reproduced the orthodoxies of their colleagues and mentors. In the late nineteenth century circumcision was recommended principally as a cure for spermatorrhoea in men and as a preventive of masturbation and nervous complaints in the young, but around 1900 the need to treat "congenital phimosis" in infants and boys and provide protection against the later possibility of venereal disease became paramount. The incidence of circumcision rose sharply between 1910 and 1920 as the First World War intensified fears of syphilis, and by the 1920s most doctors and child care manuals urged early circumcision as the act of a responsible parent. It was at this time that the practice of routinely circumcising normal baby boys before they left the hospital became common. Greater social equality, a less rigid status system and higher living standards are the social factors which probably explain why this advice was followed by parents across the social spectrum, not principally among the upper classes as in Britain. Although Britain itself dropped routine circumcision in the late 1940s (and New Zealand in the 1950s), Australia followed United States practice, and the figure rose steadily to a peak of about 85 per cent in the mid-1950s, before falling back again: down to 50 per cent by 1975, and only 10 per cent by 1995. <table border="1" cellpadding="1" cellspacing="0"> <tbody> <tr> <td width="189"> Year </td> <td width="189"> Newborn circumcision rate (%) </td> <td width="189"> Living males who have been circumcised (%) </td> </tr> <tr> <td width="189"> 1900 </td> <td width="189"> 25 </td> <td width="189"> 18 </td> </tr> <tr> <td width="189"> 1905 </td> <td width="189"> 30 </td> <td width="189"> 20 </td> </tr> <tr> <td width="189"> 1910 </td> <td width="189"> 35 </td> <td width="189"> 22 </td> </tr> <tr> <td width="189"> 1915 </td> <td width="189"> 42 </td> <td width="189"> 25 </td> </tr> <tr> <td width="189"> 1920 </td> <td width="189"> 50 </td> <td width="189"> 29 </td> </tr> <tr> <td width="189"> 1925 </td> <td width="189"> 56 </td> <td width="189"> 32 </td> </tr> <tr> <td width="189"> 1930 </td> <td width="189"> 61 </td> <td width="189"> 36 </td> </tr> <tr> <td width="189"> 1935 </td> <td width="189"> 67 </td> <td width="189"> 39 </td> </tr> <tr> <td width="189"> 1940 </td> <td width="189"> 73 </td> <td width="189"> 43 </td> </tr> <tr> <td width="189"> 1945 </td> <td width="189"> 79 </td> <td width="189"> 48 </td> </tr> <tr> <td width="189"> 1950 </td> <td width="189"> 84 </td> <td width="189"> 52 </td> </tr> <tr> <td width="189"> 1955 </td> <td width="189"> 90 </td> <td width="189"> 55 </td> </tr> <tr> <td width="189"> 1960 </td> <td width="189"> 80 </td> <td width="189"> 59 </td> </tr> <tr> <td width="189"> 1965 </td> <td width="189"> 70 </td> <td width="189"> 61 </td> </tr> <tr> <td width="189"> 1970 </td> <td width="189"> 60 </td> <td width="189"> 61 </td> </tr> <tr> <td width="189"> 1975 </td> <td width="189"> 50 </td> <td width="189"> 60 </td> </tr> <tr> <td width="189"> 1980 </td> <td width="189"> 40 </td> <td width="189"> 60 </td> </tr> <tr> <td width="189"> 1985 </td> <td width="189"> 30 </td> <td width="189"> 57 </td> </tr> <tr> <td width="189"> 1990 </td> <td width="189"> 20 </td> <td width="189"> 54 </td> </tr> <tr> <td width="189"> 1995 </td> <td width="189"> 11 </td> <td width="189"> 51 </td> </tr> <tr> <td width="189"> 2000 </td> <td width="189"> 12 </td> <td width="189"> 48 </td> </tr> </tbody> </table> NOTE: Figures before Medicare data became available in the 1970s are speculative and impressionistic. They should not be regarded as hard data. For further statistical information about the incidence of circumcision in Australia today, see: <a href="http://www.circumstitions.com/Australia.html" rel="noopener" target="_blank">http://www.circumstitions.com/Australia.html</a> <a href="http://www.cirp.org/library/statistics/Australia/" rel="noopener" target="_blank">http://www.cirp.org/library/statistics/Australia/</a> It can be seen from the table that the biggest jump in the rate of routine neonatal circumcision (RNC) occurred in the decade 1910-1920, giving Australia the distinction of being the first modern nation to circumcise half its male babies. This was a period of acute fear of venereal disease, particularly syphilis; the erroneous belief that circumcision would provide protection against syphilis was probably an important reason why more parents were having their boys cut at this time. The year 2000 was a landmark as the first time since 1945 when the total number of uncut males in Australia outnumbered the circumcised. Interestingly, though, despite the hight rate of RNC, the total number of cut males has never exceeded 61 per cent - less than two thirds. <h4>Medicalisation of childbirth</h4> Another significant factor in both the rise and decline of circumcision was the medicalisation of childbirth. In the late nineteenth century the practitioners of the new "scientific" medicine consolidated their position as the only legitimate source of medical advice and treatment, and by the 1920s "the Australian medical profession had achieved a nearly unchallenged dominance over the supply of personal health services" [1]. In the process, and with a little help from state legislation, they drove out alternative practitioners, and the rising specialism of obstetrics gradually displaced the midwives who had traditionally looked after women giving birth. In this context the decision of the Commonwealth Government, in 1912, to pay a maternity allowance (a generous 5 pounds) was also important. Expectant mothers tended to use the money to buy medical attendance at their confinement, thus bringing more doctors onto the childbirth scene and ensuring that more women gave birth in a hospital rather than at home. The proportion of births supervised by a doctor, at 63 per cent, was already quite high by 1913, but by 1935 it had increased to 83 per cent. [2] These developments have often been seen as vital factors in the decline of childbirth mortality, but in 1929 a study by Janet Campbell found that midwives actually lost fewer babies than doctors. [3] Doctors were thus in a highly strategic position: being on the spot, if they thought that the baby ought to be circumcised, there was a very good chance that he would be, and for fifty years or so he usually was. But if this medical dominance [4] can help to explain the rapid rise of neonatal circumcision between the First and Second World Wars, it also helps to explain the rapid decline of the practice in the 1970s and 80s. Once doctors had decided that circumcision was a bad idea, they were in an equally strong position to ensure that the operation was not performed. This point is also relevant to the slowing (and in some states, the slight reversal) of the decline in circumcision incidence in the late 1990s. By this time the medical profession had lost its monopoly position, and parents were increasingly exposed to an often bewildering array of alternative sources of advice on health and child care issues - women's and parenting magazines, informal mothers' groups, websites, bulletin boards and endless reports and commentary in the media etc. Among this flood of information, both old and new circumcision enthusiasts have been able to spread their alarmist message. <h4>Circumcision and infant health</h4> Over the past thirty years there has been considerable research into maternal and child health during the first half of twentieth century Australia, including major studies by Diana Wyndham, Phillipa Mein Smith, Milton Lewis [5] and Janet McCalman. [6] Although these scholars have scoured the records and covered the relevant issues in great detail, there is one word which makes not a single appearance in their pages: circumcision. Although its incidence was steadily increasing over this period, the authors apparently found no evidence that it made the slightest contribution to the improvements in infant survival rates and general child health observed at the same time. Examining the remarkable fall in infant and maternal mortality that occurred roughly between 1905 and the 1930s, they note that it was a phenomenon observed throughout the developed world, in Europe as much as in Britain or Australia, and they conclude that it is largely attributable to improved nutrition (including more breast feeding), cleaner environments and the provision of sewerage systems and clean domestic water supplies. The last of these is particularly important in explaining the fall in deaths from one of the major nineteenth century killers, diarrhoea. This was usually the result of gastro-intestinal infections caught from contaminated food or water, but the final cause of death was often dehydration - a problem which many Victorian doctors completely misinterpreted. Noticing that the boy was not urinating they concluded, not that he was dying of thirst and needed water, but that "congenital phimosis" - his appropriately tight foreskin - was preventing him from urinating, and thus that the solution to the problem was surgical. The reasonable conclusion, that the rising incidence of circumcision over the first half of the twentieth century made no contribution to improved child health outcomes, is confirmed by a recent report from the <a href="http://www.aihw.gov.au/" rel="noopener" target="_blank">Australian Institute of Health and Welfare</a> covering the period 1983 to 2003. The report, A picture of Australia's children, shows major improvements in child health over the 20 years from 1983 to 2003, and a halving of infant mortality. These are very significant dates, since 1983 was the beginning of the dramatic slide in Australian circumcision incidence, from about 40 per cent of boys in the early 1980s to less than 12 per cent in 2003. It is thus good empirical proof that "lack of circumcision" does not increase child health problems. Even more significantly, it is a decisive refutation of "scientific" predictions by various antiquated circumcision enthusiasts that the fall in the circumcision rate would lead to an explosion of genito-urinary problems in boys. No such problems are identified in this report, which does not even mention any health problems affecting the genito-urinary area. If one were to be as unscrupulous in mixing up correlation with causation as many pro-circumcision zealots tend to be, one could reasonably conclude that Australian children have become healthier because the incidence of circumcision has fallen, not merely at the same time. But there is no need to go that far. At the very least A picture of Australia's children is definitive proof that there is zero connection between circumcision and improved health outcomes. <a href="https://www.aihw.gov.au/reports/children-youth/picture-of-australias-children/summary">The report can be downloaded from the AIHW website in several pdfs here.</a> <h4>Current situation</h4> The popularity of routine circumcision declined steadily in the 1980s and 90s and looked set to fall below 5 per cent nationally, but there has been a slight rise in the frequency of the procedure since 1999, probably as a response to recent scares, heavily beaten up by the popular media, over STDs (especially HIV-AIDS), urinary tract infections (UTIs) and most recently human papillomavirus (HPV) - the wart virus implicated in cancer of the penis and cervix. Long-time advocates of RNC have been doing their best to exploit popular fears of these diseases (rare in developed countries) in order to put pressure on the medical profession to revive the procedure as a public health measure. This is despite powerful criticism of their claims in the medical literature and increasing warnings that the procedure is unethical and potentially illegal (<a href="https://assets.nationbuilder.com/darboninstitute/pages/570/attachments/original/1749258216/QLRC_1993.pdf?1749258216" rel="noopener" target="_blank">as the Queensland Law Reform Commission warned in 1993</a>). Where the Australian experience differs most markedly from the British is in the long survival of routine circumcision - which reached its peak incidence at over 80 per cent per cent of boys in the 1950s - after <a href="http://www.cirp.org/library/general/gairdner/" rel="noopener" target="_blank">Gairdner's debunking of "congenital phimosis</a>". The reasons for this have not been studied, but it may be related to the increased influence of US medical advice (particularly Benjamin Spock's Baby and child care) as a result of the Second World War, and the substantially greater incidence of the procedure at that point, meaning that there was a higher peak from which to descend, more mothers not knowing how to look after a foreskinned penis, and more circumcised fathers not wanting their sons to look different. Although Gairdner's paper was approvingly <a href="https://www.darboninstitute.org/why_circumcise" rel="noopener" target="_blank">discussed as early as 1952</a>, it was not until the late 1960s that it really made an impact, and not until 1971 that the Australian Paediatric Association decided to recommend that "male infants should not, as a routine, be circumcised". This policy was cautiously endorsed by the Medical Journal of Australia, and the incidence of circumcision then fell steadily to its current low of about 12 per cent. The trend was accelerated by <a href="http://www.circinfo.org/previous_statements.html" rel="noopener" target="_blank">a stronger statement</a> issued by the Australian College of Paediatrics in 1983 and slowed down by a weaker and rather equivocal one which mysteriously appeared in 1996. It is likely that the detailed policy issued by the Royal Australasian College of Physicians in 2002, confirming the original stance that there is no medical justification for routine circumcision, will lead to the resumption of the declining trend. The sequence observed, therefore, is that routine circumcision began slowly as a doctor-driven innovation; became established in the medical repertoire and spread rapidly; and then declined slowly as doctors ceased to recommend it, but parents, having absorbed the advice of the generation before, and many fathers themselves being circumcised, continued to ask for it. <a href="http://www.circinfo.org/news.html#8" rel="noopener" target="_blank">Even today surveys find</a> that a high proportion of young mothers of British origin, especially those living in country areas, continue to expect their sons to be circumcised and are resentful when doctors refuse to do it. A significant factor in the decline of circumcision in the 1960s - before the paediatricians took a stand - was the arrival of large numbers of immigrants from non-circumcising European countries, most of whom settled in the cities; <a href="http://www.cirp.org/library/procedure/spilsbury1/" rel="noopener" target="_blank">a recent study in Western Australia</a> found a higher incidence of circumcision in country areas, with their greater proportion of older Anglo-Celtic stock, than in major urban centres, with their more multicultural and better educated populations. Wide variation among the states There is also an enormous difference in circumcision incidence between the states, with the ACT, the Northern Territory, Tasmania, Victoria and Western Australia at around 5 per cent or less, South Australia at about 14 per cent, and New South Wales and Queensland at nearly 20 per cent. Such differences have nothing to do with health needs but reflect differences of policy and attitude among doctors and health officials at the state level. A further factor in the survival of routine circumcision is the continuing subsidy of the operation through the Medicare rebate. Although the Medicare guidelines state that the rebate is not available for cosmetic procedures or for medical treatment that is not clinically necessary, there has been no attempt (since an ill-fated decision in 1985) to drop circumcision from the Medical Benefits Schedule. The subsidy not only makes the operation more affordable, but sends a signal that it is socially acceptable and perhaps medically desirable. As with the 1912 baby bonus, the rise and survival of circumcision has as more to do with social expectation and economics than with health. <h3>References<a name="CursorPositionBM"></a> </h3> 1. James Gillespie, The price of health: Australian governments and medical politics, 1910-1960 (Cambridge University Press, 1991), p. 3 2. Philippa Mein Smith, Mothers and King baby: Infant survival and welfare in an imperial world - Australia 1880-1950 (London: Macmillan, 1997), p. 200 3. Diana Wyndham, Striving for national fitness: Eugenics in Australia, 1910s to 1930s (PhD thesis, University of Sydney, 1996), p. 198 4. Tony Pensabene, The rise of the medical practitioner in Victoria (Canberra: Australian National University Health Research Project, Research Monograph, No. 2, 1980); Evan Willis, Medical dominance: The division of labour in Australian health care (Sydney: Allen and Unwin, 1983) 5. Milton Lewis, Populate or perish: Aspects of infant and maternal health in Sydney, 1870-1939 (PhD thesis, Australian National University, 1976) 6. Janet McCalman, Sex and suffering: Women's health and a women's hospital - The Royal Women's Hospital, Melbourne, 1856-1996 (Melbourne University Press, 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 History of circumcision - Australia 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>"A source of serious mischief": The demonisation of the foreskin and the rise of preventive circumcision in Australia</h3> To the sensitive, excitable, civilized individual, the prepuce often becomes a source of serious mischief. In the East the ... secretions between it and the glans [are] likely to cause irritation and its consequences; and this danger was perhaps the origin of circumcision -- William Acton, 1865 Diseases desperate grown, By desperate appliances are relieved -- Hamlet IV. ii. 9 <h3>Part 1. Introduction</h3> <h4> <a name="syn"></a>Synopsis</h4> Between the 1890s and the 1920s there was a minor revolution in the treatment of the male body in Australia. From being an anomaly peculiar to Jews or a mutilation practised by savages, circumcision became the mark of a clean, healthy boy and one of the stigmata of a gentleman. In this paper I trace the outlines of this transformation and show how a combination of medical advice, sexual fears (particularly fear of sexual pleasure) and social ambition led to the introduction circumcision as an all but inescapable incident in the life of the Australian boy. More specifically, I argue that this institutionalisation of male genital mutilation, eventually dignified under the euphemism "routine neonatal (or infant) circumcision", was a direct response to the nineteenth century's search for a cure for the imaginary disease of spermatorrhoea, and its phobia about masturbation specifically, and that Australia inherited the medical wisdom on these matters from Britain and the US with very little local discussion and scarcely a murmur of dissent. <h4> <a name="thebrit"></a>The British background</h4> Although the Australian experience of routine circumcision generally follows the pattern established in Britain and the United States, it has its own historical trajectory and several distinctive features. Until the twentieth century, most Australian doctors were trained in Britain, and they applied the medical wisdom they had acquired back home. The only significant differences concern chronology and incidence. Routine circumcision started a generation later than in Britain and continued long after it had been abandoned there, reflecting the growing influence of US medicine after the Second World War. The practice was also more widespread than in Britain, where it was common among the rich but relatively rare among the poor; in Australia all classes were affected equally, reflecting the greater social equality here and wider access to the latest medical advances. In the 1980s and 1990s the practice declined to a far greater extent than in the US. The essential conditions for the rise of routine circumcisionâ€”or preventive circumcision as I prefer to say, acknowledging that its purpose was to prevent a variety of supposed problems (1)â€”are thus much the same in Australia as in Britain. They can be briefly summarised in five points. 1. The taboo against masturbation began as religious prohibition, but during the nineteenth century it was medicalised as belief in God and the afterlife declined. Taking over the role of priests, doctors argued that knowledge of the harmful effects of masturbation here on earth was a more effective deterrent to immoral behaviour than fear of eternal damnation. 2. The medicalistion of the taboo led to the invention of a new and imaginary disease called spermatorrhoea. This meant any loss of semen other than in heterosexual intercourse and included wet dreams, spontaneous emissions and sexual adventures outside the marriage bed as much as masturbation. Such a scarce and precious fluid had to be hoarded, or disease, debility and death would follow. Lallemand, Acton, Courtenay, Milton and others wrote eloquently on this subject, pathologising normal male sexuality in the process. 3. The nerve force theory of disease, current until displaced by the discovery of germs in the late nineteenth century, held that diseases could be caused by imbalances in nervous force. Excessive excitement in one region could induce a drain of energy from another, thus provoking illness in the affected parts. It was really a nerve-based version of the old theory of the four humours, but it persisted in explanations of how masturbation caused harm until well into the twentieth century, and it is far from dead today. Parts of the body known to be particularly sensitive, such as the foreskin, were thus implicated in the generation of disease, and it came to be blamed for tuberculosis, rickets, convulsions, polio ("paralysis") and any other problem doctors were unable to cure. 4. The outcome of these developments was what I have called the demonisation of the foreskin. It ceased to be seen as a normal part of the body and became a pathogenic structure guilty of provoking a host of medical problemsâ€”either indirectly by encouraging masturbation, or directly by disrupting the body's nervous equilibrium by its morbid sensitivity. The most extreme version of this case was put by the fanatical Dr Remondino, but most doctors shared his general viewpoint. 5. Circumcision played a vital role in the establishment of the modern medical profession. Finding a cure for spermatorrhoea (including masturbation) was the testing ground on which regular medical practitioners sought to establish their credentials and to demarcate themselves from the quacks. William Acton, F.B. Courtenay and, in Australia, James Beaney were vehement in their denunciations of the remedies for spermatorrhoea proposed by these charlatans, but essentially it was a battle for professional turf and the right to manage all the functions of the body. Unfortunately for the regular doctors, until circumcision became an option, the treatments they could offer differed little from those of their rivals. The godfather of preventive circumcision is undoubtedly William Acton, physician to Queen Victoria and the leading authority on men's sexual health in the mid-nineteenth century. His most influential book, The functions and disorders of the reproductive organs, first published in 1857, was still being reprinted in the early 1900s; it was widely read in Australia and probably the principal source of information on male sexuality. It is surprising that David Gollaher, (2) in his otherwise informative work on the history of circumcision, does not discuss Acton's contribution, so perhaps we need to be reminded of what he wrote about the foreskin. In none of the many editions of his treatise on the male reproductive organs did Acton advocate general circumcision, but his comments on the necessity for sexlessness in children and continence in young men, coupled with his belief in the pathological irritability of the foreskin, prepared the ground. Anxious to guard against its emergence, he was concerned that a long or tight foreskin was often the cause of sexual precocity in children and recommended that boys be taught "to draw back [their] foreskin and thoroughly cleanse the glans penis every day". (3) Acton realised that this routine might lead to the very manipulations it was designed to prevent but asserted that his own experience had been to the contrary. Conceding, perhaps regretfully, that circumcision was "never likely to be introduced amongst us", (4) he was confident that his own precautionsâ€”parental watchfulness, cleanliness, fresh air and tiring exerciseâ€”should be sufficient "in most cases to remove all ill effects arising from the existence of the prepuce", but he was adamant that the foreskin itself was the root of all the problems that arose: that the prepuce in man ... is the cause of much mischief, medical men are pretty well agreed. It affords an additional surface for the excitement of the reflex action, and ... aggravates an instinct rather than supplies a want. In the unmarried, it additionally excites the sexual desires, which it is our object to repress. This was ominous enough, but Acton added an even more anxious footnote: to the sensitive, excitable, civilized individual, the prepuce often becomes a source of serious mischief. In the East, the ... secretions between it and the glans [are] likely to cause irritation and its consequences; and this danger was perhaps the origin of circumcision. That the existence of the foreskin predisposes to many forms of syphilis, no one can doubt; and ... I am fully convinced that the excessive sensibility induced by a narrow foreskin ... is often the cause of emissions, masturbation, or undue excitement of the sexual desires. (5) Already the foreskin is to blame for syphilis, masturbation, the arousal of sexual desire and the febrile excitability of modern man. Acton is obviously attracted to the idea of the preventive removal of such a malignant part of the body, and in later editions of his book, reflecting the advance of circumcision in British medical practice, he notes that some authorities had suggested "the universal performance of circumcision" as a means of guarding against childhood sexual precocity and masturbation specifically. (6) He countered that the benefits of circumcision were only speculative and continued to believe (with remarkably poor powers of prediction) that the procedure would never become general "amongst us". How wrong Acton was on this point was demonstrated by the next generation of physicians in Britain and the US, as they took up his strictures against the foreskin and developed them vigorously. (7) <h4> <a name="circ"></a>Circumcision in Australia today</h4> The decline of circumcision in Australia is easier to document than its rise. From the 1920s to the 1960s it was all but universal, Chester Eagle (born 1933) commenting on the "mostly circumcised penises" of his contemporaries at Melbourne Grammar in the late 1940s. (8) Change was signalled on 24 April 1971, when the Australian Paediatric Association (APA) resolved that "new born male infants should not, as a rule, be circumcised", (9) and the incidence of the practice declined steadily thereafter. Figures quoted by Wallerstein show a circumcision rate of 49.6 per cent in 1973-74, 48.6 per cent in 1974-75 and 43.7 per cent in 1975-76. (10) The Australian College of Paediatrics (ACP) released a stronger statement in 1983, raising human rights as well as medical issues, and this was reissued in 1991. (11) In 1996 it estimated the current rate of infant circumcision at 10 per cent. (12) One mother has told me that when her first son was born in Sydney in 1983 hospital staff asked her if she would like him circumcised; when the second was born in 1988 the possibility was not mentioned. (13) Until recently it seemed safe to say that the practice began to decline in the late 1960s and largely died out in the 1980s, except among those who do it to their children for cultural or religious (mainly Jewish or Islamic) reasons. Figures collected by NOCIRC Australia confirm this picture but reveal considerable variation from one state to another. In 1995-96 the national rate of neonatal circumcision (0â€“6 months) was 10.6 per cent, while the incidence in the states ranged from 5.4 per cent in Victoria to 17.2 per cent in Queensland, as shown in the following table: (14) <table cellpadding="1" width="437"> <tbody> <tr> <td width="212">State New South Wales Victoria Queensland Western Australia South Australia Tasmania Aust Capital Territory Northern Territory </td> <td width="209">per cent 11.8 5.4 17.2 7.2 12.3 9.3 6.2 8.7</td> </tr> </tbody> </table> In the early 1990s it looked as though such preventive (non-religious) circumcision was set to disappear, but in recent years it has made a comeback: after falling to a low of 10.4 per cent in 1996, the national rate increased to 12.1 per cent in 2000. Most of this increase occurred in Queensland (from 16.3 to 20.6 per cent) and New South Wales (from 12.3 to 14.2 per cent), outweighing declines in Victoria (from 6 to 4.9 per cent) and the Northern Territory (9.3 to 5.9 per cent). (15) The reasons for the disparities are not known, but it has been suggested that the high and rising rate in Queensland is due, at least in part, to the evangelical fervour of a prominent GP there, Dr Terry Russell, who apparently tells parents that an early circumcision is the equivalent of immunization against venereal disease, cancer of the penis and many other problems. The continuing popularity of such forcible circumcision among old guard medicos thus suggests that nineteenth century theories about the link between the foreskin and disease have lost little of their relevance. Russell writes that, if they had been circumcised, "a vast number of neonates would have been saved from UTI and its consequences of renal failure, septicaemia, meningitis, hypertension and death". Circumcision "may reduce the risk of STDs (syphilis, gonorrhoea, herpes and candida) and carcinoma of the cervix of female partners. It also prevents balanoposthitis and phimosis", not to mention such "potentially fatal conditions" as neonatal UTI, HIV/AIDS and cancer of the penis. (16) A hundred years earlier Dr Remondino had asserted: Circumcision is like a substantial and well-secured life annuity; every year of life you draw the benefit, and it has not any drawbacks .... Parents cannot make a better paying investment for their little boys, as it insures them better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor-bills, as well as increases their chances for an euthanasian death. (17) Even the British Medical Journal found such an extreme advocacy "excessive and strained". (18) Any similarities between Russell's scientific approach and late Victorian quackery are purely coincidental. <h4> <a name="theearly"></a>The early spread of circumcision</h4> Few statistical details are available for the period when the circumcision of infants and boys first became popular. Unlike the composer Percy Grainger (19) (born 1882), the writer Frank Dalby Davison (born 1893) did not leave us a nude photograph to prove he was intact, but in his last novel he clearly assumes that boys have foreskins to play with. (20) Patrick White (born 1912) was circumcised, but he was born in England to upper class parents, among whom the practice was then common. (21) The historian Russel Ward (born 1914) was "one of the very few boys in the whole World who had been circumcised", as he puts it in his autobiography, but his boyhood playmates in north Queensland were not; the extra-curricular uses they found for their foreskins would certainly have confirmed the fears of those who advocated removal on moral grounds. Significantly, his parents were respectable Methodists from "staid, puritanical South Australia" who found Queensland "uncouth and barbarous". (22) Russell Braddon (born 1921) does not reveal his own status, but he reports that in Changi prison during World War II the army doctors (mainly British) "circumcized practically every man who was not already circumcized" in the belief that the operation would improve the men's health prospects. (23) Australian doctors probably started performing circumcisions on a wide scale in the 1890s, by which time the operation was well established in Britain and the US. Herbert Moran refers to circumcision in the period 1890â€“1914 as though it was a commonplace or even routine procedure, (24) and in 1903 A.S. Joske, a surgeon in the children's department at the Alfred Hospital, Melbourne, reported that the number of children being operated on was "steadily increasing". (25) By 1906 a sceptical doctor in Brisbane referred sourly to circumcision as a "mania" of "twelfth-rate surgeons" who preached "a new gospel, the conversion of baby boys into Jews, not for their love of Judaism, but for the three or five guinea fee hanging on the operation". (26) Although Australia lagged behind the mother country it was more egalitarian; while in Britain the procedure was concentrated among middle, upper and professional classes, here "the poorer portion of our population is beginning to see the advantages of the operation". (27) There was very little discussion of the practice in the Australian medical press, and it seems likely that British-trained doctors brought it with them and that Australian-trained doctors read British and US textbooks which recommended it. In 1908 the Australasian Medical Gazette published a warm review of L. Emmett Holt's The care and feeding of children. (28) Holt was an expert on paediatric medicine in the US and a professor at the College of Physicians and Surgeons in New York. He was a zealous circumciser and recommended the practice in his influential textbook, The diseases of infancy and childhood, which became a standard work and went through eleven editions between 1897 and 1940. Where many doctors advised circumcision only when the infant foreskin could not be drawn back, Holt urged it in all cases "because of the moral effect of the operation"; the effects of neglect included "priapism, masturbation, insomnia, night terrors" and "most of the functional nervous disease of childhood". (29) Mary Truby King, author of a book on mothercraft popular in the 1930s, quoted "Professor Holt" on the nature of masturbation and continued with a sentence on the need for circumcision if the fault was found to lie with the foreskin. (30) In 1910 the same journal printed an enthusiastic review of Abraham Jacobi's textbook, Diseases of children, (31) and the author was, if possible, an even keener exponent of circumcision than Holt. Jacobi (1830â€“1919) was a founder of the American Pediatric Society, first Chairman of the Section on Diseases of Children of the American Medical Association and a leading figure in many other influential bodies. He strongly advocated the circumcision of all male infants as a means of preventing masturbation and cited his personal experience as a Jewish physician as evidence for the claim that circumcised boys did not masturbate (or not as much) and hence were not so susceptible to the many diseases which arose from the practice. (32) If this was typical of the material on which Australian doctors and medical students were being educated, it is not surprising that they came to hold such strong views in favour of circumcision. With or without debate, the practice of circumcising male babies spread rapidly. In 1916 Sir Thomas Anderson Stuart, Dean of the Faculty of Medicine at Sydney University, remarked that "more and more the operation is being performed as a simple matter of hygiene". (33) By 1921 "some medical men" were advising "the circumcision of all children as a matter of routine". (34) In 1917, in a letter to the Medical Journal of Australia, J.I. Sangster of Brighton, South Australia, observed that "nowadays it has become a surgical fashion to advocate circumcision in every male infant", but he was a critic of the trend, objecting that many of the supporting arguments were based on supposition and doubting that nature was "so often at fault as to demand universal interference". (35) One other dissenting voice joined him in the wilderness, pointing out that circumcision was originally introduced as a religious ritual in which a part of the body was sacrificed. The routine removal of a normal and healthy structure, however, was "surely the last word in absurdity" and about as sensible as removing "the labia minora or the little toe". (36) These comments attracted neither support nor condemnation. The only other reference to circumcision I have located in the Medical Journal of Australia between 1914 and 1935 is a brief report that a certain Dr C.W.B. Littlejohn demonstrated four different methods of circumcision at a meeting of the Victorian branch of the British Medical Association in 1923; (37) the report did not reveal whether the demonstration was on live subjects. The steady advance of circumcision during the 1920s may be seen in the various editions of a guide for mothers prepared by Muriel Peck. The first edition (1925) makes no mention of the procedure, but by the fourth (1929) the foreskin is seen as a problem area that needs to be washed carefully yet not interfered with; if it is tight or long, medical advice should be sought, and if circumcision is considered necessary it should be done as early as possible. (38) <a href="https://www.darboninstitute.org/a_source_of_mischief_part_2">Read Part 2</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 A source of mischief (Part 1) 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>The taboo against masturbation and the malign influence of the foreskin</h3> To this period [childhood] belongs also a very important point in regard to physical educationâ€”the guarding against onanism .... one of the most certain and most terrible of those means which shorten and derange life .... I am fully convinced that the vice is exceedingly common, and highly destructive of human nature .... The grand object is to prevent onanism altogether -- Dr Christoph Hufeland, 1828 (39) ... the prepuce seems to exercise a malign influence in the most distant and apparently unconnected manner; where, like some of the evil genii or sprites in the Arabian tales, it can reach from afar the object of its malignity, striking him down unawares in the most unaccountable manner; making him a victim to all manner of ills, sufferings and tribulations; unfitting him for marriage or the cares of business; making him miserable and an object of continual scolding and punishment in childhood, through its worriments and nocturnal enuresis; later on, beginning to affect him with all kinds of physical distortions and ailments, nocturnal pollutions, and other conditions calculated to weaken him physically, mentally, and morally; to land him, perchance, in jail or even in a lunatic asylum -- Dr P.C. Remondino, 1891 (40) <h3> <a name="themast"></a>The masturbation phobia</h3> As in Britain and the US, the universal phobia against masturbation was the main driving force behind the introduction of widespread circumcision in Australia at the turn of the century. David Walker has examined the fears surrounding seminal loss and their connection with conceptions of manhood and national development in three important articles (41) which are essential for understanding this topic, but there are several areas in which his studies can be amplified and modified. As Walker points out, nineteenth century medical orthodoxy held that any seminal loss weakened the system, but that masturbation was especially dangerous, partly because it was so easy to do and partly because it was indulged in mainly by the young, who needed all their energies for proper growth and development. (42) For all the fervour with which colonial medical and moral texts catalogued the evils which arose from masturbation, they largely repeated the wisdom received from Britain (and to a lesser, though increasing, extent the US); there were few original antipodean contributions to this field of medical science. In concentrating on irregular medical practitioners who offered various quack cures for seminal loss and other "private diseases, however, Walker could leave the impression that concern with masturbation was a fringe preoccupation and that mainstream doctors (those trained in medical schools and usually members of the British Medical Association) were less worried by the problem. This is misleading: the danger of masturbation was a sacred orthodoxy of the regular medical profession, and the quacks were only trying to take advantage of the fears already generated by its own advice and propaganda. Nor is it possible to draw a hard and fast line between the regular doctors and the quacks; the former exhibited plenty of evidence of ignorant faddism and eccentricity, while the latter frequently offered more humane and less damaging treatments. Ineffective they might have been, but when you are dealing with imaginary diseases it is to the advantage of the patient if the cure is not too heroic. I shall deal with each of these points in turn. It is only in recent times that masturbation has ceased to be regarded as a serious disease likely to have frightful consequences for those who indulge in it. As late as 1966 the Principal of Grimwade House, Max Haysom, told his charge of 13-year old boys at the annual sex education lecture that masturbation was wrong for three reasons: from a religious point of view, it was a sin against purity; from a social point of view it was selfish because only a man's wife had the right to the products of his penis; and from a medical point of view it would cause blindness if persisted in. The principal added ominously that there had been trouble with this sort of thing among the boarders, though he did not explain how it had been dealt withâ€”presumably not by circumcision, as in most cases that had already been seen to. (43) Even today, when every variety of sexual expression is discussed on television and most may be viewed on video, the topic of masturbationâ€”"the earliest, most intimate and perhaps the most common of all sexual behaviours, as Bennett and Rosario observeâ€”still arouses anxious titters. (44) If Haysom represented enlightened establishment opinion in the 1960s, it is apparent that the taboo against masturbation must be very deeply ingrained. Indeed, in 1860 the Australian Medical Journal reported the case of a seaman, a "finely made Irish boy, aet. 17, who actually killed himself through masturbation. He was admitted to hospital on 8 May with "slight febrile symptoms and treated for fever, but his condition steadily deteriorated and additional symptoms appeared, necessitating examination of the lower part of the body: attention being directed to the genital organs, the penis was found to be larger than natural; the glans red and inflamed, and a slight swollen condition of the prepuce. On examining his shirt the lower part was found stiffened with some albuminous fluid, much resembling that produced by the seminal vesicles. The testicles were found atrophied to about the size of a kidney bean, soft and painless to moderate pressure. On being questioned as to his habits he denied having made any improper use of himself, or being addicted to masturbation. A friend of his ... said the young man was much given to solitude and ... thought he was addicted to this bad habit when in his berth. He was again interrogated as to the escape of this albuminous fluid and admitted that some did escape after passing stool. He was warned as to consequences but persisted in denying the existence of masturbation. As soon as the possibility of masturbation arises, the boy ceases to be regarded as a patient in need of care and becomes a malefactor who must be interrogated until he confesses his crimes. On 1 June the patient was described as having "filthy habits, pretending to be unable to get up and too lazy to use the spittoon. The next day delirium was reported, and his condition worsened steadily until the 6th, when he died. A post-mortem revealed "miliary tubercles throughout both lungs, but also a contracted bladder, enlarged vas deferens and seminal vesicle, and "congestion of the spinal cord. With tell-tale signs like these the conclusion was inescapable: "a case of masturbation, producing excessive spinal irritation, debility and, indirectly, death. (45) Whatever the poor boy was suffering from, it is remarkable how quickly the doctors turned their attention to his genitals and sought the culprit in his adolescent sex drive. Most likely he was dying of tuberculosis. <h3> <a name="james"></a>James Beaney</h3> The most voluble, if not the most influential, medical writer on masturbation for the next thirty years was Dr James Beaney. He is chiefly remembered today for a scandal relating to abortion and his arguments with fellow doctors, but he deserves to be better known as the most important Australian populariser of the new medical orthodoxy on spermatorrhoea. James George Beaney (1828â€“1891) was born in Kent, took a medical degree at Edinburgh and became an army surgeon. He settled in Melbourne in 1857 and established himself as a prominent member of the medical profession there. (46) He published prolifically, but the main works in which in sought to bring the latest the understanding of sexual function and dysfunction to his colonial audience were Spermatorrhoea in its physiological, medical and legal aspects (1870) (47) and The generative system and its functions in health and disease (1872). (48) As he explained in the preface to the first of these, his books were "intended to exercise the same influence in these colonies which the works [of Lallemand, Acton and Courtenay] exercise in Europe, by spreading correct information amongst our populations (1870, p. x). In these texts, addressed to an educated public as much as to his professional colleagues, Beaney earnestly hammered Acton's main themes: masculinity was an embattled condition; spermatorrhoea was the signature disease of the day and the most deadly single threat to men's health; semen was more precious than blood; masturbation infallibly caused a raft of serious illnesses; children were a contradictory mixture of innocence and vice; treatments for spermatorrhoea could be effective; but only if victims avoided the quacks and took their problems to genuine professionals. I will consider each of these points in turn. Like Acton, Beaney saw men as beset by sexual threats: desire nagged constantly, but to yield was to risk debility, disease and ultimately madness. He sought to elucidate "the many sources of danger which threaten the integrity of their manhood (1872, p. 12) and to acquaint young men with "the dangers connected with the abuse of the sexual functions (1870, p. 45). The most serious of these was spermatorrhoea, defined as "an abnormal emission of the seminal fluid: Of all the diseases to which man is liable, there are few which induce so much ... mental anxiety as this. It embitters all the victim's social relations and subjects him to the harrowing reflection that he is the object of the taunts and jeers of those about him (1870, p. 45). Masturbation was both a specific form of spermatorrhoea and frequently also the cause. Beaney asserts that "the chief cause of this undue discharge of semen without the intention of the patient is abuse and explains that single men "ruin the nervous equilibrium of their sexual system and find themselves "at the mercy of the least excitement. Like Acton, Beaney warns that any discharge of semen is risky: even marriage, with its opportunities for legitimate intercourse, can be a trap. A married man "may so abuse the advantages which unlimited congress gives him, as also to enervate himself and subject himself to involuntary losses (1872, p. 183). Because of the importance of semen to the health of the male organism, such losses lead inevitably to illness. Beaney observes that philosophers "in all ages have held that "excessive coit. depressed the nervous system and that there was "a close connection between the brain and the seminal fluid (1872, p. 17). He considers it to be "the most important secretion of the body ... which taxes the fountain of life more than any other (1870, p. 10) and quotes Swedenborg's view that one drachm was the equivalent of an ounce of blood; "squandering such a fluid inevitably undermined "the stability of the corporeal system (1872, p. 27). It followed that masturbation must be harmful. Beaney defines "this wretched habit as "the production of emission of seminal fluid by friction and manipulation of the virile organ; or any process which produces a flow of that important secretion which is not the natural excitement of sexual intercourse with the opposite sex. Sounding more like a tub-thumping prophet than a man of science, he goes onto denounce masturbation as "one of the most pernicious habits that can possibly be indulged in, sapping ... the strength both of mind and body, reducing the most vigorous intellect to the feebleness of old age, and the most athletic frame to a condition of helplessness (1870, p. 56). In accordance with the nerve force theory of disease, he asserts that masturbation directly caused a range of disorders by disturbing the equilibrium of the nervous system: This excessive withdrawal of semen ... involves the necessity of concentrated vital energy upon the function of seminal secretion, hence, more of this valuable fluidâ€”the mainstay of the systemâ€”is drawn from the blood than the body can bear without derangement of other functions (1872, p. 182). Among the immediate consequence are a fairly contradictory bundle of symptoms, including inflammation of the urethra, irritation of the bladder, disturbed sleep, erotic dreams and nocturnal emissions, confusion of mind, vertigo, wakefulness, depression and languor (1870, pp. 61â€“3). In the long term, the practice could lead to epilepsy, phthisis (tuberculosis), insanity and impotence (1870, p. 78). On account of the "great expenditure of nervous force during unnatural excitation, masturbation was particularly implicated in the genesis of epilepsy, and Beaney found confirmation of the connection in the confession of many epileptics that they had practised that habit when young (1870, pp. 63â€“5; 1872, p. 201). Doctors thus had a duty to make every effort to minimise seminal loss, and that meant discouraging masturbation. Children should be watched closely for signs of the vice and action taken to nip it in the bud. Although he writes approvingly of circumcision as a hygienic measure, Beaney does not link it directly with the prevention of masturbation and largely repeats Acton's prescription of parental vigilance, moral exhortation, exercise and purity. He quotes the celebrated Dr Christoph Hufeland, who held that one of the "grand objects of such training was to "prevent onanism altogether, but he had little but old remedies to offer at this stage (1872, pp. 222â€“6). The most important of these was still willpower. In advocating the necessity of restraint in sexual matters, Beaney follows Acton in pathologising the normal male sexual response and exemplifies the way in which doctors were replacing priests as the watchdogs of sexual morals. He refers to men being "troubled with morbid erections and their sleep interrupted with lascivious dreams (1872, p. 233) and claims that symptoms of spermatorrhoea include "too frequent and troublesome erections at night, with erotic dreams and emissions (1872, p. 192). That many men of that period did find erections troublesome shows how effective the doctors had been in convincing the public that normal sexuality was really a disease. Beaney sounds like St Augustine, deploring his own erections as punishments sent by god to remind him of original sin, or perhaps the Council of Trent, which believed that, before the Fall, Adam's erections were voluntaryâ€”paradise indeed, for both those who wanted fewer and those who wanted more. On the issue of moral guidance, Beaney takes the Christian view that the flesh is a snare set by the devil for the ruin of the soul, but he suggests that scientific knowledge was a better basis for behaviour than theological sanction: the need for restraint was shown by the terrible consequences of indulgence. Man's mental endowment, he writes, has rendered it unnecessary to place physical barriers to the copulative function, as it gives to man a more noble means of restraint by ... the knowledge of cause and effect. The reasoning faculty is intended to teach him the consequences of acts that do violence to his physical system (1870, p. 30). Sin will undoubtedly be punished, but in this world rather than the next. Because it was impossible to establish "a code of laws to prevent sexual excess, it was "the duty of medical men to point out the ill-consequences ... and endeavour ... to modify the evil (1872, p. 32). The appeal might be to reason, but the atmosphere is that of a confessional: the relationship between a masturbator or other victim of spermatorrhoea and his doctor is much as the same as that between a sinner and his priest: It is generally difficult to obtain from the sufferer a frank confession of the cause of which he is himself the author. ... shame prevents an honest ... disclosure in many cases. The medical man ... having first gained the confidence of the patient, will generally succeed in eliciting the truth. It is always desirable that the patient should fully admit the practice ... the fact of having "made a clean breast of it gives them an access of moral courage which is very useful ... in facilitating their cure (1872, p. 187). Elsewhere he writes that doctors should "assist the feeble victims of sexual excesses by their counsel and personal influence (1870, Preface), just like a pastor with a straying sheep. Beaney is in favour of sex education, but on the assumption that it was largely a matter of teaching boys not to have sex (1870, p. 41). The sexual nature of children was another issue on which Beaney followed Acton closely. He shared the latter's opinion that "there should be perfect quiescence of the sexual function until ... maturity (1870, p. 38), but also his uneasy awareness that there usually was not. On the one hand, "as a rule the child is ... entirely free from any knowledge of the sexual functions, or indeed of the existence of any sensation of pleasure in connection with them (1872, p. 102); and yet, "I have met with hundreds of quite young children [with] ... the most complete theoretical knowledge of the character and purpose of their sexual construction. What was worse, these children have been caught "teaching others to play with their genitals (1872, p. 103). Anomalies abound: "There will ... under judicious care and education, be no tendency on the part of young children to notice sexual impressions; yet, "there are well-authenticated cases in which ... abnormal activity occurs, and the child exhibits a surprising tendency to sexual indulgence (1872, p. 5). Beaney did not expect sexual feelings to occur before puberty, yet "at a very early period of childhood some children are very prone to handle their privates, and the habit, if unchecked, becomes permanent and injurious (1872, pp. 6, 106â€“7). It almost makes one giddy to watch Beaney contradicting himself from one sentence to the next as he dodges and weaves from the empirically normal to the morally normative: ultimately it becomes apparent that the innocence of childhood is not a natural condition, but a social desideratum which must be imposed by force: That blissful period of innocence which intervenes between the birth and the advent of puberty should command the solicitude oft the parent; for it is during that interesting transition, that the foundation of lasting mischief is laid by those whose minds have already been contaminated by evil associations. The vigilance of parents and school proprietors cannot be too constantly exercised, in order that ... thoughts and impressions of a sexual nature may be prevented (1872, pp. 5â€“6). Bad practices like masturbation "must be stamped out if the children are to grow up in that virgin purity which we all expect in those of tender years (1872, p. 119). Beaney repeatedly expresses surprise at how early this vice seems to manifest itself, necessitating "the vigilance of parents to interdict any approach to the indulgence. He warns particularly against public schools, "where boys induct each other into many improper practices and adds a long quote from Acton on the problem (1870, p. 57). Although Beaney is largely recycling the new orthodoxy on spermatorrhoea advanced by Acton et al, he does make some adaptations for his Australian audience. His main point is that is that the relatively free and easy life of the Antipodes, the more relaxed social structure and the more intimate mingling of the sexes lead to increasing sexual precocity among children, thus magnifying the threat of spermatorrhoea to colonial manhood (1872, pp. 104â€“5). He fears that the "softening and purifying influence of home life is not so strong as in England and that the rough manners and lowly origin of the servant class are a constant source of dangerous knowledge and mischievous practice, and he returns repeatedly to the "evil influence of servants ... in teaching young children to handle their genitals and thus to fall into the habit of masturbation (1872, pp. 6, 114â€“23). This was a problem that also exercised Acton, but it was more severe in a new country which lacked the social checks and balances of the old. In treating cases of seminal loss and problems arising from masturbation Beaney did not rely solely on moral exhortation, but there was not much in his battery of prescriptions which distinguished him from the quacks he so routinely denounced. The most common treatments involved sitz baths, "generous diets, different kinds of alcohol and various chemical compounds, particularly potassium bromide and phosphorous (the latter believed to be an important constituent of the brain), and the application of electricity to the nervous systemâ€”"galvanism and "Faradization in Beaney's terminology, though it is not clear how the two procedures differed from each other (1872, pp. 160, 164â€“5, 202â€“5). Treatment for a man suffering from impotence induced by masturbation included sea baths, a ban on smoking, galvanism and doses of phosphoric acid, quinine, iron and strychnine (1872, p. 164â€“5). A case of epilepsy caused by masturbation was cured by a program consisting of dry sherry, phosphorous, strychnine, iron, Faradization and sleeping on a hard mattress (1872, p. 205). Unlike Acton, Beaney did not recommend cauterisation of the urethra in cases of spermatorrhoea, but his favoured treatments for prostatorrhoea (emission of prostatic fluid) tended to be more severe than those recommended for loss of semen. In addition to the nostrums above, these might include the porte-caustique, leeches, blistering of the perineum, a No. 12 galvanic sound and injections of belladonna and camphor into the urethra (1872, p. 237). If such a preposterous mixture of poisons and placebos had any curative effect it could only confirm the imaginary status of the diseases being treated. Beaney is not yet thinking of circumcision as a treatment for spermatorrhoea, but he is moving in that direction. He notes, without going into details, that "hypersensibility of the glans penis and the urethra will often be found to be at the bottom of the troubles, and he cites a case reported in the Lancet (1867) on the connection between a tight foreskin and epilepsy. This article claimed that "a variety of cerebral symptoms ... such as pain in the head, giddiness, noises in the ears, eructations etc ... may be entirely removed by circumcision, though it conceded that circumcision of several mental patients did not reduce the incidence of their epileptic fits (1872, p. 113). In accordance with the nerve force theory, Beaney is naturally alert to the phenomenon of "sympathetic irritation (1872, p. 107) and notes that a "very important cause of "morbid sensitiveness in the penis is the extreme length of the prepuce; this was not only a "source of irritation in childhood but "an embarrassment at puberty (1872, p. 109). Beaney does see the foreskin as a source of dangerous irritation and is attracted to circumcision as a remedy, but, like Acton, he is pessimistic about the chances of the procedure winning wide acceptance because of its religious connotations. He urges that the "secretions which accumulate beneath the foreskin should not be left "as a source of mischief and quotes Acton on the complicity of the foreskin in sexual precocity (1872, p. 109). He then comments that circumcision should be more widely practised and regrets that its sacred associations (Jewish and Islamic) discourage its wider adoption: It is well known that in surgery we are often obliged to do for Christian men that which is to some extent analogous to circumcision ... and the operation is sought for much more frequently than formerly on purely hygienic grounds. It is to be regretted that so valuable a preventive against many sexual disabilities should have been environed by sacerdotalism (1872, p. 111). Medical science had learned that circumcision could prevent or cure a raft of sexual problems; only irrational prejudice (or "maudlin sentiment) held up its general application. In his book on children's health (1873) Beaney does not mention circumcision (or any sexual issues) at all, but there is a passage in his Disorders of the generative system which suggests that he might have been eyeing the operation as a possible treatment for masturbation. When children are caught handling their genitals, he writes, the parent must "confront the evil in the child and take all the necessary steps, both surgical, hygienic and admonitory, to overcome the cause of the bad habit (1872, p. 113). There is no elaboration of what surgical steps he has in mind, but one wonders. <h3> <a name="themal"></a>The malign influence of the foreskin</h3> It was possibly in the next decade that doctors in Australia made the link between the "irritability of the foreskin and the aetiology of spermatorrhoea and drew the obvious conclusion that the surgical removal of the offending tissue would offer the prospect of both prevention and cure. In a paper on the need for sexual restraint published in 1884, Dr J.W. Springthorpe considered the "problem of the sexual appetite before marriage and observed that it could be dealt with in three ways: masturbation; resort to prostitutes; and restraint. He echoed Beaney in his depiction of the threat posed by seminal loss "in a young colony and the equal danger of leaving treatment of such complaints to the quacks: Upon a subject of such importance, and one too frequently neglected or relegated to the nefarious hands of quackery, it is imperative that ... physicians ... should have fairly comprehensive knowledge and definite views. And in a young colony like oursâ€”one legacy of whose fevered past has been a distinct neurotic tendency, with climatic influences that favour early bodily development, and where the newspapers, by their almost daily tales of sexual crimes, point conclusively to the existence of an extremely grave state of affairs. Self-evidently, both masturbation and resort to prostitutes were too dangerous to contemplate, leaving abstinence before marriage as the only safe way to meet the sexual appetite. By their surgical skill, doctors could assist young men (and even young women if necessary) to restrain themselves: Hence onwards until marriage the excito-motor mechanism should be the subject of investigation and regulation, so that none but the normal impressions might travel upwards to the brain. To this end it might be necessary to snip off a redundant prepuce, divide a contracted meatus, clip a short frenum ... and the same, mutatis mutandis, in the female. In the discussion which followed there was no dissent from this proposition, and a Dr McMillan affirmed that "absolute sexual continence was compatible with perfect health and opined that "the instinct of abstinence ought to be encouraged. (51) It is interesting to note Springthorpe's assertion of the medical profession's claim to investigate and regulate the normal functioning of the body. Despite Koch, Pasteur and the discovery of germs, medical opinion in these areas did not change much over the next generation: as late as 1913 the Melbourne Pediatric Society considered the case of a 13-year old boy who complained of tiredness and pain in the back of his thighs. Dr Alan Mackay suggested "the trouble was quite possibly due to masturbation in a boy of that age, and he thought the boy should be watched. He had often noted the association of nasal catarrh, dilated pupils and bad teeth with sexual aberrations. (52) With such salutary examples as these in the professional literature, who could doubt that masturbation would inevitably lead to bodily and mental weakness, insanity and death? Certainly not the authors of manuals on child rearing, who were quick to warn parents of the need to guard against the development of evil habits in their children. In Mother and child (1913) M. Danvers Power devotes the whole of a chapter called "Teaching children the natural laws of sex to this single problem. Quite little children, she or he writes, "often form the bad habit of playing ... with the sexual organ, finding that it produces a pleasant sensation. Power considered him/herself a progressive who believed in telling children the truth about sexual functions, and the truth was that bad sexual habits had terrible consequences: The children become disobedient, rebellious against authority, cross and irritable. Next, the effect upon the nervous system is very serious. The pleasant feeling which is experienced at the beginning, ends in a spasm of the nerves, which leaves the body absolutely wasted of all nerve force, drained of all nervous energy, exhausted as is the body of a person who has had a fit. And while the nerves and character are being ruined the mind is also suffering. The memory becomes dull, the child cannot grasp his lessons, and goes down to the bottom of the class. ... Where the body is not naturally strong, a general wasting may be followed by consumption, or life may be ended by some other terrible disease. ... And if continued, not only the body and character are ruined, but the mind collapses also, and madness is the result. Note the persistence of the nerve force theory of disease and how widely diffused it has become. Mothers should therefore teach their children that their sexual organs should be used only after they marry, and then only for the purpose of creating their own babies and that if they use them "before that time, or injure them by bad habits, illness and misery and probably madness will be the result. (53) Curiously enough, a Frederick Danvers Power became a leading figure in the boy scouts and prepared the first edition of the Australian Boy Scouts Handbook in 1922. You may recall the tenth lawâ€”"A scout is clean in thought, word and deedâ€”and you would be right in thinking that this meant no playing with yourself or your mates. Unclean thoughts may be in connection with the abuse of the private parts of your body. ... Thee parts have been given to you for a special purpose, and God will reward or punish you accordingly as you take care of or abuse them. They should never be handled except to clean them. (54) Both the views and the fluffy toy language are so close to those expressed in Mother and child that it is hard to believe they are not by the same person; perhaps Frederick was the husband or son of M. In warning against the dangers of self-abuse Power was following the example of Baden-Powell himself, who had included a section on continence in the appendix to Scouting for boys (1908) and a further caution in Rovering to success (1922). This included the immortal advice to "keep the organ clean and bathed in cold water every day, a suggestion which soon acquired a ribald notoriety. (55) Of undoubted progressive sympathies was the better known Marion Piddington, an exponent of sex education for the young and a supporter of both birth control and eugenics. She was no more relaxed about masturbation than Power or anybody in the medical profession: it was a harmful habit that tended "to arouse the sexual nature prematurely and could lead to interest in prostitutes, with the attendant danger of venereal disease, as well as eugenically inadvisable marriages. Piddington was definite that the habit of self-abuse should be prevented though non-specific as to the best methods; she did, however, suggest that boys should be clothed in trousers without pockets. (56) Such examples tend to confirm Neuman's conclusion that the main aims of the early sex educators were to warn children and adolescents about the impropriety of sexual exploration before marriage and to discourage autonomous activity on their part. (57) <h3> <a name="quack"></a>Quackery and orthodoxy</h3> The views of the quacks were little different from those of the mainstream medical profession, though they did tend to be cast in more lurid language. Two of Sydney's most prominent specialists in the "nervous and private diseases of males, Drs Freeman and Wallace, referred to masturbation as a "pernicious habit which caused a whole brood of diseases, a "disgusting subject, a practice alarmingly widespread among the young, and a problem which must be overcome; their own cures (not detailed in the publicity) were always efficacious in this respect. (58) Even more colourful language was employed by another practitioner, Dr W.B. Towle, who mixed moral and scientific condemnation in a manner typical of the period: The general effects of seminal weakness, nocturnal and diurnal emissions, impotence and sterility, caused by self-abuse in early life, or excessive indulgence in later years, if not relieved by appropriate and thorough treatment, are most deplorable. This malady is one of the most widespread and destructive experienced by man. Few, except physicians, have any conception of the prevalence of self-abuse, or of its disastrous effects on both mind and body. This habit, according to the experience of the most renowned medical men, degrades man, poisons the happiness of his best days and ravages society. It is certainly one of the most ruinous vices ever practised by fallen man. Its victims are found among the young of both sexes in every country .... Many who really perish from its effects are supposed to die from other causes, such as consumption, epilepsy, heart diseases, exhaustion and failure of the vital powers. It ultimately destroys the mind as well as the body. In its milder form it produces loss of memory, melancholy, depression of spirits, timidity and loss of energy. In its worst form idiocy and insanity. Many maniacs owe their loss of reason to no other cause. In the tabulated reports of every lunatic asylum are a great number of cases in which the cause of insanity is set down as "masturbation. (59) Given their generally more hellish scenarios, you might think that the quacks would be more enthusiastic about the heroic approach to male sexual problems, and masturbation specifically, than the regular doctors. In fact, the reverse is true: it was the mainstream professionals who favoured modern scientific methods of treatment, such as mechanical restraint, infibulation of the foreskin, cauterisation of the urethra and circumcision. The remedies proposed by the quacks were altogether gentler and less punitive. Freeman and Wallace did not recommend circumcision for any genital complaint and discouraged it even in cases of phimosis: "Slitting the foreskin or circumcision is frequently adopted by some surgeons, but we never resort to such measures unless ... absolutely necessary. (60) They made their own attack on quacks who offered fake cures, especially cauterising the urethra with caustic substances, a treatment recommended by Acton and widely practised by orthodox professionals. (61) Freeman and Wallace were vague about their own methods, but not Dr Towle: he specialised in electro-therapy, offering a range of electrical appliances designed to cure female complaints, liver and kidney problems, joint disease, nervous debility and impotence. The "Hercules Life Renewer could even treat self-abuse successfully, though in cases where spermatorrhoea was also present, supplementary remedies would be required. (62) There is not a word here about surgical intervention. Indeed, if published testimonials from successfully treated patients may be believed, there is evidence that some men resorted to quacks precisely to avoid the surgical remedies proposed by regular physicians. Towle quotes the example of a young man suffering from paraphimosis: A surgeon had told him he would have to undergo an operation; that the prepuce would have to be cut through. Shrinking from this prospect he decided to consult me. I administered at one some medicine, the effect of which was to relax the constricted muscles ... [and] the patient awoke to find himself quite well. He wrote saying: "I am doubly grateful to you for having not only cured me so easily, but for having saved me from having to undergo a surgical operation, which would have been very painful, and would have left its mark upon me all my days. (63) Given this sort of resistance to the operation, it is not surprising that the circumcision lobby targeted its propaganda at parents rather than the actual subjects of the procedure and that it became common only because it was done without the consent of the patient; wherever circumcision has become general it has been an operation that authority (usually parental) has inflicted on the young or otherwise powerless, rarely a procedure that competent males have elected for themselves. For all the embarrassment they caused the regulars, it is thus not so easy to draw a firm line between the quacks and the medical profession proper. The practitioner who diagnosed a case of tinnitus as stemming from masturbation and who treated it by means of electric shocks and a long course of urethral dilation with catheters was not a quack, but Dr W.F. Quaife BA, MB etc, who described his cure in the journal of the Australian branch of the British Medical Association. (64) Indeed, the campaign against quackery was part of a wider effort on the part of doctors to establish their own professional standing and assert a monopoly over the management of bodily (and some mental) functions. The mainstream doctors had been vying with the irregular practitioners since at least the 1860s, and the main issue on which the struggle was fought was their competence to provide better treatment for "nervous and private diseases. Acton had taken numerous swipes at the quacks, and another significant writer on spermatorrhoea, F.B. Courtenay, had actually put together a broadside called Revelations of quacks and quackery (1860s) in which he emerged as a crusader against the irregulars, and particularly against their claims to cure spermatorrhoeic and related diseases. In his own work on that subject he expressed the usual views on masturbation but was fairly relaxed about involuntary nocturnal emissions and critical of the cauterisation treatment advocated by Acton and others. He attacked the quacks and deplored the reluctance of the medical profession to take spermatorrhoea seriously, thus driving men into their hands. (65) As we have seen, he was one of the influential English writers whose ideas Dr Beaney had sought to popularise in Australia. Beaney's Spermatorrhoea was explicitly part of a campaign to wrest the treatment of these diseases away from the quacks and vest it with qualified doctors; as he writes in the Preface, it was "designed to lead those who are afflicted by them to abandon the pretentious quacks and turn to "legitimate and honourable practitioners like himself. (66) Like Courtenay, he is critical of his profession for its "culpable neglect of one of the most important and serious ... diseases to which mankind is subject, thereby driving "a large section of the community ... into the hands of the vilest imposters (1870, Preface). By refusing to take the disease seriously and treat it like any other medical complaint, the profession was in fact responsible for sending "thousands of wretched sufferers ... into imbecility and the madhouse and even the grave. Rejecting the prudish and old fashioned view that medical science was too delicate to be concerned with the genitals, Beaney asserts its claim to management of the whole body: "Are not the functions of the surgeon ... to embrace all the maladies to which the body is liable?, including those afflicting the genital organs (1870, p. viii). His audience here is twofold: he wants to convince the public that victims of spermatorrhoea should seek the help of professionals like him, not patronise the irregulars; but he also wants to persuade his conservative colleagues that they should accept spermatorrhoea as a real and serious disease which demanded their professional attention. Quoting from Copland's Medical dictionary and other English authorities, Beaney regrets that too few doctors took the problem seriously, thus relinquishing it to the "unqualified empiric. He is pleased to note, however, that this state of affairs is changing and that doctors are making amends for their neglect "by the ardour with which they are investigating [the problem] and the earnestness with which they endeavour to protect the public against the frauds of those quacks who have so long preyed upon them (1870, p. 48). The nub of the case was that spermatorrhoea was too grave and complex a disease to be treated by anybody except the experts: These several phases of spermatorrhoea require special treatment and suggest the folly of trusting their management to the pretentious charlatans and ignorant quacks who parade their nostrums in the daily journals. The disorder ... is too serious in its character and consequences to be carelessly dealt with. ... the question ... calls forth the highest faculties of the surgeon or physician, and taxes the powers of his art often to their limit (1870, p. 103). Yet the sad fact is that there was very little even the most conscientious physician could do about these diseases that would distinguish them sharply from the quacks they so bitterly despised. As we have seen, their treatments for various forms of spermatorrhoea consisted largely of bathing, exercise, diets and "medicines like potassium, phosphorous and strychnine; their rivals offered much the same regimen, including the application of electricity. Beaney derided them for making use of an "Electro-Galvanic Vital restorer, apparently forgetting that he himself was an exponent of galvanism and Faradization. (67) There was not much in any of this to grab the attention of the public and persuade it to abandon the irregulars; something dramatic was needed, something that only the medical profession proper could offer, some sort of magic bullet. <h3> <a name="pfor"></a>Professionalisation of medicine</h3> The years 1881â€“1914 were a crucial period in the emergence of the modern medical profession in Australia. A five-year degree had been introduced at Melbourne University in the 1860s, and Sydney followed suit in 1883; the New South Wales branch of the British Medical Association was established in 1881. The emergence of the profession was largely a process of differentiation; as Lewis and Macleod (68) have shown, doctors were struggling on two fronts: against chemists, druggists and "quacks for control over health care; and against the friendly societies over conditions of work and fees. Doctors had been trying since the 1860s to get legislation which would define and secure their position. Their efforts were opposed as an attempt to gain sectional privilege and knocked back several times, but in 1900 the NSW parliament passed the Medical Practitioners Act, which made it an offence for anybody without recognised qualifications to use a medical title and empowered the Medical Board to debar practitioners on a range of grounds. This victory recognised the new prestige of scientific medicine: "the orthodox practitioners finally won legislative endorsement because they had established a cultural authority superior to that accorded 'alternative' practitioners, (69) though it might be more precise to say that this legislative sanction created the very categories of "orthodox and "alternative: before then it had been pretty much a free-for-all. Apart from beating the quacks in the lobbying game, however, it is hard to see what medical achievements underlay the doctors' triumph, though the promise of the new germ theory of disease may have been part of it: in 1899 the Sydney Morning Herald looked forward to the conquest of cancer and even gout. (70) As the example of Herbert Moran makes clear, however, the moral and even confessional role of the doctor increased along with the growth of his scientific status, (71) and the new scientific spirit did not lead to any immediate questioning of the links which had been drawn between masturbation, immorality and disease. The case of Dr Richard Arthur (1865â€“1932) is instructive. Born in England and educated in Scotland, he settled in Sydney in 1891 and became director of a number of major city hospitals. He lived and practised in Mosman and was an independent member of the NSW state parliament for various north shore electorates from 1904 to 1932 and briefly Minister for Health in the Bavin government in 1927. (72) He inveighed against the deceitful machinations of the quacks, yet he was himself a fervent purity campaigner who wrote numerous pamphlets for the Australasian White Cross League on the necessity of youthful continence; he was a keen practitioner of hypnotism and an advocate of vegetarian diets; he warned boys against the dangers of self-abuse and advised parents to circumcise their sons as a preventive measure. It was only the last point which distinguished him from Freeman et al. Arthur agreed with the quacks that masturbation led to severe physical and mental illness: The seed is a very valuable substance, and if it is drained away continually, all the strength and vigour leave the body. The boy or man who practises this vice becomes stunted in growth and enfeebled in mind. he becomes unfit for games and athletics of any kind, and he is not able to study or devote his attention to any object. ... He may so lower his health that he falls an easy victim to that terrible malady, consumption, or he becomes subject to epileptic fits, or, worst of all, he may so injure his brain that he develops insanity in one or other of its dreadful forms. (73) He did not mention circumcision in pamphlets directed at boys, but in one addressed to adults he advised parents to watch carefully for signs of self-abuse and to consult a doctor immediately if a child displayed "any tendency to objectionable habits. In accordance with the medical wisdom of the day, he added that "this vice in the young is sometimes brought about by the existence of some local irritation ... [and] the operation of circumcision is needed. (74) Arthur was a leading light in the Australasian White Cross League, itself an affiliate of the English organisation of the same name and a direct descendant of the groups that waged the English purity campaign of the 1880s which, among other achievements, pressured parliament to raise the age of consent, restrict the circulation of pornography, ban nude bathing and criminalise homosexual activity among males. (75) In this capacity Arthur urged moral purity in the young and the strict avoidance of sexual activity before marriage. It was this obsession which led him into disagreement with the quacks, whom he criticised for scaring boys with the claim that even involuntary seminal emissions (such as wet dreams) were harmful and in need of special treatment. He reassured them that "in most cases this emission is not unnatural. It is merely a sort of overflow of the semen, and if it do not occur oftener than once in ten days or a fortnight, there need be no cause for anxiety. If, however, they are frequent or are followed by "languor and depression, the sufferer should "seek the advice of some respectable doctor, who will probably soon cure the condition. (76) Arthur's qualified and reluctant acceptance of nocturnal emissions was a consequence of his insistence on chastity; if adolescents and young men renounced masturbation and sexual intercourse, their pent-up energies would have to find release somewhere, and wet dreams were less harmful than "artificial stimulation. Arthur appears to have held a pretty low estimate of the average adolescent sex drive: to the modern mind, a teenager needing no more sex than one wet dream a fortnight would be a sorry specimen indeed. (77) In summary, then, it was not the quacks like Freeman and Towle who offered circumcision as a cure for masturbation and other male complaints. They offered the medical stock-in-trade of Dr Beaney and his colleagues from the previous generation â€”bathing regimes, proprietary medicines, electrical devices, special diets etcâ€”but were reluctant to perform surgical procedures and were losing the right to perform them. It was the university-trained and properly accredited medical practitioners who urged circumcision and other surgical interventions as effective, scientific treatments which embodied the latest advances in modern medical understanding and which they alone could provide, in opposition to and in competition with the fringe practitioners. Some patients might have resorted to quacks expressly to avoid the harsh remedies proposed by the regular physicians. In this context it is possible to see the doctor's campaign against quackery as part of a battle for professional turf, indeed, as part of the struggle to establish their own professional identity, and the circumcision cure as one of the weapons in their armoury. Quackery is a matter of perspective, and today it is the crusaders against masturbation and the advocates of circumcision who look like quacks, an impression that some of them seem only too eager to foster. Consider these examples. During a lengthy controversy on the practice in the correspondence columns of the British Medical Journal in 1935, Dr R.W. Cockshut wrote that all male children should be circumcised. This is "against nature, but that is exactly the reason why it should be done. Nature intends that the adolescent male shall copulate as often and as promiscuously as possible, and to that end covers the sensitive glans so that it shall be ever ready to receive stimuli. Civilization, on the contrary, requires chastity, and the glans of the circumcised rapidly assumes a leathery texture less sensitive than skin. Thus the adolescent has his attention drawn to his penis much less often. I am convinced that masturbation is much less common in the circumcised. (78) Following the decision of the Australian Paediatric Association to recommend against routine infant circumcision in 1971, a doctor in Perth, G. Hall, boasting that he had performed some 2,000 infant circumcisions with bone forceps, recorded the following objection: I am convinced that when God made his covenant with Abraham and ordered this peculiar and embarrassing mark of identification of His chosen people, he regarded it as a health law as well as a ceremonial act. I am equally convinced that that unnatural edict by the APA is Satanic in origin. The only part of the body which has ever been ordered by our Creator to be surgically removed is the male foreskin. (79) Such comments emphasise the point that the moral pressure towards circumcision has always been much stronger than any scientific demonstration of its therapeutic advantages: if it really did offer health benefits great enough to outweigh the injury, it would not be necessary to do it without the consent of the subject. <h3> <a name="thedemo"></a>The demonisation of the foreskin</h3> With the rise of the masturbation phobia came the demonisation of the foreskin. It ceased to be a normal part of the male body and came to be regarded as an inherently unhealthy structure that gave nothing but trouble. By the 1930s Moran could unthinkingly refer to (healthy) foreskins in the same breath as infected appendixes and diseased gall bladders; medically they were all in the same category. (80) Acton's views were developed further in the US by Lewis Sayre and his disciples from 1870, (81) and popularised in Australia by George Beaney. A later formulation of them was by the US physician George Beard, an edition of whose home medical guide was published in Sydney in 1884. Walker reports that the reception Beard's writings is difficult to gauge, but that James Smith, one of the most prolific men of letters in late nineteenth century Victoria, was enthusiastic about his work and drew on it for his own essays and lectures, including one on the nervous system delivered in 1881. (82) As you might expect, Beard devotes a good deal of space to "nervous diseases of modern times, including neurasthenia, seminal emissions, impotence, noises in the ear, self-abuse and "sexual exhaustion, (83) and it is in this context that he focuses on the foreskin. He notes that early masturbation is nearly always present in cases of sexual exhaustion and reports that in two thirds of nervous disease cases "there is more or less abnormal condition of the prepuce. The reason is obvious: "In a nervous person a redundant, elongated prepuce, covering the gland [sic] and pressuring upon it, acts as an irritant to the whole system, and excites any number of nervous symptoms, even to melancholia and paralysis. In such cases circumcision is needed to relieve the pressure on the glans, and such operations "have been known to radically cure cases of nervous disease. (84) These views are in accordance with the nerve force theory of disease and are no more far-fetched than what Lewis Sayre, Joseph Howe (85) and their followers had claimed, but Geo. Talbot Woolley was not afraid to go further. He was honorary surgeon at Castlemaine Hospital, Victoria, and in a paper given to the Intercolonial Medical Congress in 1889 he detailed the symptoms of tight foreskins on infants in terms that suggested he was well versed in modern medical orthodoxy. The child, he asserted, has a peevish or peaky look; the skin has a shiny, dry, cracked look about it, and there are generally some sores about the nostrils and corners of the mouth, which are quite typical and different from the common herpes .... [He] is generally ill, feverish, with bad appetite and furred tongue, and passes urine very frequently; which is sometimes thick and milky, and sometimes of a very high colour; he is generally in pain about the lower part of his abdomen, but is not able to give you any definite account of his condition. Woolley remarked that most medical men, on being told that an infant is fretful and feverish, will suggest there is something wrong with his diet, but he asserts that if you inquire more closely you will often find that the child often wets his napkin almost incessantly, that his penis is almost perpetually in a state of erection, and that ... the prepuce is so tight that it is impossible to see the lips of the meatus, which ... will be found to be in a state of congestion. The secretions generated under the foreskin accumulate and gradually this material "buries itself in the surface of the glans penis, or the under-surface of the prepuce, and sets up a definite form of constitutional disturbance. This will eventually express itself in the symptoms of a wide range of diseases, including hernia, worms, consumption of the bowels, typhoid, bloody urine, inflammation of the brain, bowels and lungs, and even paralysis of the legs. Woolley claimed that he had been able to cure all these symptoms in boys ranging in age from 20 months to eight years by the simple expedient of separating the foreskin from the glans and cleaning out the sebaceous matter. (86) What was really happening here we shall never know, but it is likely that Woolley was observing what Sayre and others had taught him to expect. (87) <a href="https://www.darboninstitute.org/a_source_of_mischief_part_3">Read Part 3</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 A source of mischief (Part 2) 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"> <h2>The advocates</h2> Many persons object to the direct allusion to the sexual organs of children, and urge that they should be left ... to the chapter of accidents, lest the mind of the child should be prejudiced, by directing its attention ... to what it is supposed not to recognise. This view of the case is not defensible when the advantages of interference so frequently preponderate over any imaginary evil which is advanced. The time has passed away when maudlin sentiment is to stand in the way of the appliances and teachings of medical science -- Dr George Beaney, Melbourne, 1872 In Aged Ignorance profound, Holy and cold, I clip'd the Wings Of all Sublunary Things -- Wiliam Blake, "The Gates of Paradise" <h3>Doctors</h3> Apart from the hints of Beaney and the suggestion of Springthorpe, the first explicit public advocacy of circumcision in an Australian professional journal I have located is in 1901 from H.G.H. Naylor, whose article "A plea for early circumcision" in the Australasian Medical Gazette ran the gamut of the dangers ascribed to the foreskin and the benefits arising from its removal. The "evil results of neglected foreskins" include frequent urination, loss of flesh, convulsions, phosphatic calculus, hernia, nervous exhaustion, dyspepsia, diarrhoea, prolapse of the rectum, balanitis, phimosis and masturbation; all these problems could be rapidly cured "by the simple operation of circumcision", while "disastrous results" would arise from avoiding the procedure. Naylor is apparently conversant with some of the British and US literature: he attributes the tendency to "self-abuse among young boys" to the irritation produced by secretions under the foreskin, tempting the lad to handle his penis, but he does not appear to have read (or has not been swayed by) some of the more extreme proponents of genital discipline in the US. The major advantages of circumcision are that "at the age of adolescence there is much less disposition to masturbation" and that in adult life "there is much less danger of contracting gonorrhoea and syphilis". The latter proposition goes back to Acton, and the evidence for it at this time was the belief that Jews had a lower level of venereal disease than the uncircumcised, and Naylor duly points out that very few Jews present with such complaints. (88) Not all the advocates of circumcision who followed Naylor made such extravagant claims for its therapeutic value, but nearly all followed him in listing its major benefit as the prevention (or reduction) of masturbation, and many also mentioned its value as a protection against VD. The following year A.S. Joske, having noted that more children were being brought in to the Alfred Hospital to be circumcised, emphasised the value of the operation for adults as well: it removes certain impediments to intercourse, and is a great preventative of chances of syphilis [sic: probably a printer's error for "chancres and syphilis"], of intestinal gonorrhoea, and possibly epithelioma, and under certain conditions removing the prepuce early may tend to keep boys from masturbation. (89) Joske did not specify what those conditions might have been, but one gets his drift. Similar points were made by the better-known Philip Muskett, a prolific writer on a wide range of medical, diet and lifestyle matters. He was the author of several books on child rearing and diet, none of which discusses circumcision, and of the Illustrated Australian Medical Guide, a two-volume household reference work which first appeared in 1903 and reached a second edition in 1909. This includes a very positive entry on circumcision in which Muskett adds climate to the reasons why the operation should be generally performed: "In this semi-tropical Australian climate of ours it would be infinitely better if circumcision were the rule, and not the exception". As with Naylor, the problem was that troublesome foreskin: it was liable to phimosis; it accumulated smegma, a substance which soon acquired "a very unpleasant, even markedly offensive odour"; it was likely to adhere to the glans; its opening was inclined to be too small to urinate through comfortably; it was likely to become irritated and inflamed; it could led to bed-wetting; it could provoke nervous disorders; it could constrict the proper growth of the penis; and it led to masturbationâ€”"bad habits are frequently induced by boys meddling with themselves, in consequence of the irritation produced". There was clearly only one thing to be done, and that was to follow the example of the Jewish race and "many other Eastern nations". (90) Muskett was not an extremist like some of the US doctors. His main concern seems to have been physical cleanliness, and on the surface at least he seems to have been worried only by long or tight foreskins, not foreskins per se. But as I suggest below, these formulations were not as limiting as they might seem: "cleanliness" was often as much a matter of sexual abstinence as soap and water, and in the absence of any studies of its anatomy and functions who was to judge whether a foreskin was too long or tight? (91) Muskett writes that "no male with a proper sense of cleanliness can feel that his bath has been complete, in the presence of a long or tight foreskin", (92) but it is difficult to see why a long (but retractable) one could not be scrubbed as thoroughly as its owner could withstand. If you wanted your foreskin to pass Dr Muskett's test, it had better be pretty modest. The need for self-restraint in sexual matters, the problem of the foreskin, the dangers of masturbation and the value of circumcision were brought together at a conference on the teaching of sex hygiene, organised by the Workers Educational Association of New South Wales in November 1916. The main focus of the conference was on how sex education could be used to teach children and adolescents the value of self-control in relation to sex, "preparing the minds of the young and stiffening their moral fibre against the pitfalls that await those ignorant of their physical functions". (93) Hygiene was not just a matter of physical cleanliness; as an editorial in the Australasian Medical Gazette had pointed out, it was "a matter more of moral than of intellectual consciousness" (94) and primarily a moral issue: "Just as physical dirt causes disease of the body, so moral dirt causes disease of the soul. A clean mind is as necessary for our moral welfare as a clean body is for our physical welfare", as Power put it in the Boy Scouts Handbook. (95) Above all it was a matter of sexual purity and continence: While the intensity and all-pervading influence of the sex instinct was constantly dwelt upon, almost every speaker urged the necessity and possibility of fostering self-restraint from the tenderest years. Despite the irregularities of youthful conduct, and the strength of the temptations that beset the adolescent, no speaker would abate one jot of the influence of healthy physical and moral training in its preventive action. (96) The main concern of the conference was venereal disease, the spread of which had been accelerated by the war, but masturbation came in for its own share of condemnation and tended to be seen as a precocious awakening of the sexual instinct that would lead a young man to prostitutes later on. It is of course relevant that the medical profession at this time was powerless against VD. In an age which lacked antibiotics but believed that alternative forms of sexual gratification like masturbation were both sinful and physically damaging, the only cure for venereal infections was indeed not to contract them, so it is not surprising that continence was a policy urged by both the moral and the medical establishments. The medical profession believed that it was the duty of parents to teach children "the objects of marriage and the necessity for abstaining from the gratification of sexual desires until marriage", as well as "the prolonged and serious ill-health which may result from self-abuse", but it was up to the experts to educate the public as to the dangers of VD. (97) At the WEA conference itself the importance of the issue was underlined by the presence of that veteran purity campaigner, Richard Arthur, whose paper "Teaching control of the sex instinct" rehearsed his familiar theme that there should be no sexual activity of any kind before marriage. The sociologist H. Tasman Lovell likewise spoke about "the necessity for greater self-restraint" and referred specifically to self-abuse as one of the evils that must be inhibited. (98) In this context the prophylactic value of circumcision was quickly recognised. In his paper "Sex irregularities of childhood and youth", W.A.T. Lind, a pathologist with the Victorian Lunacy Department, noted that masturbation was the chief problem and that the main cause was usually a "peripheral source such as local irritants". To deal with these, strict rules of personal hygiene should be observed, and girls should be prevented from riding bicycles. Lind commented that it was difficult to identify individuals addicted to the habit, as there was "nothing to distinguish the casual masturbator from the ordinary youth", though the former was usually unhappy, in poor health and suffered from weakness of attention. As to treatment, Lind recommended a combination of moral suasion and surgical intervention: Every youth suspected of the practice should be sent for medical inspection. He will at first stoutly deny the habit, as all masturbators are liars for the shame of the thing. Kindly advice from the physician ... that no permanent damage to his brain ... will result, provided he ceases to practice the habit, will go far to restoring the lad's confidence in himself. If there are any physical conditions present, such as an adherent foreskin, piles etc. ... they should receive surgical attention so that the reflex irritation from them may not stimulate the sexual organs. (99) Prevention of masturbation was also the prime concern of Sir Thomas Anderson Stuart, Dean of the Faculty of Medicine at Sydney University. After a brief recital of the damage resulting from the practice and the signs by which an educator could recognise a boy with bad habits, Stuart turns to the culprit: "All this inevitably brings up the question of the foreskin", and he goes on to praise the Semitic peoples for their approach to the problem: many ancient races met the same difficulty, and quite independently got over it by cutting the foreskin off in the operation of circumcision. This was made into a sacred rite ... by the Jews, Mohammedans, and many Semitic and other races. The only important Semitic peoples who did not follow the rite were the Philistines, the Babylonians and the Assyrians, and we can imagine some Jew asking, where are these people now? (100) Stuart's tone is a touch facetious, but it is clear that he admires and is urging emulation of Jewish practice; his allusion to Ninevah and Tyre (capitals of fallen empires named in Kipling's well known poem, "Recessional") would not have been lost on his wartime audience, and it is a suggestive confirmation of the link that Hyam has drawn between circumcision and imperial destiny. (101) Turning from geopolitics to personal hygiene, Stuart attributes the origin of masturbation to the secretions which accumulate under the foreskin if it "is at all longâ€”and it often is", producing irritation and leading a boy to rub the parts. Careful washing sometimes works "if this is done as a matter of habit", but if the foreskin "gives rise to persistent trouble", then "the surgeon must procure relief by the little operation of circumcision". (102) The discussion which followed this paper provides further illustration of the extent to which Jewish custom was regarded as the right model. Geo. Lewis was concerned that the boys and girls of today were "growing up without the power of self-control" and believed that "if we could get back to the law of Moses regarding the cleanliness of our bodiesâ€”circumcision, I refer toâ€”we would have a better class of men". He went on to regret that "our Christian laws" do not require "this small surgical operation [to be] performed on our boy children", even though we admit "it is clean and necessary". (103) Two features of these remarks deserve comment. First, although doctors certainly encouraged parents to treat their children like criminals when masturbation was suspected, I am not aware of anybody else in Australia who seemed to hint that circumcision should actually be required by law. Second, Lewis exemplifies the extent to which the advocacy of circumcision in Australia was part of a progressive and scientific movement, and how support for the practice was more widely diffused among the working class than in Britain. In the working man's paradise, health benefits available only to the rich at home would be the birthright of every boy and proof of his parents' aspirations to gentility. This conference was held by the Workers Educational Association, and Lewis himself was secretary of the NSW Branch of the Federated Millers' and Mill Employees' Association of Australasia. He was also a JPâ€”all round, the very model of the respectable trade union leader. The one child care expert at the conference was Zoe Benjamin, a lecturer in psychology at the Kindergarten Training College. She had read Holt (and in fact quoted from his Diseases of infancy and childhood in her paper), so she was well versed in the dangers of masturbation and not afraid to recommend heroic remedies: The practice may be corrected by mechanical and physical means, such as tying the hands, smacking, etc., up to the age of about three years, but after that age severity rarely has any effect, as it may lead to secrecy and lying, with consequent debasing of the moral fibre of the child. ... Some harmless but unpleasant medicine, occasional bathing of the parts with cold water, would help this treatment, and for the rest one must reason with the child and encourage him in every way towards self-control. If such measures are fruitless, then a slight operation in the case of both boys and girls may be the only cure. (104) Such comments certainly make one pause to reflect on how far the treatment of children has changed over the last eighty years, but also on how uneven the process has been. Nobody in the "permissive sixties" would have proposed that children should be tied up to prevent them from touching their genitals, but no voices were raised against the practice of cutting the foreskins off baby boys until the end of the decade, (105) and even then it took another fifteen years for the practice to become rare. And what does one make of Benjamin's suggestion that masturbating girls should also be the subject of an unspecified surgical attention? Although clitoridectomy had had a brief vogue in England in the 1860s the operation was quickly discredited and condemned by the Obstetrical Society, from which its leading exponent was expelled. (106) It was more popular in the US, but Benjamin's brief mention is one of the very few references to the practice I have encountered in the Australian literature. Benjamin moderated her views slightly in later years. Although she continued to regard masturbation as a bad thing which must be stopped, she sought to discourage the practice of smacking children who did it, on the ground that this only drew attention to the habit. She also referred disapprovingly to the case of a mother who had "threatened her six-year old son that if he continued to touch himself the doctor would cut off his penis". (107) Yet who can blame the mother when the doctors and child care experts had done their work so well? They had been painting fearful pictures of the dangers of self-abuse for years, and while it was only a few doctors in the US who wanted to go this far, and then only in extreme cases, the medical profession generally did urge the routine removal of a significant proportion of the infant penis with precisely this consideration in mind. <h3>Childcare advice</h3> In the wake of doctors, academics and other opinion leaders came a host of child-rearing advisers who more or less repeated their prescriptions for a popular and information-hungry audience. Kerreen Reiger has shown how, in the Edwardian period, successful child-rearing ceased to be seen as a capacity natural to women and became a skill that had to be learned; mothers increasingly sought expert advice on how to do it properly. (108) A growing number of books on baby and child care were published, and many of these advised circumcision for male babies. One of these was by Ellice Hopkins, another veteran of the English purity campaigns, (109) who was more concerned with the moral training of boys than practical advice on baby clothes. Her book The power of womanhood went through two editions in Australia and was directed even at those who could not afford an experienced nurse. Hopkins urged mothers always to be present at their sons' bath, because "often evil habits arise from imperfect washing and consequent irritation; and many a wise mother thinks it best on this account to revert to the old Jewish rite of initiation by which cleanliness was secured". (110) Writing specifically for a working class audience was Mary Gilmore, who used her regular column in The Worker (newspaper of the Australian Workers Union) to urge the provision of properly trained nurses in rural areas who knew how to handle problems common among little boys. Her language is a little coy, but her meaning is plain: mothers will ask me about things in relation to their children which, had they had trained nurse, they would have been advised to have seen to at once. One cannot be too definite here, but cases have come under my observation ... where vicious habits were developed, and neither mother nor child knew why. Many a boy owes the ruin of his life to the lack of a small surgical attention in babyhood. But it was as much a moral as a medical issue: to send the child forth "as God made him" was to let the Devil get him. (111) It would be interesting to know what Gilmore had been reading; she gives no references, but her paragraph is a telling indication of how far the case for circumcision had spread by 1908. Muskett might have been one source, as he probably was for Edith Aitken, who repeats a number of points that could have come from the Australian Medical Guide in her own treatise on child rearing, The Australian mothers' own book (1912). Circumcision, she writes, is necessary "in the case of a tight or redundant foreskin .... Mothers should not hesitate to have it performed if advised to do so by a medical man." Following Muskett (though the point had been made by dozens of authorities), Aitken observes that a tight foreskin will cause irritation that leads to masturbation and that it may inhibit urination. It may also be the cause of bed-wetting, in the case of which "an examination of the foreskin will undoubtedly reveal something abnormal, necessitating immediate circumcision". (112) In The ladies handbook of home treatment, a popular guide for mothers which went through numerous editions between 1905 and 1930, F.C. and Eulalia S. Richards also took up these themes. They urged parents to guard against masturbation, pointing that it is "practised by children of all ages and of both sexes" and warning that it was both morally wrong and physically harmful. The "excitation of the nerves" enabled the child to enjoy the sensations which should "only be experienced by the fully-developed man or woman in the married state". Masturbation also injured the mind, leading to loss of self-control, immorality and drunkenness; in boys capable of ejaculation "the immature system is weakened by the premature loss of this most highly vitalised of body fluids". (113) To control the habit the Richards enjoined parental vigilance, moral admonition and surgical intervention: Circumcision often effects a speedy cure in cases of boys addicted to self-abuse. We have no hesitation in saying that almost every boy who practises secret vice should be circumcised, as the operation usually exerts a very favourable influence on the child, apart from the good it accomplishes in correcting local defects. (114) In discussing the contribution of the foreskin to genital irritation and hence masturbation, the Richards ran up against the problem that the infamous "adherent foreskin" is "so universal in new-born male infants that it can scarcely be termed a malformation", but they did not flinch from preferring the conclusions of medical science to the evidence of nature: however natural it may be, "it is a condition which requires treatment, as secretions collect under [it] ... and cause irritation"; if the foreskin cannot be retracted and permanently separated from the glans, circumcision is necessary. (115) Even if not adherent, tight foreskins could also cause endless problems: sleeplessness, night terrors, "spasms of the bladder", retention of urine, bed-wetting, epilepsy, frequent erections and, of course, masturbation; in such cases, whether the boy is masturbating or not, "circumcision should be performed at an early date". (116) The same enthusiasm is displayed by Dr Gertrude C. Buzzard Dunlop, who told parents that "the bad habit of self-abuse (masturbation) is easily formed" and that "a tight foreskin" was often the cause. She noted that "some people believe that all baby boys should be circumcised" and agreed that the practice made it "easier for a boy to keep himself clean" and made youths less susceptible to venereal infection. So far these were medical commonplaces, but Dunlop added the novel point that treatment for VD was more difficult in the uncircumcised. She did not make clear whether all boys should be done as a matter of course, but she believed it was better to err on the side preventive caution: "If there is any doubt about the tightness of the foreskin or if the child is masturbating, have him circumcised". Dunlop also advised that the operation should be performed as early as possible: "it is less of a shock to a young baby and he is too young to interfere with his dressings". (117) <h3>Frederic Truby King and congenital phimosis</h3> Some of the tensions in the case for circumcision are apparent in the writings of Dr (later Sir) Frederic Truby King. He was possibly the doyen of the child care guidance experts in Australia and New Zealand in the 1920s and 30s, Director of Child Welfare, New Zealand, President of the Royal Society for the Health of Women and Children and widely read on both sides of the Tasmanâ€”the Dr Spock of the inter-war years, at least within the British Empire. King's international celebrity stemmed from the success of his organisation in reducing infant mortality in New Zealand. His most important book, The feeding and care of the baby, was first published in 1908, and by the 1920s it was "a virtual bible for many in infant welfare". (118) His views on masturbation and circumcision were thus assured of a wide and attentive audience. King is impeccably orthodox in regarding masturbation as a "serious vice" that should be checked as soon as possible and quotes a number of British and US sources, including Professor Holt, on the injurious consequences of the habit and the need for preventive action. He even attributes the current vogue for circumcision to the impression that it "tends to lessen the tendency to Masturbation in boys", but at this point he surprisingly diverges from the views of his colleagues. On this crucial question he is sceptical and doubts whether there are sufficient data to warrant practising it "as a mere matter of routine". In fact he goes further and ventures that there were "reasons for regarding the normal foreskin rather as a protection ... than as necessarily a source of danger", as indeed it was generally viewed. King stops short of advising that boys should not as a rule be circumcised and turns to the problem foreskin, those that are "over-long", "tight" or "adherent" and runs into the difficulty that doctors had forgotten what a normal foreskin was meant to look like or what it was meant to do. Ignorant of the physiology of the penis and trapped by Sayre et al's categories, he is led rapidly back to the camp of the circumcisers: "a tight, too long, or adherent foreskin is objectionable, as being uncleanly, a source of local irritation and an incitement to bad habits". King assures his readers that it is only these problem foreskins that need to be removed: "If the foreskin can readily be drawn back in infancy there need be no anxiety"; if it cannot, the surgeon must be summoned without delay. (119) But what looks like a large concession turns out to be a very small one. When the development and function of the foreskin were actually studied, it was found to be retractable in only 4 per cent of newborn babies and in only 20 per cent of those aged six months; separation of the foreskin from the glans was a gradual process, taking anything from six months to five years to complete. (120) King insisted that that the first duty of mothers and nurses was to try to separate the foreskin from the glans within the first month of life; we don't know how many followed this advice (probably most), but it must be recognised that they faced a dilemma: if this project was successful, it was likely to harm the tissue of both structures (bleeding, adhesions, skin bridges and other problems), often requiring removal of the damaged foreskin later; if it was unsuccessful, immediate circumcision was clearly necessary. In another text King was stricter and enjoined nurses and mothers to achieve complete separation of foreskin from glans within the first week, by which time "full uncovering of the acorn-like end of the organ should be accomplished". (121) King thus believed that circumcision would be needed only in the 5 per cent of cases where this was not possible; but given Gairdner's findings, on the basis of his own specifications the circumcision rate would have to be 96 per cent if carried out at birth, 80 per cent at six months, and so on down at higher ages as boys' bodies developed. Like many others, King was also troubled by the problem of washing the genitals. Gollaher has pointed out that in the late Victorian period cleanliness became an essential component of respectability and an important means of distinguishing nice people from "the great unwashed"; (122) similar views were expressed in Australia by Muskett. Bodily cleanliness thus assumed great importance, but the hygiene of the genitals posed a problem. Obviously they had to be kept clean, but herein lay the equally obvious danger that the manipulation involved could be found pleasurable and give rise to the usual bad habits. Contrary to Acton, King believed that instructing parents to wash their children's genitals was bad advice; it was in fact "one of the best means of teaching the child self-abuse", and the "natural parental instinct to chide or slap a child for 'fingering the privates' is sounder and more wholesome". (123) Zoe Benjamin was also aware of this dilemma. In one of her later books on child rearing she considered the various causes of masturbation and advised: "When bathing children, great care should be taken in handling and drying those parts of the body. They should be touched firmly so that no tickling sensation is set up, but not so firmly that the child is hurt". (124) A fine line to tread. It was indeed this difficulty which lay behind the common concern that servants and nurses often taught young children bad habits by careless bathing procedures or deliberate fondling of the genitals to quieten them, a common complaint going back to Beaney, Acton and beyond. As William J. Robinson had so plainly put it in 1915: The prepuce is one of the great factors in causing masturbation in boys. Here is the dilemma we are in: If we do not teach the growing boy to pull the prepuce back and cleanse the glans there is danger of smegma collecting and of adhesions and ulcerations forming, which in their turn will cause irritation likely to lead to masturbation. If we do teach the boy to pull the prepuce back and cleanse his glans, that handling alone is sufficient gradually and almost without the boy's knowledge to initiate him in to the habit of masturbation. ... Therefore, off with the prepuce! (125) The final solution to the difficulty lay in removing the root of the irritation. <h3>References</h3> <ol> <li style="font-weight: 400;">I think the term "preventive" is more accurate than the others currently in use because it captures the fact that the aim of the procedure was not only to prevent supposed medical problems, but also to discourage sexual activity itself. The term also distinguishes the medically-based circumcision introduced in the late nineteenth century from ritual or religious circumcision, which is equally routine and forcible, but not performed with the same ends in view. Ritual circumcision is essentially a tribal initiation, intended to mark the initiate as belonging to a particular religious or ethnic group; "routine neonatal circumcision" could equally describe Jewish circumcision as the medically rationalised variety, "involuntary routine circumcision" the Moslem practice and the procedures of some tribal cultures at puberty or other stages of life. "Preventive" does not quite convey the compulsory nature of the operation, but the term "forcible preventive infant (or neonatal) circumcision" is both too clumsy and too truthful to win wide acceptance.</li> <li style="font-weight: 400;">Gollaher, David L. From ritual to science: The medical transformation of circumcision in America.Journal of Social History 1994; 28:5â€“36; Gollaher, David L. Circumcision: A history of the world's most controversial surgery. NY: Basic Books; 2000.</li> <li style="font-weight: 400;">Acton, William.The functions and disorders of the reproductive organs. 3rd edition. Philadelphia: Lindsay and Blakiston; 1865 (reprinted from third London edition), p. 21.</li> <li style="font-weight: 400;">Acton, William.The functions and disorders of the reproductive organs. 3rd edition. Philadelphia: Lindsay and Blakiston; 1865 (reprinted from third London edition). p. 22.</li> <li style="font-weight: 400;">Acton, William.The functions and disorders of the reproductive organs. 3rd edition. Philadelphia: Lindsay and Blakiston; 1865 (reprinted from third London edition),p. 22 and footnote.</li> <li style="font-weight: 400;">Acton, William.The functions and disorders of the reproductive organs. 6th edition. London: J. and A. Churchill; 1903. p. 7.</li> <li style="font-weight: 400;">Gollaher DL. From ritual to science: The medical transformation of circumcision in America.Journal of Social History 1994; 28:5â€“36; Gollaher DL. Circumcision: A history of the world's most controversial surgery. NY: Basic Books; 2000. ch. 4; Hodges FM. A short history of the institutionalization of involuntary sexual mutilation in the United States. In: Denniston GC and Milos MF, editors. Sexual mutilations: A human tragedy. New York: Plenum Press; 1997. pp. 17â€“40.</li> <li style="font-weight: 400;">Eagle, Chester.Play together dark blue twenty. Melbourne: McPhee Gribble; 1986. p. 134.</li> <li style="font-weight: 400;">Circumcision. Letter from S.P. Bellmaine, Honorary Secretary, Australian Paediatric Association. Med J Aust. 1971;1:1148.( 22 May).</li> <li style="font-weight: 400;">Wallerstein, Edward.Circumcision: An American health fallacy. NY: Springer; 1980. p. 29.</li> <li style="font-weight: 400;">Australian College of Paediatrics, Standing Committee on Perinatal Medicine. Statement on circumcision, 1983; reviewed 28 May 1991.</li> <li style="font-weight: 400;">Australian College of Paediatrics, Standing Committee on Perinatal Medicine. Position statement: Routine circumcision of normal male infants and boys. 27 May 1996.</li> <li style="font-weight: 400;">Communication from Dr Frances de Groen, University of Western Sydney, March 1999. I am pleased to report that in 1983 she said "No."</li> <li style="font-weight: 400;">NOCIRC Australia. Statistics on the incidence of circumcision in Australia, 1994â€“95. Seen at www.cirp.org/library/statistics/Australia. 11 December 2000.</li> <li style="font-weight: 400;">Statistics on the incidence of circumcision in Australia based on Medicare claims, 1994â€“2000. Seen at www.cirp.org/library/statistics/Australia. 11 December 2000. These figures are based on Medicare (public health insurance) claims and differ slightly from the NOCIRC figures, since they cover calendar rather than financial years.</li> <li style="font-weight: 400;">Russell, Terry. Debate: Male circumcision remains a valid procedureâ€”Yes.Australian Doctor. 24 May 1996. p. 54</li> <li style="font-weight: 400;">Remondino, PC.History of circumcision from the earliest times to the present: Moral and physical reasons for its performance. Philadelphia and London: FA Davis; 1891. p. 186.</li> <li style="font-weight: 400;">Review of Remondino,History of circumcision. Br Med J. 1892;1:391â€“2. (20 February).</li> <li style="font-weight: 400;">Dreyfus, Kay editor.The farthest north of humanness: The letters of Percy Grainger. Melbourne: Macmillan; 1985. p. 246.</li> <li style="font-weight: 400;">Davison, FD.The white thorntree. Sydney: Ure Smith; 1970. 2 vols. I, p. 173.</li> <li style="font-weight: 400;">Marr, David.Patrick White: A life. Sydney: Random House; 1991. p. 4.</li> <li style="font-weight: 400;">Ward, Russel.A radical life: The autobiography of Russel Ward. Melbourne: Macmillan; 1988; pp. 2, 9.</li> <li style="font-weight: 400;">Braddon, Russell.The naked island. London: Werner Laurie; 1952. p. 167.</li> <li style="font-weight: 400;">Moran, Herbert.Viewless winds: Being the recollections and digressions of an Australian surgeon. London: Peter Davies; 1939. p. 3; Beyond the hills lies China: Scenes from a medical life in Australia. Sydney: Dymocks; 1945; p. 128.</li> <li style="font-weight: 400;">Joske, AS. Methods and management of circumcision. Intercolonial Medical Congress of Australia, Tasmania, 1902.Transactions of Sixth Session. p. 281.</li> <li style="font-weight: 400;">Lucas, TP.Domestic medicine: How to live and how to avert and cure disease. Brisbane: Edwards Dunlop; 1906. p. 241.</li> <li style="font-weight: 400;">Joske, AS. Methods and management of circumcision. Intercolonial Medical Congress of Australia, Tasmania, 1902.Transactions of Sixth Session.p. 281.</li> <li style="font-weight: 400;">Reviews and notices of books.Australasian Medical Gazette. 1908;XXVII:362. (No. 7, 20 July).</li> <li style="font-weight: 400;">Holt, L Emmett.The diseases of infancy and childhood. New York; 1897. p. 698; Spitz, RA. Authority and masturbation: Some remarks on a bibliographical investigation. Psychoanalytic Quarterly 1952; 21: p. 506; Gollaher DL. From ritual to science: The medical transformation of circumcision in America. Journal of Social History 1994; 28. p. 21.</li> <li style="font-weight: 400;">King, Mary Truby.Mothercraft. Sydney: Whitcomb and Tombs; 1934. p. 213.</li> <li style="font-weight: 400;">Reviews and notices of books.Australasian Medical Gazette. 1910;XXIX:250. (No. 5, 20 May).</li> <li style="font-weight: 400;">Spitz. Authority and masturbation: Some remarks on a bibliographical investigation.Psychoanalytic Quarterly 1952; 21: p. 521; Hodges FM. A short history of the institutionalization of involuntary sexual mutilation in the United States. In: Denniston GC and Milos MF, editors. Sexual mutilations: A human tragedy. New York: Plenum Press; 1997. p. 23.</li> <li style="font-weight: 400;">Workers Educational Association of New South Wales.Teaching of sex hygiene: Report of a conference. Sydney: NSW Government Printer; 1917. p. 92.</li> <li style="font-weight: 400;">James, W Howard.Home nursing and ailments of children: A handbook for mothers. Warburton (Australia): Signs Publishing Co; 1923. p. 352.</li> <li style="font-weight: 400;">Sangster, JA. Letter: Circumcision of infants. Med J Aust. 1917;2:323. (No. 15, 13 October).</li> <li style="font-weight: 400;">Vallack, A. Letter: Routine circumcision. Med J Aust. 1917;2:367. (No. 17, 27 October).</li> <li style="font-weight: 400;">BMA News: Circumcision. Med J Aust. 1923;1:594. (No. 21, 26 May).</li> <li style="font-weight: 400;">Peck, Muriel.Your baby: A practical guide for mothers and nurses. Melbourne: Woman's World; 1925, 1929, 1939.</li> <li style="font-weight: 400;">Hufeland, Christoph Wilhelm.The art of prolonging human life. New edition, with notes by an English physician. London: Simpkin and Marshall; 1828. p. 231. (Translation of Die Kunst das menschliche Leben zu verlangen, 1797).</li> <li style="font-weight: 400;">Remondino, PC.History of circumcision from the earliest times to the present: Moral and physical reasons for its performance. Philadelphia and London: FA Davis; 1891. pp. 254â€“5.</li> <li style="font-weight: 400;">Walker, David. Continence for a nation: Seminal loss and national vigour.Labour History 1985; No. 48:1â€“14; Modern nerves, nervous moderns: Notes on male neurasthenia. Australian Cultural History 1987; No. 6:49â€“63; Energy and fatigue. Australian Cultural History 1994; No. 13.</li> <li style="font-weight: 400;">Walker, David. Continence for a nation: Seminal loss and national vigour.Labour History 1985; No. 48: p. 7.</li> <li style="font-weight: 400;">Personal recollection of the author. Grimwade House was one of the two junior schools of Melbourne Grammar, a leading private school, covering grades one to eight.</li> <li style="font-weight: 400;">Bennett, Paula and Rosario, VA editors.Solitary pleasures: The historical, literary and artistic discourses of autoeroticism. New York and London: Routledge and Kegan Paul; 1995. p. 2.</li> <li style="font-weight: 400;">Hospital Reports.Australian Medical Journal. 1860;V:233â€“4. (July).</li> <li style="font-weight: 400;">46. Australian Dictionary of Biography. Vol. 3. pp. 124â€“6.</li> <li style="font-weight: 400;">Beaney, George.Spermatorrhoea in its physiological, medical and legal aspects. Melbourne: Walker publishers; 1870.</li> <li style="font-weight: 400;">Beaney, George.The generative system and its functions in health and disease. Melbourne: FF Bailliere; 1872. Because I make so many references to these books, pages numbers are inserted in the text.</li> <li style="font-weight: 400;">Christoph Wilhelm Hufeland (1762â€“1836) was Professor of Medicine at University of Jena and author ofDie Kunst das menschliche Leben zu verlangen (The art of prolonging human life, 1797). A mixture of lifestyle advice and moral exhortation, it is hardly a medical work in the modern sense, but it was typical of its time, frequently reprinted, translated into French and English and widely read during the first three quarters of the nineteenth century.</li> <li style="font-weight: 400;">Hufeland, Christoph Wilhelm.The art of prolonging human life. New edition, with notes by an English physician. London: Simpkin and Marshall; 1828. p. 231.</li> <li style="font-weight: 400;">Springthorpe, John. On the psychological aspect of the sexual appetite.Australasian Medical Gazette 1884;V:8â€“13.</li> <li style="font-weight: 400;">Melbourne Paediatric Society [Report of meeting, 12 March 1913].Australian Medical Journal. 1913;II (New series):1014â€“15. (26 April).</li> <li style="font-weight: 400;">Power, M Danvers.Mother and child. No place of publication or publisher given. [Sydney?]: 1913; pp. 39â€“45.</li> <li style="font-weight: 400;">Power, Frederick Danvers.Australian boy scouts handbook. Sydney: Angus and Robertson; 1922. 2 vols. I, pp. 45â€“6.</li> <li style="font-weight: 400;">Hall, Lesley. Forbidden by god, despised by men: Masturbation, medical warnings, moral panic and manhood in Great Britain, 1850â€“1950, in Fout JC, editor.Forbidden history: The state, society and the regulation of sexuality in modern Europe. Chicago: University of Chicago Press; 1992. p. 301.</li> <li style="font-weight: 400;">Piddington, Marion.Tell them! Or the second stage of mothercraft: A handbook of suggestions for the sex-training of the child. Sydney: Moore's Bookshop; n.d. [c.1926]. p. 226.</li> <li style="font-weight: 400;">Neumann, RP. Masturbation, madness and the modern concepts of childhood and adolescence.Journal of Social History 1975;8:1â€“27.</li> <li style="font-weight: 400;">Freeman, Howard and Dr Wallace.Rescued at last: Being clinical experiences on nervous and private diseases. Sydney; No publisher or date of publication [1898?]. Chapter 4, pp. 30â€“51.</li> <li style="font-weight: 400;">Towle, WB.The sexual system in health and disease. Sydney; No publisher or date of publication [1898?]. 11th edition. pp. 107â€“8.</li> <li style="font-weight: 400;">Freeman, Howard and Dr Wallace.Rescued at last: Being clinical experiences on nervous and private diseases. Sydney; No publisher or date of publication [1898?]. p. 98.</li> <li style="font-weight: 400;">Freeman, Howard and Dr Wallace.Rescued at last: Being clinical experiences on nervous and private diseases. Sydney; No publisher or date of publication [1898?]. pp. 199â€“205.</li> <li style="font-weight: 400;">Towle, WB.The sexual system in health and disease. Sydney; No publisher or date of publication [1898?]. 11th edition. p. 108.</li> <li style="font-weight: 400;">Towle, WB.The sexual system in health and disease. Sydney; No publisher or date of publication [1898?]. 11th edition. p. 161.</li> <li style="font-weight: 400;">Quaife, WF. Tinnitus connected with onanism.Australasian Medical Gazette 1896; XV:20â€“22 . Discussed in Walker D. Continence for a nation: Seminal loss and national vigour. Labour History 1985; No. 48: pp. 8â€“9.</li> <li style="font-weight: 400;">Courtenay, FB.On spermatorrhoea and certain functional derangements and debilities of the generative system: Their nature, treatment and cure. London: Bailliere, Tindall and Co.; 1882; 12th edition.</li> <li style="font-weight: 400;">Beaney.Spermatorrhoea in its physiological, medical and legal aspects. Melbourne: Walker publishers; 1870. p. x. Further references in this paragraph are inserted in the text.</li> <li style="font-weight: 400;">Beaney.The generative system and its functions in health and disease. Melbourne: FF Bailliere; 1872. p. 146.</li> <li style="font-weight: 400;">Lewis, Milton and Macleod, Roy. Medical politics and the professionalisation of medicine in New South Wales, 1850â€“1901.Journal of Australian Studies 1988; No. 22:69â€“82</li> <li style="font-weight: 400;">Lewis M and Macleod R. Medical politics and the professionalisation of medicine in New South Wales, 1850â€“1901.Journal of Australian Studies 1988; No. 22: p. 79.</li> <li style="font-weight: 400;">Lewis M and Macleod R. Medical politics and the professionalisation of medicine in New South Wales, 1850â€“1901.Journal of Australian Studies 1988; No. 22: pp. 78â€“9.</li> <li style="font-weight: 400;">Moran.Viewless winds: Being the recollections and digressions of an Australian surgeon. London: Peter Davies; 1939. pp. 102, 203â€“6.</li> <li style="font-weight: 400;"> Australian Dictionary of Biography. Vol 7. p. 103.</li> <li style="font-weight: 400;">Arthur, Richard.Purity and impurity. Sydney: Australian White Cross League; n.d. [c.1900]. p. 8.</li> <li style="font-weight: 400;">Arthur, Richard.The training of children in purity: A booklet for parents. Sydney: George Robertson; n.d. [c.1900]. p. 15.</li> <li style="font-weight: 400;">Hyam, Ronald.Empire and sexuality: The British experience. Manchester: Manchester University Press; 1990. pp. 65â€“71.</li> <li style="font-weight: 400;">Arthur, Richard.Purity and impurity. Sydney: Australian White Cross League; n.d. [c.1900]. pp. 10â€“11.</li> <li style="font-weight: 400;">Arthur has evidently read his Acton, who had described nocturnal emissions "occurring once every ten or fourteen days" as "in the nature of a safety valve", but that if they were more frequent or "attended by symptoms of prostration" the "patient" should seek medical advice (William Acton.The functions and disorders of the reproductive organs. 6th edition. London: J. and A. Churchill; 1903. p. 105). The more hot-blooded Philip Muskett was willing to allow boys two wet dreams a week before apprehension need be felt: Muskett, Philip. The illustrated Australian medical guide. Sydney: William Brooks; 1903; 2 vols. II, p. 203.</li> <li style="font-weight: 400;">Cockshut, RW. Letter. Circumcision. Br Med J. 1935;2: 764. (19 October).</li> <li style="font-weight: 400;">Hall, G. Letter. Circumcision. Med J Aust. 1971;2:223. (No. 4, 24 July).</li> <li style="font-weight: 400;">Moran,Viewless winds: Being the recollections and digressions of an Australian surgeon. London: Peter Davies; 1939. p. 226.</li> <li style="font-weight: 400;">Dr Lewis A. Sayre was a distinguished orthopaedic surgeon who discovered in 1870 that a wide range of childhood illnesses was apparently caused by a tight foreskin and could be cured by circumcision. He eventually consolidated his convictions in a book entitledOn the deleterious results of a narrow prepuce and preputial adhesions, published in Philadelphia in 1888. See Gollaher DL. From ritual to science: The medical transformation of circumcision in America. Journal of Social History 1994; 28. pp. 5â€“8; Gollaher DL. Circumcision: A history of the world's most controversial surgery. NY: Basic Books; 2000. ch. 4; Hodges FM. A short history of the institutionalization of involuntary sexual mutilation in the United States. In: Denniston GC and Milos MF, editors. Sexual mutilations: A human tragedy. New York: Plenum Press; 1997. pp. 17â€“40.</li> <li style="font-weight: 400;">Walker D. Continence for a nation: Seminal loss and national vigour.Labour History 1985; No. 48: p. 57.</li> <li style="font-weight: 400;">Beard, George.The new cyclopaedia of family medicineâ€”Our home physician: A popular guide to the art of preserving health and treating disease. Sydney: McNeil & Coffee; 1884. pp. 793â€“805; 882â€“889.</li> <li style="font-weight: 400;">Beard, George.The new cyclopaedia of family medicineâ€”Our home physician: A popular guide to the art of preserving health and treating disease. Sydney: McNeil & Coffee; 1884. pp. 888â€“9.</li> <li style="font-weight: 400;">Howe, Joseph.Excessive venery, masturbation and continence. New York: 1887.</li> <li style="font-weight: 400;">Woolley, Geo. Talbot. Congenital phimosis and adherent prepuce. Intercolonial Medical Congress of Australasia, Melbourne, 1889.Transactions of Second Session. pp. 234â€“5.</li> <li style="font-weight: 400;">Compare Sayre: "Many of the cases of irritable children, with restless sleep, and bad digestion, which are often attributed to worms, is [sic] solely due to the irritation of the nervous system caused by an adherent or constricted prepuce. ... Hernia and inflammation of the bladder can also be produced by the severe straining to pass water in some of these cases." (Transactions of the American Medical Association1870). Quoted in Gollaher DL. From ritual to science: The medical transformation of circumcision in America. Journal of Social History 1994; 28. p. 7.</li> <li style="font-weight: 400;">Naylor, HGH. A plea for early circumcision.Australasian Medical Gazette 1901;XX; 239.</li> <li style="font-weight: 400;">Joske, AS. Methods and management of circumcision. Intercolonial Medical Congress of Australia, Tasmania, 1902.Transactions of Sixth Session. p. 281.</li> <li style="font-weight: 400;">Muskett, Philip.The illustrated Australian medical guide. Sydney: William Brooks; 1903; 2 vols. II, pp. 219â€“20.</li> <li style="font-weight: 400;">It was only in the late nineteenth century, with the pathologisation of male sexuality and the construction of links between the foreskin, masturbation and disease, that phimosis came to be seen as a problem at all. For an illuminating discussion, see Hodges FM. The history of phimosis from antiquity to the present. In Denniston GC, Hodges FM and Milos MF, editors.Male and female circumcision: Medical, legal and ethical considerations in pediatric practice, New York, Kluwer Academic/Plenum Publishers; 1999:37â€“62.</li> <li style="font-weight: 400;">Muskett, Philip.The illustrated Australian medical guide. Sydney: William Brooks; 1903; 2 vols. II, p 220.</li> <li style="font-weight: 400;">Workers Educational Association of NSW.Teaching of sex hygiene: Report of a conference, Sydney: Government Printer; 1917. p. vii.</li> <li style="font-weight: 400;">Sex hygiene and venereal disease [Editorial].Australasian Medical Gazette. 1914;XXXV:14. (No. 19, 9 May).</li> <li style="font-weight: 400;">Power, Frederick Danvers.Australian boy scouts handbook. Sydney: Angus and Robertson; 1922. 2 vols. I, p. 46.</li> <li style="font-weight: 400;">Workers Educational Association of NSW.Teaching of sex hygiene: Report of a conference, Sydney: Government Printer; 1917. p. viii.</li> <li style="font-weight: 400;">Sex hygiene and venereal disease [Editorial].Australasian Medical Gazette. 1914;XXXV:15. (No. 19, 9 May).</li> <li style="font-weight: 400;">Workers Educational Association of NSW.Teaching of sex hygiene: Report of a conference, Sydney: Government Printer; 1917. pp. 40â€“76.</li> <li style="font-weight: 400;">Workers Educational Association of NSW.Teaching of sex hygiene: Report of a conference, Sydney: Government Printer; 1917. p. 85.</li> <li style="font-weight: 400;">Workers Educational Association of NSW.Teaching of sex hygiene: Report of a conference, Sydney: Government Printer; 1917. p. 92.</li> <li style="font-weight: 400;">Hyam, Ronald.Empire and sexuality: The British experience. Manchester: Manchester University Press; 1990. ch. 3.</li> <li style="font-weight: 400;">Workers Educational Association of NSW.Teaching of sex hygiene: Report of a conference, Sydney: Government Printer; 1917. pp. 92â€“3.</li> <li style="font-weight: 400;">Workers Educational Association of NSW.Teaching of sex hygiene: Report of a conference, Sydney: Government Printer; 1917. p. 100.</li> <li style="font-weight: 400;">Workers Educational Association of NSW.Teaching of sex hygiene: Report of a conference, Sydney: Government Printer; 1917. p. 147.</li> <li style="font-weight: 400;">Morgan, WKC. Penile plunder. Med J Aust. 1967;1:1102â€“3. (No. 21, 27 May).</li> <li style="font-weight: 400;">Mosucci, Ornella. Clitoridectomy, circumcision and the politics of sexual pleasure in mid-Victorian Britain. In Miller AH and Adams JE, editors.Sexualities in Victorian Britain, Bloomington: Indiana University Press; 1996. pp. 65â€“69.</li> <li style="font-weight: 400;">Benjamin, Zoe.You and your children, Vol. 1: The young child. Sydney: Gayle Publishing; 1944. pp. 76â€“8.</li> <li style="font-weight: 400;">Reiger, Kerreen.The disenchantment of the home: Modernising the Australian family 1880â€“1940. Melbourne: Oxford University Press; 1985. chs. 6 and 7, esp. p.128.</li> <li style="font-weight: 400;">Hall, Lesley. Forbidden by god, despised by men: Masturbation, medical warnings, moral panic and manhood in Great Britain, 1850â€“1950, in Fout JC, editor.Forbidden history: The state, society and the regulation of sexuality in modern Europe. Chicago: University of Chicago Press; 1992. p. 299; Hyam, Ronald. Empire and sexuality: The British experience. Manchester: Manchester University Press; 1990. pp. 65â€“71.</li> <li style="font-weight: 400;">Hopkins, Ellice.The power of womanhood; or, mothers and sons. A book for parents and those in loco parentis. Melbourne: George Robertson; 1902. 7th edition. p. 47.</li> <li style="font-weight: 400;">Gilmore, Mary. Our women's page.The Worker. 10 September 1908. p. 7.</li> <li style="font-weight: 400;">Aitken, Edith.The Australian mother's own book: A complete treatise on the rearing and management of Australian children. Sydney: George Philip and Son; 1914. p. 76.</li> <li style="font-weight: 400;">Richards, FC and Richards, Eulalia S.Ladies handbook of home treatment: The ladies medical adviser. Melbourne: Signs Publishing Co; n.d. [c.1920]. pp. 50, 348.</li> <li style="font-weight: 400;">Richards, FC and Richards, Eulalia S.Ladies handbook of home treatment: The ladies medical adviser. Melbourne: Signs Publishing Co; n.d. [c.1920]. pp. 349â€“50.</li> <li style="font-weight: 400;">Richards, FC and Richards, Eulalia S.Ladies handbook of home treatment: The ladies medical adviser. Melbourne: Signs Publishing Co; n.d. [c.1920]. pp. 49â€“50, 338.</li> <li style="font-weight: 400;">Richards, FC and Richards, Eulalia S.Ladies handbook of home treatment: The ladies medical adviser. Melbourne: Signs Publishing Co; n.d. [c.1920]. pp. 339â€“40.</li> <li style="font-weight: 400;">Dunlop, Gertrude C. Buzzard.Our babies. No publisher or place of publication. [Sydney?]; 1928. pp. 68, 78.</li> <li style="font-weight: 400;">Reiger, Kerreen.The disenchantment of the home: Modernising the Australian family 1880â€“1940. Melbourne: Oxford University Press; 1985 p. 136. Both he and his daughter Mary wrote on child care issues. The well known radio author and playwright, Betty Roland, tried to get "the eight hours [sleep] prescribed by Dr Truby King" when she was pregnant in the late 1930s (The devious being. Sydney: Angus and Robertson; 1990. p. 27); and Robert Brain remarks that "in the 1920s in Tasmania Truby King was the baby king" (Rites black and white. Ringwood (Aust.): Penguin ;1979. pp. 60â€“61). In view of the links drawn by Walker between the danger of masturbation and the problem of maintaining national vigour, and those drawn by Hyam between the rise of circumcision in Britain and the fears of imperial decline, it is interesting that King turned his attention to infant welfare after a visit to Japan at the time of the Russo-Japanese war. The Japanese victory convinced him, like so many others, that the white races had better get their house in order; he would do his bit by helping to produce healthier babies (Reiger. Disenchantment of the home. p. 136). When in Japan, where breast-feeding was universal, King's enthusiasm for the practice was stimulated by what he saw of the "fitness and excellent physique of the Japanese Army". He had also been impressed by the concerns of Major-General Sir Frederick Maurice about the physical deterioration of the British race (King, Mary Truby. Truby King the man: A biography. London: Allen & Unwin; 1948, pp. 149, 155). Hyam notes that Maurice was an enthusiast for "Jewish child rearing practices" (Hyam R. Empire and sexuality: The British experience. Manchester: Manchester University Press; 1990. p. 77).</li> <li style="font-weight: 400;">King, F. Truby.Feeding and care of baby. London: Macmillan; 1931. pp. 122â€“3.</li> <li style="font-weight: 400;">Gairdner, Douglas. The fate of the foreskin: A study of circumcision. Br Med J. 1949;2:1433â€“1437. (24 December); see also Cold CJ and Taylor JR. The prepuce. Br J Urol 1999; 83 (Supplement 1): 34â€“44. (January).</li> <li style="font-weight: 400;">King, F. Truby.The expectant mother and baby's first months. London: Macmillan; 1930. pp. 70â€“71.</li> <li style="font-weight: 400;">Gollaher DL. From ritual to science: The medical transformation of circumcision in America.Journal of Social History 1994; 28:5â€“36; Gollaher DL. Circumcision: A history of the world's most controversial surgery. NY: Basic Books; 2000. ch. 4.</li> <li style="font-weight: 400;">King, F. Truby.Feeding and care of baby. London: Macmillan; 1931. p. 123.</li> <li style="font-weight: 400;">Benjamin, Zoe.You and your children, Vol. 1: The young child. Sydney. Gayle Publishing; 1944. p. 88.</li> <li style="font-weight: 400;">Robinson, William J. Circumcision and masturbation.Medical World 1915:33. Seen on internet at "Historical medical quotes on circumcision", http://circquotes.tilted.com, 11 December 2000.</li> </ol> </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 A source of mischief (Part 3) 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"> <h2>Muskett and Littlejohn express Victorian foreskin fears</h2> Dr Muskett offers helpful explanations of difficult medical terms, and avoids rude words like "penis", while Dr Littlejohn explains that tongue tie and phimosis are equally serious conditions in a newborn baby, requiring immediate surgery. <h3>Philip Muskett: How the Australian climate demands circumcision (1903)</h3> In the performance of circumcision the foreskin of the male organ is removed. This is the part which is medically known as the prepuce (pree'pews) . It owes its origin to the Latin, praeputium, the foreskin. The prepuce may be described as a kind of fleshy cuff which covers the end of the male organ. When the foreskin is unduly long, it gives rise to the condition having the medical name of phimosis (fi-mo'sis). The significance of this term will be better understood when it is explained that it comes from the Greek, phimosis, a muzzling or closure. As a matter of fact, many of these long foreskins cannot be drawn back so as to show the opening of the water pipe. The derivative meaning of phimosis â€“ a muzzling or closure â€“ is therefore very expressive. [1] The front, rounded end of the male organ, which is covered by the foreskin, is called the glans. It is derived from the Latin, glans, an acorn, because of its fancied acorn shape. Behind the glans itself there is a collection of little cells which manufacture a whitish substance termed smegma (smeg'mah) â€“ from the Greek, smegma, soap. When this material is allowed to remain undisturbed, it acquires a very unpleasant, even markedly offensive, odour. It is, moreover, particularly liable to accumulate under a long foreskin, and frequently produces considerable irritation of the parts. A long foreskin may be troublesome in one of two ways. The internal surface of the foreskin often grows to the top of the glans. When this has occurred, it will sometimes be possible to carefully peel back the prepuce. But the two parts may have so tightly grown together that this cannot be accomplished. In these circumstances the operation of circumcision is necessarily required, as it affords the only means by which the two adherent surfaces can be separated. [2] In other instances, the orifice of the foreskin is exceedingly small. The opening may be so tiny that it will barely admit the end of a hair pin â€“ after it has been made into a straight, long wire. A curious event often happens, when a foreskin has such an unusually small orifice. The urine, as it issues from the water pipe, cannot get away, but accumulates inside and distends the foreskin in a most remarkable manner. This is the so called "ballooning" of the foreskin. [3] A long or tight foreskin is likely to be attended with many serious disadvantages. The parts under the prepuce often become irritated and inflamed from the accumulation of smegma and other retained products. Different disorders of the water pipe and bladder are also disposed to occur. There may be the ailment known as "wetting the bed". The straining in trying to pass water, occasioned by a long or tight foreskin, is liable to bring on rupture. The same condition of the prepuce predisposes to various nervous disorders. It is considered, likewise, that bad habits are frequently induced by boys meddling with themselves, in consequence of the irritation produced. Nor is it to be forgotten that an unnaturally tight foreskin may actually interfere with the proper growth and development of the organ. In this semi-tropical Australian climate of ours, it would be infinitely better if circumcision were the rule and not the exception. Beside the Jewish race, many other eastern nations follow the practice. No male with a proper sense of cleanliness can feel that his bath has been complete, in the presence of a long or tight foreskin. Without the slightest exaggeration I may say that hundreds of male patients have told me how much they bitterly regretted that circumcision had not been performed on them, when they were young. But never yet have I met with a single individual who was sorry that he had been circumcised. The operation is almost uniformly successful. It has its failures, at times, but they are, comparatively speaking, rare. Philip Muskett (1903), The illustrated Australian medical guide (2 vols, Sydney: William Brooks, 2nd edn 1909), Vol. 1, pp. 219-20 <h4>NOTES</h4> 1. Philip Muskett is an interesting character who had a lot of sensible things to say about food, clothing and lifestyle generally in the Australian climate, and he has been hailed by Michael Symons as an early prophet of modern Australian cuisine. His most general book, The art of living in Australia (1893), unites an attractive advocacy of outdoor eating, the consumption of fruit and the development of the wine industry, on the one hand, with some pretty bizarre medical advice on the other. He spends over a page discussing whether iced water is injurious to health and reports, in all seriousness, that "ice-water dyspepsia" has become "a definite malady" in the United States. I have not been able to find out much about Muskett, other than that he was senior resident medical officer at Sydney Hospital in the late nineteenth century. Considering his views on the importance of climate on lifestyle and the advisability of circumcision in hot conditions, I should not be surprised if he had been an army doctor in India at some stage. See Michael Symons, One continuous picnic: A history of eating in Australia, 1982, Penguin 1984, pp. 259â€“60; Muskett, The art of living in Australia, reprinted by Kangaroo Press, 1987, p. 77 There is no entry for Muskett in the Australian Dictionary of Biography, nor in the Oxford Companion to Australian Literature, but the University of Adelaide has made his Art of living in Australia available as an e-text. 2. If it is impossible to peel the foreskin from the glans, it is hard to see how it could be isolated for the purpose of amputation. In fact, the only situations in which the foreskin fuses to the glans are when it has been injured by premature forcible retraction, and the bleeding surfaces bind together, and/or when a clumsy circumcision has been performed, also leading to this result. <a href="http://www.circumstitions.com/Botched1.html" rel="noopener" target="_blank">See some ugly visual examples here</a>. 3. Many little boys go through a phase when their foreskin balloons out when they have a leak, and most boys find it very entertaining. In the early eighteenth century Pierre Dionis actually advised men with phimosis to pinch the foreskin shut while urinating and allow the liquid to stretch the foreskin and clean the inner surface. <a href="http://www.cirp.org/library/normal/babu1/" rel="noopener" target="_blank">It has recently been shown</a> that "ballooning" does not imply any obstruction or pathological condition and is certainly not an indication for circumcision. It is also common for boys in the seven to ten year age group to have competitions to see who can piss the furthest: it would be very cruel to deprive them of this harmless and simple entertainment. <h3>Dr Littlejohn: Tongue-tie and phimosis the chief causes of breast-feeding problems (1907)</h3> The nurse should always, in the case of a [newborn] male, examine the penis to see if the child is suffering from phimosis. It is not at all uncommon to find that there is merely a pinhole opening in the prepuce, necessitating an early circumcision. Now I must go into the matter of tongue-tie here, because I find that numbers of babies are sent to the out-patients by nurses, under the supposition that that they are suffering from tongue-tie, when as a mater of fact not one in six of them has any tongue tie at all. Hence he nurse should know how to examine a child's tongue to see if it is tied or not. The best way to do this is to place the child on its back on the bed, or on a table, and then place the tips of the fist and second fingers under the tip of the tongue, one on each side of the fraenum linguae, with the palm of the hand towards the child's face, and raise the tip of the tongue upwards. This procedure puts the fraenum linguae on he stretch, and if it stands out like a white band to any extent and holds down the tie of the tongue, then the child is suffering from tongue-tie to a sufficient extent to interfere with sucking, and it should be taken to a doctor to have it snipped. Having examined the tongue and assured herself that it is not tied, the Nurse should next, if the child is male, examine the penis for phimosis. There is no more frequent cause of all sorts of troubles in young children than phimosis, and it is a very common cause of refusal to take the breast. The child takes a suck or two, then stops and cries, and obstinately refused to take any more; this is apparently because the taking of the breast causes a desire to micturate, and the child knows by experience that micturition causes him pain owing to the contracted orifice in the prepuce and adhesions between the prepuce and the glans, and he therefore refuses to take the breast, and holds his water frequently for 12 or even 24 hours. Hence it is that, what with increasing hunger and the discomfort of a distended bladder, the child cries and screams night and day, and there is no rest for mother or nurse. I have frequently known this state of things to go on for days, until everybody was worn out, and the mother has at last consented to have the baby circumcised, when immediately he takes the breast freely for the first time, empties the bladder and sleeps all night, and so do the mother and the nurse, and all the trouble is at an end. Hence the nurse should always make a point of examining the child's penis, as it is very common to find only a pinhole orifice, and in rare case there may be no opening at all. In either of these cases circumcision should be performed without delay. Then there are cases in which, though the opening appears to be large enough to allow the child to pass water, yet the prepuce is firmly adherent to the glans and cannot be at all retracted, and the retained smegma praeputii becomes inspissated [1] and causes irritation. This condition often causes just as much trouble, and circumcision is just as necessary. Now I do not wish you to suppose that I am an advocate of universal circumcision. There are many cases in which the orifice in the prepuce is satisfactory, the child passes water freely, takes the breast freely, and there are no symptoms of irritation from adhesions or retained and inspissated smegma, and though the prepuce cannot be retracted thoroughly at first, as time goes on it will be possible to retract it more and more until retraction is complete, and the smegma can be cleared away. In these cases circumcision is not necessary. [2] But I do say this, that if the orifice is so small as to prevent the possibility ultimately of complete retraction and clearing away of retained smegma, the child should certainly be circumcised. For even if there is no immediate trouble with regard to passing water and taking the breast, there are various other troubles that frequently result subsequently. In the first place, owing to the adhesions and the contracted orifice, the child has to strain more or less in passing water, and the phimosis thus becomes a frequent cause of inguinal hernia. Many cases of inguinal hernia in young infants can be cured by performing a circumcision. Then again, if the prepuce cannot be retracted, the smegma praeputii accumulates and becomes inspissated, and is a source of constant irritation. Even in young infants I have found large, hard masses of inspissated smegma. The constant irritation results in enuresis and constant erections, and later on in masturbation. Many cases of masturbation in young children have thus originated. In other cases various reflex nervous symptoms are produced, sometimes even epileptiform convulsions, and I have several times seen cases of paresis [paralysis] of the lower extremities so caused. A child of two or three and running about has entirely, to use the mother's expression, "lost the use of his legs", and the trouble has been quite cured by circumcision. Hence there are many strong reasons in favour of circumcision, and I do not know of a single one against it. [3] Dr E.S. Littlejohn, "The management of babies: Lecture delivered to the Australasian Trained Nurses Association", Australasian Nurses Journal, Vol. 5, 16 September 1907, pp. 259-65 NOTES 1. Inspissated was a favourite word of late Victorian and Edwardian medical men, who seem to have have sensed a profound affinity with it. The Shorter Oxford Dictionary defines inspissate as "to make thick or dense; esp. to reduce (a liquid) to a semi-solid consistency". From the Latin, spissus, meaning thick or dense. 2. This was also the argument of (Sir) Frederic Truby King, the most influential authority on baby care in the period between the wars, who similarly stated that circumcision was necessary only if the foreskin could not be retracted within a week of the boy's birth. Since most foreskins are not retractable until much later, this policy actually meant a very high rate of circumcision. See discussion in <a href="https://www.darboninstitute.org/a_source_of_mischief_part_3" rel="noopener" target="_blank">A source of serious mischief, Part 3</a>, and in McGrath and Young, <a href="http://www.circumstitions.com/NZ.html" rel="noopener" target="_blank">History of circumcision in New Zealand</a>. 3. Dr Littlejohn's strictures against the evils of the adherent prepuce are drawn straight from Victorian medical dogma, and especially the mythology cooked up by the <a href="http://www.cirp.org/library/history/gollaher/" rel="noopener" target="_blank">American orthopaedic surgeon Lewis Sayre</a>. Further information on phimosis and the evolution of medical myths and knowledge about it <a href="http://www.cirp.org/library/treatment/phimosis/" rel="noopener" target="_blank">available at CIRP</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 Edwardian baby care 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"> The following correspondence is from a reader of this site who grew up in Victoria in the late 1940s and 1950s. In these letters, he gives a vivid picture of the discrimination against cavaliers “as uncircumcised penises were often known in those days" at the hands of the dominant and frequently intolerant roundheads. As he reports, circumcision was the norm in those days, and commonly done automatically in the hospital or soon after, without even the formality of seeking permission from the parents. The name of the author has been changed to protect privacy <h2>David Priestly to RD:</h2> I have recently come across your site and articles regarding circumcision which I have found most interesting and informative. As one of the very few Australian born males born in the 1940s to have escaped circumcision, I was particularly interested in your sections about circumcision in Australia. Being one of a very small minority of boys (my estimate for 1944, the year of my birth, being 5%) who had foreskins and were thus significantly different in appearance from all the others, I not surprisingly became interested in circumcision and why I was not circumcised. I daresay you are contacted by many people interested in circumcision, in one way or another and probably suffer from information overload on the topic. However, I wonder if I might correspond with you on this matter regarding my experiences and views on it? <h2>RD to DP:</h2> Thanks for your message. I'd be very interested in hearing more about your own views and experiences, particularly as you were one of the few Australian boys born in the 1940s who were not circed - though I find it hard to believe that the proportion nationally was as low as 5 per cent. I do receive some correspondence on the topic, but I find that most cut men don't want to talk about the issue at all, and that most uncut men can't see that there is an issue to discuss. It's only a small minority of the former whose resentment is strong enough to drive them to any sort of action, and only an even smaller minority of the latter who have sufficient sympathy with their deprived peers to do more than count their own blessings. I do have a fair bit of testimony from circed men who resented it (and I understand that a paper of mine analysing their feelings will be published in a collection of essays later this year), but I have not seen much from uncut men who grew up in a cut world - at least, not in Australia, though there is a fair bit available in the USA. I would thus, as I mentioned, be most interested in your recollections and reflections of growing up in Australia. <h2>DP to RD:</h2> Thank you for your email and for allowing me to correspond with you. Given the puritanical strictures which in my view encompass almost all experience in Australian life, this is something from which I've felt inhibitedfrom doing hitherto. Perhaps I should begin at the beginning, as they say, with my birth. But first, re 5%, I don't know that I mean nationally, but in my experience. I was born in Geelong in 1944 and lived in several places in Victoria - the Mildura area (Sunraysia), Melbourne, a fishing port on the Victorian coast, and the Wimmera - until I left home at 16 to go to university in Melbourne. In both Melbourne and the Wimmera almost no-one had even seen a foreskin, and I was regarded as some sort of anthropological specimen, whilst in the rural areas around Mildura and at the fishing port, perhaps 20% of boys were uncircumcised. Given the respective populations involved, I think that this would average out to about 5%. In the Wimmera, it was well known and remarked on that I was one of only about half a dozen Australian-born boys in the local high school (none of whom was locally born) out of about 200, who were uncircumcised. There were perhaps another half dozen uncircumcised boys who had been born in Europe. Later I lived in at a university college in Melbourne, where there were boys for all over Victoria and beyond and it became apparent that I was the only boy in my year to have a foreskin. Still later, when I was about 25 years old, I was working in the Public Service, and in our area there was a Jewish man, who one day announced that he was uncircumcised. I replied that he could not be a Jew and to look at his Old Testament. After a fairly testy exchange, he asked what I would know about such things; to which I replied that I also was uncircumcised. He answered that therefore I was not an Australian, as he had lived here most of his life and had been to state schools and Melbourne High School and had never seen an Australian who was uncircumcised. (This being "Not Australian" was an issue for me). However, back to the beginning! I am 5th generation Australian and was born in Geelong whilst my father was away during the war. My mother's family had settled in the area from Tasmania in 1840, and my mother and elder brother were living there with my grandparents whilst he was away on active service. As I mentioned in my first email, one of the things which most intrigues me is how boys like me escaped the knife. I know in only three cases, including my own. (Basically I have been too shy to raise the matter.) I knew that it was medical dogma when I was born that boys should circumcised and that my brothers and all other males in our extended family, except my maternal grandfather who was born in 1881, had been done. Why wasn't I? Around the time of my marriage, I decided to ask my mother. She told me that I was born in a small maternity hospital, in a house near where we lived. I was delivered by a midwife and just not circumcised there. However, before she left a few days later, our doctor made an appointment for her to bring me to his surgery at a fortnight old to be circumcised. This she did, and I was prepared by his nurse for circumcising, with my mother holding me. (Gruesome!). When the doctor came he first checked my foreskin and found it, although ample, completely retractile. He told my mother that I did not need circumcising and declined to do it. He did, however, in spite of its looseness, further stretch the foreskin, which apparently caused me to hit the roof, so I can imagine the pain which circumcised boys must have felt. He also told her that the foreskin had to be drawn back, the head washed and the foreskin replaced every day. The same procedure took place during drying. This continued daily until I was six, when I was allowed to bath myself; since I disliked the feeling of my foreskin being pulled back, and even more the wiping of the glans, I then ceased the practice, to no apparent disadvantage. For a couple of years upon my father's return from the war we lived with a great uncle, who had a housemaid. She also had oversight of my elder brother and myself, sometimes including bathing. If I misbehaved she made sure that the attention she paid to my penis was unpleasant, thus ensuring good behaviour on my part! In the other two cases in which I know why boys were not circumcised, one was born prematurely and unable to be circumcised at birth and was just overlooked later on, while the other was born with jaundice and again could not be circumcised at birth. Both of these boys were circumcised as adults One told me that he hated being uncircumcised and was circumcised by his own choice. The other had severe tightness of the foreskin, never having been able to retract it. Both stated that they were very happy to have been circumcised. I also know a couple of other boys who were circumcised as children. The elder a close friend was circumcised at age 7 (This was before I knew him, and it was he who first told me about circumcision.) because he had a very long and unretractile foreskin and infections. He was happy having been circumcised, but not so his brother. He was 6 when the elder was circumcised, and apparently the doctor asked the parents if they had any other uncircumcised sons, and he'd do them too. They replied yes, one. So even though my friend said his brother had a completely loose and short foreskin, he was circumcised against his wishes, "Just in case". He told me that he envied me still having mine, whilst his elder brother used tell me how awful mine was and that I should get it cut off. Once or twice boys previously uncircumcised re-appeared after school holidays, without their foreskin, but I have no idea why. <h2>RD to DP:</h2> Thanks David, that's most interesting. I have a few questions and comments. What were your own feelings about not being circed? What about your father? You don't specifically mention whether he was circed or where he was born. From what you say he was away at the war when you were born (1944?), so where did the decision to get you circed come from? Was it the Dr giving instructions to your mother? Was this your usual family Dr? Do you happen to remember who he was? Your social situation: if you had a maid, you were presumably in an upper-ish socio-economic situation. Do you think circumcision was more common as you went up the social scale? Was it wealth or respectability that counted most? What did you study at university? What were the circumstances in which you got to check out the condition of the other boys' cocks? Showers at school after sport? Boarding school? Games of "I'll show you mine if you'll show me yours"? How was it that in the various places you mention you were regarded as an anthropological curiosity: why would the condition of your cock be such common knowledge? Or do you just mean that it was viewed in this way by the few people who saw it - but if so, what were the circumstances? Or did you talk about it? You insist that only a very small proportion of your contemporaries were not circed (5 per cent), but I am wondering just how comprehensive your sample could have been. Were you really able to check out the cocks of all the boys at your schools and at your university college? Surely you were not all showering together when you got to university? I can accept that only about 5 per cent of the boys you saw were not circed, but I should think that the uncirced boys might well be shy at that time and would go to great trouble to hide themselves. Comments It's interesting that you confirm that the fundamental reason for circumcision in those days was the myth of congenital phimosis. Although I analysed the error in some detail in my book, I am still astonished that as late as the 1940s medical authorities were insisting that mothers go through that ridiculous and harmful routine of pulling the foreskin back every day and washing underneath. The myth really was deeply ingrained. Also interesting about the boy with the tight foreskin who complained of "infections". There is no way that a normal foreskin, no matter how tight, can get infections, so one wonders what the problem was. Two possible explanations: first, that he was producing a lot of sub-preputial moisture, which does resemble pus if it is allowed to accumulate as smegma and ooze out; second, that he was continually suffering cuts and abrasions from the efforts to pull his foreskin back and that these were getting infected, or at least inflamed from the injury. Even to this day, premature retraction of the foreskin is a major cause of penis problems. (You were lucky and unusual in having a foreskin that was detached and retractable at birth.) <h2>DP to RD:</h2> Perhaps if I answer your questions, firstly, by saying that I am profoundly glad that I was "lucky and unusual in having a foreskin that was detached and retractable at birth"! I have, however, not always felt that way, as it is not easy being a small and derided minority as a child, or I suppose at any other time. Secondly, if I explain how I came to be aware that I was different and my deep and abiding shock in learning why â€“ that is, what circumcision is. This may clarify some of your queries, although I will individually address them as best I am able. Apart from being aware as a young boy of what a penis was, what it did, both sexually (I did live on a farm) and as an excretory organ, I had absolutely no interest in them, and I was blissfully unaware that all my brothers were different from me in that respect, even though I often bathed with them. I was therefore amazed when, during a game of hide and seek at a children's party when I was about 8 or 9, I was whisked away by two older boys (about 12 or14) to hide with them in the shedding (it was on another farm) and was asked to show them my cock. I wondered why anyone would want to look at such a thing and said, "No, who'd want to look at one of those". This only led to further requests, threats and offers, such as "You can look at ours etc". So eventually I said, if they'd show me theirs, I'd show them mine. They did, and I'd never seen anything like them! They looked like strange pink and white mushrooms and, to my idea, very ugly. I was dumbfounded, but had to show mine. They were likewise amazed and commented on how strange and ugly my penis looked and that they'd never seen anything like it before. I was frightened and "lost". Then the elder said, "Oh yes, I've seen something like that before, it's the same underneath", and he yanked back my foreskin to reveal the head well decked with cheese. (I'd stopped washing it, as I said in the last letter, and probably hadn't pulled my foreskin back for 2 or 3 years). They thought that I was disgusting, and I thought they looked like something from outer space. I was also shocked by the smegma, as I'd never seen it before and wondered if I had something wrong with me. When I next bathed with my brothers, I noticed that they all had pink and white mushrooms too, and, as, I observed during or after swimming (we often swam naked in the water channels), so did most other boys, with just a few like me. No one ever commented on this, so I assumed that boys were born with either of two types of penis, those like mine and the others. A year or two later the boy who I mentioned in my previous letter, who had been circumcised at around 7 years, had become a friend. He was some 2 or 3 years older than me. At some stage he saw my penis (pissing, swimming or after sport - I can't remember) and spoke to me about it in a very derogatory way. Eventually he asked me why I thought I looked as I did. I said I thought I'd been born that way. He then asked me why I thought he looked the way he did, and I replied likewise. He then said that his foreskin had been cut off. I was aghast and refused to believe him, saying, "No one would do that to their children". We argued for some time, as I could not believe it. Eventually he said, "Ask your Mother." Although our family life was, even by today's standards, very open and encompassed friends and relations whose personal preferences and lives were perhaps not quite of the mainstream, I thought long and hard about this. Eventually I plucked up the courage to ask my mother what I though to be a totally insane question: Why did I have a long piece of skin hanging down from the end of my penis? She was cross and straight away asked if I and my friends had been playing with each other. I said no, but that I wanted to know why I was different from most other boys. She asked what I thought, and I gave my opinion and the views of my friend, saying that I thought his view was mad, as no-one would do such a thing to their children! She replied that he was right, and asked if I'd like it done. Upon my vehement "No", she said "Well, you'd better be careful, or you will be circumcised whether you like it or not." My mother also told me that I was in no circumstances to talk about this to my brothers, though she realized later that it would be difficult for a boy to be telling his brothers that their parents had cut off part of their penis. Later, around the time of my marriage, when I asked her about my non-circumcision, she asked me what I thought about not being cut. I replied that I was very happy the way I was, though I had not been so as a child, because I had been different from most of the other boys and had been derided by some of them. This led to a lot of self-doubt. My mother added that if she had insisted the doctor would have cut me, and that she regretted that she had not insisted. Still later, when my first child was due, my mother told me that it was important to let doctors know well in advance of anything that I wanted them to do or not to do with young children. I asked her if she was referring to circumcision. She said yes, partially, since she assumed that if the baby was a boy I would not want him circumcised. But she said it was important to tell this to the doctor in advance, as my two younger brothers had been circumcised just like that, without any discussion or permission at all. To go back to your questions: What were your own feeling at not being circed? I have answered above. I would not be writing to you if I were not glad of this! What about my father? He was born in 1916 in Maryborough or Bendigo (Vic), where his family had been mine-owners. He told me much later that he'd been circumcised during the war (i.e. WW2). I later came to realise that he was very pro-circumcision and had been to an Aboriginal initiation in the Kimberleys. He was away when I was born and I believe, from what my mother has told me, that all decisions were made by our usual family doctor, whose name, I believe, was Dr Beck, and who was, I believe, an older man. I'm told he died some few years after I was born. I am forever grateful that he spared my foreskin, no matter on what wrongheaded basis. Your social situation? When I was born and we initially lived with my grandparents, who were very well off. We were comfortably off and employed "help" at times. Our upbringing was very different from that of today. By descent I am on one side Cornish/German on the other Cornish/Irish. I don't think that circumcision was a "class" thing. I think that it was brought in by the medical profession and applied as they found possible - in some areas from top down, so to speak, and in others, from bottom up. In my view, working class and lower middle class people are the ones most likely to follow the custom of circumcising. Certainly, a couple of families of our family friends had 2 or 3 boys, none of whom was cut. I presume it was family choice. What did you study at Uni? Arts. Within our family higher education, as it is now called, was widespread, with people going to the University of Melbourne from the 1890s onwards. Whether they were successful or not, was another matter. What were the circumstances where you were able to check out other boys cocks? Often I thought that I was the "Checkee" rather than the "Checker"! Usually it was in the showers after sport, as I played cricket (which I hated), football and swimming etc. In those days, one often seemed to be naked! Why were you regarded as an anthropological specimen? Because to be uncut was so rare. Often people thought you were deformed or that something else was wrong. When I went to school in Melbourne I boarded with a family. One night I'd had first bath, and their elder son had second. As I was drying my towel fell off. He looked at my penis and said, "What's that?" I said, "My cock". He then asked, "Are you a girl?" Incidentally, in the case of the boy who got circumcised as an adult because he hated it, his feelings came from having being tormented at school (not my school). Why would the condition of your penis be such common knowledge? In schools where lots of sport was played, we were often seen naked, dressing, undressing or showering. If you looked like me, people seemed to say something like "That boy has a funny cock." I never spoke of my own cock, but I never tried to hide it. That's a part of what I am, or a part of what is me. University college life? In those days university colleges were like extensions of boarding schools, and strictly single-sex. The older buildings had cubicles for baths, but the showers were open, and it was quicker and simpler to take a shower. Even there I sometimes got comments to my face about not being circumcised â€“ but I always ignored such talk. I have a nephew, now adult, who is uncircumcised. (One of the good things I've perhaps passed on in life, probably by osmosis, is that my brothers, after having to put up with a freak who had a foreskin, did not circumcise their own boys). He knows of my state, having stayed with us often when he was younger, and he told me that a few years back, in the football club of which he was a member, he was regularly pointed out to all and sundry as the only uncut in the team! You insist that I could have seen only a small proportion of my contemporaries. My sample was simply what I saw after sport etc, or sometimes on remarks passed. It may well be wrong and was certainly not scientifically based, but I suspect it is fairly close to the mark. I simply seldom saw anyone looking like myself. Being uncircumcised was then a pretty solitary calling! Comments I've read medical journals etc, and felt vindicated on first reading <a href="http://www.cirp.org/library/general/gairdner/" rel="noopener" target="_blank">Gardiner's comments re circumcision</a> in 1949. At one stage at about age 13, when things were very difficult, I remember thinking, "But I'm normal". By this I meant that all boys are born with foreskins; therefore it can't be normal or right to cut them off. One of the reasons why I am so grateful that I am not circumcised is that I did not have to endure the public humiliation and torture that is involved in the operation. Some of the alternatives described in the BMJ, though, sound even worse -- the one where the foreskin is firmly detached, then both layers stretched and forcibly retained behind the glans is enough to make one weep. Even if it were ever able to be brought forwards afterward, it would be useless. When my mother told me even what had happened to me -- which on the scale of these things was very mild -- I was angry and hurt to think of my own mother being willing to hold me whilst my foreskin was tortured. You can also take it from me, that unlike the view of the man who thought that having one's glans wiped and cleaned was like masturbation, it most certainly was not in the least bit pleasant to have the head of one's infant cock rubbed. Even gently, with a towel, it was not pleasurable. Once, after swimming at the beach, whoever was drying me got me to stand up on the seat and, after wiping around my buttocks, pulled back my foreskin and proceeded to wipe the head of my penis with a sandy towel. I screamed and started yelling, to his great surprise. He said, "Sorry, I was only wiping the sand off." Of course there wasn't any sand there! Clearly even when a foreskin like mine was perfectly loose and mobile some adults had the urge to interfere with it and somehow desensitise it and reduce it to the same condition as the skinless model. It doesn't differ greatly in degree from the verbal abuse dished out for simply being the way one was. I have spoken to other men who, as boys, were reduced to tears by such torment. </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 Cavalier among the roundheads 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"> Medical Societies MELBOURNE PAEDIATRIC SOCIETY A MEETING of the Melbourne Paediatric Society was held at the Children's Hospital, Melbourne, on Wednesday, November 12, 1952. <h3>Why Circumcise?</h3> Dr. JOHN D. BEGG read a paper entitled "Why Circumcise?". He said that the operation had been performed in many countries since time immemorial, but it was extraordinary how little was known of the origin and purpose of the ancient custom. It was performed in Egypt at least 4000 years. B.C., probably even earlier still, and was practised as a cult among the primitive peoples of such widely separated countries as Africa and the North American continent and among Australian aborigines. It had been a Jewish custom to circumcise on the eighth day after birth since early Biblical times, and although the Koran did not specifically ordain it, all Moslems were circumcised. It was a mystery why mankind, down the ages, should have shown such a strong aversion to the retention of a useful cutaneous appendage; for, despite the enormous literature on the subject, very fully dealt with in Hasting's "Encyclopaedia of Religion and Ethics", there was little real knowledge of the significance of the ancient rite. It was tempting to ascribe a hygienic motive to the procedure, but a critical view analysis of the literature does not support such a view. Even if the view was found to be empirically correct, it could scarcely have been the original motive that prompted the Egyptians to circumcise their young. Gray, in the Encyclopaedia of Religion and Ethics", concluded his summary by finding that in its inception, and late into its development, circumcision was essentially a religious custom, embracing in its broadest sense several concepts of an ideological nature. Thus, it might signify a sanctification of the reproductive organs, ensuring abundant fertility; it might be related to the ancient idea of human sacrifice-sacrifice of a small portion of the body as a propitiation of the Deity to protect the whole; or it might serve as initiation of the youth into the full manhood of the tribe. With primitive peoples the operation was usually carried out to the accompaniment of various ceremonials, often of a cruel and revolting nature; but in contradistinction to these, one Australian tribe performed a mock ceremony before the candidate, flourishing a large wooden knife, but leaving him untouched. That it had a deeply religious significance to the Jews was, of course, a matter of common knowledge, but whilst one maintained ancient usages, it was reasonable to examine critically a procedure which although performed as a religious rite by one section of the community, was also carried out very frequently for supposedly surgical reasons by another. Circumcision was performed on some 75% of male children born in Melbourne's private maternity homes, and although it was not performed routinely at the Women's or the Queen Victoria Hospital, many of the babies born in those institutions were later subjected to the operation at the Children's Hospital, or else at the paediatric departments of the Alfred, Queen Victoria, Prince Henry's and Saint Vincent's Hospitals, as well as at the hands of private medical practitioners. Figures revealed that in the hospitals mentioned nearly a thousand babies were circumcised annually; but as about six thousand boys were born annually in Melbourne's two major public maternity hospitals, even if allowance was made for circumcisions performed by private practitioners, the incidence of the operation was very much lower than in those of the higher income groups who attended the private institutions where three-quarters of the male babies were circumcised. <a href="http://www.cirp.org/library/general/gairdner/">Gairdner</a>, in the British Medical Journal of December 24, 1949, in making a comparison between children attending the best known public schools and those attending state institutions, had stated that "either the boys of well-to-do parents are suffering circumcision much too often or those of the poorer parents not often enough". Dr. Begg then discussed the development and function of the prepuce, as described by Gairdner. He said it developed as a ring of thickened epidermis growing forward over the glans, and during its development, which was frequently incomplete at birth, the squamous epithelium lining the inner surface of the prepuce and the outer surface of the glans was fused into one single sheet. According to <a href="http://www.cirp.org/library/anatomy/deibert/">Deibert</a>, a separation into two separate linings took place by the epithelium arranging itself into whorls, in the centres of which degeneration occurred. The fusion of these degenerate areas ultimately formed a continuous sub-preputial space. The process, which was seldom complete at birth, might be arrested at any stage of its development. Thus, again, according to Gairdner, only 4% of babies had a fully retractable foreskin at birth, only 25% at six months, and 50% at the end of the first year. At the end of the second year. At the end of the third year, however, 90% of children would have a retractable foreskin; so that it was obviously fallacious to regard non-retractability of the foreskin at birth as synonymous with phimosis. Even those which could not readily be retracted at the age of three years could usually be rendered easily retractable by the separation with a probe of the residual strands of undegenerated epithelium still persisting between the inner preputial layer and the outer layer of the glans. Dr. Begg said that he had no accurate figures with which to confirm the statistics, but eleven years of observation in a provincial town where very few babies were circumcised had convinced him that true phimosis must be a very rare condition. (Note: The values regarding age of foreskin retractability provided by Gairdner in 1949 have since been shown to be incorrect. See the <a href="http://www.mja.com.au/public/issues/178_11_020603/matters_arising_020603-1.html">letter in the Medical Journal of Australia</a> for more information.) The function of the prepuce seemed obviously to clothe and protect the sensitive glans, not only during the early years of incontinence when the organ was in contact with urine-soaked clothes, but throughout life as well. Like other surgical operations, circumcision carried an operative risk. The risk was admittedly small, but haemorrhage, sepsis, and anaesthetic accidents could occur, whilst, as the operation was frequently performed by practitioners of little surgical skill, mutilation of the organ was unfortunately by no means rare. The figures for Australia were not readily available, but for the five-year period from 1942 to 1947, an average of sixteen children died annually as a direct result of the operation in England and Wales. There was every reason to believe that a proportionate mortality would prevail in Australia. Contact of the delicate tip of the glans with ammonia-soaked clothes not infrequently led to ulceration of the urethral meatus, and that, apart from being exceedingly painful, was at times difficult to heal and could even lead to a meatal stricture. That complication of circumcision was particularly likely to occur in a child whose prepuce had become redundant from ammonia irritation-an appearance which unfortunately was regarded by some doctors as a particular indication for circumcision. Removal of the foreskin in such circumstances had been likened by a contributor to the British Medical Journal some years previously to "a soldier taking off his tin hat when the shrapnel was falling"; the irritation was transferred to the meatus with the inevitable result. Dr. Begg then proceeded to examine the reasons given by parents for requesting that their child be subjected to the operation, and mentioned that inquiries from the nursing staffs of maternity hospitals revealed that the majority of babies were circumcised at the request of their parents and not at the advice of their doctors. Dr. Begg said that in his experience in questioning mothers of newborn babies on the reason for requesting circumcision, by far the most common reason given-and this was confirmed by nursing staffs-was that the father wanted it done. The information was imparted by the mother with a slightly mysterious air as if questioning that anyone should doubt the paternal wisdom. On being further questioned, most would volunteer that they thought it prevented the child from wetting the bed or that it prevented in some mysterious way the development of venereal disease or the habit of masturbation. No doctor these days would seriously regard circumcision as a cure of enuresis, whilst, if the psychiatrists were to be believed, masturbation occurred in both sexes, and appeared to have no relation to the presence or absence of the prepuce. Venereologists agreed that the circumcised man who contracted syphilis or gonorrhoea was easier to manage, but there was no real evidence that the operation in any way lessened the incidence of those diseases. The matter was of still less importance at the present time, with chemotherapy and the greatly lessened incidence of venereal disease in general. Cleanliness was another reason given by parents, and it was in regard to that that a considerable misconception existed amongst both medical and non-medical people. It was true that smegma, the main source of which was generated epithelium lining the glans and prepuce, together with a variable amount from minute secretory glands near the fraenum, did collect in the retro-coronal sulcus, but in the young child it was non-odorous and entirely harmless. Later, as mild decomposition of the smegma might occur, and as infection might then be added, it was wise to take steps to remove it. At the stage when that was likely to happen, however, separation of the two layers had taken place, and the foreskin, if not readily retractable, could easily be made so. Miscellaneous reasons, such as "we believe in it" and the frankly feminine one, "it looks nicer," were occasionally given. Circumcision, therefore, though sometimes advised by the obstetrician, was more often performed by him to satisfy the parental wish. If non-retractability of the foreskin at birth was regarded with equanimity, it would be found that in time the vast majority of foreskins were so easily retracted as to fall within the scope of all but the most incapable. It appeared to be an indisputable fact that carcinoma of the penis was virtually unknown in those circumcised before the age of five. It did, however, occur occasionally in Moslems who were circumcised between the sixth and the fourteenth years, but less commonly than in the uncircumcised. Thus Kennaway, in the British Journal of Cancer, comparing the incidence of the disease in Moslems with that of Hindus, among whom the operation was taboo, in fourteen hospitals in India, showed that the ratio of penile cancer to male cancer in Hindus was a high as 1:3.9, while that in Moslems was only 1:34.3. He suggested that failure of the operation until the fourteenth year to confer the immunity produced by that performed in infancy, was due to carcinogens retained in the coronal sulcus, and if carcinoma of the penis was a common disease, there could be a very potent argument in favour of universal circumcision at an early age. The disease, however, was not a common one, particularly in western countries. An average of 6.3 cases annually were met with in Melbourne's public hospitals over a five-year period, representing only 0.3% of male carcinomata in general. Furthermore, it usually occurred in persons with a low standard of personal hygiene, and was almost always associated with true organic phimosis. Accordingly, a disease whose main incidence was after the sixth decade of life, and which was probably as easily prevented by simple attention to cleanliness as by circumcision, could not be cited as a convincing argument for subjecting every baby boy to the operation. In conclusion, Dr. Begg summarized his paper by saying that circumcision, commencing as an expression of primitive man's religious emotions, was carried on largely as a response to a widespread public demand. That demand was based on a misconception of the benefits conferred by the operation, which in the great majority of children is unnecessary. As unnecessary surgery was bad surgery, the time has come when the profession should deprecate its widespread performance in infancy except for religious reasons. Indications for the operation existed only if, after the first few years, true phimosis was found to be present. In short, the answer to the question which formed the title of the paper, "Why Circumcise?", must be found in many cases "Why indeed?". DR. F. STONEHAM said he agreed with Dr. Begg. Phimosis could be corrected by dilatation of the foreskin with sinus forceps in most cases and circumcision was not necessary. DR. J. FARBER said that at birth the prepuce could be retracted in certain infants but not in others. He had been surprised at the number of infants whose prepuce was not retractable at birth, but was easily retractable two to three months later. DR. M. L. POWELL referred to the advisability of circumcision in some cases in the tropics as a means to reducing dermatitis of the prepuce and glans penis. He wondered if that fact had any significance with regard to religious rites amongst Moslems. Dr. Begg replied that during the last war circumcised serviceman had certainly suffered less dermatitis of the penis, and he agreed with Dr. Powell that might have been the basis of circumcision in some religions. Medical Journal of Australia, 1953 (1), pp. 603-4 <h4>NOTE</h4> This paper was an antipodean response to Douglas Gairdner's famous article, "The fate of the foreskin" (British Medical Journal, December 1949), and it shows that Australian paediatricians were already sceptical of the benefits of indiscriminate circumcision. What is interesting, however, is how little influence this paper seems to have exercised, or at least how long it took to have an effect: what we know of the figures suggests that the incidence of neonatal circumcision continued to increase until the mid-1950s or even the early 1960s, and then began to decline only slowly. Still, the paper is of great historic interest, showing how little the debate on the so called pros and cons of circumcision has changed over the past half-century. </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 Why circumcise? 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: A Continuing Enigma</h3> by I.O.W. Leitch, Australian Paediatric Journal, 1970 <h4>Synopsis</h4> The results of 200 circumcisions are presented, together with a discussion of the indications and subsequent complications. A review of the literature suggests that many of the traditional indications remain unproven. In the light of this study, and other surveys which indicate the hazards of the operation, it is suggested that circumcision should be confined to those with a genuine medical indication. <h4>Circumcision: A Continuing Enigma</h4> Circumcision is a practice which originated in ancient Egypt (Bolande, 1969), since when the practice has spread to assume status as a ritualistic part of many religions. The original followers of those religions, Jews, Moslems, Australian Aborigines, all lived in hard dry arid conditions where the standard of personal hygiene was sub-optimal. Circumcision, therefore had appeal as a prophylactic measure against balanitis. Nowadays, in Australia, despite a state of enlightened civilization that average Australians are thought to enjoy, circumcision is still the rule. The exposed glans is the fashion. The undressed penis stands as a social symbol, and the foreskin is still a schoolboy's curiosity, viewed secretly with wonder and awe. Circumcision now performed as a social ritual, and those in favour of the operation have justified its performance on medical grounds. It has been said that circumcision is a simple operation with little associated morbidity and mortality, and that benefits include increased hygiene, and prophylaxis against malignancy. Opinion against the performance of the operation of circumcision is just as certain that if the foreskin is subjected to adequate toilet, carcinoma is not a problem, neither is balanitis. In the belief that the operation of circumcision is not without risk, it was decided to analyse some of the case records of circumcision performed at this Hospital to obtain statistics concerning the actual morbidity. Should a significant morbidity exist, then it seems obvious that there are no grounds for the present-day practice of social circumcision. Materials and Methods The case notes of 200 consecutive patients from the records of this hospital were studied to obtain such information as the indication, operation, method of controlling bleeding and the incidence of complications. The results were partially analysed by computer. Results The mean age of the patients in this survey was 2 years 4 months, the mean stay in Hospital 2 days, and the mean time on the waiting list was 2.1 months. While awaiting operation, 39 children developed some additional symptoms or sequelae. 10 developed "difficulty in passing urine'' without ballooning the foreskin; in 5, the prepuce became non-retractile; 5 developed an attack of balanitis which settled with conservative measures; 3 developed urinary obstruction necessitating advancement of the operation; 2 developed frequency of micturition; 2 had an episode of paraphimosis, and in one the indication for the operation disappeared, i.e. the penis prepuce became retractile. 10 other children had other complications, e.g. "nappy rash,'' and one developed a urinary tract infection. There was a significant age distribution in the 10 patients who developed urinary difficulty; one was less than 1 year of age, no one was between 1 and 2 years of age, and 9 were over the age of 2 years. Stated Indications for Operation These were obtained from the Outpatient records, and have been divided into 2 categories; medical and social (Table 1). The prepuce was supposedly non-retractable in 102 out of the 200, i.e. 51%. Table 1: Stated Indications for Operation <table border="1" cellpadding="7" cellspacing="1" width="481"> <tbody> <tr> <td width="34%"> Medical </td> <td width="17%"> </td> <td width="34%"> Social </td> <td width="16%"> </td> </tr> <tr> <td width="34%"> Phimosis alone </td> <td width="17%"> 74 </td> <td width="34%"> Familial </td> <td width="16%"> 43 </td> </tr> <tr> <td width="34%"> - with balanitis </td> <td width="17%"> 9 </td> <td width="34%"> Mother </td> <td width="16%"> 8 </td> </tr> <tr> <td width="34%"> - with obstruction </td> <td width="17%"> 1 </td> <td width="34%"> Father </td> <td width="16%"> 4 </td> </tr> <tr> <td width="34%"> Hypospadias </td> <td width="17%"> 23 </td> <td width="34%"> Advised by GP </td> <td width="16%"> 2 </td> </tr> <tr> <td width="34%"> Non-retractile </td> <td width="17%"> 18 </td> <td width="34%"> Religious </td> <td width="16%"> 1 </td> </tr> <tr> <td width="34%"> Balanitis </td> <td width="17%"> 9 </td> <td width="34%"> </td> <td width="16%"> </td> </tr> <tr> <td width="34%"> Paraphimosis </td> <td width="17%"> 8 </td> <td width="34%"> </td> <td width="16%"> </td> </tr> <tr> <td width="34%"> Total </td> <td width="17%"> 143 </td> <td width="34%"> </td> <td width="16%"> 58 </td> </tr> </tbody> </table> The Social Indications followed the pattern described in most reports on the subject. In most cases the operation was requested for reasons of conformity, supposed cleanliness, because it was more attractive, or because it was socially the "done thing,'' In 2 cases the operation was advised by the family doctor because it was "better to have it done now and got out of the way.'' One case was a Moslem child circumcised for religious reasons. The Operation In 150 cases this was simple primary circumcision. In 19 (9.5%), the operation was performed because an earlier circumcision had failed or been followed by complications; 14 were circumcised as an encore to another elective surgical procedure. In 12 cases circumcision was performed for minimal hypospadias; 2 cases had a dorsal preputial slit followed by a circumcision for true phimosis; 2 cases had freeing of congenital adhesions only, and in one case freeing of adhesions was performed before proceeding to circumcision. From these figures it appears that only 5 of the 102 cases diagnosed as being non-retractable were in fact non-retractable. Of those cases considered, before operation, to have phimosis or a non-retractable prepuce, 44 were more than 3 years of age and 23 of those were over 6 years old. Complications The incidence was rather high (Table 2), and for convenience they have been analysed in 2 groups, early and late, according to whether they occurred before or after 2 weeks. Late complications occurred in 15 (7.5%). One of the 2 cases of meatal stenosis eventually required a meatotomy; in one healing was delayed for 5 1/2 weeks; and in 2, too little skin was removed at operation. Table 2: Complications of Operation Early Haemorrhage 12 Infection 1 Meatal Ulcer 1 Meatal Stenosis 1 Other 1 Total 16/200 (8%) Late Haemorrhage 2 Meatal Ulcer 7 Meatal Stenosis 2 Recurrent Phimosis 1 Prolonged Healing 1 Other 2 Total 15/200 (7.5%) Total complications 31 (15.5%) The total complication rate was 31 in 200 cases, i.e. 15.5%. In an attempt to evaluate these complications, several aspects were analysed. The first of these was the experience of the operator; surgeons had a complication rate of 14.9%, surgical registrars 17.6% and resident medical officers 50%. Perhaps this would not suffer statistical scrutiny, but it probably reflects the residents' lack of experience. Haemorrhage was the most common complication, and on clinical grounds was classified as mild, arterial or brisk venous haemorrhage as moderate, while clinical signs of blood loss and/or the need for transfusion were classified as severe. The procedures required to control this haemorrhage were also listed. Haemorrhage (early or late occurred in 14 cases, 9 mild and 4 moderate; in one case the degree is not known, and there was no instance of severe haemorrhage. In the 9 cases with mild haemorrhage, 3 ceased spontaneously, 3 required topical adrenaline, 3 were controlled by re-dressing and digital pressure, and in one case a dressing of tinc. benz. co. was applied. Of the 4 cases of moderate haemorrhage, 3 required ligation of persistent bleeding points under a second general anaesthetic, and in one a persistent bleeder was ligated in the ward without anaesthesia. Meatal ulcer was the second most common complication, and an attempt was made to correlate it with the type of dressing or any adjunct smeared on the glans after circumcision. It was assumed that management after circumcision was similar in most instances, and in fact the type of dressing used had no significant effect on the incidence of meatal ulcer. No adjunct was used in 74 cases and 3 (4%) developed a meatal ulcer. With "KY Jelly,'' 2 out of 82 (2.4% developed a meatal ulcer. The development of a meatal ulcer bore no significant relationship to the age of the patient. Recircumcisions constituted 19 (8.5%) of the 200 operations. These were patients who had been circumcised in the neonatal period for social reasons mostly, as far as could be ascertained, in other hospitals. 11 were recircumcised for phimosis occurring after routine circumcision; 7 were recircumcised for other reasons - mostly because too little skin had been removed at the first operation - and in many cases, the appearances suggested that circumcision had never been performed. One child developed paraphimosis which required emergency circumcision, reduction being otherwise impossible. Of 19 recircumcisions, 18 were simple circumcisions and in one a dorsal slit was followed by a circumcision. Complications followed in 3 patients, infection (one), meatal stenosis (one), and mild haemorrhage (one) a rate of 15.7% which is comparable to that of the series as a whole. Finally, analysis of the type of operation, and the month in which it was performed, showed that these had little effect on the complication rate. Discussion A multiplicity of reasons have been proposed for the performance of circumcision, and the variety of these only reflects the uncertainty and the emotional undertones that surround the whole subject. The reasons proposed can be conveniently subdivided into 3 categories. 1. Prevention of cancer, and/or better hygiene 2. Social or religious reasons 3. Correction of definite abnormalities, whether congenital or acquired 1. Prevention of cancer, and/or better hygiene Increased incidence of carcinoma of the penis, the cervix uteri, and the prostate, have all been attributed to lack of circumcision. Plaut and Kohn-Speyer (1947), using cerumen as a control, introduced horse smegma into the a subcutaneous tube constructed on the back of several mice, and showed that smegma was weakly carcinogenic. Most other evidence on carcinoma is based on racial or ethnic difference. (a) Carcinoma of the prostate In a series of prostatectomies for prostatomegaly, Ravich (1942) noted an incidence of malignancy of 1.7% in Jewish males ritually circumcised some 8 days after birth, compared with a rate of 20% for uncircumcised non-Jewish males. From this, it was deduced that circumcision decreases the incidence of prostatic carcinoma. (b) Carcinoma of the cervix Elliot (1964) reported that the incidence of carcinoma of the cervix is one-fifth to one-six as great in Jewish women as in the general population. Being a disease which is associated with a lower socio-economic status, the incidence declined in a survey period from 1910 to 1954, during which time socio-economic status and standards of personal hygiene are two factors which have risen conspicuously. Boldt (1959) and Hubert (1960) independently noted that the incidence of carcinoma of the cervix of women in Abyssinia was higher than, or comparable to, that in Europe and the U.S.A., even though 90% of Abyssinia males are ritually circumcised at birth. Weiss (1964) found that the disease is associated with poor socio-economic circumstances, sexual promiscuity, and early-childbearing, but was not affected by the use of a condom, which would presumably have a similar effect to circumcision in preventing the contact of smegma and cervix. Carcinoma of the cervix in India is most frequent in the Hindu women from Deccan (Khanolkar, 1950), and proportionally less in Moslem women. Circumcision before the age of 12 years is obligatory for Moslem males. In Hindu women from Gujarat, who enjoy a higher social standing and who are more fastidious about their personal hygiene, the incidence is four-fifths that of Hindu women from Deccan. In Moslem women the incidence is two-fifths that of the Hindus from Deccan. Carcinoma of the cervix seems to be associated with a multiplicity of aetiological factors, the most consistent being poor socio-economic circumstances and the related lack of personal hygiene. (c) Carcinoma of the penis Speert (1953) quoted the work of Wolbarst (1933) which showed that: (i) in a series of 1103 cases of carcinoma of the penis, there were no Jews, and; (ii) the greater frequency of carcinoma of the penis in uncircumcised Hindus compared with circumcised Moslems in India. Moslems are circumcised between the ages of 4 and 12 years, and comparisons of the incidence in Moslems and Jews show a lower incidence in Jews, who are circumcised on the eight post-natal day. However, Jewish ritual demands the removal of more prepuce than the Moslem ritual. Carcinoma of the penis in the Chinese accounts for 18.5% of all carcinomata, compared with 2% in the U.S.A. (Ngai, 1933) There are wide geographic variations, and the disease is associated with a congenitally, tight, or a long redundant foreskin. The disease is rarely seen among the more well-to-do, whose level of personal hygiene is higher. Circumcision has been thought to provide complete protection from carcinoma of the penis, but recently 2 cases have been reported in Jews circumcised in infancy (Dean, 1936; Melmed and Pyne, 1964) and 5 cases of carcinoma of the penis in non-Jews circumcised in infancy. (Amclar, 1956; Kauffman and Sternberg, 1963; Ledlie and Smithers, 1956; Marshall, 1953); Pacquin and Pearce, 1955). In Australia , between 1960, between 1960 and 1966, there were 78 deaths from carcinoma of the penis; in the same period that there were 2 recorded deaths from routine circumcision. Carcinoma of the penis seems to be associated with lack of circumcision, which by no means affords absolute protection. Also associated are a long redundant, and a congenitally adherent foreskin, while good personal hygiene appears to decrease the incidence. In these three malignancies, it appears that more factors than simple circumcision and non-circumcision are involved, and those, personal hygiene seems to be the most consistently relevant. 2. Social or religious reasons Bolande (1969) wrote that circumcision originated through imitation of the practices of a superior or revered individual in a society, and has now become established as a fashion perpetuated by the need to conform. MacCarthy et al (1952) reported that 24% of children in the United Kingdom had been circumcised by the age of 4 years and 3 months. Patel (1966) noted an incidence of 48% at Kingston General Hospital, Canada, and Wall (1968), reported an overall incidence in the United States of 69-97%, Fredman (1969) in a survey in Victoria, Australia, found an incidence of 70%, most of the operations having been performed for reasons of family uniformity, Australian custom, aesthetics, and so on. Two deaths from routine circumcision occurred in Australia during the period 1960-1966. Speert (1953) in a survey of the period 1939-1951 quoted one death in a series of 566,463 circumcisions, and 243 deaths from carcinoma of the penis during the same period. In England and Wales, between 1942 and 1947, 16 children died annually as a result of routine circumcision (Begg, 1953), while Gairdner (1949) reported 16 deaths in a series of 90,000 circumcisions, high mortality figures for a simple operation. Mortality aside, circumcision is accompanied by a considerable number of less serious complications (15.5%) including haemorrhage, meatal ulcer, meatal stenosis and infection in the series reported here. Other complications included laceration of the glans during operation, delayed wound healing, and ineffectual circumcision. A less serious delayed complication of circumcision is ammoniacal dermatitis causing a meatal ulcer and stenosis, a sequel which only occurs in the circumcised. Other less common but more serious complications not seen in this survey are urethral fistula, amputation of the glans, avulsion of the scrotum and septicaemia (Patel, 1966). Severe haemorrhage, also absent from this series, may require transfusion with its attendant occasional complications, or further surgical intervention with the possibility of an additional anaesthetic. Meatal stenosis may require a meatotomy, and the rarer severe complications may require elaborate plastic surgical procedures. A second operation because of the failure or complication of the first is not unusual and constituted 9.5% of this series. A circumcision, then, is an operation which is accompanied by a not inconsiderable risk which should be seriously considered when the operation is entertained. 3. Correction of abnormalities The most common abnormality in this series seemed to be a non-retractable foreskin, and there seemed to be some uncertainty concerning this diagnosis. At birth, separation of the prepuce from the glans has not occurred in some 90% of males. The epidermis of the prepuce and glans is adherent until separated by a process of desquamation and before this has occurred the prepuce cannot be separated without difficulty. Table 3: Retractability of Prepuce According to Age At birth 4% Fully Retractable 54% Meatus can be exposed 42% Completely non-retractable Prepuce non-retractable 6-12 months 80% 1 yr 50% 2 yr 20% 3 yr 10% 6-7 yrs 8% 16-17 yrs 1% Gairdner (1949) studied retractability at different ages, and showed that only 4% of males have a fully retractable foreskin at birth, while at the age of 3 years it is fully retractable in all but 10%. Ã¿ster (1968) extended the study and found that 8% of boys at the age of 6 years and 1% at the age of 16 years, still have a non-retractable prepuce. Ã¿ster also found significant amounts of smegma in 1% of uncircumcised 6 year old boys, and that smegma tended to increase after 12 or 13 years, so that 8% of 16 year old boys had significant amounts. A prepuce made fully retractable after age of 3 years by simple separation of adhesions with a blunt probe, not necessarily under anaesthesia, would assist hygiene, decrease balanitis and true phimosis, and prevent the accumulation of smegma, thus deceasing the risk of carcinoma of the penis, possibly to an almost negligible level. Circumcision is still necessary to correct genuine phimosis, and occasionally to alleviate that uncommon condition, paraphimosis. In this series paraphimosis was usually caused by an overzealous mother forcibly retracting, in the bath, a still congenitally adherent foreskin in a child less than 3 years of age, on the mistaken advice of a doctor. Surely this shows the need for proper education of those members of the medical profession most closely associated with those problems. With proper counselling, circumcision becomes an unnecessary operation, even more so when it is realized that the prepuce plays an important part in protecting the glans during the period of urinary incontinence in the first years of life. Conclusions A study of 200 consecutive cases of circumcision has shown that: 1. Only 5 cases (of 102 diagnosed) actually had pathological phimosis at operation. 2. The incidence of complications (15.5%) was probably a reflection of the diverse techniques and operators employed. Better results would no doubt be obtained if all necessary circumcisions were performed by consultant surgeons or their equivalent. 3. The type of operation does not seem to be overly important, except that it is probably more important, as in all surgery, that the operator be experienced in this technique and use a technique with which he is familiar. 4. Finally, from a review of the recent literature and the results of this survey it is deduced that routine circumcision is largely unwarranted, and that adequate personal hygiene, possibly aided by making all foreskins retractable at the age of 3 years, has exactly the same effect as circumcision with none of the complications. We would recommend that hospital waiting lists be unburdened of unnecessary routine circumcisions, and that if parents request the operation as a social ritual, it should be done in private, not public beds. Acknowledgements My thanks to Mr. R.S. Douglas for his help in the preparation of this paper, to those Honoraries responsible for allowing me to include their cases and to the Commonwealth Statistician for supplying figures of the mortality of carcinoma of the penis and circumcision in Australia. References Amelar, R. D. (1956), Carcinoma of the penis due to trauma occurring in a male patient circumcised at birth. J. Urol., 75: 728-729 Bolande, R. P. (1969), Ritualistic surgery-circumcision and tonsillectomy. New Engl. J. Med., 280: 591-596. Boldt, W. (1959), On first experiences with routine circumcision of newborn infants in Germany and thoughts on cancer prophylaxis. Geburtsh. H. Frauenhllk., 19: 624-626. Dean, A. L. (1936), Epithelioma of the penis in a Jew circumcised in early infancy. Trans. Amer. Ass. Gen.-urin. Surg., 29: 493-499. Elliot, R. I. (1964). On the prevention of carcinoma of the cervix. Lancet 1: 231-235. Fredman, R. M. (1969). Neonatal circumcision-a general practitioner survey. Med. J. Aust, 1: 117-120. Gairdner, D. (1949), The fate of the foreskin: a study of circumcision. Brit. Med. J., 2: 1433-1437. Huber, A. (1960), Uteruskarzinom und Zirkumzision. Wein. Med. Wsehr., 110: 571-574. Kaufman, J. J. and Sternberg, T. H. (1963) Carcinoma of the penis in a circumcised man. J. Urol., 90: 449-450. Khanolkar, V. R. (1950) Cancer in India. Acta Un. Int. Cancr., 6: 881-890. Ledlie, R. C. B. and Smithers, D. W. (1956) Carcinoma of the penis in a man circumcised in infancy. J. Urol., 76: 756-757. MacCarthy, D., Douglas, J. W. B. and Mogford, C. (1952), Circumcision in a national sample of 4-year-old children. Brit. Med. J., 2: 755-756. Marshall, V. F. (1953), Typical carcinoma of the penis in a Jew circumcised in infancy. Cancer, 6: 1044-1045. Melmed, E. P. and Pyne, J. R. (1967), Carcinoma of the penis in a Jew circumcised in infancy. Brit. J. Surg., 54: 729-731. Ngai, S. K. (1933), The aetiological and pathological aspects of squamous-cell carcinoma of the penis among the Chinese; and analytical study of 107 cases. Amer. J. Cancer., 19: 259-284. Ã¿ster, J. (1968), Further fate of the foreskin. Incidence of preputial adhesions, phimosis and smegma amongst Danish schoolboys. Arch. Dis. Childh., 43: 200-203. Paquin, A. J. Jr., and Pearce, J. M. (1955). Carcinoma of the penis in a man circumcised in infancy. J. Urol., 74: 626-627. Patel, H. (1966). The problem of routine circumcision. Can. Med. Ass. J., 95: 576-581. Plaut, A. and Kunh-Speyer, A.C. (1947). The carcinogenic action of Smegma. Science. 105: 391-392. Ravich, A. (1942) The relationship of circumcision to cancer of the prostate. J. Urol., 48: 298-299. Speert, H. (1953). Carcinoma of the newborn; an appraisal of the present status. Obstet. and Gynec., 2: 164-172. Wall, R. L. Jr. (1968). Routine circumcision? Recent trends and concepts. N. C. med. J., 29: 103-107. Weiss, C. (1964) Routine non-ritual circumcision in infancy. A new look at an old operation. Clin. Pediatr. (Phila.) 3: 560-563. Wolbarst, A. L. (1932), Circumcision and penile cancer. Lancet, 1: 150-153. Department of Paediatric Surgery Adelaide Children's Hospital 72 King William Road North Adelaide, 5006. Received December 8, 1969. Leitch IOW. Circumcision: A continuing enigma. Aust Paediatr J 1970;6:59-65 <h3>Note</h3> This article played a significant role in turning Australia away from routine infant circumcision. The year after it was published, the <a href="http://www.circinfo.org/previous_statements.html">Australian College of Paediatrics issued a statement</a> that baby boys should not be routinely circumcised. Although this article was published over thirty years ago, it can be seen that two of the major justifications for circumcision offered today (prevention of cancer of the penis and of the cervix in possible future sex partners) remain the same. It can also be seen that they were very feeble: not only was there no firm evidence that circumcision did prevent these cancers, but even if it did, it was clear that the disease were so rare that universal circumcision was a crazy and arrogant over-reaction. The so called "new claims" for the "benefits" of circumcision are actually very old. Further information on circumcision and cancer <a href="http://www.cirp.org/library/disease/cancer/" rel="noopener" target="_blank">http://www.cirp.org/library/disease/cancer/</a> The advice in this article on the care of normal boys does not reflect the current state of medical knowledge and is not valid today. The foreskin should never be forcibly retracted; this can expose the urinary tract to the risk of infection and is likely to cause bleeding and other damage to the penis. Further information on phimosis <a href="http://www.cirp.org/library/treatment/">http://www.cirp.org/library/treatment/</a> Information on urinary tract infections (UTIs) <a href="http://www.cirp.org/library/disease/UTI/" rel="noopener" target="_blank">http://www.cirp.org/library/disease/UTI/</a> Further information on sexually transmitted diseases (STDs) <a href="http://www.cirp.org/library/disease/STD/" rel="noopener" target="_blank">http://www.cirp.org/library/disease/STD/</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 The enigma of 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"> <h3>The Age (Melbourne) 1996</h3> There is no medical reason why baby boys are circumcised. Why then do we put newborn children through such pain? PAMELA BONE reports. ONE had to feel sorry for baby Kane, with a blood-stained bandage sticking to his poor little penis in an episode of the ABC's recent documentary-soap, 'Sylvania Waters'. However, as Paul, his father, lovingly explained to the baby, "It has to be done because when Daddy was a little boy and he went to the toilet with the other kids, the ones that weren't circumcised were laughed at. They weren't normal because they weren't circumcised." Even so, Paul said, he had to cry himself when he saw the tears running down the baby's face after the cut. But was little Kane's pain necessary? Because, contrary to what Paul believes, by the time Kane goes to school he is more likely to be different because he is circumcised. A generation ago parents who didn't want their baby boy circumcised had to take a firm stand. Today it is parents who do want their child circumcised who have to take a stand. Nearly everyone, in this country at least, finds the idea of female circumcision abhorrent. Bring up the subject of male circumcision, however, and you are likely to get reactions ranging from amusement to defensiveness and hostility; because the majority of Australian adult males, whether Christian, Jew, Muslim or atheist, have been circumcised. About 24 per cent of newly born boys in Australia are being circumcised today, but during the 1960s the proportion was about 70 per cent. Earlier, it was a routine procedure in Australian hospitals, almost as common as cutting the umbilical cord, and it was often done without the parents even having been consulted. Today most doctors agree that there is no medical reason why baby boys should be routinely circumcised. For Jews and Muslims, circumcision is a religious requirement. But Jews and Muslims together make up just over one per cent of the Australian population, which suggests that a lot of baby boys are undergoing a painful surgical procedure for no good reason. It is true that there is little comparison between the horrific practice of female circumcision, which is more properly described as genital mutilation, and male circumcision. Female circumcision, according to in which country the procedure is carried out, can range from what is described as a "ritual scratch" of the clitoris, to the removal of the clitoris and labia and even the sewing up of the area with catgut or thorns. It often leads to lifelong gynaecological problems. And it is done for an extremely nasty reason - to ensure a woman's sexual fidelity by denying her sexual pleasure. Male circumcision is the removal of the foreskin, the skin which usually covers and protects the head of the penis. The most common reason given for non-religious male circumcision is that it is more hygienic. But some men are now saying that male circumcision is genital mutilation, too, and that, like female circumcision, it represents a cruel denial of the human rights of a helpless child. In the United States, groups such as "Nocirc" have been campaigning strongly against the practice. They are facing a battle, because with 60 per cent of baby boys in the US still being circumcised, it is more common there than in any other Western country. (In Canada the rate is 40 per cent, in New Zealand two per cent, and in the countries of Europe less than one per cent, though that proportion is probably increasing with the growth of migration from Muslim countries). Male circumcision was carried out in Egypt 6000 years ago. It is also known to have been practised by Australian Aborigines about 300 years ago. In Judaism and Islam, circumcision is taken from the prophet Abraham, who, it was said, was directed by God to circumcise his sons. The earliest Christians had been Jews and so would have been circumcised in infancy. But St Paul, who had been an orthodox Jew, denounced circumcision as a heathen mutilation, and said Christian circumcision should be metaphorical, a control over oneself. So why did circumcision become so prevalent in Christian countries in the 19th and 20th centuries? It seems we have to thank for it the sexual repression of Victorian England. During the reign of Queen Victoria, circumcision was very widely practised, and the main reason for it was to "cure" masturbation. Masturbation, or the "secret vice" was an enormous worry in both England and America at that time. According to the experts of the day, it was responsible for sleeplessness, night terrors, frequent urination, bed-wetting, epilepsy, St Vitus's Dance, kidney disease and insanity. Dr Kellogg, of Cornflakes fame, listed 38 suspicious signs by which habitual masturbators could be detected, and recommended the eating of his breakfast products to effect a cure. While today it is known that the foreskin is naturally adherent in the newborn male and grows free later in childhood, in Victorian times "a tight foreskin" was seen as something that needed to be corrected. According to the "Ladies' Handbook of Home Treatment", published in 1907, "many a nervous, irritable, restless baby has been transformed into a most contented bit of humanity by the simple operation of circumcision". The same handbook noted that "A fact almost unknown among the laity is that girls sometimes require a slight operation which resembles circumcision in the boy ... Any girl who does not yield to the ordinary measures employed in the treatment of self-abuse should be examined with a view to having this operation performed ...". The mere fact "of undergoing an operation and of having the genital organs carefully covered with protective dressings and bandages for some time, tends in itself to lessen the force of the habit", the book said. A medical text book published in the US in 1912 noted that "circumcision for the girl or woman of any age is as necessary as for the boy or man ... but the girls have been neglected ... I do feel an irresistible urge to cry out against the shameful neglect of the clitoris and its hood". Despite such pleas, the practice of female circumcision never became as popular in Anglo-Saxon countries as did male circumcision. The Australian Medical Association has no official policy on male circumcision,* though a spokesman said it is becoming increasingly difficult to find a doctor who is comfortable with the procedure. The AMA "strongly disapproves of female circumcision". While female circumcision is not specifically forbidden by any Australian law, the Australian Law Reform Commission says there is little doubt that it would constitute an assault, and it would be no defence that the operation was performed in hospital by a doctor. (It is widely suspected, however, that female circumcision is taking place among some ethnic communities in Australia, and that some girls are sent overseas for the ritual.) Female circumcision is not a requirement of Islamic law. However, a study of female circumcision in Egypt in 1985 found that 81 per cent of a large group of women had been genitally mutilated, and of the sample, 94 per cent were Muslim and six per cent Coptic Christian. The study concluded that "religious beliefs are a strong predisposing factor for female genital mutilation. A large percentage of women whose genitals are mutilated are affiliated with the Islamic religion despite the fact that female genital mutilation is not prescribed by the Islamic religion". Male circumcision is legal in Australia and the costs of it are recoverable under Medicare. In 1985 the then Health Minister, Dr Blewett, attempted to drop the Medicare rebate for circumcision of babies under six months, but reversed the decision after pressure from Jewish and Muslim communities. Dr Blewett said he was concerned that circumcision may be performed by untrained people if removal from Medicare "proved an economic hardship". The Australian College of Paediatrics discourages the practice of circumcision in newborn males (and of course in females). However, the registrar, Dr Paul Roy, said that the "religious imperative" of Jews and Muslims for male circumcision was respected. Are there any health benefits from routinely circumcising baby boys? There are some studies that show that baby boys who have been circumcised have fewer urinary tract infections in the first 12 months. However, Dr Roy said, even if circumcision does helps prevent urinary tract infections in newborn boys, it is not sufficient reason for routine circumcisions. "It means doing 100 circumcisions to prevent one infection. One only has to see a couple of boys get a mutilated penis to realise it is not a good enough reason." Dr Roy said circumcision of newborn boys was not done under anaesthetic and agreed it "must hurt like crazy". Dr George Williams, a Sydney paediatrician who is writing a book about male circumcision, says on the available evidence there is no medical reason for routine circumcision. He said penile hygiene can be maintained simply by washing with soap** and water without forcible retraction of the foreskin. He also said the foreskin contains tactile sensitive structures for erotogenic function. It used to be believed that the partners of uncircumcised men were more likely to develop cervical cancer. However, Dr Williams said studies that indicated this were "confounded by other variables". A large study in the US in 1973 found there was no difference in the circumcision status of sexual partners of women who had developed cervical cancer from that of other women. Some men who are campaigning against circumcision say it is most often done because of pressure from the mother, as a kind of Freudian revenge against all men. But Dr Williams says that in his experience it is usually wanted by the father, because the father has himself been circumcised and wants his son to be just like him. Circumcision may become necessary for some men in later life. But adults are capable of making an informed decision about whether or not to have the operation, whereas babies are not. Circumcision is a surgical procedure with inherent risks of bleeding, trauma and mutilation, pain and infection, and rarely, death. The onus of proof should be to show that it is not harmful, Dr Williams said. But even if there are no compelling medical reasons for it, most men who were circumcised will stoutly defend the practice. "It didn't affect me", is the common response. How can they know, if they were circumcised as babies? One man, who had been circumcised at the age of 23, said in an article in the US 'Journal of Nurse-Midwifery': "On a scale of 10, the intact penis experiences pleasure that is at least 11 or 12; the circumcised penis is lucky to get to three. If American men who were circumcised at birth could know the deprivation of pleasure they would experience they would storm the hospitals and not permit their sons to undergo this unnecessary loss." It is true that all kinds of unnecessary surgical procedures are carried out, from ear-piercing and tattooing to hair transplants and breast augmentation. These are done at the behest of adults, who supposedly can make an informed decision. A newborn child certainly can't. Opposition to male circumcision has been described as "bordering on paranoid". Yet men against circumcision believe it is discriminatory that while female circumcision is condemned, even if for religious reasons, male circumcision is condoned when it is done for religious reasons. John Fleming, a member of an informal group of men who have been campaigning in Australia against circumcision, says the human rights and legal aspects of both male and female circumcision of children need to be clarified. He says: "It is bizarre that while tattooing is illegal for children under 18 it is apparently OK for a doctor, or a religious-authority figure, to painfully mutilate for life a poor child's most sensitive organ." The United Nations convention on the rights of the child,*** recently ratified by Australia, guarantees the rights of all children to enjoy their own culture. However, the convention also calls upon the signatories to "take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children". Professor Carl Wood, of the department of obstetrics and gynaecology at the Monash Medical Centre (and well-known IVF pioneer) said the widespread use of circumcision for little or no medical advantage "is an emblem of brutality in society". "I hated performing the operation when I was a young doctor. No anaesthetic was used and the baby most often screamed. It appeared to be a much worse experience than birth and possibly the worst experience for the baby in its early life. What effect does this imprint have?" The Age (Melbourne), 2 December 1996, p. 6 <h3>Notes</h3> * In 1997 the AMA adopted a policy which stated: The AMA will discourage circumcision of baby boys in line with the Australian College of Paediatrics "Position Statement on Routine Circumcision of Normal Male Infants and Boys". The statement, released in June and supported by the AMA's November Federal Council meeting, includes: <ul> <li>The Australian College of Paediatrics should continue to discourage the practice of circumcision in newborns. </li> <li>Educational material should be available to parents before the birth of their baby and in maternity hospitals. </li> <li>Some parents after considering medical, social, religious and family factors will opt for circumcision. It is then the responsibility of the doctor to recommend this is performed at an age and under circumstances which reduce hazards to a minimum.</li> </ul> Australian Medicine, 6-20 January 1997, p. 5. </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 Why doctors are cutting down on 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"> <h2>Australia's new witchdoctors</h2> <h4>Did ritual and religious circumcision arise from motives of hygiene?</h4> What do African witchdoctors and a modern zoologist like Dr Roger Short have in common? What beliefs are shared by the superstitious moon priests of ancient Egypt and a contemporary expert in molecular biology such as Professor Brian Morris? What conviction animates a Brisbane GP like Dr Terry Russell as much as it gripped a nineteenth century medical quack and snake oil salesman like Dr Peter Remondino? At what point to the ritual practices of Aboriginal elders in the central Australian desert converge with the deeply-pondered recommendations of the New England Journal of Medicine? There is a striking degree of unanimity among the traditional superstitions of ancient and tribal cultures, the nostrums of Victorian quackery and the certainties of an influential band of contemporary medical researchers and doctors on one sensitive point: that young males ought to have part of their penis cut off. The reasons offered by each category of enthusiast are slightly different: tribal uniformity and religious requirement in the first case; prevention and cure of nervous diseases and masturbation in the second, though not forgetting claims about protection against syphilis, tuberculosis, polio, epilepsy and many other problems; and in the third case reducing the risk of infection with intractable modern diseases such as HIV-AIDS (as well as cervical cancer in female partners), particularly among Third World populations. <h4>Egypt: So long ago that nobody knows the truth</h4> Surprisingly, modern medical researchers do not try to hide their continuities with the ignorant and superstitious past. Almost every article on routine male circumcision in medical journals opens with the same little mantra: that "circumcision is the oldest surgical operation known to man, practised by many ancient cultures etc", and some refer to an old Egyptian bas relief which is supposed to represent the operation on two adolescent boys. (1) Why the mysterious rites of a pre-scientific, priest-ruled culture like that of ancient Egypt should be hailed as a model for contemporary medicine is not entirely clear. Whatever its ritual significance to stone-age man and antique civilizations, circumcision as a medical procedure is a recent invention, dating from only the eighteenth century as a treatment for severe venereal sores on the penis; it was practised by relatively few pre-modern cultures; and the much-reproduced Egyptian bas relief is so eroded that it is impossible to make out even what is depicted, let alone to be sure about what is happening. There is no evidence that the ancient Egyptians practised widespread circumcision (though it does seem to have been a ritual requirement for priests and possibly court officials â€“ who were sometimes eunuchs, as the story of Potiphar's wife reminds us â€“ at certain periods), and the actions shown in the relief look more like the shaving of the boys' pubic hair than the amputation of their foreskins. (2) If it is a representation of circumcision it reveals an important aspect of the procedure which its modern advocates always gloss over: one of the boys is being forcibly restrained, suggesting that whatever is being done to him is not something he is too eager about. Are the principles of contemporary medical ethics and personal freedom no further advanced than in the days of a despotic, divine-right monarchy like that of the pharaohs? If it is surprising to see modern medical experts associating themselves with the coercive rituals of ancient priests and slave-driving kings, it is even stranger to observe the similarity of their warnings against the foreskin with the tub-thumping propaganda of a nineteenth century quack like Dr P.C. Remondino, author of History of circumcision from the earliest times to the present: Moral and physical reasons for its performance (1891), in which the foreskin is vilified at length as a malign influence and "moral outlaw". According to Remondino its removal would not only discourage boys from masturbating, but immunise them against tuberculosis, cancer, syphilis, polio, idiocy, forgetfulness, impotence, unwanted erections, wet dreams and just about any medical problem you cared to mention. <h4>Modern crusaders</h4> Australia's leading crusaders for universal male circumcision are Dr Terry Russell, a GP in Brisbane whose whole practice consists of little more than excising the foreskins of baby boys by means of the Plastibell device; and Dr Brian Morris, a professor of physiology at Sydney University, who (not being medically qualified) just likes to talk about it. Both are frequently seen in the media urging parents to have their boys circumcised, and much of their routine is just a long list of nasty diseases, designed to terrify people into seeking urgent medical intervention. Russell apparently tells parents that an early circumcision is the equivalent of immunization against venereal disease, cancer of the penis and many other problems which, he implies, boys will be likely to contract unless they are liberated from the malevolent portion of their penis. He writes that, if they had been circumcised, "a vast number of neonates would have been saved from UTI [urinary tract infections] and its consequences of renal failure, septicaemia, meningitis, hypertension and death". Circumcision "may reduce the risk of STDs (syphilis, gonorrhoea, herpes and candida) and carcinoma of the cervix of female partners. It also prevents balanoposthitis and phimosis", not to mention such "potentially fatal conditions" as neonatal UTIs, HIV/AIDS and cancer of the penis. (3) Scary. You would think though, given that only about 12 per cent of Australia boys are circumcised these days, that if these claims were true the others would be dropping like flies. Seemingly not. (In fact, the Australian Institute of Health and Welfare reports that in the twenty years since 1983, as the incidence of circumcision has plummetted, there has been a <a href="http://www.circinfo.org/news.html" rel="noopener" target="_blank">dramatic improvement in child health outcomes</a>.) A hundred years ago Dr Remondino referred to: "The tight-constricted, glans-deforming, onanism-producing, cancer-generating prepuce that is ... at the bottom of the ills ... that may affect man" (4). He reminded his wide-eyed readers that: the prepuce seems to exercise a malign influence in the most distant and apparently unconnected manner; where, like some of the evil genii or sprites in the Arabian tales, it can reach from afar the object of its malignity, striking him down unawares in the most unaccountable manner; making him a victim to all manner of ills, sufferings and tribulations; unfitting him for marriage or the cares of business; making him miserable and an object of continual scolding and punishment in childhood, through its worriments and nocturnal enuresis; later on, beginning to affect him with all kinds of physical distortions and ailments, nocturnal pollutions, and other conditions calculated to weaken him physically, mentally, and morally; to land him, perchance, in jail or even in a lunatic asylum. (5) Just as scary. Brian Morris concludes his own booklet on the necessity to circumcise all male infants with dire warnings that retention of the foreskin "confers a higher risk of death in the first year of life (from complications of urinary tract infections leading to kidney failure, meningitis and infection of bone marrow"; increases the danger of cancer of the penis; leads to "balanitis (inflammation of the glans), posthitis (inflammation of the foreskin), phimosis (inability to retract the foreskin) and paraphimosis (constriction of the penis by a tight foreskin"; and he concludes that being circumcised "will result in better sexual function" and "a penis that is generally regarded as more attractive" (6). How could he disagree with Dr Remondino's assurance that: Circumcision is like a substantial and well-secured life annuity; every year of life you draw the benefit, and it has not any drawbacks .... Parents cannot make a better paying investment for their little boys, as it insures them better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor-bills, as well as increases their chances for an euthanasian death. (7) Professor Morris admits his affinity with the Remondinos of this world by acknowledging that "the Victorians cited many of the same medical conditions associated with uncircumcised penises as do people today", yet at the same time he denies that a major reason why they introduced it was to discourage boys from masturbating: that claim is "a falsehood that has been promoted by anti-circumcision groups". (8) Morris is very critical of the unscientific approach of such activists, but it is strange to see him endorsing the Victorian enthusiasm for circumcision as consistent with his own arguments in its favour, yet denying that control of masturbation had anything to do with the matter. Remondino was quite definite that, in his view, even the ancient origins of circumcision lay in the desire of Judaic lawgivers first to discourage the idolatrous debaucheries practised among their free-spirited neighbours in the Middle East, and masturbation specifically; and secondly to encourage procreation. Referring to the story of the circumcision of Abraham and the impregnation of Sarah, he writes: "Here we have suggestions of a preventive to onanism, and a cure to male impotence when due to preputial interference" (9). Dr Morris follows this lead closely when he writes: The Bible records that Abraham circumcised himself at age 99, along with his 13 year-old son Ishmael. Not long afterwards his wife Sarah, after many barren years, became pregnant and bore Isaac. Weiss speculates that Abraham had a foreskin problem, possibly exacerbated by the desert environment, and that this problem interfered with his sexual activity. The difficulties were solved by having a circumcision. (10) It comes as a bit of a shock to see a modern scientist treating the Old Testament as though it were literal history. No serious scholar in biblical studies today believes that the early books of the Old Testament are a factual record of history, and it is now generally accepted that they are a collection of stories assembled by Jewish religious leaders in the 6th century BCE. It follows that Abraham et al are as much mythical figures as Hercules or Oedipus, and that Weiss's "speculations" are on a par with Archbishop Ussher's calculations of the age of the earth in the 17th century. Recent research also suggests that Judaic ritual circumcision did not become routine and privileged as a sign of the Covenant until the Babylonian exile of the 6th century (at about the same time as the first five books of the Old Testament â€“ the Torah â€“ were compiled), when the rationale was the maintenance of cultural identity and racial purity in a hostile social environment by the enforcement of physical distinctiveness. It had nothing to do with "foreskin problems", protection against disease or the irritation caused by desert sands. (11) The foreskin was more likely a protection against such irritation than a source of it, as Remondino himself conceded: Nature â€“ always careful that nothing should interfere with the procreative functions â€“ had provided him [primitive man] with a sheath or prepuce, wherein he carried his procreative organ safely out of harm's way, in wild steeple-chases through thorny briars and bramble-brakes. (12) Professor Morris apparently forgot this passage when he warned that yet another drawback of having a foreskin was that it might get caught in your zipper. Allowing the myth for a moment, if it was Abraham who had the foreskin problem, why did he also circumcise his son Ishmael, followed by his servants and slaves? And if this "problem" prevented him from begetting children, how come he already had a 13 year-old son? Not surprisingly, Professor Morris' booklet <a href="https://www.darboninstitute.org/brian_morris_reviewed" rel="noopener" target="_blank">has not been warmly reviewed</a> by experts in paediatrics or sexual health. <h4>Queensland is different?</h4> Dr Russell, too, found it necessary to bolster a weak medical case by reference to religious prescription. Interviewed on the Australian current affairs program 60 Minutes in October 2000 he was caught out by the interviewer's awareness that no medical body in the world recommended routine circumcision. Interviewer: Can you point to one international medical body which doesn't say maybe you should circumcise but says definitely. Russell: Yeah, I think the American Academy of Pediatrics has said that. I've got a .... Interviewer: No they don't. Can you think of one which says you absolutely should do it? Russell: The Bible did. [giggles] No, not off the top of my head, no. (13) Unfortunately the interviewer did not press Dr Russell on why an unexplained biblical precedent established a requirement for modern-day Australians. He was presumably referring to the Genesis story also cited by Professor Morris rather than St Paul's advice that Christians should not continue to practise the many rules imposed on the Jewish people by their exacting god. It is hard to see why the rules of the Old Testament should be relevant to modern medical practice in Queensland today. <a href="https://www.darboninstitute.org/three_persistent_myths_about_the_foreskin" rel="noopener" target="_blank">Further information on the ritual/religious page</a> References 1. Robert Szabo and Roger V. Short, "How does male circumcision protect against HIV infection?", British Medical Journal, Vol. 320, 2000, pp. 1592-4 2. Frederick Hodges, "The ideal prepuce in Ancient Greece and Rome: Male genital aesthetics and their relation to lipodermis, circumcision, foreskin restoration and the Kinodesme", Bulletin of the History of Medicine, Vol. 75, 2001, pp. 375-405 3. Terry Russell, "Debate: Male circumcision remains a valid procedureâ€”Yes", Australian Doctor, 24 May 1996, p. 54 4. P.C. Remondino, History of circumcision from the earliest times to the present: Moral and physical reasons for its performance, Philadelphia and London, 1891, p. 187 5. Remondino, pp. 54-5 6. Brian Morris, In favour of circumcision, Sydney, New South Wales University Press, 1999 pp. 87-8 7. Remondino, p. 186 8. Morris, p. 57 9. Remondino, p. 201 10. Morris, p. 60, citing G.N. Weiss, "Prophylactic neonatal surgery and infectious diseases", Pediatric Infectious Diseases Journal, 1997 11. Lawrence W. Hoffman, Covenant of blood: Circumcision and gender in rabbinic Judaism, University of Chicago Press, 1996; Leonard Glick, "Jewish circumcision: An enigma in historical perspective", in Marilyn Milos, George C. Denniston and Frederick Hodges (eds), Understanding circumcision: A multi-disciplinary approach to a multi-dimensional problem, London and New York, Kluwer Academic and Plenum Press, 2001 12. Remondino, p. 8 13. "Fore and against", 60 Minutes, 8 October 2000, 9 Network (Australia), presenter: Ellen Fanning (video in possession of the author) </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 Australia's new witchdoctors darby