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George W.TobiaSjM.D. 
 
 W. 133rd Street, 
 
 New York; 
 
Hebraic Circumcision. 
 
 (From an old sixteenth century Italian print in the author's collection, 
 representing the scene of the Holy Circumcision.) 
 
No. 11 IN THE PHYSICIANS'. AND STUDENTS' READY 
 REFERENCE SERIES. 
 
 HISTORY 
 
 OF 
 
 CIRCUMCISION 
 
 FROM THE 
 
 EARLIEST TIMES TO THE PRESENT. 
 
 Moral and Physical Reasons for its Performance, 
 
 WITH A 
 
 HISTORY OF EUNUCHISM, HERMAPHRODISM, ETC., AND 
 
 OF THE DIFFERENT OPERATIONS PRACTICED 
 
 UPON THE PREPUCE. 
 
 P. C. REMONDINO, M.D. 
 
 (JEFFERSON), 
 
 Member of the American Medical Association, of the American Public Health Association, 
 
 of the San Diego County Medical Society, of the State Board of Health of 
 
 California, and of the Board of Health of the City of San Diego; 
 
 Vice-President of California State Medical Society and of 
 
 Southern California Medical Society, etc. 
 
 Philadelphia and London : 
 
 THE F. A. DAVIS CO., PUBLISHERS, 
 1891. 
 
C-\&S-'^ 
 
 Entered according to Act of Congress, in the year 1891, by 
 
 F. A. DAVIS, 
 
 In the Office of the Librarian of Congress, at Washington, D. C, TJ. S. A. 
 
 
 Philadelphia, Pa., XJ. S. A.: 
 
 The Medical Bulletin Printing House, 
 
 1231 Filbert Street. 
 
PREFACE. 
 
 In ancient Egypt the performance of circumcision 
 was at one time limited to the priesthood, "who, in ad- 
 dition to the cleanliness that this operation imparted 
 to that class, added the shaving of the whole bodj" as a 
 means of farther purification. The nobilit}', royalty, 
 and the higher warrior class seem to have adopted cir- 
 cumcision as well, either as a hygienic precaution or as 
 an aristocratic prerogative and insignia. Among the 
 Greeks we find a like practice, and we are told that in 
 the times of Pythagoras the Greek philosophers were 
 also circumcised, although we find no mention that the 
 operation went beyond the intellectual class. In the 
 United States, France, and in England, there is a class 
 which also observe circumcision as a hygienic precau- 
 tion, where, from my personal observation, I have found 
 that circumcision is thoroughly practiced in every male 
 member of many of the families of the class, — this 
 being the phj^sician class. In general conversation with 
 phj^sicians on this subject, it has really been surprising 
 to see the large number who have had themselves cir- 
 cumcised, either through the advice of some college pro- 
 fessor while attending lectures or as a result of their 
 
 (iii) 
 
iv Preface. 
 
 own subsequent convictions when engaged in actual prac- 
 tice and daily coming in contact both with the benefits 
 that are to be derived in the way of a better physical, 
 mental, and moral health, as well as with the many dan- 
 gers and disadvantages that follow the uncircumcised, — 
 the latter being probably the most frequent incentive 
 and determinator, — as in many of these latter examples 
 the operation of circumcision, with its pains, annoy- 
 ances, and possible and probable dangers, sink into the 
 most trifling insignificance in comparison to some of the 
 results that are daily observed as the tribute that is 
 paid b}'^ the unlucky and unhappy wearer of a prepuce 
 for the privilege of possessing such an appendage. 
 
 There is one thing that must be admitted concerning 
 circumcision : this being that, among medical men or 
 men of ordinary intelligence who have had the opera- 
 tion performed, instead of being dissatisfied, they have 
 extended the advantages they have themselves received, 
 by having those in their charge likewise operated upon. 
 The practice is now much more prevalent than is sup- 
 posed, as there are many Christian families where males 
 are regularly circumcised soon after birth, who simply 
 do so as a hj^gienic measure. 
 
 Tor the benefit of these, who may congratulate 
 themselves upon the dangers and annoyances that they 
 
Preface. v 
 
 » 
 and their families have escaped, and for the benefit of 
 
 those who would run into these dangers but for timely 
 
 warning, this book has been especiallj^ written. To my 
 
 professional brothers the book will prove a source of 
 
 instruction and recreation, for, while it contains a lot 
 
 of pathology regarding the moral and physical reasons 
 
 why circumcision should be performed, which might 
 
 be as undigestible as a mess of Boston brown bread 
 
 and beans on a French stomach, I have endeavored to 
 
 make that part of the book readable and interesting. 
 
 The operative chapter will be particularly useful and 
 
 interesting to phj'sicians, as I have there given a careful 
 
 and impartial review of all the operative procedures, — 
 
 from the most simple to the most elaborate, — besides 
 
 paying more than particular attention to the subject of 
 
 after-dressings. The part that relates to the natural 
 
 history of man will interest all manner of people. I 
 
 regret that the tabular statistics are not to be had, but 
 
 in this regard we must use our best judgment from the 
 
 material we have on hand ; at any rate, I have tried to 
 
 furnish a suflScieney of facts, so that, unless the reader 
 
 is too overexacting, he will not find much diflSculty in 
 
 arriving at a conclusion on the subject. 
 
 P. C. Remondino, M.D. 
 
 San Diego, California, 1891. 
 
CONTENTS. 
 
 PAGE 
 
 Preface, iii 
 
 Introduction, . 
 
 CHAPTER I. 
 Antiquity of Circumcision, 21 
 
 CHAPTER II. 
 
 Theories as to the Origin of Circumcision, . 28 
 
 CHAPTER III. 
 Spread of Circumcision, 34 
 
 CHAPTER IV. 
 Circumcision Among Savage Tribes. . . .42 
 
 CHAPTER V. 
 
 Infibulation, Muzzling, and other Curious 
 
 Practices, 46 
 
 CHAPTER VI. 
 Attempts to Abolish Circumcision, ... 63 
 
 (vii) 
 
viii Contents. 
 
 PAGE 
 
 CHAPTER VII. 
 Miracles and the Holy Prepuce, ... 70 
 
 CHAPTER VIII. 
 
 History of Emasculation, Castration, and 
 
 Eunuchism, 82 
 
 CHAPTER IX. 
 
 Philosophical Considerations Relating to 
 
 Eunuchism and Medicine, .... 105 
 
 CHAPTER X. 
 Hermaphrodism and Hypospadias, . . .117 
 
 CHAPTER XI. 
 Religio Medici, 134 
 
 CHAPTER XII. 
 Hebraic Circumcision, . . . . . .143 
 
 CHAPTER XIII. 
 
 Mezizah, the Fourth or Objectionable Act of 
 
 Suction, . , . 150 
 
 CHAPTER XIV. 
 What are the Benefits of Circumcision?. . 161 
 
 CHAPTER XV. 
 
 Predisposition to and Exemption and Immunity 
 
 FROM Disease, . . . . . . .183 
 
Contents. ix 
 
 PAGE 
 
 CHAPTER XVI. 
 The Prepuce, Syphilis, and Phthisis, . . 187 
 
 CHAPTER XVII. 
 Some Reasons for Being CiRcrMcisED, . . 200 
 
 CHAPTER XVIII. 
 
 The Prepuce as an Outlaw, and its Effects 
 
 ON THE Glans, 206 
 
 CHAPTER XIX. 
 
 Is THE Prepuce a Natural Physiological 
 
 Appendage? ,217 
 
 CHAPTER XX. 
 
 The Prepuce, Phimosis, and Cancer, . . . 226 
 
 CHAPTER XXL 
 The Prepuce and Gangrene op the Penis, . 236 
 
 CHAPTER XXII. 
 The Prepuce, Calculi, and other Annoyances, . 248 
 
 CHAPTER XXIII. 
 Reflex Neuroses and the Prepuce, . . . 254 
 
 CHAPTER XXIV. 
 Dysuria. Enuresis, and Retention of Urine, . 2T5 
 
X . Contents. 
 
 PAGE 
 
 CHAPTER XXV. 
 
 General Systemic Diseases Induced by the 
 
 Prepuce, 284 
 
 CHAPTER XXVI. 
 Surgical Operations Performed on the Prepuce, 302 
 
 JSToTES to Text, 323 
 
 Works and Authorities Quoted, . . . 336 
 Index, 389 
 
INTRODUCTION. 
 
 This book is the amplification of a paper, tlie subject 
 of whicli was, " A Plea for Circumcision ; or, tlie Dangers 
 tliat Arise from tlie Prepuce," which was read at the 
 meeting of the Southern California Medical Society, at 
 Pasadena, in December, 1889. The material gathered 
 for that paper was more than could be used in the 
 ordinary limits of a society paper; it was gathered and 
 ready for use, and this suggested its arrangement into 
 book form. The subject of the paper was itself sug- 
 gested by a long and personal observation of the changes 
 made in man by circumcision. From the individual 
 observation of cases, it was but natural to wish to en- 
 large the scope of our observation and comparison ; 
 tliis naturally led to a stud}' of the phj'sical character- 
 istics of tiie only race that could practically be used for 
 the purpose. This race is tlie Jewish race. On carefully 
 studying into the subject, I plainly saw that much of 
 tlieir longevity could consistently be ascribed to their 
 more practical humanitarianism, in caring for their poor, 
 their sick, as well as in their generous provision for 
 their unfortunate aged people. The social fabric of the 
 Jewish fixmily is also more calculated to promote lono- 
 life, as, strangely as it may seem, family veneration and 
 family love and attachment are far more strono- and 
 practical among this people than among Christians, 
 this sentiment not being even as strong in the Christian 
 races as it is in tlie Chinese or Japanese. It certainly 
 forms as much of a part of the teachings of Christianity 
 as it does of Judaism, Buddhism, or Confucianism, only 
 
 ' ' (1) 
 
2 Introduction. 
 
 Christians, as a mass, have practically forgotten it. The 
 occupation followed by the Jews also in a certain degree 
 favors longevity, and the influence on heredity induced 
 by all these combined conditions goes for something. 
 But it is not alone in the matter of simple longevitj' — 
 although that implies considerable — that the Jewish 
 race is found to be better situated. Actual observations 
 show them to be exempt from many diseases which affect 
 other races ; so that it is not onlj- that they recover more 
 promptly, but that they are not, as a class, subjected to 
 the loss of time b}^ illness, or to the consequent suffer- 
 ings due to illness or disease, in anything like or like 
 ratio with other people. 
 
 There is also a less tendency to criminality, debaucli- 
 er}- , and intemperance in the race ; this, again, can in ft, 
 measure be ascribed to their familj- influence, which 
 even in our daj^ has not lost that patriarchal influence 
 which tinges the home or familj^ life ia the Old Testa- 
 ment. Crimes against the person or property committed 
 by Jews are rare. They likewise do not figure in either 
 police courts or penitentiary records ; they are not in- 
 mates of our poor-houses, but, what is also singular, they 
 are never accused of man}^ sillj' crimes, such as indecent 
 exposures, assaults on young girls ; nor do they figure in 
 any such exposures as the one recently made bj^ the 
 Pall Mall Gazette. 
 
 After allowing all that,- which we can, in its fullest 
 limit, to religion, familj^, or social habit, there is still a 
 wide margin to be accounted for. This has naturallj^ 
 let the inquir_y, followed in the course of this book, into 
 a careful review of the Jewish people ; into tlieir religion 
 and its character, its relation to other creeds, and to the 
 world's history; into their many wanderings, and into 
 the dispersion, and we have even been obliged to follow 
 
Introduction. 3 
 
 them into the midst of the people among wliom they 
 have become nationed, to try, if possible, to find the 
 cause of this racial difference in health, resistance to 
 disease, decay, and death. It has been necessary, in fol- 
 lowing out the research, to give a condensed resume of 
 the religious, political, and social condition of the Jewish 
 commonwealth, which, although in a state of dispersion, 
 still exists. I need offer no apology for the extended 
 iiotice this has received in the coui'se of the book. We 
 read with increasing interest either Hallam or May, 
 Buckle or Guizot, through the spasmodic, halting, retro- 
 grading, advancing, erratic, aimless, and accidental 
 piiases that England has plowed through, from the 
 days of goutless, simple, and chaste, but barbarian 
 England of the Saxons, to the present civilized, en- 
 lightened, gouty, "Darkest England" of General Booth; 
 and, after all is said and done, we are no wiser in anj'^ 
 l)ractical resulting good. We simply know that the 
 English people, so to speak, have, as it were, gone tlirough 
 the figures of some social aspects, as if dancing the 
 '• Lancers," with its forward and back movements, gallop, 
 etc., and have finall}^ sat down, better dressed and better 
 housed, but in an acquired state of moral and plij'sical 
 degeiioration. The Briton of Queen Yictoria is not the 
 Briton of Queen Boadicea, either morallv or physically. 
 On the other hand, the system of sociological tables 
 adopted by Herbert Spencer would have but little to 
 record for some six thousand j-ears — either in religion, 
 morals, or physique — as making any changes in the 
 histor}^ of that simple people which, in the mountainous 
 regions of Ur, in distant Armenia, started on its pil- 
 grimage of life and racial existence; in one branch of 
 the family — that of Ishmael — the changes to be recorded 
 are so invisible that its descendants may really be said 
 
4 Introduction. 
 
 to live to-day as they lived then. So that I do not feel 
 that 1 need to apologize for the space I have given to 
 this snbject in the course of the book. The causes that 
 make tliese racial distinctions should be of interest alike 
 to the moralist, theologist, sociologist, and to the phy- 
 sician. 
 
 Ecclesiastical writers and moralists, as well as writers 
 of fiction or dramatizers, can write on an^^thing they 
 please, and it is eagerly taken up and read by the people 
 generally, either of high or low degree, alike ; and some- 
 how these people seem never to require an apology on 
 the part of the author, for having attempted rapes, se- 
 ductions, or even unavoidable fornication committed 
 through the leaves of the stor^', or having it imaginably 
 take place between acts on the stage. But if the ph}-- 
 sician writes a book touching an^'thing connected with 
 the generative functions, and with the best intent and 
 for the good of humanity, he is expected to make some 
 prefatory apology. He is supposed to address a public 
 wlio all of a sudden have become intensely' moral and 
 extremely sensitive in their modestj''. Wh}^ things 
 are thus I cannot explain. They are so, nevertheless. 
 From the time that the celebrated Astruc wrote his 
 treatise on female diseases, near the end of the seven- 
 teenth centur}'^, — who felt compelled by the extreme 
 modesty of the people in this particular — but who, out- 
 side of medicine, were about as virtuous as the average 
 Tabby or Tom cats in the midnight hour — to write the 
 chapter touching on nymphomania in Latin, so as not to 
 shock the morbidly sensitive modest}" of the French 
 nobility, who then enjoyed Le Droit de cuissage, — down 
 through to Bienville, who wrote the first extended work 
 on nymphomania, and Tissot, who first broached the 
 subject and the danger of Onanism, all have felt that 
 
Introduction. 5 
 
 they must stop on the thresliokl and " apologize." Tissot, 
 however, seemed to possess a robust and a plain Hip- 
 pocratic mind, and as he apologized he could not help 
 hut see the ridiculousness of so doing, as in the preface 
 to his work we find the following: "Shall we remain 
 silent on so important a subject ? B}^ no means. The 
 sacred authors, the Fathers of the Church, who i)resent 
 their thoughts in living words, and ecclesiastical authors 
 have not felt that silence was best. I have followed 
 their example, and shall exclaim, with St. Augustine, 
 ' If what I have written scandalizes any prudish persons, 
 let them rather accuse the turpitude of their own 
 thoughts than the words I have been obliged to use.'" 
 
 For my part, I think that people who can go to the 
 theatre and enjoy " As in a Lookiug-Glass," and witness 
 some of the satyrical or bill3'-goat traits of humanity so 
 graphically exhibited in "La Tosca," with evident 
 satisfaction ; or attend the more robust plays of " Yir- 
 ginius " or of " Galba, the Gladiator," with all its 
 suggestions of the Caesarian section, and the lust and 
 the fornications of an intensely animal Roman empress, 
 without the destruction of their moral equilibrium or 
 tending to induce in them a disposition to commit a 
 rape on the first met, — I think such people can be safely 
 intrusted to read this book. 
 
 And as to the reading public, there are hut few 
 general readers who could honestl}'^ plead an ignorance of 
 the "Decameron," Balzac, La Fontaine, " Heptameron," 
 Grebillon fils^ or of matter-of-fact Monsieur le Docteur 
 Maitre Rabelais, — works which, more or less, carry a 
 moral instruction in every tale, which, like the tales of 
 the " Malice of Women," in the unexpurged edition of 
 the literal translation of the "Arabian Nights," contains 
 much more of practical moral lessons, even if in the 
 
6 Introduction. 
 
 flowery and warm, spiced language of the Orient, than 
 an}'^ supposed nastiness, on account of which the}^ are 
 chissed among the prohibited. To these, and the readers 
 of Amelie Rives's books, or other intensel}" realistic 
 literature, I need not imitate the warning of Ansonius, 
 who warned his readers on the threshold of a part of 
 his book to " stop and consider well their strength 
 before proceeding with its lecture." Metaphorical!}^ 
 speaking, the general theatre-going, or modern literature- 
 reading public, can be considered pretty callous and 
 morally' bullet proof. I shall therefore make no apology. 
 Some fault maj', perhaps, be found with some of the 
 occasional st^le of the book, or with some of the sub- 
 jects used to illustrate a principle. To the extremely 
 wise,, good, and scientific, these illustrations were un- 
 necessary ; this need hardly be mentioned ; and the 
 passages which to some may prove objectionable were 
 not intended for them, either with the expectation of 
 delighting them or with the purpose of shocking them. 
 These passages, they can easily avoid. This book, 
 however, was written that it might be read : not only i-ead 
 by the Solon, Socrates, Plato, or Seueca of the laity or 
 the profession, but even by the billy -goated dispositioned, 
 vulgar plebeian, who could no more be made to read cold, 
 scientific, ungarnished facts than you can, make an 
 unwilling horse drink at the watering-trough. Human 
 weakness and perversity is silly, but it is sillier to ignore 
 thiit it exists. So, for the sake of boring and driving a 
 few solid facts into the otherwise undigesting and un- 
 thinking, as well as primarilj^ obdurate understanding 
 of the untutored plebeian, I ask the indulgence of the 
 intelligent and broad-minded as well as the easiU" in- 
 ducted reader. Cleopatra was smuggled into Caesar's 
 presence in a roll of tapestry ; the Greeks introduced 
 
Introduction. 7 
 
 their men into Tro}^ by means of a wooden horse; and 
 the discoverer of the broad Pacific Ocean made his 
 escape from his importunate creditors disguised as a 
 cask of merchandise. So, when we wish to accomplish 
 an object, we must adopt appropriate means, even if 
 they may appareiitl,y seem to have an entirely diametric- 
 ally opposite object. The Athenian, Themistocles, when 
 wishing to make the battle of Salamis decisive, was in- 
 spired with the idea of sending word to the Persian 
 monarch that the Greeks were tr3ing to escape, advisino- 
 him to block the passage ; this saved Greece. 
 
 There is a weird and ghostly but interesting tale 
 connected with the Moslem conquest of Spain, of how 
 Roderick, the last of the Gothic kings, when in trouble 
 and worry, repaired to an old castle, in the secret re- 
 cesses of which was a magic table whereon would pass 
 in grim procession the diflerent events of tlie future of 
 Spain ; as he gazed on the enchanted table he there saw 
 his own ruin and his country's and nation's subjugation. 
 Anatomy is generally called a dry stud}^ but, like the 
 enchanted brazen table in the ancient Gothic castle, it 
 tells a no less weird or interesting tale of the past. Its 
 revelations lighten up a long vista, through the thou- 
 sands of years through which the human species has 
 evolved from its earliest appearance on earth, gradually 
 working up through the different evolutionary processes 
 to wliat is to-day supposed to be the acme of perfection 
 as seen in the Indo-European and Semitic races of man. 
 Anatomy points to the rudiment — still lingering, now 
 and then still appearing in some one man and without a 
 trace in the next — of that climbing muscle which shows 
 man in the past either nervously escaping up the trunk 
 of a tree in his flight from man^- of the carnivorous ani- 
 mals with whom he was contemporary, or, as the shades 
 
8 Introduction. 
 
 of iiiglit were beginning to gather aronnd him, we again 
 see him by the aid of these nmscles leisure!}' climbing 
 up to some hospitable fork in the tree, where the robust 
 habits of the age allowed him to find a comfoi'table 
 resting-place ; protected from the dew of the night by 
 the overhanging branches and frijm the prowling hyena 
 by the height of the tree, he passed the niglit in security. 
 The now useless ear-muscles, as well as the equally use- 
 less series of muscles about the nose, also tell us of a 
 movable, flapping ear capable of being turned in any 
 direction to catch tlie sound of approaching danger, as 
 well as of a movable and dilated nostril that scented dan- 
 ger from afar, — the olfactory sense at one time having a 
 ditferent function and more essential to life than that of 
 merely noting the differential aroma emitted by segars 
 or cups of Mocha or Java, and the ear being then used 
 for some more useful pur[)ose tlian having its tympanum 
 toi'tured b}^ Wagnerian discordant sounds. Our ances- 
 tors might not have been a very handsome set, nor, 
 judging from the Neanderthal skull, could they have 
 had a ver^^ winning physiognomy, but they were a ver}' 
 hardy and self-reliant set of men. Nature — always care- 
 ful that nothing should interfere with the procreative 
 functions — had provided him 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, or, when hardl}^ pushed, and not 
 able to climb quickly a tree of his own choice, he was 
 by circumstances forced up the sides of some rough- 
 barked or tliorny tree. This leather}^ pouch also pro- 
 tected him from the many leeches, small aquatic lizards, 
 or other animals that infested the marshes or rivers 
 through which he had at times to wade or swim; oi' 
 served as a protection from the bites of ants or other 
 
Introduction. 9 
 
 vermin when, tired, he rested on bis haunches on some 
 mossy bank or sand-hill. 
 
 Man has now no use for any of these necessaries 
 of a long-past age, — an age so remote that the specu- 
 lations of Ernest Renau regarding the differences 
 between the Semitic race of Shem and the idolatrous 
 descendants of Ham, away off in the far mountains 
 and A-alleys of Asia Ij'ing between the Mediterra- 
 nean Sea and the Euphrates, seem more as if he 
 were discussing an event of 3'esterda3^ than something 
 which is considered contemporary with our earlier his- 
 tor3% — and we find them disappearing, disuse graduallj^ 
 producing an obliteration of this tissue in some cases, 
 and the modifying influence of evolution producing it 
 in others ; the climbing muscle, probably the oldest 
 remnant and legac}' that has descended from our 
 long-haired and muscular ancestry, is the best ex- 
 ample of disappearance caused by disuse, while the 
 efiectual disappearance of the prepuce in man}' cases 
 shows that in that regard there exists a marked dif- 
 ference in the evolutionary marcli among different 
 individuals. 
 
 There is»a strange and unaccountable condition of 
 things, however, connected with the prepuce that does 
 not exist with the other vestiges of our arboreal or 
 sylvan existence. Firstl}^ the other conditions have 
 nothing that interferes with their disappearance ; whereas 
 the prepuce, by its mechanical construction and the 
 expanding portions which it incloses, tends at times 
 rather to its exaggerated development than to its dis- 
 appearance. Again, whereas the other vestiges have no 
 injury that they inflict by their presence, or danger that 
 they cause their possessors to run, the prepuce is from 
 time of birth a source of annoyance, danger, suffering, 
 
10 Introducti'on. 
 
 find deatli. Then, again, the other conditions are not 
 more developed at hirtli ; whereas the prepuce seerns, in 
 our pre-natal life, to have an unusual and unseen-for-use 
 existence, being in bulk out of all proportion to the 
 organ it is intended to cover. Speculation as to its 
 existence is as unprolific of results as any we maj'^ 
 indulge in regarding the nature, object, or uses of that 
 other evolutionary appendage, the appendix vermiformis, 
 the recollection of whose existence always ad^s an 
 extra flavor to tomatoes, figs, or an^^ other small-seeded 
 fruits. 
 
 We may well exclaim, as we behold this appendage 
 to man, — now of no use in health and of the most 
 doubtful assistance to the verj^ organ it was intended 
 to protect, when that organ, through its iniquitous 
 tastes, has got itself into trouble, and, Job-lilce, is l.ying 
 repentant and sick in its manj^ wrappings of lint, with 
 perhaps its companions in crime imprisoned in a sus- 
 pensory bandage, — what is this prepuce ? Whence, why, 
 where, and whither ? At times. Nature, as if impatient 
 of the slow march of gradual evolution, and exasperated 
 at this persistent and useless as well as dangerous relic 
 of a far-distant prehistoric age, takes things in her own 
 hands and induces a sloughing to take place, which 
 rids it of its annoj^ance. In the far-off land of Ur, 
 among the mountainous regions of Kurdistan, something- 
 over six thousand 3'ears ago, the fathers of the Hebrew 
 race, inspired by a wisdom that could be nothing less 
 than of divine origin, forestalled the process of evolu- 
 tion by establishing the rite of circumcision. Whether 
 this has been beneficial or injurious to the race will be, 
 in a measure, the object of the discussion in this book. 
 
 One object of this book is to furnish my professional 
 brotliers with some embodied facts that they ma}^ use in 
 
Introduction: 11 
 
 convincing the lait}" in man}' cases where they themselves 
 are convinced that circumcision is absolutel}' neces- 
 sary- ; but, -having nothing in their text-hooks to back 
 up their opinion with, their explanations are too apt to 
 pass for their mere unfounded personal view of the 
 matter. If tiie patient, or the parents of the patient, 
 ask the physician for his authority, he is at a loss, as 
 there is nothing that deals with the subject in Viwy ex- 
 tended manner; so that this book has been written in as 
 plain English as the subject-matter could possibly allow, 
 so that non-professionals could easily read and under- 
 stand it. I have often felt the need of such a work ; 
 people can understand emergency or accident surgerj^, 
 militarj^ surgery, or reparative surgery, but such a thing 
 as surger}' to remed}' a seemingly medical disease, -or 
 what might be called the preventive practice of surgery, 
 is something they cannot understand. First, and not 
 the least, among the incentives to skepticism on this 
 subject is the unwelcome fact of a surgical operation, 
 which, no matter how trivial it may seem to the surgeon, 
 is a matter of considerable magnitude to the patient, his 
 parents, or friends ; there are risks, pain, worry, annoy- 
 ances, and expenses to be undergone, — considerations 
 which, either singly or unitedly, often lead one to 
 reason against the operation, even when otherwise con- 
 vinced of its need or utilit3\ 
 
 The hardest to convince are those, however, who 
 insist on having a four-and-a-half- foot-gauge fact driven 
 through their two-foot-gated understanding, without 
 it ever occurring to them that the gate, and not the 
 fact, is the fault}' article. Some of these gentry are 
 very unconvincible. They at times remind one of that 
 description given by Carlyle in regard to one of the 
 Georges^ who found himself, when Prince of Wales, 
 
12 Intr'oduction. 
 
 leading an army in Flanders, and actually engaged in a 
 battle. His Ro^al Highness was on foot, and was seen 
 standing facing the enem}-, with outstretched legs, like 
 a Colossus of Rhodes, impassive and stolid, — the very 
 impersonification of Dutch courage and aggressiveness. 
 There he stood, unconscious whether he was at the head 
 of an army or single attendant ; he might be overridden 
 and annihilated, overturned and expunged, but there he 
 would most assuredly stand and fall, if need be; over- 
 whelming sqnadrons, by their impetus and weight, might 
 ride him down and crush him ; but one thing was most 
 certain, this certain fact being that he never could be 
 made to retreat or advance, as no impression from front 
 or rear could convince him of the necessit}^ of either. 
 
 Then, there is our statistical friend, who cannot dis- 
 criminate between the exception and the rule b}- any 
 common-sense deductions. He must have all the 
 authentic, carefully-compiled statistics before he can 
 allow himself to form an^^ opinion. As long as there 
 is the smallest fraction of a decimal unaccounted for in 
 a mathematical wa}^, this individual is inconvincible. 
 These men pride themselves upon being methodically^ 
 exact; they express their willingness to be convinced if 
 30U can present acceptable proofs; but, trying to pre- 
 sent simple rational proofs to these individuals is con- 
 siderably like presenting a meal of boiled pork and 
 cabbage to a confirmed and h^^pochondriacal dyspeptic, 
 — it only increases their mental dyspepsia. 
 
 Had Columbus waited to discover America, or had 
 Galileo waited to proclaim the motion of the earth, nntil 
 authorized to a serious consideration of the matter by 
 properl}' -tabled statistics, they would have w^aited a 
 long, long time; and, it may be added, the inconve- 
 nienceg that attend the proving of a negative will so 
 
Introduction. 13 
 
 interfere with the proper arrangement of statistical 
 matter which relates to the prepuce and circumcision 
 that, before such tables could be satisfactorily' and con- 
 vincingly constructed, time and the evolutionary^ proc- 
 esses that follow it will bid fair to completely remove 
 this debatable appendage from man. It maj' be at a 
 A'ery far-distant period that tliis evolutionary preputial 
 extinction will take place, — probably contemporary with 
 the existence of Bulvver's '• Coming Race," — but not at 
 a too remote period for the proper and satisfactory 
 tabulation of the statistics. 
 
 The ideas of the etiology and pathological processes 
 through which we journe3', — from a condition of health 
 and good feeling to one of disease, miserable feeling, and 
 death, — as described in, or rather as the}' control the 
 sentiment and polic}' of, this work, are such as have been 
 followed by Hutchinson, Fothergill, Beale, Black, Al- 
 butt, and Richardson ; so that if I have totally ignored 
 the old conventional sj^stems, with their hide-bound 
 classification of diseases to control the etiolog}^, I have 
 not done so without some reliable autliority. In studying 
 the etiology of diseases we have, as a rule, been content 
 to accept the disease when fully formed and properly 
 labeled, being apparently satisfied with beginning our 
 investigation not at the - initial point of departure 
 from health, but at some distant point from this, — at 
 the point where this departure has- elaborated itself, on 
 favorable ground, into a tangible general or local dis- 
 ease. As truthfully observed by T. Clifford Albutt : 
 " The philosophic inquirer is not satisfied to know that 
 a person is suflfering, for example, from a cancer. He 
 desires to know why he is so suffering, — that is, what are 
 the processes which necessaril}^ precede or follow it. 
 He wishes to include this phenomena, now isolated, in 
 
14 Introduction. 
 
 a series of which it must necessarily be but a member, 
 to trace the period of which it must be but a pliase. He 
 believes that diseased processes have tlieir evolution 
 and the laws of it, as have other natural processes, and 
 he believes that these are fixed and knowable," To do 
 this, the physician must travel beyond the beaten path of 
 etiology as found in our text-books. He must follow 
 Hutchinson in the train of reasoning that elucidates the 
 pre-cancerous stage of cancer, or tread in the path fol- 
 lowed by Sir Lionel Beale, in finding that the cause of 
 disease depends on a blood change and the develop- 
 mental defect, or the tendency or inherent weakness 
 of the affected part or organ ; to fully appreciate the 
 inherent etiological factors that reside in man, and 
 which constitute the tendenc}^ to disease or premature 
 decay and death, we must also be able to follow Can- 
 statt. Day, Rostan, Charcot, Rush, Cheyne, Humphr}^ 
 or Reveille-Parise into tlie study of the different con- 
 ditions which, though normal, are nevertheless factors 
 of a slow or a long life. We must also be able to ap- 
 preciate fully the value of that interdependence of each 
 part of our organism, which often, owing to a want of 
 equilibrium of strength and resistance in some part 
 when compared to the rest, causes the whole to give 
 Avaj', just as a fiaw in a levee will cause the whole of the 
 solidl3--constructed mass to give wa}^ or a demoralized 
 regiment may entail the utter route of an army. As 
 described by George Murray Humphry, in his instruc- 
 tive work on " Old Age," at page 11 : — 
 
 " The first requisite for longevity must clearly be an 
 inherent or inborn quality of endurance, of steady, per- 
 sistent nutritive force, which includes reparative force 
 and resistance to disturbing agencies, and a good propor- 
 tion or balance between the several organs. Each organ 
 
Introduction. 15 
 
 must be sound in itself, and its strength must have a 
 due relation to the strength of the other organs. If the 
 heart and the digestive system be disproportionately 
 strong, the}' will overload and oppress the otlier organs, 
 one of which will soon give way; and, as the strength 
 of the human bod}", like that of a chain, is to be meas- 
 ured by its weaker link, one disproportionately feeble 
 organ endangers or destro3^s the whole. The second 
 requisite is freedom from exposure to the various casu- 
 alties, indiscretions, and other causes of disease to which 
 illness and early death are so much due." 
 
 In following out our study of diseases, we have been 
 too closely narrowed down by the old S3'mptomatic 
 story of disease ; we have too much treated surface 
 symptoms, and neglected to stud}' the man and his sur- 
 roundings as a whole ; we have overlooked the fact that 
 there exists a geographical fatalism in a ph3'sical sense 
 as well as the existence of the influence of that climatic 
 fatalism so well described b}' Alfred Haviland, and the 
 presence of a fatalism of individual constitution as well, 
 which is either inherited or acquired. The idea that 
 Cliarcot elaborates, that, as the 3^ear passes successivel3^ 
 through the hot and the cold, through the dr3' and the 
 wet season, with advancing age the human bod3' under- 
 goes like changes, and diseases assume certain charac- 
 teristics, are also points that are overlooked ; and 
 nowhere is this latter view seen to be more neglected 
 than in the relations the prepuce bears to infancy, 
 prime and old age, as will be more full3^ explained in 
 the chapters in this book which treat of cancer and 
 gangrene. Admitting that Haviland has exaggerated 
 the influence of climate as an etiological factor in its 
 specific influence in producing certain diseases ; or that 
 M. Taine claims more than he should for his " Theorie 
 
16 Introduction. 
 
 des Milieux," or influence of surroundings ; or that 
 Hutchinson has drawn the hereditary- and pedigreeal 
 fatherhood of disease too finelj- ; it must also be ad- 
 mitted that the solid, tangible truths upon which these 
 authors have founded their premises are plainl_y visible 
 to the most skeptical ; the architectural details of the 
 superstructure may be defective, but the foundation is 
 permanent. 
 
 From the above outline it will be easier for the reader 
 to follow out the reasons, or the Tsdiys or wherefores, of 
 the views expressed on medicine in the course of the 
 book; and, altliough I do not wish to enter the medical 
 field like a Peter the Hermit on a new crusade, to lure 
 thousands into the hands of the circumcisers, nor, as a 
 new Mohammed, promise the eterual bliss and glory of 
 tlie seventh heaven to all the circumcised, I ask of my 
 professional brothers a calm and unprejudiced perusal of 
 the tangible and authentic facts that I have honestly 
 gathered and conscientiously commented upon from my 
 field of vision, which Avill be plainly presented in the 
 following pages. I simplv have given the facts aud 
 m}' impressions : the reader is at libertj' to dravr his 
 own conclusions. 
 
 If 1 have been too tedious in the multiplication of 
 incidents in support of certain views, I must remind the 
 reader that the verdict goes to him who has the pre- 
 ponderance of testimony, and that many a lawsuit is 
 lost from the neglect, on the part of the loser, to secure 
 all the available testimony. Having brought the subject 
 of circmmcision before the bar of public opinion, as well 
 as that of my professional brother, I would but illy do 
 justice to the suliject at the bar. or to myself, not to 
 properly present the case; as it was remarked by Xa- 
 poleon, *•■ God is oil the side of the heaviest artillerj-," and. 
 
Introduction. 17 
 
 he who loses a battle for want of guns should not rail 
 at Providence if, having them on hand, he has neglected 
 to bring them into action. 
 
 The reasons for the existence of the book will be- 
 come self-evident as the reader labors through the 
 medical part of the work. Our text-books are, as a 
 class, even those on diseases of children as a specialt}', 
 singularly and unpardonabl}^ silent and deficient on the 
 subject of either the prepuce and tlie diseases to which 
 it leads, or circumcision ; and even our surgical works 
 are not sufficientl}^ explicit, as they deal more with the 
 developed disease and the operative measures for its 
 removal than on any preventive surgery or medicine. 
 Our works on medicine are equally silent, and, although 
 from a perusal of the latter part of the book the pre- 
 puce and circumcision will be seen to have considerable 
 bearing on the production and nature of phthisis, this 
 subject would, owing to our strabismic way of studying 
 medicine, look most singularly out of place in a work 
 devoted to diseases of the lungs or throat. Owing to 
 this poverty of literature on the subject, and that the 
 library of the average practitioner could therefore not 
 furnish all the data relating to* it that the profession 
 have in their possession, a book of this nature will 
 furnish them the required material whereupon to form 
 the basis of an opinion on the subject. 
 
 To argue that the prepuce is not such a deadly ap- 
 pendage because so many escape alive and well who are 
 uncircumcised, would be as logical as to assume that Lee's 
 •chief of artillery neglected to properly place his guns on 
 the heights back of Fredericksburg. He had asserted, 
 the night before the battle, that not a chicken could live 
 on the intervening plateau between the heights and the 
 town. On the next day, when these guns opened their 
 
18 Introduction. 
 
 fire, the Federals were unable to reach the heights, while 
 many men were for hours in the iron hail-sweeping dis- 
 charges of that artillery that mowed them down by 
 whole ranks, and jj^et the majority escaped alive. We 
 take the middle ground, and, while admitting that many 
 escape alive with a prepuce, claim tliat more are crippled 
 than are visibly seen, as, like Bret Harte's '' Heathen 
 Chinee," the wa3'S of the prepuce are dark and mysterious 
 as well as peculiar. 
 
 A discussion of the relative merits of religious creeds, 
 when considered in relation to health, has been, from the 
 nature of the subject of the book, unavoidable. Modern 
 Christianit}^ but very imperfectly explains wh}^ this rite 
 was either neglected or abolished. Frequent reference 
 is made to what Saint Paul said and did, but, as Saint 
 Paul was not one of the Disciples, it is inexplicable 
 wherefrom he received his authority in this matter, see- 
 ing that the Disciples themselves had no new views on 
 the subject. To the student who prefers to study his 
 subject from all its aspects, the question naturally arises, 
 " Where, when, and wliy came the authority that abolished 
 this rite?" There is one probable explanation, this 
 being that Paul, who M^as the real promulgator of Gen- 
 tile Christianity, had to establish his creed among an 
 uncircumcised race; although, as we shall see, devotees 
 have not scrupled to sacrifice their virility in the hope 
 of being more acceptable to God and to be better able 
 to observe His commandments, and others, in their 
 blind bigotry, have not objected to sitting naked on 
 sand-hills, with a six-inch iron ring passed through the, 
 prepuce, it is very evident that the Apostle Paul's good 
 sense showed him the uselessness of attempting to 
 found the new creed, and at the same time hold on to 
 the truly distinctive marking of Judaism among Gen- 
 
Introduction. 19 
 
 tiles, the Hebrew race being tliose among wliom he 
 found the least converts, as even the Disciples and 
 Apostles in Palestine disagreed with him. In the words 
 of Dr. I. M, Wise, it was impossible for the Palestine 
 Apostles, or their flock, either to acknowledge Paul as 
 one of their own set or submit to his teaching ; for they 
 obe^-ed the Law and he abolished it ; they were sent to 
 the house of Israel onlj"^, and Paul sought the Gentiles 
 with the message that the Covenant and the Law were at 
 an end ; tbey had one gospel story and he another ; 
 they prophesied the speedy return of the Master and a 
 restoration of the throne of David in the kingdom of 
 heaven, and he prophesied the end of the world and the 
 last day of judgment to be at hand ; they forbade their 
 converts to eat of unclean food, and especially of the 
 sacrificial meats of the Pagans, and he made light of 
 both, as well as of the Sabbath and circumcision. In 
 the attempted reconciliation that subsequently took 
 place in Jerusalem at the house of James, the Jacob of 
 Kaphersamia of the Talmud, Paul was charged by the 
 synod of Jewish Christians " with disregarding the Law, 
 forsaking the teachings of Moses, and attempting to 
 abolish circumcision." He was bid to recant and un- 
 dergo humiliation with four other Nazarenes, that it 
 might be known that he walked orderly and ob- 
 served the Law ; Paul submitted to all that was de- 
 manded. 
 
 This, in short, with the exception of the sayings of 
 Paul on the subject, which are all secondary con- 
 siderations, is really all that there is relating to the 
 abolishment of circumcision by the Christians. The 
 real Disciples and Apostles believed in Jesus with as 
 much fervor as Paul, but it is singular that the}'^ who 
 were with the Master should always have insisted on the 
 
20 Introduction. 
 
 observance of the Law, while Paul as energetically 
 insisted on its abolishment. 
 
 From these premises, I have seen J5t to inquire into 
 the relative merits of the three religions practiced by 
 what we call the civilized nations, as they aflect man 
 morally, physically, and mentally. I have given the tacts, 
 my impressions, and reasons for being so impressed ; from 
 these, the reader can easily see that religion has more to 
 do with man's temporal existence than is generally 
 believed ; its discussion is not, therefore, out of place in 
 this book. 
 
 Repetitions in the course of the work have been 
 unavoidable. This is not a novel nor a work of fiction, 
 and wherever the want of repetition would have been an 
 injury, either to the proper representation of a fact or a 
 principle, the repetition has not been avoided. In 
 describing the opei'ations, I had desired to avoid any too 
 numerous descriptions, as that is confusing, but have 
 thought it best to give a number, as the reader will 
 thereby obtain the views of the different operators, the 
 mode of the operation often being an index to the view 
 of the .operator in regard to the needs or utility of a 
 prepuce. In the general plan of the work, I have 
 adopted the idea and the historical relation carried out 
 by Bergmann, of Strasburg, who included all the mutila- 
 tions practiced on the genitals while discussing the 
 subject of circumcision, they being, in the originalitj' of 
 performance, somewhat intimately connected ; this also 
 tends to make the subject more interesting as a con- 
 tribution to the natural history of man, — something in 
 which all intelligent persons are more or less interested. 
 
 P. C. Remondino, M.D. 
 
 San Diego, Califobnia. 
 
A HISTORY OF CIRCUMCISION. 
 
 CHAPTER I. 
 
 Antiquity of Circumcision. 
 
 If the ceremonials of the Catholic Church or the 
 High Church Episcopalians carry us back into the depths 
 of antiquity, or, as remarked hy Frothingham, that the 
 ceremonies of St. Peter, at Rome, carried him back to 
 the mysteries of Eulesis, to the sacrificial rites of 
 ancient Phoenicia, to what misty antiquity does not the 
 contemplation of the rite of circumcision take us? The 
 Alexandrian library, with its vast collection of precious 
 records, could probably have furnished us some informa- 
 tion as to its origin and antiquitj' ; but Moslem fanati- 
 cism, with its belief in the all-sufficiency and infallibility 
 of the Koran, was the destruction of that wonderful 
 repository. We must now depend wholly on the rela- 
 tion of the Old Testament or on what has since been 
 Written by the Greek and Italian historians as to its 
 origin and practices. The Egyptian monuments and 
 their hj'eroglyphics give us no information on the sub- 
 ject further back than the reign of Rameses II ; while the 
 oft-quoted Herodotus wrote some fourteen centuries after 
 the Old Testament relation, and Strabo and Diodorus 
 some nineteen centuries after the same chronicler. We 
 have, therefore, in their chronological order, first, the 
 relation of the Bible ; then the Eg3fptian monuments and 
 their revelations; and, thirdly, the information gathered 
 by Pythagoras, Herodotus, and other philosophers and 
 
 (21) 
 
22 Hidory of Circumcision. 
 
 historiiins. To these three sources we may add the 
 misty mixture of tradition and mythological events, 
 whose beginnings as to period of time are indefinite. 
 These are the sources from which we are to determine 
 tlie origin and antiquity as well as the character of the 
 rite. 
 
 Voltaire found in the subject of circumcision one 
 that he could not satisfactorily make enter into his pecu- 
 liar s^'stem of general philosophy. For some reason, he 
 did not wish that the Israelites should have the credit 
 of its introduction ; were he to have admitted that, he 
 would have had to explain away the divine origin of 
 the rite, — something that the Hebrew has tenaciously 
 lield for over thirty-seven centuries. Yoltaire thought 
 it would simplify the subject by making it originate 
 with the Egyptians, from whom the Hebrews were to 
 borrow it. To do this he adopted the relation of Hero- 
 dotus on the subject. His treatment of the Jewish 
 race, however, brought out a strong antagonism from 
 tliose people to his attacks, and in a volume entitled, 
 " Letters of Certain Jews to Monsieur Voltaire," — being 
 a series of criticisms on his aspersions on the race and 
 on the writings of the Old Testament (written by a 
 number of Portuguese, German, and Polish Jews then 
 residing in Holland^), — they pi'oved conclusiA^ely that 
 the Phoenicians had borrowed the rite from the Israel- 
 ites, as tliey (the Phoenicians) had practiced the 
 rite on the newborn, whereas, had they followed the 
 Egyptian rite, they would have only circumcised the 
 cliild after its having passed its thirteenth year, — these 
 being the distinctive differences between the Jewish and 
 Egyptian ritea. 
 
 Luckily, in the small temple of Khons, which formed 
 an annex to the greater temple of Maut, at Karnac, 
 
Antiquity of Circumcision. 23 
 
 there was found a bas-relief, partly perfect, "vvhicli goes 
 far toward giving light on the subject of Eg\yptian cir- 
 cumcision. The upper part of the sculpture was so 
 defaced that the upper portions of four of the five figures 
 were destroyed, but the lower portions were so perfect 
 in every detailas to furnish a full history of the age of 
 the candidates for the rite and the manner of its per- 
 formance. It is further interesting from the fact that 
 it establishes also the time during which the rite was so 
 performed. M. Chabas and Dr. Ebers argue, from the 
 founder of the temple having been Rameses II, that 
 the sculpture refers to the circumcision of two of his 
 children. The knife appears to be a stone implement, 
 and the operator kneels in front of the child, who is 
 standing, while a matron supports him in a kneeling 
 posture, and she holds his hands from behind hira.^ In 
 this bas-relief we can see the great difference that ex- 
 isted between the two forms of the operation, that of 
 the Hebrews being performed, as a rule, on the eighth 
 day after birth, while in the bas-relief they are ten or 
 twelve 3'ears old. 
 
 Although tradition and mythology veil past events 
 in more or less obscuritj^, they do, in regard to circum- 
 cision, furnish considerable explanatory light on mattei's 
 which would be otherwise hard to reconcile. Circum- 
 cision has been performed by the Chippeways, on the 
 Upper Mississippi, and its modifications were performed 
 among the Mexicans,' Central Americans, and some 
 South American tribes of Indians, as well as among 
 many of the natives dwelling among the islands of the 
 Pacific Archipelago. There is a tradition, mentioned 
 by Donnelly in connection with the sunken continent of 
 Atlantis, that Ouranos, one of the Atlantean kings, 
 ordered his whole army to be circumeised that they 
 
24 History of Circumcision. 
 
 might escape a fatal scourge then decimating the people 
 to their westward.^ This tradition tells us that the 
 hygienic benefits of circumcision were recognized ante- 
 diluvian facts, as it also points out the way by which 
 circumcision traveled westward across to tlie Western 
 World. As Donnelly has pointed out, man}- of the 
 Americans possessed not onl}' traditions, habits, and 
 customs that must have come from the Old World, but 
 the similarity of many words and their meaning that 
 exists between some of the American languages and 
 those of the indigenous inhabitants that have still their 
 remains in spots on the southwestern shores of Europe- 
 — the ancient Armorica whose colony in Wales still 
 retains its ancient words — leaves no room for doubt that 
 at ona time a landed higliway existed between the two 
 worI(!lst The Mandans, on tlie Upper Missouri, have 
 many words of undoubted Armorican origin in their 
 vocabulary,* just as the Ghiapenec, of Central America, 
 contains its principal words denotive of deitj^ family 
 relations, and many conditions of life that are identi- 
 cally the same as in the Hebrew,^ the name of father, 
 son, daughter, God, king, and rich being essentially the 
 same in the two languages. It must have been more 
 than a passing coincidence that gives the Mandans some 
 of their most expressive words from the Welsh, or that 
 gave to Central America many cities bearing analogous 
 names with the cities of Armenia.^ Canadian names of 
 localities, as well as those of the Mississippi Yallej^ 
 denote the French origin of their pioneers, as well as 
 the names of Upper California denote the nationality 
 and creed of its first settlers. So that there is nothing 
 strange in asserting that American civilization and 
 many of the customs as found in the fifteenth century 
 by the early Spanish discoverers were nothing more 
 
Antiquity of Circumcision. 25 
 
 than the remains of ancient and modified Phoenician 
 civilization, among which figured circumcision. 
 
 Dr. A. B. Arnold, of Baltimore, argues that, with the 
 present state of our anthropological knowledge and the 
 material that research has been able to furnish, we need 
 no longer be surprised to find customs, laws, and morals, 
 among nations living in regions of the world widely 
 apart from each other, which betray an identity of origin 
 and development, and that beliefs and institutions, 
 whether wise or aberrant, grow up under apparently 
 dissimilar circumstances, circumcision forming no ex- 
 ception.'^ Dr. Arnold leaves too much to chance. It is 
 hardly likely that the similarity that existed between 
 the architecture of the Phoenicians and the Central 
 Americans, as evinced in their arches ; in the beginning 
 of the century on the 26th of February ; the advance- 
 ment and intei'est taken in astronomical science ; the 
 coexistence of pyramids in Egj'pt and Central America ; 
 that five Armenian cities should have their namesakes 
 in Central America, should all be a matter of accident. 
 The historiographer of the Canaiy Islands, M. Benshalet, 
 considers that those islands once formed a part of the 
 great continent to its west ; this has been verified by tlie 
 discovery of many sculptured s^'mbols, similar in the 
 Canaries and on the shores of Lake Superior, as well as 
 by the discovery of a mummy in the Canaries with san- 
 dals whose exact counterparts were found in Central 
 America.* A compound word used to signify the Great 
 Spirit being found identical in the Welsh and Mandan 
 languages, each requiring five distinct sounds to pro- 
 nounce, words as intricate as the passwords of secret 
 societies, can hardly be said to be the result of chance.^ 
 There must, at some remote period, have existed some 
 communication between the ancestors of these Missouri 
 
26 History of Circumcision. 
 
 Maudans aud the shoves of ancient Annorica : the ances- 
 tors of these Maudans may have then been living farther 
 to the east; they even may have then been a tribe of 
 since lost Atlantis: but the analogy, not only in regard 
 to the word jnst irienti'.'ned. — M:r'>o-y C'li^'o.. of the Welsh 
 and Mandan. — ;jut in the similarity ot tiie pronouns of 
 both languages, aud the existence of the idea of the 
 c<:i;r.;:-: ;■: rr of the sacred white ball of the Egyptians 
 l.'L-:;"i_ :''j;in .1 arnoug the Dakotas. or Sioux, all point to the 
 fact ti:at these people, in common with the rest of the 
 Americans, originallj came from the East : from whence 
 came their languages, manners, customs, rites, and what 
 civilization tliey possessed, among wliicli circumcision 
 iias. tlirongli the mist of centuries, held its own in i^ijme 
 shape or otiier. 
 
 That -"n;^ ttrrrii/.e catastrophe occurred to divide 
 the hemispheres is eviderit : the "Western World remain- 
 ing stationary in its civilization and retaining the 
 customs ay: 1 r;' ■- of the times as evidence of their 
 origin. W.rii r^;^ view of the case, the existence of 
 circumcision as found among the inhabitants of the 
 West can easily be trace^l to its origin among the hills 
 of Chaldea. The ancient traditions and m^'thological 
 relations of the Eg^^ptians in regard to the great nation 
 to the West are amply verified by the deep-sea soundings 
 of the " Challenger," the "Dolphin," and the • Gazelle.'' 
 which plainly indicaie the presence of a sul'^marine 
 plateau that once formed the continent of Atlantis, 
 whose only vis;l:iie evi.lenee alx>ve the waves of the 
 boisterous Atlay.v'>: i- t'.,f; Az^a-es au'l the remains of 
 Phoenician civilizuti-ju amoijg the Americans. 
 
 Professor Worman. of Brooklyn, scouts the idea that 
 cir':"v:";;''''-:':'ri wli-, ever connected in an}' wny or that it 
 origirjatc'i m anv of the rites connected with phallic 
 
Antiquity of Circumcision. 27 
 
 worship.^'' Bergmann,^^ of Strasbnrg, however, not 
 Gill}' claims circumcision to be a direct result of phallic 
 worship, but looks upon the rite as something that has 
 been reached by what maybe termed a gradual evolution- 
 ary process of manners, customs, and society, from the 
 time of what is termed the hero-warrior period of tradi- 
 tional historj^, when war and the clashing of shields and 
 sword or spear were the main delights and occupations of 
 man. It is strange to note what difference must have ex- 
 isted between these hero-warriors in regard to their ideas 
 of manliness; some were brutal and fiendish, whilst others 
 were magnanimous. McPherson, the historiographer of 
 early Britain, cannot help but contrast the superior 
 manliness of the heroes of Ossian in his graphic descrip- 
 tion of the ancient Caledonians, when compared to the 
 brutality of Homer's Greek heroes. The traditions 
 upon which Bergmann undertakes to found the origin 
 of the rite of circumcision are all connected with the 
 inhuman and brutish passions that animated our bar- 
 barous ancestry. The first incident given is the Egyptian 
 traditional tragedy, which was, in all probabilit}', the 
 initial point of that phallic worship which, with increas- 
 ing debauchery, assisted in the final demoralization of 
 Rome and Greece, after its introduction into those 
 countries. 
 
CHAPTER 11. 
 
 Theories as to the Origin of Circumcision. 
 
 We are told that in battle man looked upon the 
 vanquished as unfit to bear the name of man, looking 
 • upon the weakness or want of skill which contributed 
 to their defeat as something effeminate. The victor then 
 proceeded by a very summary and effective mode, done 
 in the most primitive and expeditious manner, to render 
 his victim as much like a female as possible to all out- 
 ward appearances ; this was accomplished by a removal 
 at one sweep of aZZ the organs of generation, the phallus 
 being generally retained as a trophy, — a practice which 
 was also carried into effect with dead enemies, to show 
 that the victor had vanquished men. It has been the 
 practice from time immemorial for a victor to carry off 
 some portion of the body of his victim or defeated 
 enemy, as a mark or testimony of his prowess ; it was 
 either a hand, head or scalp, lower jaw, or finger. The 
 carrying off of the phallus or virile member was con- 
 sidered the most conclusive proof of the nature of the 
 vanquished, and, as it established the sex, it conferred 
 a greater title to bravery and skill than a mere collection 
 of hands or scalps, which would not denote the sex. In 
 conformity with this custom, we find that Osiris, when he 
 returned to Egypt and found that Typhon had fomented 
 dissension in his absence, being vanquished by the latter 
 in the conflict that followed, was dismembered and cut 
 into pieces, the followers of Typhon each securing a 
 piece and Typhon himself securing the phallus or gen- 
 erative member. Isis, the spouse of Osiris, seems in 
 turn to have secured the control of government, and, 
 (28) 
 
Tlieories as to the Origin of Circumcision. 29 
 
 having secured all the pieces of the dissected Osiris 
 except the phallus, — Typhon having fled with that, and, 
 according to some traditions, having thrown it into the 
 sea, — Isis ordered that statues should be constructed, 
 each to contain a piece of the unfortunate Osiris, who 
 should thereafter be worshiped as a god, and that the 
 priestliood should choose from among the animals some 
 one kind which should thereafter be considered sacred. 
 The phallus which was missing was ordered special wor- 
 ship, with more marked solemnities and mysteries ; from 
 this originated the phallic worship and the sacredness of 
 the white bull, Apis, among the Egyptians, which was 
 chosen to represent Osiris. 
 
 By gradual evolution and the progress of society, 
 the cultivation of the ground and the need of menials, 
 warriors found some other use for their prisoners taken 
 in strife besides merely cutting off the phallus as a 
 trophy; these prisoners began to have some intrinsic 
 value. From this a change came about ; the warrior in- 
 stinct, however, still claimed that the vanquished, even 
 if a slave, should still convey or carry some sign of ser- 
 vitude. The original idea of the ablation of the phallus 
 was to emasculate the victim ; investigation developed 
 the idea that the same object could be accomplished by 
 castration, an operation which also finally reached a 
 tolerable state of perfection through different stages of 
 evolution, it first being performed by a complete re- 
 moval of the whole sci'otum and contents. This opera- 
 tion, with the ignorance of the times in regard to 
 stopping hfemorrhage, was, however, accompanied by a 
 large mortality, and it finally evolved into the simple 
 removal of the gland, or its obliteration by pressure 
 or violence. Bergmann conveys the idea that circum- 
 cision was at one time the indestructible marking and 
 
30 History of Circumcision. 
 
 the distinctive feature of tlie slave, the mind of the 
 period not being able to emancipate itself from the idea 
 that the genitals must in some manner be mutilated, not 
 being able to conceive an}^ other degrading mark of 
 manhood which barbarians felt they must iuflict on 
 slaves. 
 
 The generally- accepted idea in regard to the physical 
 mutilation of captives taken in war, or that some token 
 from the body of the vanquished must be carried oft' by 
 the victor, has not onl^^ the support of tradition and 
 monumental sculptured evidence, but its practice is still 
 in vogue among man}" races. Among the ancient 
 Scythians, only the warriors who returned from the 
 battle or foray with the heads of the enemj- were en- 
 titled to a share in the spoils. Among the modern 
 Berbers it is still a practice for a j'oung man, on propos- 
 ing marriage, to exhibit to his prospective father-in-law 
 the virile members of all the enemies he has overcome, 
 as evidence of his manhood and right to the title of 
 warrior. The Abyssinians and some of the negro tribes 
 on the Guinea coast still follow the custom of securing 
 the phallus of a fallen foe. However barbarous this 
 l)ractice maj' seem, its actual performance is only sec- 
 ondar}", the primary' motive being that the warrior 
 wished to prove that he had been there, engaged in 
 actual strife, and that his enem}^ had been overcome. 
 The writer remembers that, after one of the battles in 
 the West during the late war, man^'^ letters arrived in 
 his locality with pieces of the garments or locks of 
 the hair of the unfortunate Confederate general, Zolli- 
 koff"er, who had been slain in the battle ; a disposition in 
 the warrior, seemingly still existing, such as animated 
 the old Egyptians. On an old Egyptian monument, — 
 that of Osj-mandyas, — Diodorus noticed a mural sculp- 
 
Theories as to the Origin of Circumcision. 31 
 
 tare, a bas-relief representing prisoners of war, either 
 in cliains or bound with cords, being registered by a 
 royal scribe preparatory to losing either the right hand 
 or the phallus, a pile of which is visible in one corner 
 of the foreground ; from this sculpture we learn that the 
 practice was not only an individual performance, but 
 that it was a national usage among the Egyptians as 
 well, who subjected, at times, their vanquished foes to 
 its ordeal in a wholesale but business-like manner. 
 
 Bergraann argues that the Israelites were given to 
 like practices, and cites the incident wliereiu David 
 brought two hundred prepuces — as evidence of his liav- 
 ing slaughtered that number of Philistines — to Saul, as 
 a mark of his being worthy to be his son-in-law. He 
 argues that, whereas many have made that Old Testa- 
 ment passage to read " two hundred prepuces," it should 
 have read " two hundred virile members '' wliicli David 
 and his companions had cut off from tl»e Philistines, the 
 word 07^loth meaning the virile member, and not the 
 prepuce. Tliat Israelitish circumcision could have 
 originated from either phallic worship or any of the 
 hero-warrior usages is untenable as a proposition, as 
 regards the living prisoners, and is contrary to the 
 monotheistic idea wliich ruled Israel, or to the benign 
 nature of their God. The strict opposition of the 
 religion of Judaism to any otlier mutilation except that 
 of the covenant is also antagonistic to tlie views 
 advanced by Bergmann, as it is well known that even 
 emasculated animals were considered imperfect and 
 unclean, and therefore unfit to be received or offered as 
 a sacrifice to their deity. No emasculated man was 
 allowed to enter the priesthood or assist at sacrifices. 
 The whole idea of Judaism being opposed to such 
 mutilations, their observance of circumcision and its 
 
 2 
 
32 History of Circumcision. 
 
 performance can in no way have developed from either 
 phallic or other warlike rites or usages ; but we must 
 accept its origin as a purely religions rite, — a covenant 
 of the most rigid observance, coincident in its inception 
 with the formation of the Hebraic creed in the hills of 
 Chaldea. 
 
 What Herodotus or Pythagoras may have written 
 concerning tlie practice among tlie Egyptians was 
 written, as already remarked, some nine centuries after 
 Moses had recorded his laws ; Moses himself having 
 come some centuries after Abraham. Herodotus is 
 quoted as representing that the Phoenicians borrowed 
 the practice from the Egyptians, in support of the theory 
 that Eg3'pt was tlie central nucleus from whence the 
 practice started, and not that it traveled toward Egj'pt 
 from Phoenicia. The difference in the ages, already 
 mentioned, at which the rite was practiced — that of 
 Phoenicia and Israel being at one time identical — shows 
 that the testimony of Herodotus in this one particular 
 was the result of faulty judgment, as we find the people 
 who have borrowed the practice from the Egyptians, as 
 well as their descendants, closel}' follow their practice 
 in regard to the age at which the operation should be 
 performed. Another evidence of tlie strictly religious 
 nature of the rite, as far as the Hebrews are concerned, 
 lies in the fact that, with all their skill in surgery and 
 medical sciences, — they being at one time the only intel- 
 ligent exponents of our science, — they never made any 
 alteration or improvement in tlie manner of performing 
 the operation. It is evident that even Maimonides, a 
 celebrated Jewish ph3'sician of the twelfth centuiy, who 
 furnished some rules in regard to the operation, was 
 held under some constraint \)y the religious aspect of 
 the rite. As a summary of this part of the subject, it 
 
Theories as to the Origin of Circumcision. 33 
 
 ma}^ be stated that the Old Testament furnished tlie 
 only reliable and authentic relation prior to Pythagoras 
 and Herodotus. From its evidence, Abraham was the 
 first to perform the operation, which he seems to have 
 performed on himself, his son, and servants, — in all, 
 numbering nearly four hundred males ; he then dwelt in 
 Chaldea. In absence of other as reliable evidence we 
 must accept this testimony in regard to its origin, 
 causes, and antiquity. 
 
 Voltaire, in his article on circumcision in his " Philo- 
 sophical Dictionar}^," seems more intent on breaking 
 down an3' testimony that might favor belief in any 
 religion than to impart any useful light or information. 
 He bases all his argument^ on the book "Euterpe," of 
 Herodotus, wherein he relates that the Colchis appear 
 to come from Egypt, as the}' remembered the ancient 
 Egyptians and their customs more than the Egyptians 
 remembered either the Colchis or their customs ; the 
 Colchis claimed to be an Egyptian colon}^ settled there 
 by Sesostris and resembled the Eg3'ptians. Voltaire 
 claims that, as the Jews were then in a small nook of 
 Arabia Petrea, it is hardly likely that, they being 
 then an insignificant people, the Eg^^ptians would have 
 borrowed any of their customs. To read Voltaire's 
 " Herodotus " is somewhat convincing, but Voltaire's 
 ''Herodotus " and Herodotus writing liimself are two 
 different things, and the book "Euterpe" saj^s quite 
 another thing from what M. Voltaire makes it say. A 
 perusal of Voltaire and a study of his Jewish critics on 
 this subject, as found in the "Jews' Letters to Vol- 
 taire," will convince any reader that as to circumcision 
 M. Voltaire is an unreliable authority. 
 
CHAPTER III. 
 
 Spread of Circumcision. 
 
 From Chaldea, then, in the mountains of Armenia 
 and Kurdistan, the practice of circumcision was, in all 
 probability^, first adopted by the Plioenicians, who finally 
 relinquished the Israelitish rite as to age of performance 
 and exchanged it for the Egyptian rite. From Phoenicia 
 its spread through the maritime enterprises of this race 
 to foreign parts was easy. Egypt was the next place to 
 adopt its practice ; at first the priesthood and nobility, 
 which included royalty, were "the only ones who availed 
 themselves of the practice. The Egyptians connected 
 circumcision with hygiene and cleanliness; this was the 
 view of Herodotus, who looked upon the rite as a strictly 
 hygienic measure. History relates of the existence of 
 circumcision among the Egyptians as far back as the 
 reign of Psammetich, who ruled toward tlie end of the 
 sixth century B.C. The practice must then have been 
 of a very religious and national nature, as we are told 
 that Psammetich, having admitted some noted strangers, 
 whom he allowed to dwell in Egj^pt without being cir- 
 cumcised, brought himself into great disfavor among 
 his subjects, and especially by the" army, who looked 
 upon an uncircumcised stranger as one undeserving of 
 favors. During the next century Pythagoras visited 
 Egypt, and was compelled to submit to be circumcised 
 before being admitted to the privilege of studj-ing rn 
 the Egyptian temples. In the following century these 
 restrictions were removed, for neither Herodotus nor 
 Diodorus, who visited the country, were obliged to be 
 (34) 
 
Spread of Circumcision. 35 
 
 circumcised, either to dwell among the people or to 
 follow their studies. There is one curious habit that is 
 mentioned in connection with the rite of circumcision 
 among these people, this being its relation to the taking 
 of an oath or a solemn obligation. Among the Egyptians 
 the circumcised phallus, as well as the rite of circum- 
 cision, seemed to be the symbol of the religious as well 
 as of the political community, and the circumcised 
 member was emblematical of civil patriotism as well as 
 of the orthodox religion of the nation. To the Egyptian, 
 his circumcised phallus was the symbol of national and 
 religious honor ; and as the Anglo-Saxon holds aloft his 
 right hand, with his left resting on the holy Bible, while 
 taking an oath, so the ancient Egyptian raised his cir- 
 cumcised phallus in token of sincerity, — a practice not 
 altogether forgotten by his descendants of to-day. It 
 was partly this custom of swearing, or of affirming, with 
 the hand under the thigh, by the early Israelites, that 
 caused many to believe that their circumcision was bor- 
 rowed from the Egyptians, especially by M. Voltaire, 
 who insists that it was the phallus that the hand was 
 placed on, and that the translation has not the proper 
 meaning, as given in the Bible. 
 
 Among the Arabs it was the practice to circumcise 
 at the age of thirteen years, this being the age of 
 Ishmael at his circumcision by his father, Abraham. 
 The Arabs practiced circumcision long before the advent 
 of Mohammed, who was himself circumcised. Pococke 
 mentions a tradition which ascribes to the prophet the 
 words, " Circumcision is an ordinance for men, and hon- 
 orable in women." Although the rite is not a religious 
 imposition, it has spread wherever the crescent has 
 carried the Mohammedan faith. Uncircumcision and 
 impurity are to a Mohammedan sj-nonymous terms. 
 
36 History of Circumcision. 
 
 Like the Abyssinians, the Arabs also practice female 
 circumcision, — an operation not without considerable 
 medical import, as will -be explained in the medical part 
 of the work. This practice is also common in Ethiopia. 
 Some authorities argue, from this association of female 
 circumcision among the Southern Arabs, Ethiopians, 
 and Abyssinians,that they did not derive their rite from 
 the Israelites ; but there is not much room for doubt 
 but that the operation came down to the Arabians from 
 Abraham through his son Ishmael. Considering the 
 occupancy of Syria, Arabia, and Egypt by the French, 
 and the intercourse with these countries by tlie British, 
 it is surprising that the profession in the early part of 
 the present century had not full information regarding 
 the nature and objects of female circumcision as prac- 
 ticed in these countries. Delpesh observes, in relation 
 to the Oriental practice, that his information was too 
 vague to determine whether it was the nymphae or tlie 
 clitoris that were removed, or whether it was only prac- 
 ticed in cases of abnormal elongations of these parts. 
 M. Murat, however, writes at length on the subject, \Q\-y 
 intelligently, as well as Lonyer-Yillermaj^ who, writing 
 in the same work with Delpesh, thinks it is certainly 
 the clitoris that is removed.^^ In Arabia, the trade or 
 profession of a resectricis nyvipharum or she-circum- 
 ciser is as stable an occupation with some matrons as 
 that of cock-castration or caponizing is the sole occupa- 
 tion of many a matron in the south of Europe. It is 
 related by Abulfeda that, in the battle of Ohod, where 
 Mohammedanism came very near to a sudden end by 
 the crushing defeat of the prophet and his followers, 
 Haraza, the uncle of the prophet, seeing in the op- 
 posing ranks a Koreish chief, whom he knew, thus 
 called out: "Come on, 3'ou son of a she-circumciser 1" 
 
Spread of Circumcision. 37 
 
 As Hfimza was among the slain, it is most likely that 
 he met his death from the hands of the chief, whose 
 mother really followed that occupation. So extensive 
 is the practice, that these old women sometimes go 
 through a village crying out their occupation, like 
 itinerant tinkers or scissors-grinders. 
 
 The present ceremonies attending the performance 
 of the rite among the Arabians are well described by Dr. 
 Delange, a surgeon of the French arm}', as witnessed by 
 him in the province of Constantine, in Algeria. 
 
 With these Arabs, circumcision is performed on a 
 whole class, so to speak, at the same time, regardless of 
 the trifling differences in their ages. It is preceded by 
 feasting, the total length of the feast being for eight days. 
 For tlie first seven da^'s, all the Arabs of the quarter 
 where the candidates for circumcision reside dress in 
 their best. The poor have their mantles and clothes 
 carefully washed, and the rich deck themselves out in 
 tlieir gold and silver brocaded vests and pantaloons. 
 During these seven da3's there is general rejoicing, and 
 the Arabs spend most of this time in the village street, 
 racing^, firino; guns, or engaging in sham battles between 
 the different camps, during which one carries the green, 
 or sacred banner, which is supposed to render the bearer 
 invulnerable. The battle ends by the standard-bearer 
 being fired at by all parties, and falling, but quickly 
 rising again and waving the flag in token of its protect- 
 ing power. The Arabs now adjourn to another public 
 place, where the notables and strangers are furnished 
 seats on carpets ; here a dance to the music of tumtums 
 and the singing of invisible females takes i)lace, the 
 dancers being only males.^^ In the evening the women 
 sing, to which the men listen in silence, this concert 
 being kept up until midnight. On the seventh da}^ the 
 
38 History of Circumcision. 
 
 women, decked out in their best, and with all their per- 
 sonal ornaments, accompanied by all the 3'oung men, 
 armed with their guns and pistols, repair to the extremity 
 of the oasis, where they gather plates of fine sand. 
 With this sand tiiey return to the village, where it is 
 exposed OA^ernight to the glare of the full moon on the 
 terraces of the house. This last day closes with a grand 
 banquet, given by the rich whose children are about to 
 be circumcised, to which all the people are invited. 
 
 The next moi'ning all the relatives of the candidates 
 repair to the house where the rite is to be performed; 
 the women going up into the second floor, wherefrom 
 they can look down into the court from a porcli screened 
 with lattice-work, without themselves being seen. The 
 men gather together on the ground-floor, together with 
 the operator and his assistants and the children about 
 to be circumcised, who are dressed in 3'ellow, silken 
 gowns. The child to be operated upon is seated in a 
 pan of sand, while an assistant fixes liis arms and holds 
 the tliighs well separated from behind. The circumciser 
 then examines the pi'epuce, the glans, and removes any 
 sebaceous collection. This done, a compress with an 
 aperture to admit of the passage of the glans is slipi)ed 
 over the organ ; a small piece of leather, some six centi- 
 metres in diameter, with a small hole in the centre, is 
 now used, the free end of the prepuce being drawn 
 through the aperture ; a ligature of woolen cord is then 
 tied on to the prepuce next to the front of the leather 
 shield, and, the knife being applied between the thread 
 and the leather, the prepuce is removed at one sweep ; 
 the mucous inner layer is then lacerated with the 
 thumb-nails and turned back over to join the other 
 parts. The surface is then sprinkled with arar or 
 genevriere powder nnd dressed with a small cloth band- 
 
Spread of Circumcision. 39 
 
 age, the subsequent dressings consisting of arar powder 
 and oil. During the operation the women in the gallery 
 keep up A,\\ unearthly music by means of tumtums, cym- 
 bals, and ail the kettles and saucepans of the neighbor- 
 hood, which are brought into requisition for the occasion. 
 This music is accompanied with songs and chants, each 
 woman striking out with an independent song of her 
 own, either improvised or suggested by the occasion. 
 This not only serves to drown the cries of the children, 
 but it must, in a manner, assist to draw them away from 
 the immediate contemplation of their sufferings. The 
 prepuces arenow gathered together and carried to the end 
 of the oasis, where they are buried with ceremony and 
 rejoicings. This circumcision only takes place once in 
 three or four years, and the children are from four to eight 
 5'ears of age ; of fifteen circumcised at the feast witnessed 
 by M. Delange, only two had passed their eighth j^ear. 
 
 In a very interesting old book,^"* " The Treaties of 
 Alberti Bobovii," who was attached to the court of 
 Mohammed IV, published with annotations by Thomas 
 Hyde, of Oxford, in 1690, there is a description of the 
 Turkish performance of the rite which leads one to infer 
 that they circumcised the children quite 3'ouug: " Et 
 cum puer prae dolore exclamat, imus ex duobus parenti- 
 bus digitis in melle ad hoc comparato os ei obstruit ; 
 cseteris spectatoribus acclamantibus. Deus, Deus, 
 Deus, Interim quoque Musica perstrepit, tympana 
 et alia crepitacula concutiuntur, ne pueri planctus et 
 ploratus audiatur." Bobovii says that the age at which 
 circumcision is performed is immaterial provided the 
 
 candidate is old enough to make a profession of faith, 
 
 which, however, is made for him b}' the godfather, — in 
 the following words : " There is no God but God. and 
 Mohammed is his Prophet," or, as rendered by our 
 
40 History of Circumcision. 
 
 autlioi", " Noil esse Deuiii nisi ipsum Deum, et Moham- 
 medeui esse Legatum Dei." To wliicli he adds that the 
 child must not be an infant, but that he must be at 
 least eight years of age. Like to the Arabs, the Turks 
 celebrated the occasion by feasts, plan's, and a general 
 good time ; the child was kept in bed for fifteen days to 
 allow complete cicatrization to take place. The circum- 
 cision was performed with the boy standing. 
 
 Michel Le Feber, writing in 1681,^^ speaks of the 
 tax levied on the Christians by the Turks, that the^', 
 the Christians, may enjoy liberty of conscience, and ob- 
 serves that, circumcision not being compulsory among 
 the Turks, it aften led to trouble and anno3'ances, as 
 man}^ of the Turks evaded the operation. The tax- 
 gatherers in Turkey are very industrious, and, as being 
 circumcised was, as a rule, sufficient evidence of not 
 being a Christian, he often witnessed on the streets 
 scenes wherein strangers, arrested b}' these tax-collectors, 
 were compelled to show their circumcision as an indis- 
 putable sign of their exemption from the tax. He also 
 relates that in their zeal for 'converts to Mohammedanism 
 the Turks often resorted to presents to induce Christians 
 to embrace their faith. While in Aleppo, he saw a 
 Portugese sailor, who, through presents, had forsaken 
 his religion, but who had repented in the most emphatic 
 manner when brought to face circumcision. Finding 
 entreaties in vain, the Cadi ordered the immediate ad- 
 ministration of a stupefj'ing draught, and the sailor was 
 then seized and circumcised without further ceremony. 
 
 In cases where the new Mohammedan is reasonable 
 and submits like a hero, the ceremonies are more elabo- 
 rate. Le Feber relates that if the candidate is a man of 
 note or wealth he is mounted on a horse and exhibited 
 all over the city ; he is dressed in the richest of Turkish 
 
Spread of Circumcision. 41 
 
 robes and in his hand he holds an arrow with the point 
 directed to the sky ; he is followed hy a great concourse 
 of people, some dressed in holiday attire and others in 
 fantastic costumes; and general feasting and enjoyment 
 is the rule over the course of the march, where all the 
 people run to swell the crowd. If the man happens to 
 he a poor man, he is simpl}' hurriedly marched about on 
 foot, with a simple arrow in his hand pointed skyward, 
 to distinguish him from ordinary mortals ; before him a 
 crier proclaims in a loud voice that the new religionist has 
 ennobled himself by professing the faith of the prophet in 
 this solemn manner. A collection for his benefit is taken 
 up among the booths and shops, which is mostly appro- 
 priated by the conductor, circumciser, and his assistants, 
 after which he is cii'cumcised without further ado. 
 
 The same author describes the operation as per- 
 formed on the 3"onng Turks and the accompanying cere- 
 monies. They differ in some respects from those 
 emplo^^ed in circumcising a convert. The parents of 
 the child give a feast in proportion to their means, to 
 whicli are invited the relatives of the family and personal 
 friends ; if of the upper ranks, he is promenaded about the 
 town to the mnsic of drums and cj'mbals, dressed in rich 
 attire ; two warriors lead the procession with drawn 
 swords, and a troop of females who sing songs of joy 
 bring up the rear; the procession now and then stops, 
 when the two gladiators in the front indulge in a fierce 
 set-to, hacking at each other in the most determined and 
 murderous manner, but so studiedlj- shammy tiiat neither 
 is injured ; on the return to the house, the child, who is 
 •usually eight or ten j'ears of age, is bound hand and foot 
 to prevent his causing any injur\- to himself, laid on a 
 bed, and circumcised with a razor, the operation being 
 performed either by a surgeon or the chief of a mosque. 
 
CHAPTER lY. 
 
 Circumcision Among Savage Tribes. 
 
 E. Casalis,^^ who, in the capacity of missionary, for 
 a veiy long time resided among the Bassoutos, tells us 
 that among that nation the operation is performed at 
 tlie age of from thirteen to fifteen j^ears. The ceremony 
 is gone through once in three or four years. So im- 
 portant an event is it considered by the Bassoutos that 
 the^'^ date events from one of these observances, as the 
 Romans dated events from a certain consulship, or the 
 Gi'eeks from an Olympiade. At the time fixed, all the 
 candidates go through a sham rebellion and escape to 
 the woods; the warriors arm and give chase, and, after 
 a sliam battle, capture the insurgents, whom the}- bring 
 back as prisoners, amidst dancing and great rejoicings, 
 which are the preludes to the feast. The next day the 
 huts of mystery {mapato) are erected, where, after the 
 circumcision, the young men are to reside for some eight 
 months, under the tutorship of experienced teachers, 
 who drill them in the use of the spear, sword, and shield, 
 teaching them to endure hunger, thirst, blows, and all 
 manner of hardships ; prolonged fasts and cruel flagella- 
 tions being regarded as pastimes between the exercises. 
 The severit}^ of the regulations ma^^ be judged from the 
 fact that the instructors have a right to put to death any 
 one who may try to escape from these ordeals. The 
 women are rigorously excluded from these camps, but 
 the men are allowed to visit them, when the}^ have the 
 privilege of assisting the teachers by adding additional 
 blows and precepts to the backs of the unlucky candi- 
 ^42) 
 
Circumcision Among Savage Tribes. 43 
 
 dates. After eight months of such training, the young 
 men are oiled from head to foot and dressed in a gar- 
 ment, and are now given the name which they are to 
 bear for the rest of their lives. The mapato, or mystery 
 hut, is now burned to the ground and the young men 
 return to the village. The maternal uncle of the 3'outh 
 here presents him with a javelin for his defense, and a 
 cow that is to furnish him with nourishment. Until the 
 time of his marriage, tlie newly circumcised dwell 
 together ; their duties being of a menial character, such 
 as gathering wood and attending to the flocks and droves. 
 
 M. Paul Lafargue looks upon circumcision among 
 the negro races as being a rite commemorating their 
 advent to manhood ; Livingstone, who has also observed 
 the above, related incidents in relation to the perform- 
 ance of boguera, or circumcision, among the Bassoutos, 
 believes tliat with them the rite has a purely civil sig- 
 nificance, being in no wa}'^ connected with religion. 
 
 Among many of the African tribes the j^oung maids 
 have an ordeal approaching to circumcision that they 
 must pass wlien near the age of thirteen, this rite bear- 
 ing precisely the same relation regai'ding their entrance 
 into the state of womanhood that male circumcision 
 denotes the entrance into manhood on the part of the 
 males among tlie Bassoutos, At the appointed time the 
 maids are gathered together and conducted to the river- 
 bank; the}' are placed under the care of expert matrons. 
 Tliey here reside, after having undergone a kind of bap- 
 tism ; they are maltreated, punished, and abused by the 
 old women, with a view of making them hardy and 
 insensible to pain ; they are also schooled in the science 
 and art of African household duties. Among the Gal- 
 linas of Sierra Leone, in addition to the other observ- 
 ances, the clitoris of the 3'oung maid is excised at mid- 
 
44 History of Circumcision. 
 
 night, while the moon is at its full, after which they 
 receive tlieir name by which they are to be known 
 througli life. The initiation of each sex into these 
 mysteries is exclusively for the sex engaged, and it 
 would be as fatal for a man to steal into the camp of the 
 women during the performance of these ceremonies as it 
 would be fatal for a woman to enter a mapato where the 
 young men are undergoing their ordeal. After their 
 initiation into womanhood, tlie maids live by themselves, 
 similarly to the young men, until they marry. 
 
 Lafargue relates that among the Australians circum- 
 cision is held in such importance that tribes at war will 
 suspend all hostilities and meet in peace during the 
 observance or performance of the rite. Here, again, 
 we have a repetition, with a slight variation, of the prac- 
 tices of the Bassoutos, — something which gives some 
 countenance to the hero-warrior idea of the origin of 
 circumcision advanced by Bergmann. The Australian 
 warriors go through a mimic battle, and, after a series 
 of combats, finally capture the boys aged about from 
 thirteen to fourteen 3ears, whom they bear away amidst 
 tlie cries and lamentations of the mothers and other 
 female relatives, who, in their excess of grief, mutilate 
 themselves by cutting gashes into their thighs, so that 
 they bleed profusely. The boys are, in the meantime, 
 carried to some out-of-the-way place, where an old man, 
 perched on a tree or some rising ground, through the 
 means of a musical instrument made of a deal-board 
 and human hair, announced that the rite is in process 
 of performance, so that neither women nor children 
 might approach. Tufts of moss are placed in the 
 axilla and on the pubis, to represent puberty, and among 
 some tribes the skin of the penis is divided to the 
 scrotum with a stone knife, while others content them- 
 
Circumciaion Among Savage Tribes. 45 
 
 selves with simply making a circular incision, which 
 removes the prepuce, after the Jewish manner, the ex- 
 cised portion being placed as a ring on the median 
 finger of the left hand. Tiie circumcised then takes 
 himself to the hills or woods, and there remains until 
 healed, carefully guarding himself against the approach 
 of any female. After this the third part of the ceremo- 
 nies takes place: the godfather of the 3^outh opens a 
 vein in his own arm, the circumcised 3'outh is placed on 
 all-fours, and an incision is made from the neck down as 
 far as the lumbar region, and the blood of the god- 
 father is made to flow and mingle with that of tlie god- 
 child ; this being in realit3' a bloody baptism, and a 
 near relation to the l)lood-compacts of the Arabs. 
 
 The Malays, as well as the men of Borneo, are 
 circumcised. The Battos likewise perform the rite. 
 Among the Islanders they sometimes ligate the prepuce 
 so that it drops ofl". Among the Battos the same object 
 is reached by small bamboo sticks, between which the 
 prepuce is fastened. In New Caledonia and Tidshi the 
 boys are circumcised in their seventh 3'ear. Tlie Tonga 
 Islanders split the prepuce on the dorsum with a piece 
 of bamboo or of shell. In the Marquesas and Sandwich 
 Islands the operation is superintended b3^ the priests. ^'^ 
 
CHAPTER Y. 
 
 Infibulation, Muzzling, and other Curious 
 Practices, 
 
 It seems a matter of controvers}^ as to whether the 
 Mexicans did or did not circumcise their cliildren. Tiiat 
 they had a blood-covenant is admitted by tlie historians, 
 as well as the fact that this blood was taken from the 
 prepuce ; but that the prepuce was actually removed is 
 something that is not agreed upon by all authorities. 
 Las Casas and Mendieta state that it was practiced by 
 the Aztecs and Totonacs, while Brasseur de Bourbourg 
 found traces of its practice among the Mijes. Las Casas 
 states that on the twenty-eighth or the twenty-ninth day 
 the child was presented to the temple, when the high- 
 priest and his assistants placed it upon a stone and cut 
 off the prei)uce, the excised part being afterward burnt 
 in the ashes. Girls of the same age were deflowered by 
 the finger of the high-priest, who ordered the operation 
 to be repeated at the sixth 3'ear; and once a year, at the 
 fifth month, all the children born during the year were 
 scarified on the breast, stomach, or arms, to denote their 
 reception as servants of their god. Clavigero, on the 
 other hand, denies that circumcision was ever practiced. 
 It was customary in Mexico, according to most authori- 
 ties, to take the children while infants to the temple, 
 where the priests made an incision in the ear of the 
 females, and an incision in the ear and prepuce of the 
 males.^* 
 
 Grotius and Arias Montan at one time advanced the 
 idea that the western coast of South America was 
 (46) 
 
Tnjib Illation, 3Iuzzlwg, and other Curious Practices. 47 
 
 peopled by some mutinous sailors from the fleets of 
 King Solomon, who, in their endeavor to go away far 
 enough to be out of reach, were driven by winds and 
 chance to the Peruvian coast. Others have imagined 
 that some of tlie lost tribes of Israel found their way 
 eastward to America, by the way of China, to the 
 Mexican coast. The same ideal tradition has made the 
 lost tribes the fathers of the Iroquois Nation in the 
 northeastern parts of the United States. An author, 
 who will be quoted in another part of this work, scouts 
 the idea that the rite, as performed in America, had any 
 connection or common origin with the rite performed 
 in Asia and Africa; but, true to his theory of the climatic 
 causes of the origin of circumcision, he maintains that 
 it originated here as it did elsewhere, being a perform- 
 ance born of climatic necessity. He is, however, dis- 
 satisfied with Father Acosta fur not being more explicit 
 in relation to the modus operandi of the Mexican cir- 
 cumcision. The w^ant of being explicit, and its conse- 
 quences in this particular regard, may be inferred from 
 a " Diatribe on Circumcision," by a Mr. Mallet, in an 
 encj'Clopaedic dictionary of the last century, in which 
 Mr. Mallet informs his readers that the Mexicans were 
 in the habit of cutting off the ears and prepuces of the 
 newl}^ born. Herrera and Acosta agree with Clavigero 
 in asserting that the Mexicans simply hied the prepuce. 
 Pierre d'Angleria and other contemporar}^ writers are 
 as emphatic in asserting that in the island of Cosumel, 
 in Yucatan, on the sea-board of the Gulf of Mexico 
 and on the Florida coast, they have observed circum- 
 cision b}^ the complete removal of the prepuce with a 
 stone knife. The Spanish monk, Gumilla, relates that 
 the Saliva Indians of the Orinoco circumcised their 
 infants on the eighth day. These Indians also included 
 
48 History of Circumcision. 
 
 the fenifiles in the observance of the rite. The same 
 author tells us of the barbarous and bloody perform- 
 ances, in relation to the rite, of the nations on the 
 banks of the Quilato and the Uru, as well as those 
 dwelling along the streams that empty into the Apure. 
 The same is said of the Guamo and of the Othomacos 
 Indians ; according to Gumilla, many of these Indians, 
 in addition to the rite of circumcision, inflicted a num- 
 ber of cuts on the arms, legs, and OA'er the body, to a 
 degree that amounted to butcher}', the child being 
 reserved for this inhuman treatment until the age often 
 or twelve years, that he might, by iiis greater powers of 
 resistance and of recuperation, stand some chance of 
 escaping alive from the ordeal, Tiie friar mentions that 
 in 1721 he fonnd a child dying from this treatment, the 
 wounds having become gangrenous and the chikl dying 
 of pyaemia ; prior to the operation the children were 
 stupefied with some narcotic drink, and were insensible 
 during its performance.^^ 
 
 Besides circumcision, the Americans practiced sev- 
 eral other operations that bore an analog^'^ to tlie opera- 
 tion of infibulation, a procedure common to the Orient 
 and to early Europe, and so ancient that, like circum- 
 cision, its source is in the misty clouds of antiquity-. 
 It consisted in introducing a large ring, either of 
 gold, silver, or iron, tlirough an opening made into 
 the prepuce, the free ends being then welded together. 
 Females were treated likewise, the ring including both 
 labia. In some countries an agglutination of the parts 
 induced by some irritant or a cutting instrument an- 
 swered the purpose aniong females. Dunglison mentions 
 that the prepuce was first drawn over the glans, and 
 then that the ring transfixed the prepuce in that posi- 
 tion ; that the ancients so muzzled the gladiators to 
 
Infihulation, Muzzling^ and other Curious Practices. 49 
 
 prevent them from being enervated by venereal indul- 
 gence. Tlie ancient Germans lived a life of chastity 
 wntil their marriage, and to their observance of a chaste 
 life can be attributed the superior pln'sical development 
 of the race, as both males and females were not only 
 fully developed, but were not enervated by either 
 sexual excess or inclinations before having offspring, 
 which were necessarily robust and health}'. To obtain 
 the same results in a nation given to indolence and 
 luxury, and lax in its moralit}^, some physical restraint 
 was required, and we therefore find the practice of infibu- 
 lation coming from the warm countries to the East. The 
 ancients not only infibulated their gladiators to restrain 
 them from venery, but they also subjected their chanters 
 and singers to the same ordeal, as it was found to improve 
 the voice ; comedians and public dancers were also re- 
 strained from ruining their talents b}^ the means of 
 infibulation. In an old Amsterdam edition of Locke's 
 " Essa}^ on the Extent of the Human Understanding," 
 there is a quotation from the voyages of Baumgarten, 
 wherein he states having seen in Egypt a dcA'out der- 
 vish seated in a perfect state of nature among the sand- 
 hillocks, who was regarded as a most holy and chaste 
 man for the reason that he did not associate with his 
 own kind, but only with the animals. As this was by 
 no means an uncommon case, it led the Greek monks, 
 in Greece and Asia Minor, to resort to everj- expedient 
 to protect their chastity ; in some of the monasteries 
 not only were the monks muzzled by the process of 
 infibulation, but they even had rules that excluded all 
 females, either human or animal, from within their con- 
 vent, — a habit that still prevails among man}' of the con- 
 vents of the Orient to this day, — that on Mount Athos 
 especially, omitting the infibulation of the ancients. 
 
50 History of Girmimcision. 
 
 Readers living in the climates of extreme ranges 
 and of seasonal change cannot understand the physical 
 temptations that beset mortals in certain climates, any 
 more than they can imagine the faultless condition of 
 the climate itself. The subject of climatic influences 
 will be more full}- discussed further on ; but climate, as 
 a factor of habits and usages in one part of the world, 
 that are incomprehensible to those living in others, 
 plays a part that is but little appreciated or understood ; 
 whether it be the question of diet, dress, or custom, 
 climate exerts its influence in no uncertain manner. As- 
 Sulpicius Severus remarked to the Greek monks, when 
 the^' accused the Gaulish monks with voracit}^ and glut- 
 tony, " That which you of Greece consider as superfluous, 
 the climate of Gaul renders into a positive necessit\'."' 
 So of all physical needs and passions, — they are subject 
 to a similar law. Those who have read Canon Kings- 
 le^^'s small work on the " Hermits of Asia, Africa, and 
 Europe" will appreciate the above remarks ; and it may 
 be incidentally mentioned that his description of the 
 climate that is common to the hilly country' bordering on 
 the eastern half of the Mediterranean Sea gives as vivid 
 and as graphic a description of the physical condition 
 of the climate and of its effects as can well be written. 
 It occurs in the life of the hermit Hilarion, and the de- 
 scription given relates to his last home in the ruins of 
 an old temple, situated on a cliff in the island of Cy- 
 prus, where the air is so invigorating that " man needs 
 there hardly to eat, drink, or sleep, for the act of breath- 
 ing will give life enough." The work gives the best 
 insight also into origin and causes that led to mona- 
 chism, as well as it tells the benefit tliat the condition 
 conferred on humanit}', showing a phase in the march 
 of civilization that is but little understood. 
 
Injibulation, Muzzling, and othe?- Curious Practices. 51 
 
 But, to return to the subject of infibnlation, wliicb 
 has, in a manner, necessitated this digression from the 
 main topic. Thwing^" informs ns that in ancient Ger- 
 many woman was considered the moial equal of man, 
 and that woman might traverse the vast stretches of 
 country unprotected and unharmed. Woman never 
 held such a position in the Oriental countries ; neither 
 has man, under the sub-tropics, a like self-conmiand as 
 shown b}^ those ancient Gaids. So that, with the advent 
 of Christianity' and the moral revolution tliat followed, 
 primitive metliods, either inflicted on others or self- 
 inflicted, were adoi)ted to insure a chaste life. Infibnla- 
 tion was known, as already stated, for centuries, and in 
 those rude times it seemed as the most natural and ■ 
 effective mode of accomplishing the object. It was not 
 s barbarous an operation as emasculation on the male, 
 .IS it onl3' temporarily interfered with his functions. 
 
 In the Old World the practice is still performed in 
 various manners. In Ethiopia, when a female child is 
 born the vulva is stitched together, allowing only the 
 necessary passage for the needs of nature. These parts 
 adhere together, and the father is then possessed of a 
 virgin which he can sell to the highest bidder, the union 
 being severed with a sharp knife j ust before marriage. In 
 some parts of Africa and Asia, a ring, as before stated, 
 transfixed the labia, which, to be removed, required 
 either a file or a chisel ; this is worn only bj'- virg-ins. 
 Married women wear a sort of muzzle fastened around 
 the body, locked by means of a key or a padlock, the 
 key being onl}^ in the possession of the husband. Thp 
 wealthy have their seraglios and eunuchs, that take the 
 place of the belt and lock. Another method is a mailed 
 belt worn about the hips, made of brass wire, with a 
 secret combination of fastenings, known only to the 
 
52 History of Circuvicision. 
 
 husband. In the museum in Naples are to be seen some 
 of these belts, studded with sharp-pointed pikes over 
 the abdominal part of tlie instrument, which was calcu- 
 hited to prevent even innocent familiarity, such as nest- 
 hiding, to say nothing of greater evils. 
 
 In the ■" Les Femmes, Les Eunuchs, et Les Guer- 
 rieres du Soudan," Col. Du Bisson mentions a very 
 peculiar custom invented by the careful jealousy tliat 
 is inseparable from harem life. He had noticed that 
 man}- of the harem inmates, contrary to the general Ori- 
 ental custom, were allowed to go about unattended by the 
 usual guard of eunuchs, but that they walketl in a pain- 
 ful, hesitating, and impeded manner. This walk was 
 jiot the conventional, short, shuffling step that pecu- 
 liarity^ of dress and shoe-wear imposes on the Jn panese 
 beauty, nor the willowy, swa3'ing gait produccrl in the 
 Chinese beauty by the lack of a sufficiency ot foot ; 
 neither could it be ascribed to the presence of the an- 
 cient jingling chain of bells which induced the mincing 
 steps of the virgins of Judea, — an invention which con- 
 fined the lower limbs within certain limits b}^ being worn 
 just below the knees, and calculated to prevent the rup- 
 ture of the hymen by any undue length of step or vio- 
 lent exercise ; hence a tinkling noise and a mincing step 
 alwaj'S denoted a virgin. In Du Bisson's cases, how- 
 ever, virgins were out of the question ; they might be 
 the victims of enforced continence, but a Soudanese 
 harem contains no virgins. On inquiry he learned that 
 the very peculiar and unmistakably painful gait was 
 due to the fact that each woman carried a bamboo stick, 
 about eight inches in length, three inches or more being 
 inserted in the vagina so as to effectually fill the opening, 
 the balance projecting beyond, between the thighs of the 
 person ; tnis bamboo stick, or guardian of female virtue, 
 
Injibulation, Muzzling, and other Curious Practices. 53 
 
 was held in place by a strap with a shield that covered 
 the vulva, the whole apparatus being strapped about the 
 hips and waist, and the whole being held in an undis- 
 pkceable position by a padlock. This was affixed to the 
 woman whenever she was allowed outside the harem 
 grounds, being placed in position by the eunuch, who 
 carried the key at his girdle. In such a harness virtue 
 can be considered perfectly safe ; even safe from any 
 mental depredation or revolution, as, with the plug 
 causing such uncomfortable sensations, it is perfectly 
 safe to infer that the imagination could not be seduced 
 by an}' Don Juanic or other B3'ronic unvirtuous revelry. 
 Tlie pliysical ills that this contrivance must cause are 
 necessarily without number, as the instrument is not as 
 liglitlj' constructed as our modern stem pessaries ; but to 
 the Oriental who can replace a woman at any time and 
 who prizes the virginitj', continence, and chastity of his 
 slaves, even if enforced, more than their health or their 
 lives, these are matters of secondary importance. In 
 the Soudan there are no divorce courts, hence the prob- 
 able necessity of the apparatus, and, as the woman is 
 not obliged to wear it unless she chooses to go out un- 
 attended, it can hardly be considered as a compulsory 
 barbarity. In the United States such a practice might 
 do away with considerable divorce proceedings. 
 
 Celsus gives a detailed description of the manner of 
 infibulating as practiced among the Romans. Accord- 
 ing to this autliority, it was employed by them on the 
 youth attending the public schools, as well as upon the 
 actors, dancers, and choristers, who were sold to the 
 directors of the plays and s[)ectacles. In the cabinet of 
 the Roman College there ai-e to be seen two small statues 
 representing two inflbulated musicians, which are re- 
 markable for the excessive size of the ring and the lean- 
 
54 History of Circumcision. 
 
 ness of the persons to wliicli they are attached. The 
 mode of applying this ring did not differ much from 
 the usual method of preparing the ear for pendants.^^ 
 
 Among the Greek monks mentioned, the infibulation 
 serves a manifold purpose ; it not only is a sure badge 
 of chastity, but its weight and size is very often in- 
 creased so as to render it an instrument of penitence, 
 and considerable riA^alry exists at times in this regard. 
 Virey notices that the Hindoo bonze, or fakir, at times 
 submits to infibulation at the same time that he takes 
 his vows of eternal chastity. This ring is at times 
 enormous, being sometimes six inches in diameter ; so 
 that it is a l)urden. These saints are held in great 
 esteem and veneration. 
 
 Nelaton, in the sixth volume of his " Surgery," 
 mentions the case of a man who presented himself at 
 Dupuytren's clinic with a tumefied, thickened, and some- 
 what dilapidajted and ulcerated prepuce ; this prepuce 
 had worn a couple of golden padlocks for five j^ears, 
 a woman havino- thus infibulated his oroan. 
 
 In an elaborate work on the subject of circum- 
 cision ,^2 de Vanier du Havre relates, on the authority 
 of M. Martin Flaccourt, that with the Madecasses the 
 children are circumcised on the eighth day after birth; 
 and that in some portions of the country the mother 
 swallows the removed portion of the prepuce, while in 
 others the father loads the prepuce in some form of fire- 
 arm, which is afterwai'd fired in the air. In the neigh- 
 borhood of Djezan, in Arabia, as reported by M. Ful- 
 gence Fresnel in the Revue de Deux Mondes of 1838, 
 courtship and matrimony are not so great social events 
 as they are with our society beaux. The occasion is 
 probabl}^ considered social enough by the rest of the 
 invited guests, but it can hardly be called an agreeable 
 
Infihidation^ Muzzling^ and other Curious Practices. 55 
 
 episode in tlie life of tlie groom. Tliose wliose bashful- 
 uess prevents them from contracting marriage in civil- 
 ized communities can have the consolation of knowing 
 that in far-ojff Arabia, among the fierce followers of the 
 conquerors of Spain and of the Eastern Empire, they 
 have sympathizing fellow-sufferers whom the conven- 
 tionalities of the country deter from rushing into matri- 
 mony. In this region, circumcision is performed on the 
 adult at the time of his candidacy for matrimonial bliss. 
 A more inauspicious occasion could not possiblj' have 
 been chosen, unless as in another Mohammedan tribe, who 
 circumcise the bridegroom on the day after his marriage 
 and sprinkle the blood that falls from the cut onto the 
 veil of the bride. The bride is present, and the victim 
 is handed over to what might be called the executioner 
 of the holy office, who proceeds to circumcise the victim 
 in what might be called its utmost degree of perform- 
 ance and barbarit}'. This attention does not stop at the 
 pendulous and loose prepuce. He devotes himself to 
 the skin of the whole organ ; beginning at the prepuce 
 he gradually works backward, removing the whole skin 
 of the penis — a flaying alive, and nothing more. Should 
 the victim betra3^ any sign of weakness, or allow as 
 much as a sigh or groan to escape him, or even allow the 
 muscles of the face to betray the fact that he is not 
 immensely enjoying the occasion, the bride elect at once 
 leaves him for good, saj-ing that she does not wish a- 
 woman for a husband. A large proportion of the male 
 population annually die from this operation. So that 
 the Arabs of the Djezin can be likened to those spiders 
 who lose their life while in the act of copulation, — the 
 female making a dinner from off the male, — onl}' the 
 spider is said to die a happy death, while that of the 
 Arab is one of misery. 
 
56 History of Circumcision. 
 
 Margrave and Martyr have recorded a very peculiar 
 practice common among some Soutli American tribes : 
 A kind of a tube is fastened onto tiie prepuce by means 
 of threads of ttie tacoynhaa, the latter being the bark of 
 a certain kind of a tree. Cabras brought one of the 
 natives, so muzzled, to Lisbon, on the return from his 
 first voyage. Some tribes were observed to wear an 
 apparatus like the old-fashioned candle-extinguisher, the 
 virile member having been forced into this receptacle, 
 which was strapped about the loins. 
 
 The travelers Spix and Martius found the practice 
 of circumcision of both sexes in the region of the upper 
 Amazon River and among the Tuncas. Squires men- 
 tions a curious custom of the aborigines of Nicaragua. 
 The3' wound the penis of their little sons and let some 
 of the blood flow on an ear of corn, which is divided 
 among the assembled guests and eaten by them with 
 great ceremony. 
 
 On the fifth day after birth it is the custom among 
 the Omaha Indians of North America to christen the 
 infant, the child being stripped and spotted with a red 
 pigment; considerable ceremon}' accompanies the act.^' 
 
 Among the cannibals of Australia, Lumholtz^* ob- 
 served a practice that seems to have no analogue in the 
 wide world, either as an operation or in i-egard to itf 
 purposes. About ninety-live per cent, of the childre: 
 are subjected to the ordeal. This is no less than the fo/ 
 mation of an artificial hypospadias ; this abnormality is 
 formed through the penis into the urethra, near its junc- 
 tion with the scrotum ; the wound is about an inch in 
 length and is made with a flint knife which serves for no 
 other purpose ; the edges of the wound are burned with 
 a hot stone, and the wound is subsequentl}- kept open 
 b}- the introduction of a small piece of wood, which, on 
 
Tnfibulation, Muzzling^ and other Curious Practices. 57 
 
 healing, leaves a permanent opening. These cannibals 
 undoubtedly are inspired by some Malthnsian spirit 
 which impels them thus to functionally eunuchize them- 
 selves in one sense, as during copulation the seminal 
 discharge flies out backward through this opening, being 
 thereby a most efl'ectual check on further procreation. 
 By some, this practice has been attributed to the unrelia- 
 bility of the seasons in regard to food-production ; but 
 Lumholtz observes that where the practice is most in 
 vogue — among the tribes to the west of the Diamantina 
 River and west and north of the Gulf of Carpentaria — 
 the food-supplj' is not deficient, the region being 
 full of rats, fish, and vegetables. All the tribes are not 
 subject to the practice of the operation at the same time 
 of life; in some, the h3'pos[)adias is not produced until 
 in adult life and after the person has married and has 
 become the father of one or two children, when he must 
 submit to the requirements of the law; the operation 
 seems to be invested with some civil or religious signifi- 
 cance, as a palisade or stockade of trees is placed 
 around the place where it is performed. A native, 
 aged about twenty j-ears, informed Lumholtz that 
 the operation was performed because the blacks did 
 not like to hear the children cry about the camp, and, 
 further, that they were not desirous of having many 
 children ; this native had not yet become a father and 
 had not j'et been subjected to the operation. The 
 natives T\ere observed to be fat and in good physical 
 condition. 
 
 Thei'e is something mj'sterious in this operation. It 
 can easily be conceiA'ed how^ circumcision might at 
 limes have been suggested b}- its spontaneous and 
 natural performance without any assistance from man. 
 Culleri'^r reports one case of partial circumcision 
 
58 History of Circumcision. 
 
 througli the ineaus of an accident happening to a painter. 
 The man was at work on a ladder, with a small bucket 
 of paint hooked into one of tlie rounds above him ; 
 through some means the bucket lost its hold and in 
 falling struck tlie penis on its dorsum with such force 
 that the prepuse was cut througli on a parallel with the 
 corona of the glans for fully two-thirds of its circumfer- 
 ence, the glans slipping through the opening and gather- 
 ing in a fleshy bunch underneath the frenum. This man 
 carried this abnormality for some 3"ears, when, desiring 
 to many and seeing tiiat this appendage would be as 
 much of an impediment as one of the huge rings worn 
 by the Hindoo devotee, he applied to Cullerier for 
 advice, who promi)tly removed it with tlie knife.^" The 
 writer has seen tliree cases, during his practice, of spon- 
 taneous circumcision, ail resulting from pliymosis as a 
 secondary affection to venereal disease. The first case 
 occurred wlien he first entered into practice; it was in 
 a young, stout, and full-blooded man with a Adolent 
 gonorrlio3a. There was much swelling and tumefactioii 
 of the whole organ, which seemed to be A^ery rebellious 
 to all treatment. At one of his morning visits he was 
 horrified to observe a transverse, livid mark at what 
 seemed to be the middle of the organ ; by noon this had 
 gained ground to the right and left and there was no 
 mistaking that it meant nothing less than mortification. 
 Never having seen a case, the natural uncomfortable 
 conclusion was that, through some cause or other or the 
 natural result of excessive congestion, the man was 
 about to lose one-iinlf of his organ ; and Burnside at 
 Fredericksburg wns in no grenter state of suspense and 
 uncertainty with the fate of the Army of the Potomac 
 on liis hands than the writer must acknowledge he was 
 with this man and his organ apparently liquefying under 
 
Injibulation, Muzzling, and other Curious Practices. 59 
 
 his treatment. The surprise can be better imagined 
 than described when, on 'the following morning, the 
 glans made its appearance safe and sound out of its 
 imprisonment, and at right angles with the organ there 
 hung the prepuce, thick and as large and as long as the 
 penis itself, inflammatorjr deposit and inllltration having 
 brought it to that shape and consistence ; the glans 
 became completely uncovered ; the parts gathered under- 
 neath, where, in thff course of some weeks, they had 
 shrunk to the size of a walnut, which was afterward 
 removed b}^ the knife. In this case, as in the other 
 two cases observed, the corona was ver^^ prominent 
 and acted as an internal tourniquet by its upward 
 pressure, tlie line of demarkation being on the dorsum 
 in the three cases noted. 
 
 That such cases would suggest circumcision is not 
 only probable but possible, as it would point out the 
 manner of performing the operation ; but, in the cases 
 of the Australian savages, who performed an artificial 
 hyi)ospadias on themselves for a specific purpose, re- 
 quiring a knowledge of the anatomical relation of the 
 parts as well as of their physiological functions, it is 
 liard to speculate how the operation was first suggested 
 or how it came at first to be performed. As a Malthu- 
 sian agent it is certainly an operation of the highest 
 merit, and it should be introduced, by all means, in the 
 United States, where tlie wealth and luxurj' in which 
 the people dwell is fast drifting them toward the same 
 whirlpool that engulfed Rome, which was preceded by 
 a dislike to have children. Whenever the writer sees 
 the poor anaemic, broken-down victim of many mis- 
 carriages, he cannot help but feel that, if the laws 
 of the Damiantina River saA'ages were enforced on their 
 husbands, it would be a blessing to the poor women 
 
60 History of Circumcision. 
 
 without materiall3' injuring the husbands, who, in case 
 of need of a re-establishment of the functions of pro- 
 creation, might be fitted with a vulcanite plate for the 
 occasion, — something like our cleft-palate patients are 
 supplied witli a plate that enables them to articulate. 
 
 It was the custom among the Hottentots, when first 
 discoveied or known to the whites, to remove one' of 
 their testicles. This was supposed to enable them to 
 run more swiftly and to be lighter- footed in the race. 
 The -real reason, afterward found, was a mixture of 
 pure humauitarianism and Maltluisianism boiled down 
 to Hottentot ethics. With them a monorchid was not 
 supposed to beget twins; when twins are born in the 
 family, tlie mother generally smothers the female, if one 
 iiappens to be such; if not, then the feeblest of the two 
 is sacrificed. In their migrator3' and nomadic life the 
 mother finds it impossible to either carry or care for the 
 two children. The male Hottentot, rather than have 
 any avoidable infanticide in his family, or that his wife 
 should go through and suffer the annoyance and pangs 
 of an unnecessiiry and unprofitable pregnane}', gener- 
 ously has one testicle removed ; this is something that 
 the ordinary civilized white man would not do, even if 
 his legitimate wife and all his outside concubines were 
 to have twins or triplets every nine months; so that, 
 even as strange as it may appear, civilization must need 
 go to the wild Bushmen in search of that grand old 
 Quixotic chivalry that was in ancient times alwaj'S 
 read}^ to sacrifice itself for the welfare of woman. 
 
 The old Greek and Roman statues, representing the 
 gods and athletes of ancient Greece and Rome, are a 
 puzzle to many, owing to the diminutive and phimosed 
 virile organ tiiat the artists have attached to tliem. 
 Galen represents that the disuse of the organ b^' the 
 
Injibulation , Muzzling, and other Curious Practices. 61 
 
 athletes was the cause of its mideveloped form, and that 
 as the organ of these did not figure in the worship of 
 Veuus, or participate in the festivals of Bacchus, hut 
 was used solely and simply for micturating purposes, 
 impotence was often the result, citing the case of a 
 patient wlio came to consult him for an obstinate pria- 
 pism resulting from veiiereal excess, who met, in his 
 anteroom, an atiilete who was being treated for the 
 opposite condition, due to tlie too rigid continence to 
 which lie had been for years subjected. Acton does 
 not believe that continued continence has that effect, 
 quoting Dr. Bergeret, wlio had long been physician to 
 a number of religious societies, as saj'ing that lie had 
 never seen serious troubles of tlie organs of generation 
 in these communities, which denotes that if they in- 
 dulged in i)roper fasting and pra3'er they were in the 
 same condition of flaccid impotence as the athlete in 
 Galen's anteroom. Louis VII, of France, tried fasting 
 and prayer in connection with rigid continence, and, as 
 a result, his wife, Queen Eleonore, was divorced from 
 him and married Henry II, of England, who had not 
 been continent. Hence, we see that the old sculptors, 
 whether wishing to represent Jupiter or Pluto, ^Escu- 
 lapius or Mars, a strongly' knit and muscular frame was 
 desired, an athlete, gladiator, or soldier being used as a 
 model ; the small, puerile, funnel-prepuced organ belonged 
 to all these muscular or well-trained classes, was a natural 
 appendage, as enforced continence and the most absolute 
 chastity was the rule, to enforce which they even resorted 
 to inflbulation. This enforced continence often resulted 
 in impotence, even before the prime of life was passed, 
 accompanied by an inevitable atropli}' of the male organ, 
 with the resulting prepuce in the shape in which it is 
 found in a boy of from eight to twelve years, precisely 
 
62 History of Cii'cnmcision. 
 
 as tliey are found ou the statutes. How faithful the 
 sculptors and artists were to nature and life in their 
 representations can well be imagined b}^ a critical ex- 
 amination of the Apollo Belvidere, where the difference 
 of the scrotal position that exists between the right and 
 left testicles is carried out to the minutest anatomical 
 detail. In our age it is hard to conceive wh}' their 
 most masculine men should be deified, and all their gods 
 represented as the most perfect of bodil3r development, 
 while at the same time the finest physical specimens of 
 manhood were doomed to a life of the most rigorous 
 continence. It is also astonishing that all this should 
 be done not from any principle or consideration of 
 morality or virtue, but simply as a means subservient 
 in producing at its maximum the highest degree of 
 physical development and endurance. 
 
CHAPTER YI. 
 
 Attempts to Abolish Circumcision, 
 
 Probably ho rite or practice of a custom has been 
 such a, loug-standiug bone of contention as circumcision ; 
 nor does the Sph_ynx surpass this relic of bygone ages 
 in mj'sterj'. From time immemorial its practice has 
 been the subject of disputes, and its hterature finds 
 oftentimes its friends and foes ranged side hy side. At 
 one time a noted Israelite and Voltaire, the scoffer of 
 Judaism, ma}' be consulted on the question as to whether 
 Israelite or Egyptian is entitled to priority as to its 
 original practice with a like answer; and, again, Chris- 
 tians are found who, after a careful investigation, will 
 accord this to the Israelites. In Rome, the persecuted 
 Hebrew was stopped on the street and eompelkd to 
 show the mark of circumcision, that he might be taxed, 
 and in Turkish parts the Christian was subjected to the 
 same indignity to enable the tax-gatlierer to harvest the 
 impost which he paid for his libert}' of conscience and 
 not being circumcised. When the monkish missionaries 
 of the Catholic faith first entered Abyssinia, they were 
 shocked to find their converts insisting on their time- 
 honored practice of circumcision ; and later, when the 
 Propaganda sent its own missionaries, they were scan- 
 dalized to see Christians practicing what they looked 
 upon as an infidel rite; and nothing but the most earnest 
 confession of faith, with the assurance that the rite of 
 circumcision was only a physical remedy, and that in 
 their conscience it in no wise possessed any religious 
 significance, and that neither did the3',in any sense, hold 
 it in any connection with the sacrament of baptism, per- 
 mitted these Abyssiniaus to save themselves from excom- 
 
 3 (63) 
 
64 History of Cii'cumcision. 
 
 munication. Later still, when an Abyssinian bishop was 
 present in Lisbon, the clergy of the cit}' refused him the 
 right of celebrating the sacrifice of the holy mass in the 
 Cathedral of Lisbon, on the ground tliat he, having been 
 circumcised, was no better than a heretic. The Abys- 
 sinian Christians still practice the rite at the present day. 
 The Turks, although very fanatical and greater prose- 
 lyters than the Christians of Rome, seem now and then 
 to relax in favor of general utility, as we find Bajazet II 
 writing to the Pope, Alexander VI, supplicating his 
 Holiness to confer a cardinal's hat on the Archbishop 
 of Aries as a special favor to the Turkish emperor, as 
 lieknew that the archbishop had a secret leaning toward 
 Mohammedanism. As the clergy of those days, from 
 the Holy Father down, were more politicians than fol- 
 lowers of the humble Nazaiene,the heaven of Mohammed 
 had probabl.y more attractions for their taste than the 
 ideal Christian paradise, and it is possible that the good 
 archbishop would have submitted to a cardinal's hat 
 and circumcision at the same time to secure the good 
 tilings of this world and of those in the world to come. 
 History also relates that his most Christian majesty, 
 Henry III, of France, as a relaxation to the intermin- 
 able squabble between two Christian religions Mictions 
 which were rending France, and which in the end cost 
 him his life, actually wrote a letter to the Sultan, asking 
 the favor to.be allowed to stand as godfather at the cir- 
 cumcision of his son. When it is remembered that the 
 godfather at a Turkish circumcision has to make a strong 
 profession of Moslem faith and the answers as sponsor 
 for the child, and must promise that the child will be 
 faithful to the Koran and Mohammed, it will be seen 
 that, however much the lower levels of humanity may 
 quarrel over trifles, the heads of the people easily 
 
Attempts to Abolish Circumcision. 65 
 
 accommodated tliemselves to vMy existing circumstances. 
 Friar Clemens might as well have let such a liberal- 
 minded monarch live, as any of the existing churches 
 could easily have got along Avitli him. 
 
 On the other hand, we have the remarkable tenacity 
 to custom and habit in this regard, as exhibited by the 
 Moslems, who, although having neither ordinance nor 
 authority for its performance, either in their law, creed, 
 or in any order from their prophet, still no more zealous 
 circumciser exists than the son of Islam, who exacts 
 from all proselytes the excision of the prepuce. Moham- 
 med was circumcised in his boyhood, and, although he 
 did not order its performance to his followers, he did 
 not see fit to proscribe a custom so general to the 
 Arabians, where the greater development of the prepuce 
 probably renders circumcision a necessit}'. From the 
 same reason it is easy to perceive wh}' the rite has found 
 such general observance among the Africans, who are 
 as noted for long and leather^^ prepuces as for their slim 
 shanks. One author, writing in 1772, in a work entitled 
 " Pliilosophical Researches on the Americans," treats the 
 subject in a very intelligent manner. His arguments are 
 both ingenious and plausible. This author looks upon 
 circumcision as of purely climatic origin in its inceptive 
 causes. From a careful survey of the natural history 
 of man in his general distribution over the globe, he 
 finds that circumcision may be said to be restricted to 
 within certain boundaries of latitude, equidistant on 
 both sides of the line. No circumcised peoi)le have ever 
 inhabited northern regions, and the bulk of the circum- 
 cised races are found within certain climates. From 
 this reasoning it is easy to see why the rite should lose 
 its standing under certain climatic conditions, unless 
 bolstered up by some religious significance, as it is 
 
66 Hidoj^y of Circumcision. 
 
 eqimlly easy to foresee why it should flourish elsewhere, 
 even without any religious backiug or ordinance. It is 
 well known that in Ethiopia and the neighboring coun- 
 tries, excrescences and elongation of either the prepuce 
 or n3'niph8e are as probable as the existence of an en- 
 larged thyroid gland or goitre among the inhabitants of 
 some of the valleys of Switzerland or of those of the 
 Tyrol. According to the author of the treatise just 
 quoted, circumcision would be nothing more than a 
 remedy to repair the evils that a fault}' construction of 
 the human body developed in certain climatic conditions. 
 With the Israelites it is observed as a religious rite, 
 although they are not strangers to the physical benefits 
 that circumcision confers upon them ; the fact that even 
 where no prepuce exists, as sometimes happens, the cir- 
 cumciser nevertheless goes on with the rite, being satisfied 
 with drawing a few drops of blood from the skin near 
 the glans, stamps the operation essentially as being a 
 religious rite. Persecutions have signally failed to sup- 
 press its performance b}^ those of the Hebrew faith. 
 Beginning with the decree of Antiochus, 167 B.C., which 
 consigned every Hebrew mother to death who dared to 
 circumcise her oflspring, they have not ceased to suffer 
 in defense of their rite. Adrian, among other repres- 
 sive measures, forbade circumcision ; under Antonine 
 this edict was still enforced, but he afterward recoiled 
 it and gave to the Hebrews the right of observing their 
 religious rites. Miircus Aurelius, however, revived the 
 edict of Adrian. Heliogabalus, who ascended the Ro- 
 man throne iu the 3'ear 218 a.d., was himself circum- 
 cised. During the reign of Constantiue all the laws 
 that interfered with Hebraic rites were renewed, with 
 the addition that any Hebrew who should circumcise a 
 slave should suffer death. Under the sway of Justinian, 
 
AttemjJts to Abolish Circumcision. 67 
 
 in the sixth centuiy, the persecutions against tliese 
 people were so oppressive that a Hebrew was not allowed 
 to raise or educate his own child in the faith of his 
 fathers. In the seventh century-, the augurs havino- 
 prophesied the ruin of the Roman Empire bj^ a circum- 
 cised race to the emperor Heraclius, the persecutions 
 were renewed against these unfortunate people. In tliini 
 century, Hebrews refusing baptism suffered, banishment 
 and confiscation of all their property ; they were oblioed 
 to renounce the Sabbath, circumcision, and all Hebraic 
 rites if they wished to remain. About this period the 
 success of the Saracens induced persecutions of the 
 Hebrews in Spain, where their children were taken away 
 from them that the3- might be raised in the Christian re- 
 ligion. In the fifteenth century they suffered the 
 greatest persecution and mart3Mxlom at the hands of the 
 Spanish Inquisition. The persecutions above cited were 
 national and governmental persecutions levelled directly" 
 at the Jewish nation and creed ; the persecutions that 
 they momentarily suff"ered at other times had no signifi- 
 cation beyond the exhibition of popular spite and furj^, 
 but those above cited Avere moves calculated to extirpate 
 the creed, if not the people, from off" the face of the 
 globe. If repressive measures are of any avail, circum- 
 cision as an Hebraic rite should now have no existence. 
 Its present existence and observance show a vitality 
 that is simply phenomenal ; its resistance and apparent 
 indestructibilit}" would seem to stamp it as of divine 
 origin. No custom, habit, or rite has survived so many 
 ages and so man}'^ persecutions ; other customs have died 
 a natural death with time or want of persecution, but 
 circumcision, either in peace or in war, has held its own, 
 from the misty epochs of the stone age to the present. 
 There is something pathetic and soul-appealing in 
 
68 History of Circumcision. 
 
 contemplating the early Christians forced to worship in 
 the catacombs of Rome, hunted like wild animals in 
 their subterranean burrows, and then given the choice 
 of making offerings to the heathen gods or being- 
 thrown into the iai'ena as prey to wild beasts ; so are we 
 stirred when we think of tlie Spanish Jew, who had 
 made Spain his home for centuries, being driven into 
 exile in such droves that no country could receive 
 them; we see them perishing of hunger by the thousands 
 on the African coast, and dying* of starvation on the 
 quays of the ports of civilized Italy. That many, through 
 all these trials, were forced to embrace other religions is 
 not astonishing. In Si)ain npostacy was to no purpose, 
 as the Inquisition could not be expected to split hairs in 
 regard to an apostate Jew, when it sent the best of Gothic 
 blood, raised in tlie Catholic faith, to the auto da fe or 
 the scaffold, — the rack respecting neither faith nor pro- 
 fession that fell into its clutches. In milder persecu- 
 tions, however, he escaped by outwardly conforming to 
 the demands of his oppressors ; and history tells us of the 
 circumcisions secretly' performed on the dead Jew, that 
 the spirit of the law of their fathers might be carried out. 
 In other cases, threatened exile, confiscation, or ex- 
 orbitant taxation drove them to adopt every possible ex- 
 pedient to eradicate the sign of their Israelitism and 
 make attempts to reform a prepuce. The first attempts 
 in tills line were made during the reign of Antiochus, 
 when a number of Hebrews wished to become as the 
 people about them who were not persecuted — fecerunt 
 cibi praeputia. This is no easy operation, and in later 
 times by the aid of appliances, both in Rome and in 
 Spain, they undertook to cause the skin to recover the 
 glans. Martial, in speaking of the instrument used in 
 Rome, a sort of a long funnel-shaped copper tube in 
 
Attemjyts to Abolish Circumcision. 69 
 
 which the Hebrew carried his virile oi-gfin, terms it 
 Judoem Pondum, the weight of "which, by drawing. down 
 the skin, was supposed iu time to draw it down far 
 enough to answer tlie purpose. The apostle Paul, in his 
 epistle to the Corinthians, refers to these practices 
 when he says, "Was any dne called being circumcised, 
 let him not be uncircumcised." The operation of 
 reforming a prepuce, or of obliterating the marks of 
 circumcision, does not appear to have beeu a success. 
 
 The writer had one experience that was interesting. 
 On one occasion he advised circumcision for the relief 
 of a reflex nervous disease, in a tali, athletic Austrian 
 sailor from the Adriatic ; although the nature of the 
 operation was explained to the man, he evidently did 
 not appreciate its full nature and importance until a 
 a sweeping cut with a scalpel left the excised prepuce in 
 the operator's hand. Most Adriatic sailors have sailed 
 up the Bosphorus and are more or less familiar with 
 both the Grreek and Turkish nations ; the latter they 
 despise with gusto, "po?•c/;^ c^i Turci^^ being the affec- 
 tionate appellation they bestow on their national neioh- 
 bors. No sooner did he perceive the real condition of 
 affairs than he began to beat his head, saying that he 
 was disgraced forever, as he never would dare to asso- 
 ciate with his countrymen again, as he would be liable 
 to be taken for a porcho di Turco ; his frenzy increased 
 to such a pitch that to spare any unpleasantness it was 
 deemed advisable to replace the prepuce, which was 
 done accordingly, the man making a tolerable good 
 recovery, as far as the grafted prepuce was concerned. 
 It required a secondary operation to overcome some 
 cicatricial contraction, and, on the whole, he had a very 
 serviceable prepuce ; but, what was more to the point, 
 it prevented his ever being mistaken for a Turk. 
 
CHAPTER YII. 
 
 Miracles and the Holy Prepuce. 
 
 What strange fancies have circled tliemselves abont 
 the subject of generation or its organisms during the 
 different stages of moral civilization since the world 
 has existed 1 The efforts in this regard among different 
 creeds have been something peculiar. Neither Moham- 
 medans nor Hebrews — both zealous circumcisers — ever 
 went to the lengths reached by Christian churches and 
 their followers in some particulars concerning this rite ; 
 this being especially strange when it is considered that 
 the new creed was the one that abolished the rite and 
 tlirough wliich the Jews suffered such cruel and nnjust 
 persecutions. Tlie earlj^ Christian Cliurcli celebrated 
 and continues to celebrate the Feast of Circumcision, 
 and histor^^ relates some sti'ange events in connection 
 witli this circumcision. Having abolisiied and repudi- 
 ated the rite, it would seem inconsistent that it should 
 celebrate its performance on an^^ occasion and consider 
 such an event sufficiently memorable that its occurrence 
 should excite the veneration of the church and be the 
 means of exciting the pious zeal of the faithful. The 
 strangest events in this connection are still more mys- 
 terious and incomprehensible, if not amusing, the only 
 excuse for the occurrence being the greedy thirst for 
 relics of any and all kinds that in the middle ages 
 pervaded Europe. 
 
 At some remote period — in the thirteenth or four- 
 teenth century — the abbey church of Coulombs, in the 
 diocese of Chartres, in France, became possessed in 
 (70) 
 
Miracles and the Holy Prepuce. *l\ 
 
 some miraculous manner of the holy prepuce. This 
 holy relic had the power of rendering all the sterile 
 women in the neighborhood fruitful, — a virtue, we are 
 told, which filled the benevolent monks of the abbey 
 with a pardonable amount of pride. It had the 
 additional virtue of inducing a subsequent easy delivery, 
 which also added to the reputation and pardonable 
 vanity of the good monks. This last virtue, liowever, 
 we are told, came near causing the loss to the abbey of 
 this inestimable prize, for, as a Frencl writer observes, 
 a too great reputation is at times an unlucky possession ; 
 at an}^ rate, tlie royal spouse of good and valiant King 
 Henry V — he of Agincourt, whom England waded up to 
 its knees in the sea at Dover to meet on his return from 
 that campaign — had followed the example of all good 
 dames and was about to give England an heir. Henry 
 then governed a good part of France. Having heard 
 of the wonderful efficacy of the relic of Coulombs, he 
 early one morning thiew the good monks into consterna- 
 tion by the arrival at the convent gate of a duly 
 equipped herald and messenger from his kingship, ask- 
 ing for the loan of the relic with about as much cere- 
 mony- as Mrs. Jones would ask for the loan of a flat-iron 
 or saucepan from her neighbor, Mrs. Smith. The queen, 
 Catherine of France, was of their own country and 
 Henry was too powerful to be put off" or refused ; there 
 was no room for evasion, as the holy prepuce could not 
 be duplicated ; so the poor monks with the greatest reluc- 
 tance parted with their precious relic, entrusting it into 
 the hands of the xojiiX envoy, which wended its way to 
 London, where it in due time, being touched by the 
 queen, insured a safe delivery. Honest Henry then 
 returned the relic to France; but so gi-eat was its repu- 
 tation that royalty caused a special sanctuary to be 
 
*r2 History of Circumcision. 
 
 erected for its reception, and a full period of twent3-five 
 years occurred before the monks of Coulombs again 
 regained possession of tlieir prize, during which period 
 the population of the neighborhood must have suffered 
 from the natural increase of sterilit}^ and the physicians 
 must have reaped a rich harvest owing to the increased 
 difficulty and comj)lications of labor induced by the 
 absence of the relic. On its return, the relic was found 
 to have lost none of its virtues, and the good people and 
 monks were all correspondingly made happ^^ ; in 1870, 
 when the writer was in France, it was still working its 
 miracles. Balzac found ample facts to found his famous 
 " Droll Stories " without straining his imagination. 
 
 So great an attraction was not to go without at- 
 tempted rivalry or imitators ; hence we fliid in the " Dic- 
 tionarj^ of Moreri," edition of 1715, in tlie third volume, 
 at page 108, that several other establishments claim the 
 honor of a like relic, — nameh'', the Cathedral of Puy, 
 in Velay ; the collegial church of Antwerp ; the Abbey 
 of our Saviour, of Charroux; and the Church of St. 
 John Lateran, in Rome. All of these have had very 
 adventurous histories. The Abbey of Charroux was 
 founded by Charlemagne in 7So, and among the relics 
 with which that monarch endowed the abbey the pi'in- 
 cii)al one was a fragment of the hoi}' prepuce. This 
 abbey enjoj^ed great reputation, and indulgences were 
 granted b}' Papal bull to all those who assisted at the 
 adora,tion of the relics. In the internecine wat's of the 
 sixteenth century the abbey fell into the hands of the 
 godless and heretical Huguenots and the hoi}' relic disap- 
 peared. In 1856, while some workmen were at work de- 
 molishing an ancient wall on the abbe}' site, they discov- 
 ered some relic cases. The bishop was at once notified, 
 who immediately proceeded to investigate, when, lo and 
 
lliracles and the Holy Prepuce. tS 
 
 behold I there, sure enough, wjis a piece of desiccated 
 flesh, witli marks of coagulated blood ; nothing more or 
 Jess than the lost prepuce — long lost, but now found. 
 It was placed in charge of the Ursuline Sisterhood, 
 where it has remained ever since undisturbed, except by 
 a controversy in regard to the propriety of the relic, in 
 which the good bishop ambled about in the most am- 
 biguous manner, the only clearly defincvi portion of his 
 dissertation being the one wherein lie laments "the de- 
 cadence of that trul}^ Christian spirit which animated 
 the laity of the middle ages witii a radiant zeal. A piety 
 also pervaded those gentle Chi-istians of former times, 
 who were possessed of a religious instruction which 
 determined for them the tenets of the creed and its 
 l)ractices, — a happy state or condition of affairs, which 
 prevented the intelligence of the faithful from wander- 
 ing into the sloughs of unprofitable skepticism." This 
 settled the question as to the propriety of the prepuce 
 being converted into a miracle-working I'elic ; at least, as 
 far as the good bishop was concerned. 
 
 It would be an injustice not to mention the other 
 shrines in detail after the prominence that has been 
 given to the abbeys of Coulombs and Charroux ; so the 
 history of another will be given. We are not told just 
 how the Church of St. John Lateran in Rome first be- 
 came possessed of its holy prepuce, but it nevertheless 
 had one ; also the only authentic one in existence, like 
 all the others. It disappeared at one of the periodical 
 sackiugs that Rome has repeatedly suffered at the hands 
 of Goth,yandal,or Christian. This time it was the sol- 
 diery of the eldest son of the church — Charles V — who 
 did the sacking; it was in the 3'ear 1527, a soldier — 
 probably some impious, heathenish mercenar}^ — broke 
 into the holy sanctuary of the church arid stole there- 
 
74 History of Circumcision. 
 
 from the box that contained the holy relics, among them 
 the holjr prepuce. These impious wretches, as a rule, 
 came to grief in short order ; hence we are told that 
 this mercenary and sacrilegious soldier was compelled 
 to secrete his box, when only a short distance from 
 Rome, where the box remains and the mercenary wretch 
 disappears, probably carried off bodil}'^ by the devil, as he 
 deserved. Thirty years afterward the box is discovered 
 by a priest, who, ignorant of its con-tents, carries it to 
 the lady on whose domain it was found. On being 
 opened it was found to contain a piece of the anatomy 
 of Saint Yalentine, the lower jaw of Saint Martha, with 
 one tooth still in place, and a small package upon which 
 the name of the Saviour was inscribed. The lady 
 picked up the package, when immediately^ the most fra- 
 grant odor pervaded the apartment, being exhaled by 
 the miraculous packet, while the hand that held it was 
 seen perceptibly to swell and stiffen ; investigation 
 proved it to be the holy prepuce stolen b}^ the miscreant 
 mercenary from St. John Lateran. It is related that in 
 1559, a canon of tlie church of St. John Lateran, im- 
 pelled by a worldl}'- curiosity nntempered by pietj^, 
 undertook to make a critical examination of this relic, 
 in the process of which, to better satisfy himself, he 
 had the indiscretion to break off a small piece ; instantly 
 the most dreadful tempest broke over the place, followed 
 by crashing peals of thunder and blinding flashes of 
 lightning ; then a sudden darkness covered the countr\^, 
 and the luckless priest and his assistants fell flat on their 
 sacerdotal noses, feeling that their last hour had ar- 
 rived.^' 
 
 Wonderful and miraculous cures are performed at 
 these shrines, and some of the cures are of a nature 
 that would baffle the intelligence of the most learned 
 
Miracles and the Holy Prepuce. 75 
 
 mind to ascertain the intricate and devious way that 
 nature must at times journe}' to accomplish some of 
 these changes. The writer well remembers seeing, in the 
 Churcli of Corpus Christi, in Turin,^^ a long hall, cov- 
 ered, from marble pavemeut to ceiling, with votive 
 tablets, after the manner inaugurated in the old temples 
 of Greece. Moderu votaries have the advantage of 
 being able to record their cure, safe A'enture or escape 
 from peril, b}^ means of faithful representation of the 
 event in painting or drawing, as the material and art is 
 more common now than in the days of ancient Greece, 
 who recorded its cures by simple inscription in lacoiiic 
 terms. Modern medicine labors under the disadvantage 
 of presuming that the people are endowed with an in- 
 telligence that was unknown to ancient or mediaeval 
 people, when, in fact, the people are as credulous and 
 as subject to imposition as they were in the earlier 
 centuries of the present era. With all its supposed 
 superior intelligence, there is no fatter pasture for 
 quacks and impostors than that presented Ijy the people 
 of the United States. Whenever I see the poor, intelli- 
 gent, broad-minded physician struggling along, barely 
 able to procure for himself the necessaries required to 
 maintain himself with proper books and appliances, 
 while the itinerant quack or dogmatic practitioner rolls 
 in undeserved affluence, I question the wisdom of our 
 ethical code. Braddock, at the Monongahela, scorned 
 to have his regulars, who had fought under Marlbor- 
 ough and Eugene, break ranks before a lot of breech- 
 clouted savages, and take shelter that the nature of the 
 ground and the trees could afford, thinking it an unfit 
 action for men who had faced the veterans of Louis 
 XIV on many a hard-fought European field. I some- 
 times think that if oar regulars were, for only a season, 
 
76 History of Circumcision. 
 
 to follow the example of the provincial militia at that 
 battle, it would be better for the country, the people, 
 science, and last, but not the least, for the profession. 
 The theory that we should not counsel with quacks is 
 altogether mischievous and fallacious, although right 
 and rigidly orthodox in its intent ; were we to counsel 
 and meet these gentry, we should exjoose their ignorance 
 and assumption, and we should not be exposed to the 
 charge of jealousy and of fear to meet them in consulta- 
 tion. I remember on one occasion a client went to a 
 lawyer for advice as to how he might dispossess some 
 parties who had some adverse claim to some property 
 which he owned, after due deliberation and a pro- 
 tracted siege of the house, in the vain hope of gaining 
 admittance; the law^'er advised his client to go and 
 nail up all exits and fasten them in, which had the effect 
 of driving them out. So with our profession — we should 
 not neglect an opportunity of meeting a quack in con- 
 sultation, regardless of the nature of the case ; it is the 
 only way to nail them up ; as it is, we have simply 
 chained up the shepherd-dog and given the wolves 
 full play. 
 
 The French Guards at Fontenoy, who out of courtesy 
 refused to fire first on the English, may have been very 
 ethical and chivalrous, but the_y were very foolish, as the 
 English discharge nearly swept them from the field, and 
 but for the Irish Brigade, who knew no ethics, Louis XV 
 would in all likelihood have followed the example of 
 King John, who, after Crecy, visited England for a 
 season. A disregard of ethics gave Copenhagen to 
 LordNelson,who insisted on looking at Admiral Parker's 
 signal to withdraw from action with his sightless e3'e, 
 which could not see it. A fear of disregarding ethics lost 
 to Grouch}' the chance of assisting Napoleon at Waterloo. 
 
Miracles and the Holy Prepuce. TY 
 
 [n our strife against ignorance and quacker}' the profes- 
 sion should follow the general plan of action usually 
 adopted by Lord Nelson — lie alongside of whom ^'ou crn 
 and sink or capture your enemy ; let each man do his 
 duty ; never mind any general plan. A reverse to this 
 mode of fighting invariably lost the battle to the French 
 and Spaniards, who were, as a rule, all tied up in ethical 
 red tape. Our profession is broad, intelligent, and fear- 
 less ; we do not profess any exclusive dogma, and should 
 not, therefore, exclude persons; as a large ship throws 
 its grappling-irons on to its adversary, we should alwaA's 
 seek an opportunit}' to meet these gentry when practi- 
 cable. As it is, we have placed them on the vantage- 
 ground of appearing as being persecuted ; our ethics 
 need circumcising in this regard, and the prepuce of 
 exclusion should be buried in the sands of the desert. 
 
 Moreover, we often are apt to learn something from 
 even the most ignorant of these men. Rush investigated 
 the nature of a cancer-cure by not refusing to meet and 
 talk with one of this kind ;2^ Fothergill learned from nn 
 old, unlicensed practitioner that there was a knowledge 
 important to the pliysician beyond that picked up in the 
 pathological ]al)oratory or the study of microscopv ; and 
 that the practiced eye of an otherwise unlearned man 
 could detect that there were general ph3'sical signs thnt 
 negatived the unfavorable prognosis suggested by the 
 presence of tube-casts.^^ It is related of Sir Isaac 
 Newton, that while riding homeward one day, the 
 weather being clear and cloudless, in passing a herder 
 lie was warned to ride fast or the shower would wet him. 
 Sir Isaac looked upon the man as demented, and rode 
 on, not, however, without being caught in a drenching 
 shower. Not being able to account for the source of 
 information throuirli which the rustic had gained his 
 
78 History of Circumcision. 
 
 knowledge, he rode back, wet as he was, to learn some- 
 thing. " M3' cow," answered the man, " alwajs twists 
 her tail in a certain way just before a rain, 3'our Worship, 
 and she so twisted it just before Isawyou."^^ Although 
 twisting cow-tails do not figure in his " Principia," it is 
 yevy probable that such a lesson was not without its 
 remote effects on a mind like Newton's. A spider taught 
 a lesson to one of Scotland's kings ; so that one man may 
 learn something from another. 
 
 Professor Letenneur, of the Medical School of 
 Nantes, in his "• Causerie a propos de la Circoncision," 
 mentions that the Convent of Saint Corneille, in Com- 
 piegne, claims to possess the identical instrument with 
 which the Holy Circumcision was performed. Such a 
 holy relic must have been unusually potential in per- 
 forming many miracles. 
 
 In this connection it will not be amiss to notice the 
 lapping over that the old phallic worship and idea has 
 made on the new religions. It is also as interesting to 
 observe how the human mind still leans toward observ- 
 ances and ideas which are believed to belong to a solely 
 pagan i)eople. IIargra\e Jennings, in a chapter devoted 
 to phallic worship among the ancient Gauls, gives man}'- 
 interesting and curious examples, the first example that 
 he notices being that of Saint Foutin (from whom the 
 very expressive French word '■'■ f outre'''' is taken). 
 Foutin Avas the first Christian bishop of Lj'ons, and 
 after his death, so intimately was priapic worship inter- 
 mingled with the religion or theology of the Gauls, that 
 somehow the memory of St. Foutin and the old, de- 
 throned Priapus became commingled, and finally the 
 former was unconsciously made to take the place of the 
 latter. St. Foutin was immensely popular. He was 
 believed to have a wonderful influence in restoring fer- 
 
Miracles and the Holy Prepuce. 79 
 
 tility to barren women and vigor and virility to impo- 
 tent men. It is related that, in the church at Varages, 
 in Provence, to such a degree of reputation had the 
 shrine of this saint risen, it was customary for the 
 afflicted to make a wax image of their impotent and 
 flaccid organ, which was deposited on the shrine. On 
 windy daj's the beadle and sexton were kept busj^ in 
 picking up these imitations of decrepit and penitent 
 male me'inbers from the floor, whither the wind wafted 
 them, much to the anno3'anee and disturbance of the 
 female portions of the congregation, whose devotions 
 are said to have been sadly interfered with. At a church 
 in Embrun there was a large phallus, which was said to 
 be a relic of St. Foutin, The worshippers were in the 
 habit of offering wine to this deit}', — after the manner 
 of the earlj' Pagans, — the wine being poured over the 
 head of the organ and caught underneath in a sacred 
 vessel. This was then called " holy vinegar," and was 
 believed to bean efficacious remed}' in cases of sterility, 
 impotence, or want of virility. 
 
 Near the city of Bourges, at Bourg Dieu, there 
 existed, during the Roman occupation of Gaul, an old 
 priapic statue, which was worshipped by the surround- 
 ing country. I'he veneration in which it was held and the 
 miracles with which it was accredited made it impolitic as 
 well as impossible for tlie earl_y missionaries and monks 
 to remove it ; it would have created too mucli oppo- 
 sition. It was therefore allowed to remain, but gradu- 
 ally changed into a saint, — St. Guerluchon,— which, 
 however, did not detract any from its former merit oi 
 reputation. Sterile women flocked to the shrine, and 
 pilgrimages and a set number of da3^s of devotion to 
 this saint were in order. Scrapings from this statue 
 infused in water were said to make a miraculous drink 
 
80 History of Circumcision. 
 
 whicli insured conception. Similar slirines to this same 
 saint were erected at other places, and we are told that 
 the good monks, who must have had an intense and 
 lively interest in seeing that the population was in- 
 creased, were kept busy supplying the statues with new 
 members, as the women scraped away so industriously, 
 either to prepare a drink for themselves or for their hus- 
 bands, that a phallus did not last long. At one of these 
 shrines, so onerous became the industry of replacing a 
 new phallus to the saint, that the good monks placed an 
 apron over the organ, informing the good women that 
 thereafter a simple contemplation of the sacred organ 
 would be sufficient ; and a special monk was detailed to 
 take special charge of this apron, which was only to be 
 lifted in si)ecial cases of sterilit3^ By this innovation 
 the good monks stole a march on their brothers in like 
 slirines in other localities, such as tliose of St. Grilles, in 
 Brittau}^, or St. Rene, in Anjou, where the old-fashioned 
 scraping and rei)lacing still was in vogue. Near the 
 seaport town of Brest, in Brittany, at the shrine of St. 
 Giiignole, the monks adopted a new expedient. They 
 bored a hole through the statue, through which a phallus 
 was made to project horizontally ; as fast as the devo- 
 tees scraped away in front the good monks as industri- 
 ously pushed forward the wooden peg that formed the 
 phallus, so that it gave the member the miraculous 
 ai)pearance of growing out as fast as scraped off, which 
 greatly added to its reputation and efficacy. The shrine 
 continued in great vigor until the middle of the last 
 century. Delanre mentions a similar shrine at Puy, 
 also in France, which existed up to the outbreak of the 
 French Revolution. The scrapings in this case were 
 immersed in wine, and the guardians of the statue saw 
 to it that no amount of paring or scraping should re- 
 
Miracles and the Holy Prepuce. 81 
 
 move from the saint any of that appearance of vigoi' or 
 virility which his great reputation demanded, this 
 being done by a similar procedure as followed at the 
 church near Brest, one of the attendants having been 
 sent to investigate into the marvelous growth of the 
 Brest phallus. 
 
CHAPTER YIIL 
 History op Emasculation, Castration, and Eunuchism. 
 
 For the earliest records in regard to emasculation 
 we must go back to m^ythological relations. In the old 
 legendary lore of ancient Scandinavia or of Gerinan3^, 
 the loves and hatreds of their seini-m^ythological heroes 
 and heroines space over many romantic incidents before 
 reaching a cidmination. Tlie swiftly' flowing Rhine, 
 with its precipitous banks, eddies, and rapids ; the broad 
 and more majestic Danube or Elb; the broad meadows 
 and Druidical groves on its hilly slopes and stretches 
 of dark and gloomy forest, — all conspired to people the 
 fancy with elfs, gnomes, fairies, and goblins, who were 
 more or less intermingled in all the episodes that en- 
 gaged their semi-mythological heroes. This helped to 
 fill in all their deeds with entertaining incidents ; their 
 halls and castles were made necessary accessories by the 
 rigors of the climate, as well as were the beeiy feasts and 
 carousals with the inspiration of monotonous song also 
 rendered necessaries bj'^ the same element ; hence, we 
 have various incidents, either entertaining or exciting, 
 connected with their legendary tales, acting like periods 
 of intermission between their love scenes, spites, hatreds, 
 murders, and general cremations. From such material 
 and such opportunities it was comparatively easj'^ for 
 Wagner to construct the thrilling and interesting in- 
 cidents that compose his opera on the legend of the 
 Nibelungenlied. 
 
 The Grecian landscape and topography does not 
 permit of such richness of romantic incidents or details, 
 (82) 
 
Emasculation, Castration, and Eunuchism. 83 
 
 ail}' more than the love-making of tlie iiiifortuuate spider 
 ■who is deA'oured by his spideiy Cleopatra at the end of 
 his first sexual embrace could furnish an^' incidents for 
 one of Amelie Rives's spirited novels ; so that neither 
 minstrel nor bard have recorded the details of the first 
 emasculating tragedv, which from all accounts was a 
 kind of an Ol3'mpian Donnybrook-fair sort of a paricidal- 
 ending tragedy. 
 
 TJnfortunatelj-, Homer was not tliere to describe the 
 event, or we might have had a "Wagnerian opera with its 
 Plutonic music to illustrate all its incidents ; or even a 
 Virgil could have made it into interesting verses; but, as 
 it is, we must content ourselves with the laconic recitals 
 that have been handed down by tradition, and, as all the 
 Greek performances of those da^-s were marked by an 
 intense decisiveness, with an utter lack of circumlocu- 
 tion, it is probable that there was not much to relate 
 bej'ond the bare facts. 
 
 In Smith's " Dictionary of Greek and Koman Biogra- 
 phies and Mythology" we find it related that Uranos,or 
 Coelus, was the progenitor of all the Grecian gods. His 
 first children were the Centimanes ; his next progeny 
 were the Cyclops, who were imprisoned in Tartarus 
 because of their great strength. This so angered their 
 mother, Gaa, that she incited her next-born children, 
 the Titans, into a rebellion against their father, Uranos. 
 In the general turmoil that followed Uranos was de- 
 posed, and, so that he would be incapable of begetting 
 any more children, Saturnus, the youngest of his sons, 
 with a sickle made from a bright diamond, successfully 
 emasculated poor old Uranos. The records are not clear 
 whether the operation only included the penis, or the 
 scrotum and contents, or whether, like the Turkish or 
 Chinese taille a fieur de ventre, Saturnus made a clean 
 
84 History of Circumcision. 
 
 sweep of all the genitals; it is probable' that he did, 
 however, as the members fell into the sea, and in the 
 foain caused b^^ the commotion from their contact with 
 the element Yeniis was born. Meanwhile, the blood that 
 dripped from the wounded surface caused the Giants, 
 the Furies, and the Melian nymphs to spring into life. 
 tJranos is also represented as being the first king of 
 Atlantis ; so that the first eunuch was a god and a king, 
 more unfortunate than any of Doran's heroes, in his 
 " Monarchs Retired from Business," because he was 
 more effectually retired from business than any monarch 
 that Doran records. 
 
 After this the practice seems to ha^-e been adopted 
 in a general wa}^ ; and the fnct that the future proceed- 
 ings, of men and things on earth do not much interest 
 these unfortunate members of societ}' in an3^ great de- 
 gree, interest in worldly affairs and testicles seemingly 
 having been as intimately connected in those early and 
 remote days as with us of the present, it yaxy natnrall3' 
 followed that this disinterestedness, as well as the 
 docility and pliability which emasculation engenders, 
 first suggested their use as servants or in position of 
 trust, as a eunuch, having no incentive either to run away 
 or to embezzle, would naturally be a valued and trusted 
 servant. In the days of eunuchism there were no de- 
 faulting bank, city, or county cashiers, — a circumstance 
 which would suggest that such a condition should form 
 one of the qualifications for eligibility to such offices, 
 the very opposition to any such proposal that the class 
 would make showing in itself the benefits that would 
 follow such an innovation, as it would show that the 
 class is not possessed witli that total spirit of abnega- 
 tion requisite in the guardians of public funds. The 
 requirement might be extended to bank-presidents with 
 
Emasculation^ Castration^ and Eunuchism. 85 
 
 benefit, if some Cincinnati episodes are any criterion. 
 It is safe to assume that tlie bank that could advertise, 
 ill connection with its attractive quarterly' or semi- 
 annual statement, that the president and cashier were 
 properly- attested and vouciied-for eunuchs would find 
 in the public sucli a recognition of the fitness of things 
 tliat the patronage it would receive would soon compel 
 otlier banks to follow the example. The procedure 
 might, with national benefit, be extended as an ordeal 
 to our legislators at tiie national capitol, as it would 
 do away with the particular influential lobby so graphi- 
 cally described in Mark Twain's " Gilded Age." These 
 things or ideas are merely thrown out as suggestions 
 to be used b3' those who wn'ite those interesting articles 
 in the Forum, or the North Americayi or Fortnightly 
 Reviews, on government and social reforms, as a perusal 
 of the man}' articles written in that direction will con- 
 vince any one that, from a practical psj'chological view 
 of the matter, the^- are sadly deJicient. To make those 
 ailicles effective the reflex impressions made by the 
 animal on the psj'chological and moral nature of man 
 should not be neglected. 
 
 Semiramis, whose beautj' and many accomplishments, 
 assisted by the murders of several of her husbands by 
 the hand of the succeeding one, had this subjecft in hand 
 in a far more practical manner than it is generally forced 
 on the understanding; hence we see that she was the 
 first to introduce the use of eunuchs in the capacitj^ of 
 servants as well as in official positions in and about the 
 palace, as well as trusting some of the positions of the 
 highest importance to the class. From her epoch, eu- 
 nuchism has become an inseparable attendant on Orien- 
 tal despotism, and has so continued to the present day. 
 Like yellow fever, phthisis, and some diseases, as well as 
 
86 History of Circumcision. 
 
 many otlier social afflictions and customs, ennncbism 
 does not seem to flourish beyond certain degrees of 
 north and south latitudes, — a Tact that probably assisted 
 Montesquieu to arrive at tlie conclusion that climate 
 was a powerful factor in all things. 
 
 Bergmann, of Strasburg, quotes the ancient tradi- 
 tions, wherein it is stated that man was taught the 
 art of castration by the brute creation. The hyena is 
 cited as having so instructed man by the habit it ex- 
 hibited of castrating its infant males in removing the 
 testicles with its teetii, the habit being instigated by a 
 jealousy, for fear of future competition in the exercise of 
 the procreative act on the part of the young males. 
 Another tradition attributes its origin to the castor. 
 Bergmann here traces out the et} mological relation ex- 
 isting between the name of the operation and that of the 
 animal with that of a Greek verb tliat forms the root of 
 castritm^ or camp ; casa, or house ; castigare, to arrange; 
 from whence also is traced cosmos, the world ; kastorio, 
 the Greek for wishing to build, and the Latin kasturio 
 having the same relative but a more imperative significa- 
 tion ; kastor, signifjing as loving to build ; vastitiator, 
 Latin for arcliitect, and casticheur, old French for con- 
 structor. The tale or tradition in regard to the self- 
 mutilatic)'n inflicted by the castor is traced to the Ara- 
 bian merchants who purcliased the castoreum, which was 
 imported from the sliores of the Persian Gulf and from 
 India. It was called, also, by tlie Arabs, chuzyalu-l-bahhr, 
 or testicles from bej'ond the sea ; or, in French, testi- 
 cules cfoutre mer. These terms and the tradition that 
 the castor on being pursued, knowing the reason of the 
 chase, was in the habit of tearing out liis testicles and 
 throwing them at his pursuers, were invented b}- these 
 merchants to heighten the price and value of the article 
 
Emasculation^ Castration, and Eunuchism. 87 
 
 intrinsically, as well as to make it more interesting by 
 this peculiar individuality of adventure. The Latins, 
 believing and adopting the tradition as a matter of fact, 
 coined the word castorare, or doing like the castor. 
 Bergmann uses in this connection a number of terms in 
 French to denote diiferent forms or degrees of this mu- 
 tilation which have no equivalents in English, — for in- 
 stance, chatrure, as applied to animals, making also 
 a distinctive difference between the meaning of the 
 French words castration and cliatrement. Bergmann is 
 a decided evolutionist as regards circumcision being- 
 evolved from prior forms of physical mutilation, as will 
 be more fully explained in the next chapter; the shaving 
 of the head of a conquered people by the Hindoos, or 
 the shearing the royal locks of the ancient Frankish 
 kings ; the blinding of one eye of their slaves by the 
 old Sc\'thians, or crippling one foot by the division of 
 a tendon in a captive by the Goths, he considers as on 
 the same line with the idea that led to castration, the 
 ditferent forms of eunuchism, and circumcision. ^^ 
 
 From a purely materialistic and utilitarian A'iew of 
 the subject, he observes tiiat.what we call moral prog- 
 ress and civilization owe their advancement more to 
 material interest and cold, selfish calculation than to 
 anj'^ development of the humaiiitarian sentiments, and 
 that neither morality nor justice has much to do with 
 it. The evolution of the slave and the marks inflicted 
 npon him by his fellow humans are the most emphatic 
 evidences of the justness of the above proposition. The 
 study of the subject is equally interesting when consid- 
 ered in connection with the evolutions of the Christian 
 Church. In its divergence from Judaism and its benefi- 
 cent laws, both social and moral, the Christian Church 
 was but Illy fit to cope with its persecutors of Pagan 
 
88 History of Circumcision. 
 
 tendencies, or to enforce an nn written law or code of 
 morality or hygiene among an idolatrous, barbarous, 
 and ignorant population such as it had to encounter. 
 To its professors, the formation of that monachism 
 whiph has been so much misunderstood and abused was 
 but an inevitable condition. ^^ Tliese men had not the 
 stead3' compass to guide them in the path that was pos- 
 sessed by the Jewish people. The mart^-rdom of Clirist 
 and many of his apostles, and tiie teachings of the early 
 church, pointed to phj'sical denials, castigations, humilia- 
 tions, and sutierings as the oid^' wa}'^ to salvation; all 
 pleasures were sin and all denials and pain were looked 
 upon as steps to heaven. The climate pointed to sexual 
 indulgence as the sum of all happiness, as can readily 
 be inferred from the Mohammedan idea of heaven; so, 
 witli the earl}' Christians who were born in the same 
 climates, the denials of sexual pleasui'es were looked 
 upon as the most acceptable offering that man could 
 make to the Deit\'. Continence, celibacy, infibulation, 
 and even castration were the conditions looked upon by 
 many of these men as the only means of living a life on 
 earth that would grant them an eternal life in the next. 
 This view of the situation peo[)led the deserts with a 
 lot of men dwelling in caves and in huts, living on such 
 a scarce diet that they barely existed. That many went 
 insane, and in their frenzy died while roaming in these 
 solitudes, we have ample evidence. The tortures and 
 impositions of the Pagan rulers also drove man^^ to this 
 life or death. 
 
 Religious mania has caused man}' cases of self- 
 mutilation, either to escape continued promptings and 
 desires, or simply from a resulting species of insanity. 
 Of the first, Sernin^^ reported to the Medical Societ}' 
 of Paris the case of a young priest who had' castrated 
 
Emasculation, Castration, and Eunuchism. 89 
 
 himself with the blade of a pair of scissors, and who 
 nearh^ lost his life with the subsequent haemorrhage. 
 The writer saw an analogous case on board an American 
 war-vessel, of which Dr. Lj'on was surgeon, in the 
 harbor of Havre, in the spring of 1871, the subject being 
 the ship's cobbler, a religious fanatic, who was driven 
 Insane by self-imposed continence. We are not sur- 
 prised, from the lack of intelligence of the times, the 
 extreme but undefined views as to religion that then 
 rnled men, that self-imposed castration should have been 
 sanely considered and carried into effect bv Origines 
 and his monks. The Cybelian priesthood had formerly 
 set the example in their Pagan worship, and when we 
 are told that tiie monks of Mount Athos accused the 
 monks of the convent of a neigliboriug island with fall- 
 ing away from grace, because they allowed hens to be 
 kept within the convent inclosure, we ma}^ well believe 
 that Origines and his monks felt that they were gradu- 
 ally ascending in grace Avhen they submitted to this 
 sacrifice. As strange as it may sound, self castration is 
 still practiced by the Skopts3',a religious sect in Russia, 
 In justice to the Church, however, it must be said that 
 she neither asked for nor did she sanction these per- 
 formances, altliough she was not quick enough in assert- 
 ing that she recognized the same law in regard to her 
 presb3'tery that controlled that of the Hebraic priest- 
 hood. 
 
 Eunuchism presents man}^ contradictor}'- conditions; 
 eunuchs have not alwa^ys been the fat and sleek attend- 
 ants on Oriental harems as tradition and custom places 
 them or would have us believe ; neither does the loss of 
 virilit}'^, in a procreative sense, seem to have always 
 robbed them of their A'irility in other senses, as we find 
 eunuchs holding the highest offices in the State under 
 
90 History of Circumcision. 
 
 the reigns of Alexander, the Pfcolemys, Lysim.ichus, 
 Mithrades, Nero, and Arcadius, The ennnch Aristo- 
 iiikos, under one of the Ptolemys, and another, Narces, 
 under Justinhin, led the armies of their sovereigns. 
 These are, however, exceptional cases ; as a rule, the 
 result is as we observe in the domestic animals, — loss 
 of spirit, vim, and ambition. The Chnrch recognized 
 this result, and, while the Hebraic law excluded eunuchs 
 from participating in the priesthood as being imperfect 
 and unclean, the Church reproached Origines and his 
 mouks and excluded eunuchs from its presbytery on 
 the ground that such beings lack the moral and ph3-sical 
 energy requisite in a calling that is supposed to guide 
 or lead men ; moreover, there are many reasons for 
 doubting that the ministers of state and the generals of 
 the reigns above mentioned were actually eunuclis in the 
 full acceptance of the word. Among the ancients there 
 were several methods of performing the operations that 
 made the eunuchs ; some were more effectual than others. 
 From the removal of all the genitals, or the penis 
 alone, or the scrotum and testicles, or removing onl_y the 
 testicles, down to compression or to distorting the sper- 
 matic vessels, or, as in the case of the Scytliiaus, who 
 often became eunuchs from bareback riding, as Ham- 
 mond describes a eunuchism manufactured b}^ our 
 southwestern Indians of New Mexico and Arizona, are 
 performances that left many degrees of eunuchism ; as 
 we find some eunuchs that not only contracted mar- 
 riage, but engendered children. Voltaire mentions 
 Kislav-aga, of Constantinople, a eunuch a outrance, 
 with neither penis, scrotum, nor anything, who owned 
 a large and select harem. Montesquieu, in his " Persian 
 lietters," admits this class of marriages as being prac- 
 ticed, but doubts the resulting conjugal felicity, es- 
 
Emasculation, Castration, and E aniichism. 91 
 
 pecially on the part of the wife. Potiphar's wife was 
 one of these unfortunate wives; no wonder that she 
 tore Joseph's cloak in her desire. Juvenal mentions 
 that some eunuchs were held in higli esteem by the 
 Roman matrons ; it possibly could have been some of 
 this kind of a eunuch that led armies or ruled in the 
 palaces. Among the sultans and Oriental potentates 
 those who had every exterior evidence of virility re- 
 moA'ed, so as to be obliged to micturate through the 
 means of a catheter, were considered the safest guards, 
 as well as they were the highest-priced eunuchs, for in 
 their manufacture fully 75 per cent, of those operated 
 upon died as a result. It is related that the Caribs 
 made eunuchs of their prisoners of war on the same 
 principle that caponizing is resorted to for our kitchens, 
 — the prisoners were easier to fatten and were more 
 tender when cooked. The Italians allowed their chil- 
 dren to be eunuchized for chorister purposes in church 
 services, their soprano voices after this treatment beino- 
 simpl}^ perfect. It was considered that, in the 3'ear prior 
 to the papal ordinance of Pope Clement XVI forbidding 
 the practice or the emplo^nnent of eunuchs in choirs, 
 four thousand boj's, mostly in the neighborhood of 
 Rome, were castrated for chorister purposes. 
 
 In China eunuchs were in use during the reign of 
 the Emperor Yen-Wang, in 781 B.C. The Chinese make 
 their eunuchs by a complete ablation of all genitals. In 
 India the followers of Brahma never placed their women 
 in charge of eunuchs. In Italj^ it was customary to 
 emasculate boj^s that they might grow up with the 
 faculty of taking the female parts in comedies, their 
 voices thereby assimilating to that of the other sex, this 
 being on the same principle that the basso-profundos 
 W2re infibulated that they might retain their bass. 
 
92 History of Circumcision. 
 
 Eunuchism resulting from an operation owing to 
 disease has at times given queer and unlooked-for 
 results, as, for instance, in the case of the old man that 
 Sprengle mentions, in whom castration did not remove 
 an inordinate sexual desire. Sir Astley Cooper men- 
 tions a case in his " Diseases of tlie Testes " that is 
 somewhat unique. After castration Sir Astley 's patient 
 showed the following results : " For nearly the first 
 twelve months he stated that he had emissions in coitu, 
 or that he had the sensations of emission ; that then 
 he had erections and coitus at distant intervals, but 
 without the sensation of emission. After two years he 
 had excretions very rarely and ver}'- imperfectly, and 
 they generally ceased immediately upon the attempt at 
 coitus. Ten years after the operation he said he had 
 during the past year been only once connected. Twenty- 
 eight 3'ears after the operation he stated that for years 
 he had seldom any excretion, and then that it was im- 
 perfect." In regard to the mortality from castration 
 done in a professionnl manner and for disease, Curling, 
 in his work on " Diseases of the Testis," observes that 
 he saw or performed some thirty operations without a 
 death, and that in a table of like operations performed 
 at the Hotel Dieu, in Paris, it appeared that the mortal- 
 ity was one in four and a quarter. 
 
 J. Royes Bell, in the sixth volume of the " Inter- 
 national Encyclopaedia of Surgery," has the following 
 in regard to the practice among the Mohammedans in 
 India: "Young boj^s are brought from their parents, 
 and the entire genitals are removed with a sharp razor. 
 The bleeding is treated b}^ the application of herbs and 
 hot ponltices; haemorrhage kills half the victims, and 
 at times brings the perpetrators of the vile proceeding 
 within the clutches of the law." 
 
Emasculation^ Castration^ and Eunuchism. 93 
 
 The ta.ille a fleur de ventre of the Chinese is a some- 
 what primitive procedure. According to Dr. Morache, 
 in his account of China in the " Die. Ency. des Sciences 
 Medicates, " tlie operation is as follows : " The patient, 
 be he adult or child, is, previous to the operation, well 
 fed for some time. He is then put in a hot bath. 
 Pressure is exercised on the penis and testes, in order 
 to dull sensibilit3^ The two organs are compressed into 
 one packet, the whole en.circled with a silk band, regu- 
 larly applied from the extremit}^ to the base, until the 
 parts have the appearance of a long sausage. The 
 operator now takes a sharp knife, and with one cut 
 removes the organ from the puljis ; an assistant immedi- 
 ately applies to the wound a handful of styptic powder, 
 composed of odoriferous raisins, alum, and dried putt- 
 ball powder (boletns-i)owder). The assistant continues 
 the compression till haemorrhage ceases, adding fresh 
 supplies of the astringent powders ; a bandage is added 
 and the patient left to himself. Subsequent haemorrhage 
 rarely occurs, but obliteration of the canal of the 
 urethra is to be dreaded. If at the end of the third or 
 fourth da}'^ the patient does not make water, his life is 
 despaired of. In children the operation succeeds in two 
 out of three cases ; in adults, in one-half less. Poverty 
 is the cause which induces adults to allow themselves to 
 be thus mutilated. It is said to be difficult to distin- 
 guish, these last from ordinary Chinese men. Adult- 
 made eunuchs are much sought after, as they present 
 all the attributes of virility without any of its incon- 
 venience." 
 
 The study of the evolutionary moves or processes 
 passed by eunuchism in its relation to music and the 
 di'ama tends to rob these otherwise civilizing and 
 enlightened arts of the aureoles of poetry and gen- 
 
94 History of Circifincision. 
 
 tility with which the}'' have been surrounded. From 
 Bergmann we learn that the practice originated in tlie 
 Orient, where female voices were held in liigher esteem 
 in singing, and where the profane songs that accompa- 
 nied the dance were chanted hj^ women. The Hebraic 
 regulations permitted neither women nor eunuchs to 
 sing in their temples. With the establishment of the 
 earl}' Christian Churcli in Oriental countries, more or 
 less of tlie ancient Judaic customs were retained, and in 
 addition a too literal interpretation of the words of St. 
 Paul was adhered to, which said that women should not 
 be heard m the Church. The Oriental Churcli from these 
 reasons long remained in a quandary ; according to the 
 ceremonials, it was deemed requisite to imitate as near 
 as possible the voices of the angelic seraphims, and this 
 could not be done by the rasping bass voices of the 
 well-fed monks ; women were out of the question in the 
 then social stage of church evolution; so that at last a 
 compromise was effected by admitting the eunuch, who 
 could chant in a most seraphic soprano, as his proto- 
 type, the mendicant priests of Cybele, had done before 
 him. 
 
 Constantinople became the centre of learning for 
 Greek music, and the fine soprano solos which now form 
 the attraction of many of our modern churches were 
 sung by the eunuchs. Eunuchs were not onl}^ the chief 
 singers, but tlie}- cultivated the art into a science, and 
 Constantinople furnislied through this class the music- 
 teachers for the world, as we learn that in 113Y the 
 eunuch Manuel and two other singers of his order estab^ 
 lished a school of music and singing in Smolensk, 
 Russia. There is no doubt but that in a moral sense, 
 considering that women are generall}^ the pupils, this 
 was a most meet and an appropriate arrangement ; for, 
 
Emasculation, Castration, and Eunuchism. 95 
 
 as St. Alphonsns M. Liquori observed, rna,n was a fool 
 to allow his daughters or female wards to be taught 
 letters b}' a inau, eveu if that man were a saint, and, 
 as real saints were not to be found outside of heaven, it 
 can well be imagined how much more dangerous it might 
 be to liave them taught music and singing by a man not 
 a eunuch, — elements which have a recognized special 
 aphrodisiac virtue, as was well known to the ancient 
 Greeks, who onl^- allowed their wives to listen to a 
 certain form of music when thej' (the husbands) were 
 absent from home. 
 
 There is not much room for doubt but that both 
 morality and medicine have too much neglected tlie 
 study and contemplation of the natural history of ma:;, 
 and relied altogether too much on the efficacy of church 
 regulations and castor-oil and rhubarb. There are 
 other things to be done l)esi(les simply framing mor:il 
 codes and pouring down mandrake into the stomach ; 
 the old conjoined service of priest and doctor sliouhl 
 never have been discontinued, as, by dividing duties 
 th:it are inseparable, much harm has resulted. Herein 
 dwelt the great benefit of the early practice of medicine 
 among the Greeks, and to the ph^ysical understanding 
 and supervision of human nature by the Hebraic law 
 may be said that the creed owes its greatness and sta- 
 bility, and the Hebrew race its sturdy stamina. The 
 wisdom of the Mosaic laws is something that always 
 challenges admiration, the secret being that it did not 
 separate the moral from the physical nature of man. 
 Bain, Maudsley, Spencer, Haeckle, Buckle, Draper, and 
 all our leading. sociologists base all their arguments on 
 the intimate relations that exist between the ph3^sical 
 surrounding and the physical condition of man and his 
 moralit}'. Churches foolishly ignore all this. 
 
 4 
 
96 History of Circumcision. 
 
 From Constantinople the fiisliion or custom gracliv 
 ally inA'aded Italy ; and as Rome was the centre of the 
 new religion, so it also became the centre of music, and 
 Rome and Naples were soon the home of the eunuch 
 devoted or immolated to the science of music. The 
 eunuchs reached the height of their renown in music, as 
 well as what might be termed their golden era, with the 
 establishment of the Italian opera, in the seventeentli 
 century. At this period all the stages of Italj- were the 
 scenes of the lyric triumphs of this otherwise unfor- 
 tunate class, some of whom accumulated vast fortunes. 
 In the following centurj^ as has been seen, Clement 
 XVI abolished the practice as far as the church Avas 
 concerned, and in the present century the first Napo- 
 leon abolished the practice secularly and socially. 
 Mankind cannot sufflcientl,y appreciate the benefits it 
 received from the results of the French Revolution ; we 
 are too apt to look at that event simpl}' from the un- 
 avoidable means which an uneducated class — rendered 
 desperate by long suffering and brutalization under an 
 organized S3stem of oppressive misrule — had adopted 
 to remedy existing evils. After the dissolution of tiie 
 Directory France cannot be said to have been in a state 
 of anarch}', and the long and bloody wars with which 
 Napoleon is usually blamed should rather be charged to 
 that government and imbecile ministerial polic}' that 
 lost to England the American colonies. The series of 
 battles from Marengo to Waterloo are as much the 
 creation of the cabinet of George III as those from 
 Concord to Yorktown. AVaterloo involved more than 
 the simple defeat of Napoleon ; it meant the defeat 
 of moral and intellectual progress, as well as the sup- 
 pression of the rights of man. The suppression of 
 the Inquisition in Spain, and of eunuchism in Italj'^; 
 
Emasculation^ Castration^ and Eunuchism. 97 
 
 the Code Napoleon ; the Imperial highways of France; 
 the construction of its harbors, — notably' tliat of Havre ; 
 and the political and social emancipation of the Jews 
 in France, Italj-, and German}^ are monnments to tliis 
 great man that have not their equals to crown the 
 acts of any other French monarch. Like the Phrygian 
 monk who leaped into the arena in Rome to sepnrate 
 the niaddened gladiators, and who was stoned to death 
 by the angry and brutal mob of spectators whose amuse- 
 ment he stoi^ped, Napoleon's work has had its results, in 
 spite of Waterloo and St. Helena. The mart3'rdom of 
 the poor monk caused an abolishment of the brutal 
 sports of the Colosseum, which henceforth crumbled to 
 pieces. Little did the peo[)le look for this result who 
 trampled the monk under foot. Neither did Blucher, 
 debouching on the English left with Bnlow's battalions 
 on the evening of Waterloo, foresee, some fifty years 
 hiter, Prussia extending its hand to make a united Italy, 
 wliich wMth Napoleon — who was by blood, nature, 
 instinct, and education an Italian — had been the dream 
 and ambition of his life. 
 
 Eunuchism as a punishment is an old practice, as 
 the ancient Egyptians inflicted it at times upon their 
 prisoners of war ; so it formed part of their i)enal code, 
 and we are told tliat rape was punished by the loss of 
 the virile organ ; a like punisliment for the same offense 
 was in vogue with the S|)aniards and Britons ; with the 
 Romans at different times and with the Poles the 
 punishment was castration. The difficult}^ of proving 
 the crime, as well as the ease with whicii the crime 
 could be charged throngli motives of revenge, spite, or 
 cupiclitj'on innocent persons, should never have allowed 
 this form of punishment to be so generally used as his- 
 tory relates that it was ; rape being one of the most 
 
98 History of Circumcision. 
 
 complex and intricate of medico-legal subjects, unless we 
 take M. Voltaire's summarj' and Solomonic judgment, 
 who relates that a queen, who did not wish to listen to a 
 charge of rape made hj one person against another, took 
 the scabbard of a sword rtnd, while she kept the open 
 end in motion, asked the accuser to sheath the sword. 
 
 Count Raoul Du Bisson, Dedjaz de VAbyssinie, gives 
 some A'er}^ interesting information in regard to eunuch- 
 ism in his work entitled " The Women, the Eiuiuchs, 
 and the Warriors of the Soudan." Count Bisson has 
 looked on the question from its moral, physical, and 
 demographic stand-points, and, having seen eunuchism 
 in its different as[)ects, from his landing at Alexandria 
 and Cairo, down through his different expeditions into 
 Arabia, the Soudan, and Abyssinia, his observation^ are 
 well worth repeating. 
 
 From a demographic and statistical view of the sub- 
 ject, its truly Malthusian results become at once shock- 
 ingly and persistently prominent, — not alone in the 
 interference that the condition induces in arresting any- 
 further procreation on the part of the unfortunate vic- 
 tim, but in the unparalleled mortality that, in the gross, 
 is made necessar}' by the results of the operative pro- 
 cedures. The Soudan alone furnished, according to reli- 
 able statistics, some 3800 eunuchs annually, the material 
 coming from Ab^-ssinia and the neighboring countries, 
 it being gathered by war and kidnapping parties, or by 
 purchase, from among tiie young male population of 
 those regions. These children are brought to the Sou- 
 dan frontier and custom duties are there paid for their 
 passage across the border, the duty being about two 
 dollars per head. At Karthoum the}' are purchased by 
 pharmacists, apothecaries, and others engaged in thj 
 manufacture of eunuchs, who generall}' perform simple 
 
Uniasculation, Cadratioii., and Ebnuchiam. 99 
 
 castration ; the mortality among these amounts to about 
 33 per cent. These simi)ly castrated eunuchs bring 
 about $200 apiece. Tlie great eunuch factor3' of the 
 country, however, is to be found on Mount Ghebel-Eter, 
 at Abou-Gerghe ; liere a large Coptic monaster}^ exists, 
 where the unlbrtunate little African children are 
 gathered. Tlie building is a large, square structure, 
 ]-esembling an ancient fortress ; on the ground-floor the 
 operating-room is situated, with all the ap[)liances 
 required to perform these horrible operntions. The 
 Coptic monks do a thriving business, and furnish Con- 
 stantinople, Arabia, and Asia Minor with manj' of their 
 complete, mueh-sought-for, and expensive eunuchs. 
 They here manufacture both grades, — those who are 
 simpl}^ castrated and those on whom complete ablation 
 of all organs has been performed, the latter bringing 
 from $750 to $1000 per head, as only the most robust 
 are taken for this operation, which nevertheless, even 
 at the monastery, has a mortalit}' of 90 per cent. 
 
 The manner of performing the operation is as bar- 
 barous and revolting as the nature of the operation 
 itself, and the cruel and ignorant after-treatment is as 
 full^' in keeping with the whole. The little, helpless, 
 and unfortunate prisoner or slave is stretched out on 
 an operating-table; his neck is made fast in a collar 
 ftxstened to the table, and his legs spread apart and the 
 ankles made fast to iron rings; his arms are each held 
 by an assistant. The operator then siezes the little 
 penis and scrotum and with one sweep of a sharp razor 
 removes all the appendages. The resulting wound 
 necessarily bares the pubic bones and leaves a large, 
 gaping sore that does not heal kindly-. A short bamboo 
 cannula or catheter is then introduced into the ui-ethra, 
 from which it is allowed to project for about two inches, 
 
] 00 History of Circumcision. 
 
 and no tittention is paid to any arterial haemorrhage ; 
 the wliole wound is simply plastered up with some 
 haemostatic compound and the little victim is then 
 buried in the warm sand up to his neck, being exposed 
 to the hot, scorching rays of the sun ; the sand and soil 
 is tightly packed about his little bod}^ so as -t© prevent 
 any possibility of any movement on the part of the 
 child, perfect immobility being considered hy the 
 monks as the main element required to promote a suc- 
 cessful result. It is estimated that 35,000 little Africans 
 are annually sacrificed to produce the Soudanese average 
 quota of its 3800 eunuchs. 
 
 When this immense sacrifice of life, the useless 
 barbarity, and the really unnecessary needs of such 
 mutilated humanity existing are full}^ considered, it 
 would seem as if Christian nations might, with some 
 reason, interfere in this horrible traffic, by the side of 
 which ordinary slavery seems but a trifle. When we 
 further consider that, in some instances, the child 
 is also made mute by the excision of part of the 
 tongue, — as mute or dumb eunuchs are less apt to enter 
 into intrigues, and are therefore higher prized, — the 
 barbarity', cruelt}^, and extremes of inhumanity that 
 these poor children have to suffer cannot be over- 
 estimated. Neitlier must Ave be astonished at the stolid 
 indifference that is exhibited b3' the eunuchs in after life 
 to any or all sentiments of humanity, or that they should 
 hold the rest of humanity in continual execration. 
 
 Often-occurring accidents in harems make complete 
 eunuchs a desideratum. Bisson mentions that on one 
 occasion he saw the chief eunuch of the Grand Cherif 
 of Mecca — a large, finely-proportioned, powerful black — 
 on his wa}^ to Stamboul for trial and sentence ; he was 
 heavily chained and well guarded. It appears that the 
 
Emasculation, Castration, and Eunuchism. 101 
 
 eunuch had only been partl}'^ castrated, and that the 
 operation had been performed during infancy; his tes- 
 ticles had not fully descended, so that in the operation 
 the sac was simply obliterated, which gave him the 
 a[)pearance of a eunuch. In this condition he seemed 
 to have kept a perfect control of himself and passions 
 until made chief eunuch of the Cherif, who possessed a 
 well-assorted harem of choice Circassian, Georgian, and 
 European beauties. The neglige toilet of the harem 
 bath and the seductive influence of this terrestrial 
 Koranic seventh heaven was too much for the warm 
 Soudanese blood of the chief; his forays were not sus- 
 pected until a blonde Circassian houri presented her 
 lord and master, the Cherif, with a suspiciously mulatto- 
 looking son and heir. A consultation of the Koran 
 failed to explain this discrepanc3', and suspicion pointed 
 to the chief eunuch, who was accordingly watched ; it 
 was found that he had not only corrupted the fair Cir- 
 cassian, but every inmate of the harem as well. The 
 harem was promptly sacked and drowned and the false 
 eunuch shipped to the Sultan for sentence, the Cherif 
 having the right to sentence and drown the harem, but 
 having no such rights over such a high personage as the 
 chief eunuch. 
 
 There are physiological facts and pathological con- 
 ditions brought forth for our contemplation, while inves- 
 tigating the subject of eunuchism in all its details, that 
 cause us to feel that, after all, the old Hippocratic 
 principle of inductive philosoph}^ upon which our study 
 and practice of medicine is founded, with rational 
 experience and observation for its corner-stone, is, even 
 if commonplace, the only proper avenue of knowledge. 
 To exemplify this proposition we have in this particu- 
 lar subject the practical observations and experience of 
 
102 History of Circumcision. 
 
 M. Moiulat, of Moutpellier ; in his interesting work on 
 '' De la Sterilite rle I'Homnie et de la, Femine," published 
 in 1840, he details some instructive information on the 
 subject of eunuchs, giving some explanation as to wh}^ 
 many simply castrated eunuchs are, like the much-prized 
 eunuchs of the Roman matrons, still able to acquit 
 themselves of the copulative function. He mentions 
 that while in Turkey he studied the subject in its de- 
 tails, and, having found some of these copulating 
 eiuiuchs, he secured some of the ejaculated fluid and 
 subjected it to a careful examination. The discharge 
 was lacking the characteristic seminal odor ; it was in 
 other respects, to the palpation especially, very much 
 like the seminal fluid. He found that these eunuchs 
 were much given to venereal enjoyment, but that either 
 legitimate intercourse or masturbation, to which many 
 were addicted, was apt to be followed by a marasmus 
 ending in galloping consumption. Mondat personally 
 knew the opera-singer Yelutti, who died in London ; 
 Velutti W'as, when a child, castrated by his parents, 
 having both testicles removed, being intended by his 
 father, who had himself performed the operation, for 
 the choir of the Papal Chapel at Rome. Velutti Avas 
 as much of a favorite in his day as our present 
 tenors and handsome actors. The admiration of the 
 opposite sex was fatal to him ; he formed a liaison with 
 a young English lady residing in London, and the re- 
 sulting excesses in which he indulged quickly brouglit 
 him to his grave. He was passionately fond of women 
 and was able to acquit himself perfectl^^ ; at least, as 
 far as the copulative act — barring fecundation — was 
 concerned. 
 
 Li a preA'ious part of this chapter I have alluded 
 to the very appropriate arrangement which formerly 
 
Emasculation^ Ca.slration, and Eunuchism. 103 
 
 existed ■u'lieii niusic-teacLers were eunuchs, and that 
 our higher circles of societ\^ wouhl do Avell to employ 
 euiiuchized coaclnneu, especially if possessed of suscep- 
 tible and elopahle daughters ; but, from the accounts 
 giveu by Mondat, it would seem that they are not as 
 safe as might at first be imagined. However, they could 
 not be as dangerous as the chief eunuch of the Grand 
 Cherif of Mecca and increase the population to the same 
 extent; but I should judge that they might be a ver^' 
 demoralizing moral element if introduced into modern 
 society. If eunuchs must be emplo3'ed, it can easilj^ be 
 understood why the Turk and Chinese prefer the real, 
 clean-cut article. The New York "Four Hundred" 
 should make a note of this, as in their present thirst 
 for European aristocratic notions, coats of arms and 
 titles, there is no telling how soon they may cross over 
 into Oriental customs and run a hareni, in which case it 
 would be sad to have them make an}' mistakes in the 
 quality and ability of the eunuch. 
 
 Dr. Gardner W. Allen has furnished the American pro- 
 fession with a faithful translation of the vnluable work 
 of Professor Ultzniann on '• Sterility and Impotence.'' 
 In this, we h:i,ve a clear and intelligent dissertation that 
 explains the above conditions, and I am only surprised 
 that the observations of Mondat have not develop/ed 
 such explanations before, as the principle was fully 
 explained in practice fifty years ago by the Montpellier 
 physician. According to Ultzmann, there is a form of 
 fecundating impotence in persons otherwise well pro- 
 vided with an apparent complete apparatus, an impo- 
 tence which he terms potentia generandi. He states, 
 however, that this form of impotence was not recognized 
 until a few years ago, citing the fact that females have 
 had, as a rule, to bear all of the blame for the unfruit- 
 
104 History of Circumcision. 
 
 fulness of the familj', and tliat the}' have been accord- 
 ingl}' subjected to all manner of operations, general and 
 local treatment, even to being sent to watering places 
 and sanatoria where red headed male attendants are 
 emplo3'ed, to sa}- nothing of the pra3ers, intercessions, 
 pilgrimages, and novenas to the holy shrines, as men- 
 tioned in the chapter on the holy prepuce. Ultzmann 
 observes that a man may be perfeetlj' able to go through 
 the procreative or, rather, the copulative act, even to the 
 great satisfaction of all parties concerned, and yet be 
 perfectl}^ impotent ; he even goes further, by observing 
 tliat there are cases in which copulation maj^ take place 
 without an}^ fluid whatever being ejaculated. He men- 
 tions two such cases at pages 87 and 116 of his book. 
 In the first instance the ejaculated fluid is precisely as 
 that observed in such cases as those of the eunuchs and 
 of Yelutti, mentioned hy Mondat, and consisted of an 
 azoospermia discharge, made up mainly from" the secre- 
 tion of the seminal vesicles, the accessory glands of the 
 urethra, the prostate, and Cowper's glands, as well as the 
 discharge from the secretor}^ glands distributed along 
 the course of the urethral mucous membrane. Some of 
 the cases of this form of impotence have exhibited won- 
 derful copulating desire and power of endurance, and, 
 even if unfecundating, they must be said to be better 
 off than the victims of that other form of male impo- 
 tence, the poteyitia coeiindi of Ultzmann, where, with a 
 normal semen, either the power of erection or that of 
 ejaculation may be entirely absent. 
 
CHAPTER IX. 
 
 Philosophical Considerations Relating to Eunuchism 
 AND Medicine. 
 
 Eunuchism does not alwa3's siilKlue the animal pns- 
 sioiis ; this is the view that the church took in connec- 
 tion with the eniasciihition of Origenes and his monks; 
 the church here heUl that not onlj- was it possible 
 for them to still sin in heart or imagination, but that, 
 even were the complete eradication of the sexual idea 
 possible, they had b^' their act lost the main glory 
 of a Christian, — that of successfully striving against 
 temptation, and by a force born of triumphant virtue 
 overcome all the wiles of the devil. It is related that 
 among the eunuchs at Rome tliere were some who, 
 having been made so Inte in life, still retained the power 
 of copulatiou, although the final act of the performance 
 was absent. Montfalcon relates that Cabral rei)orted 
 dissecting a soldier who was hanged for committing a 
 rape, but who on dissection showed not the least trace 
 of testicles, either in the scrotum or abdomen, although 
 the seminal vesicles were filled with some flu id. ^* Spren- 
 gle, in his '' History of Medicine," relates of the complete 
 removal of both testicles from an old man of seventy 
 years of age, on account of inordinate sexual desire, the 
 operation having no perceptible effect in subduing the 
 disease. ^^ These cases are analogous to those exception- 
 able cases in which, after extirpation of the ovaries, 
 both menstruation and fecundation have still taken 
 place. 
 
 Modern civilization and its unnatural mode of dress- 
 ing inflict great harm on men by keeping these parts 
 
 (105) 
 
106 History of Circumcision. 
 
 too warm and constricted. Much of the irritability of 
 tliese organs, as well as their decadence at an age some 
 generation or two before the time when they should 
 still possess all their virile attributes, can be directly 
 attributed to this cause. A more intelligent wa}- of 
 dressing would result in less moral and physical wreck- 
 age, and require less galvanic belts and aphrodisiacs in 
 men under fift3\ If those who habitually swath their 
 scrotums in the heavy folds of their flannel shirts, to 
 which are superadded the cotton shirts, drawers, and 
 outer clothes in which civilized man incases himself, 
 would cast a backward eye into the dim and mist}^ past, 
 and see the priest of some of the old Pagan gods soak- 
 ing the scrotum in hot water, and then graduall}- rub- 
 bing the testicles within, by gentle but firm friction, 
 to make the testicles disajopear ^ a process by which many 
 of the heathen priests prepared themselves for the dis- 
 charge of their sacerdotal duties and the strict observ- 
 ance of those rules of chastit3'^ and celibacy which they 
 were henceforth to live up to, they would find one ex- 
 planation of why civilized man does not possess that 
 vigor and retain that proereative power into advanced 
 age that was one of the ciiaracteristics of our ancient 
 progenitors in the days 'that breeches were as abbre- 
 viated as those now worn by the Sioux Indians. These 
 are reality but leggins, which run onh^ to the perineum 
 and are simply tied by outer points to a strap from each 
 hip. Finely and comfortabl\' cushioned chairs ma}^ be 
 a luxury to sit on, but the}' will have, on the man Avho 
 uses them in youth and in his prime, a wonderful seda- 
 tive and moral influence later on, about as effectual as 
 the miniature warm baths for the scrotum and gentle 
 pressure to the testicles that were used by the heathen 
 priests of old, who preferred a gradual disappearance of 
 
Considerations of Eunuchism and Medicine. 107 
 
 the glands to the too sadden and summary methods of 
 tlie Cjbelian clergy, who used a, piece of shell and an 
 elaboratelj' -performed castration. According to Paulas 
 -^gineta, this was a common practice of making ennuchs 
 out of 3'oang boys in the Orient, tlie mortalit}- being 
 hardl}^ anj- ; whereas tlie taille a fiear de ventre, the 
 favorite method for making eunuchs for harem guards 
 and attendants, and more suited to the jealous disposi- 
 tion of the Turk, has a mortality of three out of every 
 four, according to Cliardin, and of two out of evei'y three, 
 according to Clot Bey, the chief physician of the Pasha,^® 
 and of nine out of ten, according to Bisson. So prone 
 to reach high offices were intelligent eunuchs that it is 
 related that parents were at times induced to treat their 
 bo3's in the manner above stated, that they might be on 
 the highwaj^ to royal favor, honor, and rank ; such is 
 the ennobling tendency' of Oriental despotism, polyg- 
 amy, and harem life. On the same principle Europeans 
 subjected their boys to a like operation to fit them for a 
 chorister life or the stage, where fame and honor and 
 wealth were to be found. 
 
 Medicine has been the butt of wits and philosophers, 
 as well as of the men wlio, from the profession, have 
 gone into the ranks of literature. Smollet, himself a 
 physician, gives us an insight into our wandering and 
 erratic misapplication of our knowledge on therapeutics 
 in " Peregrine Pickle," where the poor painter. Pallet, 
 is believed to be a victim of hydrophobia. The learned 
 opinion of the doctor, wlio explains the many and va- 
 rious reasons by which he arrives at his diagnosis, the 
 A^avious phj'sical signs exhibited by the patient as being 
 pathognomonic of the disease, and his final venture with 
 the contents of the pot de chambre, as a diagnosis veri- 
 fier, which he dashes in the patient's face in preference 
 
108 History of Circumcision. 
 
 to ordinaiy water on account of the medicinal virtues 
 contained in urine, wliich in the case seemed to him to 
 have a peculiar therapeutic value, is something worth 
 reading, however ludicrous it all sounds. There are 
 few intelligent physicians but who liave seen as ridicu- 
 lous performances, in wh:it might be called medical 
 g_ymnasts, that equal, if not surpass, those of Smollet's 
 doctor. Rabelais was also a professiouMl brother, who, 
 equally with SmoUet, attempted to waken up the i)ro- 
 fession by his satires. Smollet was not onlj' a physician, 
 but in his early life had seen some very active and prac- 
 tical work, having participated in and been a witness tc 
 the ills and misfortunes that follow any attempts to 
 " lock horns " with nature througii ignorance of ph\'sical 
 laws and preventive medicine,— having been a surgeon's 
 mate in the fleet which assisted the land forces in the 
 murderous and ill-fated Carthagena expedition which 
 cost England so many lives, ignorantly and needlessly 
 sacrificed to ministerial disregard of physical laws and 
 its consequences, — lessons which, unfoitunately, seem to 
 have but little effect on cabinets, owing to their shifting 
 personelle^ England following up the disasters of Car- 
 thagena with the still greater blunder of the Walcheren 
 expedition, where, out of England's small available 
 ])hvsical war material, nearly forty thousand men were 
 either left to fatten the swamps of Walcheren, or to 
 wander thi-ough England in after j'ears on the pension- 
 list, physical wrecks and in bodily and financial miser3^27 
 Again, the same disregard, born of ignorance and red 
 tnpe, crippled the British army in the Crimea, causing 
 in its ranks the greatest mortality'. It has seemed as 
 if it would be of advantage if all the blunders, either 
 philosophical or of statesmanship, committed by a cabi- 
 net, should be written in large letters of gold, to be hung 
 
Considerations of Eunuchism and Bfedicine. 109 
 
 in tlie coiincil-lialls of the nations, that similar blun- 
 ders at least might not occur again. 
 
 Dumas, in his " History of the Two Centuries" and 
 his " History of the Century of Louis the XIV," gives 
 some very interesting medical touches. Le Sage, in his 
 "Adventures of Gil Bias," gives us food for speculating 
 on medical philosoph}' in connection with the interesting 
 subject of how to make the profession remunerative. 
 Dickens's ideas of the doctor, as given in his works, are 
 life touches. Witness his description of the little doctor 
 who superintended little David Copperfield's advent into 
 the world, or of Dr. Slammer of the army; they repre- 
 sent his view of the professional character. Fontenelle, 
 probably, was right in ascribing the fact of his becoming 
 a centenarian, and maintaining a stomach with the force 
 and resistance that are the peculiar characteristics and 
 attributes of a chemical retort, to the fact that when sick 
 it was his practice to throw the doctor's physic out of 
 the window as the doctor went out of the door, as in his 
 day a man required the constitution of a rhinoceros and 
 the stomach of an ostrich, with the external insensibility 
 of a crocodile, to withstand the ordinary doctor of the 
 period and his medications. Napoleon believed that 
 Baron Larrey was the most virtuous, intelligent, useful, 
 and unselfish man in existence ; in fact, it is doubtful if 
 any man of his time commanded from this trul}' great 
 man so much admiration or respect, either for bravery, 
 courage, intelligence, or activity, as the great and simple- 
 minded ho-vvey. As observed by Napoleon of his bravest 
 general, — poor Marshal Ney, the bravest of the brave, 
 the rear guard of the grand armv, the last man to leave 
 Russian soil, — Ney was a lion in action, but a fool in 
 the closet. All his generals had some great distinguish- 
 ing characteristic, beyond which was a barren waste, a 
 
110 Hidory of Circumciaion. 
 
 A'acuity, but too apparent to a man of Napoleon's dis- 
 eernnient. But the cool, unflinching bravery of Larrey, 
 that (lid not require the stimulus of the fight or the 
 phrenzy of strife to bring it to tlie surface and keep it 
 alive ; bravery and intelligence alike active under 
 showers of sliot and shell or in the thunders of cliMrg- 
 ing squadrons : in the face of infective epidemics or con- 
 tagiousness, walking about in these scenes in which his 
 own life was as much at stake as that of the meanest 
 soldier, with tlie same cool exercise of his intelligence 
 that he exhibited in the organization and superintend- 
 ence of his hospitals in the time of peace ; always the 
 same, untiring, unnuirmuring, brave, studious, observing, 
 unflinching in his duties, unselfish; whether in the burn- 
 ing sands of Egypt or in the snowy steppes of Russia, 
 in the marshy plains of Italy or in the highlands of 
 S[)ain, he always found him the same, and his notes and 
 observations, from his first government service on 
 the Newfoundland coast to his last, always showed 
 him the same hiborer and student in the field of medi- 
 cine. And yet at St. Helena we find Napoleon refusing 
 to take remedies for internal disease whose real nature 
 was unknown, and onl^' toward the end did he consent 
 to take anything, and then only when seeing that the 
 end was approaching, and more from a kindly desire to 
 express his jipi)reciation of the services of his attend- 
 ants, and not to wound tlieir feelings, than from nny 
 hope of assistance. Napoleo)i had not neglected tlie 
 studj^ of me<licine any more than he had the study of 
 every other science. This is evident from the instance re- 
 l;ited as takino^- place during the march of the grnnd army 
 from the confines of Poland into Russia, in 1812, when 
 dysentery became A^ery prevalent, of his inviting several 
 of his favorite guard to his own table, where he experi- 
 
Considerations of Eunuchism and Medicine. Ill 
 
 mented on each particular grenadier witli a specific form 
 of diet, so as to determine its cause and possible rem- 
 edy. He did not look upon our knowledge of pathology 
 and our skill in diagnosis as being sufficiently advanced or 
 perfect to make him feel but that a treatment for an ob- 
 scure disease like his own would be pretty much a matter 
 of guess-work. Charles Reade, in his " Man and Wife," 
 shows an intimate knowledge of medical science where he 
 philosophizes on the effects of an irregular life and of over- 
 ph}- sical training. His logic is sound science. Defoe and 
 Cervantes show a like intelligent insight as to medicine; 
 and it was not without reason tliat^3'denham, the Eng- 
 lish Hippocrates, advised a student of medicine who en- 
 tered his office as a student to begin the study of medi- 
 cine by the careful study of " Don Quixote," remarking 
 that he found it a work of great value, which he still 
 often read. The works of Bacon and of Adam Smitli 
 on "Moral Sentiments;" the famous treatise on the 
 " Natural History of Man," by the Rev. John Adams; 
 the later works of Buckle, Spencer, Darwin, Draper, 
 Leck,y, and other robust wielders of the Anglo-Saxon 
 pen, as well as the works of Montaigne, Montesquieu, 
 La Fontaine, and Yoltaire, are all works that the medical 
 man could probably read with more profit than loss of 
 time. In fact, either Hume, Macaulay, or any philo- 
 sophical work on history will furnish to the physician 
 additional knowledge of use.in his profession. No phy- 
 sician can afford to neglect any study that in any man- 
 ner adds to his knowledge of the natural history of man, 
 as therein is to be found the foundation of our knowledge 
 as to what constitutes health, and as to what are the 
 causes that lead humanity to diverge from the paths of 
 health into those of physical degeneracy and mental 
 and bodily disease. 
 
112 History of Circumcision. 
 
 We have in medicine many sayings which pass for 
 truisms, which are, after all, misleading. We say, for 
 instance, keep the feet warm and the head cool ; this 
 will not always either keep you comfortable or well, as 
 we know that in neuralgias it is absolutely necessary, 
 either for comfort or to get well, to keep the head warm. 
 While so much stress is laid on the necessity of keeping 
 the head cool, a thing a person is sure to look after 
 whenever the head becomes uncomfortably warm, and 
 to which can be ascribed but few ailments or deaths, we 
 hear comparatively ^nothing about the thermometric 
 condition of the perineum, which, from the varying 
 temperatures in which it is at times plunged, produces 
 more beginnings for diseases in the future, during 
 3^outh and our prime, as well as it quite often causes 
 the sudden ending of life in more advanced periods. 
 People who carefully observe the rule of keeping their 
 heads cool and their feet warm will stand with out- 
 spread legs and uplifted coat-tails with their backs to a 
 blazing grate, and then,' going outside, incontinently sit 
 down on a stone or iron door-step, or, stepping into a 
 carriage or other vehicle, they sit down on a cold oil-cloth 
 or leather cushion, without the least knowledge of the 
 harm or danger that they are liable to incur. They little 
 dream of the prostatic troubles that lie in wait for the 
 imwaiy sitter on cold places, ready to pounce upon him 
 like the treacherous Indian lying in ambush, — ti-oubles 
 that carry in their train all the battalions of urethral, 
 bladder, kidne\^ disease and derangments, and subsequent 
 blood disorganization, which often begin in a chilled 
 perineum, and, in conjunction with the local disease 
 that ma}^ result, end in handing us over to Father Cha- 
 ron for ferriage across the gloomy Styx long before our 
 life's journey is half over. It is true, neither the savage 
 
Considerations of Eunuchism and Medicine. 113 
 
 of Africa or America nor the nomads of Asia are sub- 
 ject to anj' of these troubles ; but with us, hampered 
 with all the benefits of the dress, diet, habits, and luxu- 
 ries of civilization, and with a civilized prostatic glivnd, 
 it is quite otherwise. Herein, again, comes that connec- 
 tion between religion, morality, and medicine, that ex- 
 isted with so much benefit to mankind, but from which 
 we of later daj^s have, in our greater wisdom, seen fit 
 to separate ; although, inconsistently as it may seem, the 
 present age has done more than any previous epoch in 
 practically^ demonstrating the intimate and inseparable 
 relation existing between the physical and moral nature 
 of man. The persistent priapism which oftentimes re- 
 sults from riding with a wet seat and the inordinate mor- 
 bid sensibility of the sexual organs that may result from 
 the same cause or from spinal irritation are not to be 
 allayed by any homily on morality or on the sanctiA'ing 
 attempts at keeping the animal passions under subjec- 
 tion, any more than will praj^ers or oflTerings to all the 
 gods of Olj^mpus restore the eunuchized, either through 
 foolish civilized dress and customs or through exces- 
 sive indulgence. We must mix medicine with our 
 religion and make the clergy into phj'sicians, or ordain 
 our physicians into full fledged clergymen. 
 
 The science of medicine, or what might be called the 
 natural ways of nature through its physical laws, is true 
 to itself; the fault lies in our interpretation of its phe- 
 nomena, which we fail to study with suflScient discrimi- 
 native precision and nicety. We have repeatedly 
 mistaken causes and results from this want of close ob- 
 servance and of precision, attributing results to causes 
 which did not exist. As an example, when the early 
 disciples of homoeopathy in ancient Palestine under- 
 took to revive poor, old, withered King David, by 
 
114 History of Circumcision. 
 
 putting him to bed with a j^onng and caloric-generating 
 Sunamite maid, when it was by like incontinent prac- 
 tices that he had brought himself to that state of decrepi- 
 tude, it is plain that the}' misunderstood the principle. 
 Boerhaave — who, as a true eclectic practitioner, tbllow^ed 
 these ancient and Biblical homoeopaths in their practice 
 in a similar case, the subject being an old Dutch burgo- 
 master, whom he sandwiched between a couple of rosy 
 Netherland maids — also failed to grasp the true con- 
 dition of the nature of things, or the true philosophical 
 explanation. The exhalations from the aged are by no 
 means an elixir of health or life to tlie young, and the 
 fact that the 3'oung were apt to lose health by sleeping 
 ■with the aged was wrongly attributed to their loss being 
 the others gain, and the result of its passing into the 
 bodies of their aged companions, and not to its true 
 cause, — the deteriorating influence to which the}- were 
 subjected ; and, fuither, when we analyze the subject 
 still more, we can understand how a full blooded and 
 active, lithe-bodied, thin, and active-skinned Sunamite 
 maid might and would impart caloric to King David ; 
 but, from our knowledge (not altogether practical) of 
 the difference that exists between differently constitu- 
 tioned and differently built maids in imparting caloric, 
 and from our knowledge of the physique of the Nether- 
 land maids, who are cold and impassive, with a layer of 
 adipose tissue that answers the same purpose as that 
 of the blubber in the whale, — that of retaining heat and 
 resisting cold, — we can well believe that the poor, shriv- 
 eled burgomaster could receive but little heat, even 
 when sandwiched between the two ; but, on the contrary, 
 he was, in fact, more liable to lose the little he had, un- 
 less we look at the subject in another light, and con- 
 sider that sentiment that is common to both animals and 
 
Considerations of Eunuchism and Medicine. 115 
 
 men of spirit, a sentiment that has furnished the subject 
 for more than one canvas in the hands of the true and 
 sjanpathetic artist, as seen on the awakening and alert 
 attitude of the worn-out and old decrepit war-horse, 
 browsing in an inclosed pasture, as he hears from afar 
 the familiar bugle notes of his early youth, or some 
 cavalry regiment with prancing steeds and jingling 
 accoutrements, with bright colors and shining arms, 
 going past the pasture, restoring for a time to the stiflen- 
 ing joints and dim eyes the suppleness and fire of bygone 
 times, with visions of gallant charges and prancing re- 
 views ; or, how the same sentiment erects once more the 
 bowed and withering frame of the old veteran, and once 
 again fires his soul with the martial zeal of his prime as 
 lie sees the passing colors and active-stepping regiment 
 which he followed in the bright sunshine and flush of 
 his 3'outh. Aside from these sentiments, which might 
 possibly have inspired David and the Dutch burgo- 
 master with an infusion of a new and transient good 
 feeling, it is unquestionable but that some heated brick- 
 bats or stove-lids, curocoa jugs or old stone Burton ale- 
 bottles filled with hot-water, would have been more 
 effectual in imparting warmth than either Sunamite or 
 Netherland maids. 
 
 It is hard to reconcile the beliefs of some people or 
 nations with their manners and customs. For instance, 
 there is the Turk ; when a Jew becomes a Mohammedan 
 he is made to acknowledge that Jesus Christ, the son of 
 Mar}'', is the expected Messiah, and that none other is to 
 be expected ; they know of Christ's speech on the cross, 
 made to the repentant thief; they believe in a heaven 
 full of houris, with large black eyes and faces like the 
 moon at its full, in which all good Moslems are to have 
 continual rejoicings, and yet they go on performing 
 
116 History of Circumoision, 
 
 the most barbarous and inhuman^ forms of castration 
 imaginable, wliich not only deprives its victims of tbeir 
 virility, but subject more than three-fourths of those 
 operated upon to a painful death, and the remaining to 
 a life of continual misery. Have these poor subjects no 
 right to future bliss, or in what shape will they reach 
 there ? If the heavens of these eunuchisers were like the 
 heaven of Buddhism, or, as the Chinese call it, the Para- 
 dise of the West, where, although all forms of sensual 
 gratifications are to be enjoyed, no houris are to be sup- 
 plied to the saints of Buddhism, — as even the women who 
 enter this paradise must first change their sex, — we might 
 understand that, the genitals not being needed in the 
 eternal world, it might be considered a matter of small 
 moment to compel a man to go through this short and 
 transient life without them; but where a robust con- 
 dition of the sexual organs is suggested as one of the 
 heavenly requisites, it would seem as if the Turk would 
 look upon the suffering, misery, and death that they 
 cause, in connection with the inhuman mutilation they 
 inflict, with horror. Doctrinal theologj'^, whether in the 
 East or West, is something incomprehensible. 
 
CHAPTER X. 
 Hermaphrodism and Hypospadias. 
 
 There exists a class of human beings whose descrip- 
 tion is connected with the subject of this work. Tliey 
 date bade to mythological times, and the confusion inci- 
 dent to the misapplication of names and the want of 
 proper observation on the part of the narrators has tended 
 to carry the uncertainty of their real existence to the 
 present day. One reason that this part of the subject 
 would be incomplete without their description is on 
 account of the origin of their existence being intimately 
 connected wuth eunuchism, being, in fact, an outgrowth 
 of this condition; and any history of eunuchism would 
 be but lialf told, without the additional information 
 concerning these persons. 
 
 Hermaphrodites, as stated, date back to mytholog3'. 
 Tradition tells us that Hermaphroditus, a son of Venus 
 and Mercury, was educated by the Naiades dwelling on 
 Mount Ida. At the age of fifteen 3'ears, he began his 
 travels ; while resting in the cool shades on the wood 3'^ 
 l)anks of a fountain and spring near Caira, he was 
 approached bj' the presiding nj'mph of the fountain, 
 Talmacis, wlio. becoming enamored of him, attempted 
 to seduce him. Hermaphroditus, like Joseph, was the 
 pattern and mirror of continence, and would not be 
 seduced. Talmacis then, like Potiphar's wife, seized on 
 the unluck}' pattern of virtue, and praj^ed to the gods 
 that they should so amalgamate poor Hermaphroditus 
 to her body as to make them one. The prayer was 
 heard on Olympus, and forthwith the two became one, 
 
 (117) 
 
118 History of Circumcision. 
 
 but with the distinctive characteristics of each sex un- 
 changed. Thus began that fabled race of the androgynes 
 of the ancients. Another tradition, which is probably 
 correct, affirms that ancient Carnia, or Halicarnassus, 
 was in those days the Baden-Baden of Asia Minor ; that 
 thither repaired all the victims of gluttonj', debauchery, 
 and general physical bankruptcy. Its name in ancient 
 Caria denotes its seaside-resort location, Hali-Karnas- 
 Sos meaning literally " Karnassus-b3'-the-sea," like 
 Boulogne-sur-mer. The city was under the protection 
 of Hermes and Aphrodite, whose temples were near 
 each other. Human nature in the days of Halicarnas- 
 sus did not much differ from human nature at Monte 
 Carlo or Baden-Baden. The baths had a number of 
 3'oung and handsome eunuchs who waited on the old, 
 debauched, and nervous wrecks, and the nj'mph who 
 presided over the whole was Talmakis, a name derived 
 from the salty nature of the springs which fed the 
 baths ; this nymph was worshiped as Aphrodite. 
 Pederasty was one of the practices at these baths. From 
 these conjoined conditions the place was said to be peo- 
 pled with hermaphi'odites, — meaning, at first, simply that 
 they were under the protection of Hermes and Aphro- 
 dite; and latterly the name was attached to the passive 
 agent in the pederastic art, — a name that has followed 
 the class and crossed the ocean into the interi'or wilds 
 of America, as in Powell's history of the manners and 
 customs of the Omahas, an Indian tribe of the Missouri, 
 we find that they at times practiced pederast}^, the 
 passive agent being called by the Indians an hermaphro. 
 dite, or double sexed.^ 
 
 The relations that from eunuchism led to pederasty 
 are very easy of explanation. Eunuchism induces an 
 effeminate form, softer body, and prevents the growth 
 
Hermaphrodism and Hypospadias. 119 
 
 of the beard ; the voice is softer and more melodious ; 
 and tlieir timidity renders them also more effeminate, 
 obedient, and dependent. The peculiar commingling 
 of the female form with that of tiie male furnished 
 to the sculptors the models for those wonderfully well- 
 made forms which are yet to be seen, representing in 
 statuary the forms of Androgjmes and Hermaphrodites ; 
 tnat of the favorite eunuch of the emperor Adrian 
 being remarkable for the symmetry of its form and 
 grace of pose. 
 
 Europe must have been astonished at the tales that 
 were carried back by the early explorers and voyagers, 
 in relation to the New World. The story of the im- 
 mensity of the quantity of gold and silver, of great 
 stores of hidden treasures, of the quantities of precious 
 gems and priceless crystals was full}' discounted when, 
 from the Florida coast and the explorers of the Lower 
 Mississippi, men returned with the tale that in the 
 everglades and in the trackless forests, intersected by 
 navigable sloughs, there dwelt a people half of whom 
 were hermaphrodites. Neither the explorers nor their 
 European historiographers seem able to have grasped the 
 true state of affairs. Many believed in the actual exist- 
 ence of such numbers of these monstrosities, while 
 others, arguing from what was then known regarding 
 the extraordinary development of the nymphse and 
 clitoris, as well as of the great labia, of the women in 
 tlie African regions, concluded that these supposed 
 androgynes^ or hermaphrodites, must be women, the 
 dress assumed by these and the menial labors to which 
 they were consigned assisting to favor this opinion. 
 The early Franciscan missionaries to California found 
 the men who were used for pederasty dressed as 
 woinen.^^ Hammond mentions the practice as in 
 
120 History of Circumcision. 
 
 vogue among the Indians of the southwest, which 
 in a measure greatly reseml)led that of the ancient 
 Scythians in its operation, the men being dressed as 
 women, associating with women, and used for pederastic 
 purposes during the orgies of their festivals. These men 
 had previously been eunuchised b}' a process of con- 
 tinued and persistent onanism, which caused at the end 
 a complete atrophization of the testicle. 
 
 In regard to the great number of hermaphrodites 
 observed in Florida and on the Mississippi, the accounts 
 are only reliable as far as they were present in female 
 garb and in an apparent state of slavery, being com- 
 pelled to do all the menial labor of the villages and 
 camps, besides being used for pederasty, no examina- 
 tion having been made by any traveler. Their lot was 
 different from those described by Hammond in his work 
 on " Male Impotence," where the whole transaction 
 seems to have some sort of religious and civil signifi- 
 cance. In Florida, however, they tilled the ground, ex- 
 tricated and carried off the dead during a battle, and did 
 all the work generall}^, being used for beasts of burden 
 and not allowed to cut their hair ; but all authorities are 
 silent or in complete ignorance as to whether they had 
 suffered castration. Pere Lafiteau, however, gives an 
 explanation which was in the last century considered 
 ridiculous, but which, in the light that has been thrown 
 on the existence of a former continent, and of the un- 
 disputable relation that must, some ages in the past, 
 have existed between Phoenicia and Central America, 
 seems a strongl}^ probable solution of these customs. 
 The Father accounts for the presence of these American 
 androgynes in the following manner : The Carribeans, 
 or Caribs, were originallj' a colony from Carnia ; with 
 these colonists was brought over the worship of their 
 
Herviaphrodism and Hypospadias. 121 
 
 Pagan gods of Caria and Pliiygia ; tliese two localities 
 were the homes of the Cybelian priesthood, who dressed 
 in female garb, as did the sacrificial priests of the 
 Temple of Yenus Urania. It is true that the Java or 
 Floridian priest had nothing in common with the priests 
 of Cjbele or of Venus Urania; but, still, Lafiteau gave 
 as lucid an explanation for the existence of these con- 
 ditions as an}' of his contemporaries. Charlevoix ob- 
 served the same practices among the Ulinoi-s, which he 
 attributed as being due to some principle of religion. 
 The Baron de la Hontan insists tliat the missionary, 
 Charlevoix, was mistaken ; that the persons whom he saw 
 in female attire, whom he took to be men, were not men. 
 Hontan asserts that they were veritable hermaphrodites. 
 The missionaries were, however, correct, as wliat has 
 since been observed confirms their opinion. M. du 
 Mont, who ascended tlie Mississippi for a distance of 
 nine hundred leagues, also reported meeting Indians 
 at different places attended by these petticoated andro- 
 g^'nes.*** 
 
 As strange as it may seem, many intelligent men were 
 loth to part with their belief in the existence of these 
 double-sexed individuals; the logic used by manj' of 
 these insisters of hermaphrodism, although now very 
 ridiculous, was no doubt sensible logic one hundred and 
 fifty years ago. As a matter of curiosity, some of this 
 reasoning will bear repeating. It is taken from a Latin 
 edition of an ancient description of Florida, originally 
 in the English, but translated into the Latin by the 
 geographer, Mercator. In this book we find the roots 
 of some of the myths that led Ponce de Leon and his 
 steel-clad warriors to wander through Florida in a A'ain 
 search of that spring or fountain of the waters of per- 
 petual youth and of everlasting life which they were 
 
122 History of Circumcision. 
 
 never to find. We there learn that, in the daj'S of the 
 good old Spanish knight, the inhabitants of Florida 
 lived to a very old age, and that they did not marry 
 until very late in life, as before that period it was A^ery 
 difficult to determine the sex of the individual. 
 
 From what has since been seen among the Indians, 
 the pi'obability is that these were really eunuchs, and 
 probably in slaver}'^, as the result of the fortunes of war, 
 as their great number and servile condition will hardly 
 admit of the belief that they belonged to the same tribe 
 as their masters and oppressors. Pederasty was an old, 
 very old practice, being mentioned before circumcision; 
 it prevailed among many of the Orientals, and among 
 the many peoples by whom the early Jews were sur- 
 rounded, who were, according to the Old Testament, 
 about as an immoral, dissolute, and bestial a set as one 
 could well imagine. Their religions were nothing but a 
 gross mixture of stupid superstition and blind idolatry, 
 pederasty, fornication, and general cussedness. In the 
 then state of the Jewish nation, to have allowed them to 
 mingle freely with these people would have ended in 
 having the Jews adopt all their customs and habits. 
 The aim of the Jewish leaders was to prevent any too 
 free intercourse of their people with these nations, that 
 they might remain uncontamlnated even while dwelling 
 near them. To accomplish this it was necessary to raise 
 a barrier that would be the distinguishing mark of the 
 Jewish nation. Jahns, in his learned work on the " His- 
 tory of the Hebrew Commonwealths,"*^ lays down the 
 idea that circumcision, as well as many articles in their 
 laws, — which to us appear trivial, — were in reality in- 
 tended to separate the Jews farther and farther from 
 their idolatrous, bestial, and heathenish neighbors, while 
 at the same time these same ordinances were intended 
 
Hermaphrodism and Hypospadias. 123 
 
 to presei'A^e a constant knowledge of the true and only 
 God, and maintain their moral and physical health. 
 
 Although hermaphrodism on a large scale, as an ex- 
 isting condition, was a matter of serious belief at the 
 end of the. eighteenth centur^^ it has occupied no little 
 attention in this. Courts have been called to decide on 
 cases to invalidate marriages, or to decide the sex, more 
 than once ; and physicians are often asked the question, 
 Do hermaphrodites reall^^ exist ? Dr. Debierre, of Lyons, 
 published in 1886 a valuable paper, entitled " Hermaph- 
 rodism Before the Civil Code: its Nature, Origin, and 
 Social Consequences," which was published in the 
 Archives of Criminal Anthropology of Lyons, Frnnce. 
 In this short but very concise treatise, Debierre gives 
 us a complete review of the subject from m3'thological 
 times to 1886. It must be quite evident to all that 
 there exists no logical reasons why the sexual or gen- 
 erative organs should be exempt from, at times, being 
 subject to variations from the normal, either through 
 the commingling of two conceptions or of faulty devel- 
 opment affecting other parts of the bod}^ — conditions 
 that go to form monstrosities. Debierre gives one 
 peculiar case of a duplication of vagina and uterus in a 
 girl of nineteen, the appearance of the parts and the 
 septum between the vaginge giving to the whole an ap- 
 pearance precisely similar to that of a double-barreled 
 shot-gun. These monstrosities are as likelj' to happen 
 as the different forms that affect — either by arrested 
 development or some abnormality of excessive develop- 
 ment — the head, which is a vary prolific subject of 
 anomalies. 
 
 Hermaphrodism is a common attribute in the vege- 
 table kingdom, where fixed habitation or position makes 
 such a condition necessary ; it is also common to many 
 
124 History of Circumcision. 
 
 of our lower forms of animal life, and even in the human 
 fcetus the presence of the Wolfian bodies and tlie canal 
 of Miiller in the same individual attest a primitive case 
 or condition of hermaphrodisra. In other words, hu- 
 manity begins its existence in a state of hermaphrodism. 
 Tliis condition is found up to the end of the second 
 month of foetal life in the human being, in common with 
 all mammals, as well as all tlie vertebrates, where, how- 
 ever, it is subject to variationsas to time of development 
 and limit of existence in the normal condition. In tlie 
 chick, it is Qx\\y after the fourth day that the genital 
 gland begins to determine whether it will turn into an 
 ovary or a testicle ; in the I'abbit it is on the fifteenth 
 day, and in the human embryo on the thirtieth day. 
 Hermaphrodism does not occur, however, from this at 
 first uncertain state of affairs, but rather from subse- 
 quent developments of the external organs that by their 
 abnormality of formation simulate one or the other sex, 
 while the internal organs xn^iy belong without any equivo- 
 cation of structure to its definite pex ; as it has often 
 happened that some of these cases, having been the sub- 
 ject of differences of opinion among experts during life, 
 were, after death, unanimously assigned to one sex by 
 all of the same experts, the organs readily defining the 
 sex being completely of the one sex. As observed by 
 Debierre, where the subject is reall}'^ a female, even where 
 the vagina or uterus is unperceived, the presence of the 
 menstrual function or some physical disturbance at its 
 stated periods are sufficient evidences, as a rule, by which 
 to determine the sex. The case of Marzo Joseph, or 
 Josephine, reported by Crecchio in 1865, had rudiments 
 of an hj'pospadic penis ten centimetres in length and 
 a prostate of the male sex, with a vagina 6 centimetres 
 in length and 4 in circumference, ovaries, oviducts, and 
 
Hermaphrodism and Hypospadias. 125 
 
 uterus of the female ; it was not until her death, at the 
 age of fifty-six, that her sex was fully determined. The 
 case reported by Sippel in 1880, supposed to be a male 
 from external evidences, was at death found to be a 
 female. Guttmann reported a like case in 1882. The 
 celebrated case of Michel-Ann Dronart is remarkable ; 
 this case was declared a male by Morand .Pere and a 
 female by Burghart, as well as b}^ Ferrein ; declared 
 asexual or neutral by the Danish surgeon, Kruger; of 
 doubtful sex by Mertrud. The case of Marie-Madeleine 
 Lefort, to which Debierre devotes four figures, is full 
 of interest. One of the figures is her portrait at the age 
 of sixteen, and another is from her photograph at the 
 age of sixty-five. She has a man's head in everj'^ par- 
 ticular of physiognomy and expression, having in the 
 latter figure a full beard and the peculiar intellectual 
 development of a male sage ; she has the hairy breast of 
 the man, with the mammary development of the female, 
 and an abnormally-enlarged clitoris, which was often 
 mistaken for the male organ. The vagina at its lower 
 end was nai'row, and the urethral aperture opened into 
 it some distance from its outer opening ; otherwise she 
 was sexually a perfect woman, and menstruated regularlj'. 
 Debierre quotes the case which Duval gives in his work 
 on hermaphrodites, wherein a man asked for a dissolu- 
 tion of marriage, claiming that his wife had a male organ, 
 which, although she was a woman in everj'^ other sense, 
 prevented by its interference the consummation of the 
 marriage act. The court had the case examined, when 
 it was found that the erection of the clitoris, which was 
 large, was enough to interfere as the husband had stated. 
 It decreed that the young woman should have the ob- 
 jectionable and interfering member amputated, and on 
 the refusal to have this done the marriage should be 
 
126 History of Circumcision. 
 
 dissolved. She refused, and the divorce was conse- 
 quently granted to the man. 
 
 From the history of Marie Lefort, it can well be 
 conceived how the popular mind, in ignorant times, 
 could easily be imposed upon. Montaigne relates the 
 history of a Hungarian soldier who was confined of a 
 well-developed infant while in camp, and of a monk 
 brought to a successful accouchement in the cell of a 
 convent; while Duval reports the case of a priest in 
 Paris who was found to be pregnant with child, who 
 was in consequence imprisoned in the prison of the 
 ecclesiastical court. These cases were strongly females 
 in every sense, but with some male characteristic suffi- 
 ciently developed, like in the case of Marie Lefort, to 
 allow them to believe themselves men and to pass for 
 such. 
 
 On the other hand, males have had some female 
 characteristics so well pronounced that they have passed 
 for females. Debierre mentions a number of cases, to 
 wit: Ambroise Pare reported such a case in his time; 
 Ladowsky, of Reims, reports the case of Marie Goulich, 
 who, up to the age of thirtj'-tliree, was believed to be 
 a female, at which time the descent of the testicles re- 
 moved all doubts as to sex. Sheghelner and Cheselden 
 have reported analogous cases, and Giraud's case — who 
 was happil3'^ married to a man with whom he lived until 
 the death of the husband, in which the only female 
 attribute was a blind vagina, which, in his case, seems 
 to haA'^e answered all purposes — was a most remarkable 
 case. As a rule, the cases of males who have been mis- 
 taken for hermaphrodites have been cases of h3'pospadic 
 urethrse in a greater or lesser sense of deformit3^ 
 
 Debierre, however, mentions some cases of true 
 hermaphrodism. He quotes a number of cases, the 
 
Hermaphrodism and Hypospadias. 127 
 
 earliest being from the writings of Coelius Rhodigin, 
 who claimed to have seen in Lombardy a case in which 
 the organs of the two sexes were side by side ; Ambroise 
 Pard records that in 1426 a pair of twins were born, 
 joined back to back, wherein both were hermaphrodites. 
 Among the many reporters that he quotes, he mentions 
 Rokitansky, who reported a case in 1869, at Vienna, 
 this being the autopsy of Hohmann, who had two ovaries 
 and oviducts, a rudimentary uterus, and a testicle, 
 with a sperm-duct containing spermatozoa. This in- 
 dividual menstruated regularly, and it is an interesting- 
 question as to what the result would have been had 
 some of the spermatic fluid come in contact with some 
 of the ovules that were periodically discharged. Hoh- 
 mann had an imperforate penis and a bifide scrotum. 
 Ceccherelli, who gives a more minute description of this 
 interesting case, relates that Hohmann, who died at tlie 
 age of fort}', had menstruated regularly to the age of 
 thirty-eight. The penis was imperforate but hypospadic, 
 from whence came the urinary and spermatic discharges, 
 and Hohmann could in turn copulate as either male or 
 female. Odin is also quoted in relation to the case seen 
 at the H6tel-Dieu-de-L3'on, during the service of M. 
 Bondet. The subject was aged sixt3r-three, and named 
 Mathieu Perret. The case greatly resembled that of Holi- 
 mann, at the autopsj- being found to be double sexed. 
 So that, while most of the cases mentioned are fictitious 
 and only apparent, the fact remains that the existence 
 of true hermaphrodites is indisputable.^ 
 
 If the subject of either apparentl}'^ or true hermaph- 
 rodism is one of unhappiness, and oftentimes of dis- 
 comfort and miser}', history relates that this unfortunate 
 class has suffered additionall}'^, from the laws and ac- 
 tion of ignorant and barbarian times, as such freaks of 
 
 5 
 
128 History of Circumcision. 
 
 nature must of necessity have occurred at all times ; 
 only in the then ignorant state of medicine and anatomy 
 they must have been considered as occurring much 
 oftener — every deviation from the normal being con- 
 sidered as hermaphroditic. Opmeyer relates that in ex- 
 cavating in the neighborhood of the capitol in Rome, 
 the laborers discovered the bronze tables on which were 
 inscribed the twenty-two laws of Romulus, termed by 
 many historians " The Double Decalogue of Romulus." 
 Article XV of this law, as well as Articles IX and X, 
 seem to be directed against the life of these androgynes. 
 In Roman history, however, we have an event whicli 
 would seem to contradict that there existed any laws, in 
 actual force against this unfortunate class. It hap- 
 pened during the existence of the Punic wars, when the 
 people were more or less laboring under fear and excite- 
 ment, which would readily prepare them to accept any 
 superstitious notion. It was during these times that 
 three of these androgynes were known to exist in Italy. 
 Titus Livius mentions that the existence of one of these 
 was denounced during the consulships of C. Claudius 
 Nero and of Marcus Livius, Etruscan soothsayers and 
 seers were summoned to Rome, that they might con- 
 sult the signs and the conditions of the constellations 
 tliat accompanied the nativity of this hermaphrodite, 
 or androgyne. These impostors, after a careful con- 
 sultation of airattending circumstances, gave it as their 
 opinion that the occurrence was an unfortunate im- 
 purity, and that it could only result to the disadvantage 
 of Rome, unless she at once took steps to purify her- 
 self of such a monstrosity, with the conclusion that the 
 androgyne should be first exiled from Roman soil, and 
 then drowned in the depths of the sea. The unfortunate 
 being was accordingly inclosed in a chest and put on 
 
ffermaphrodism and Hypospadias. 1 29 
 
 board a galley, which put immediately to sea; when the 
 vessel was out of sight of land the chest was thrown 
 into the Mediterranean.*^ 
 
 A hermaphrodite born in Umbria during the consul- 
 ship of Messalus and C. Lucinins was condemned to 
 death, as well as was the one born at Luna during the 
 consulship of L. Matellus and Q. Fabius Maximus. De- 
 bierre states that in the reign of Nero this barbarous 
 custom was discontinued, as this emperor admired these 
 freaks of nature from their novelty, as it is related that 
 his chariot was drawn by four hermaphroditic horses.^ 
 
 In connection with hermaphrodism it has been shown 
 that the males who have been supposed to be so mal- 
 formed were reallj'^, in most instances, but cases of 
 hypospadias. It ma^^ not be uninteresting to observe 
 that, while during nearly four thousand j-ears circum- 
 cision has been practiced without the habit or condition 
 ever having become transmissible or hereditary, h^-po- 
 spadias has shown a decided tendency to being trans- 
 mitted. In Virchow's Archives, Lesser reports having 
 treated eight subjects during one generation in a famil3'.*' 
 Fodere records the case of In^pospadias reported by 
 Schweikard, in a person of forty-nine years of age, 
 whose urethral orifice was near the junction of the 
 penis and scrotum, but who, neA'ertheless, had three fine 
 children. The same author records the remarkable case 
 reported by Hunter to the Royal Soeietj'' of London, 
 also so deformed, who successfully impregnated his wife 
 by receiving the spermatic fluid in a warm spoon and 
 immediately injecting it into the vagina.^ Another 
 interesting case is taken from L'' Union 3Iedicale of 
 August 26, 1856. It instances both the heredity con- 
 nected with hj'pospadias and the peculiar circumstances 
 under which impregnation at times takes place ; it is 
 
130 History of Circumcision. 
 
 reported by Dr. Trexel, of Kremsier, and is as follows : 
 " On April 1, 1856, a newborn infant was brought to Dr. 
 Trexel, that he might determine its sex. The father and 
 mother were servants of a peasant. On an examination 
 of the alleged father, he was found to have all the ex- 
 ternal characters of a male ; the urethra, which was 
 rather shorter than ordinary, but of large size, was ira- 
 perforate ; the scrotum was divided into two pouches, 
 each containing a testicle. The apposed surfaces of the 
 scrotal pouches were covered with a red skin, and the 
 division extended through their entire length. At the 
 root of the penis, in the anterior angle of these pouches, 
 was an opening of the size of a lentil ; this was the 
 orifice of the urethra. The lower surface of the penis 
 was grooved from the above-mentioned orifice to the end 
 of the glans. There was no prepuce. Almost in a line 
 behind the corona of the glans, and in the groove, were 
 two elliptical openings, which readily admitted a large 
 hog-bristle ; there was a third smaller opening two 
 lines from the orifice of the urethra. This man had 
 always passed for a woman. He lay in the same room 
 with the mother of the child ; and they acknowledged 
 having had frequent connection. The woman declared 
 that she had had no commerce with any other man for 
 three years, and the man did not deny this assertion. 
 The idea of cohabitation with another man was further 
 negatived by the circumstance that the infant had the 
 same conformation of the genital organs as the father. 
 How did fecundation take place ? The three openings 
 in the'penis were pi'obably the orifices of the excretory 
 ducts of Cowper's glands. But might not these have 
 been the openings of the ejaculatoi'y ducts? It is to be 
 regretted that Dr. Trexel did not examine these canals ; 
 their length and direction would have thrown light on 
 
Herviaphrodism and Hypospadias. 131 
 
 the subject. The fact of fecundation may also be ex- 
 plained by supposing that during coition the posterior 
 wall of the vagina supplied the place of the absent floor 
 of the urethra, thus forming a complete canal. This is 
 the most probable explanation."^^ 
 
 The above case, as stated, had passed for a woman ; 
 these cases are by no means such rarities. The case of 
 Marie Dorothee, mentioned by Debierre in his work, 
 was as peculiar, Hufeland and Marsina had pronounced 
 Marie a woman, while Stark and Martens pronounced 
 her a man, and Metzger could not determine on the sex. 
 The case of Valmont, noticed by Bouillaud and Manee, 
 is on a par with that of Giraud, in which the party was 
 married as belonging to one sex and where it was not 
 until after death ascertained that the person belonged to 
 the other sex. Valmont had a hypospadic urethi'a and 
 penis ; a scrotum witliout testicles ; ovaries with the 
 Fallopian tubes ; a uterus opened into a vagina of two 
 inches in length, which, gradually narrowing, ended in 
 tiie male urethra, to which was attached a prostate 
 gland. Valmont contracted marriage as a man and was 
 not discovered to have been a female until the autopsy 
 revealed her to be a woman. The relation does not 
 state anything in regard to menstruation; so that her" 
 condition in that regard is unknown.*^ 
 
 There has also been reported a number of cases in 
 the male analogous to the double organed female men- 
 tioned by Debierre. Geoffrey St. Hilare reports a case 
 where the penis was double, one being above the other, 
 urine and semen flowing through both urethras. Gore 
 mentioned a like case to the Academy in 1844. 
 Dr. Vanier (Du Havre) records the case reported by 
 Huguier to the Academ^^, where the organs in the ana- 
 tomical preparation which he exhibited were so anoma- 
 
132 History of Circumcision. 
 
 lous that it was impossible to decide the sex. Aside 
 from the medico-legal aspects that these cases present, 
 there is an interesting Jewish theological question con- 
 nected with them. The law is explicit as to circum- 
 cision ; the cases presenting, if males, should be circum- 
 cised, but how to determine the sex where an autopsy 
 alone will decide the question is not defined. It has 
 been decided, in such cases whei'e the presumption is 
 that the child is of the male sex, that, like in cases of 
 absence of prepuce, a suppositious circumcision should 
 be performed, so that the covenant should be observed ; 
 this being in keeping with the sentiment sliown by the 
 Jews when persecuted by the Romans, or, later, by the 
 Spaniards, who often were not able to circumcise until 
 after death ; but they never fail to comply with the 
 covenant as far as it is possible. 
 
 Cases are liable to occur, however, which, without 
 leaving the question as to sex in doubt, if reasoned by 
 exclusion, would not furnish any possible opportunity 
 for circumcision. Such a case is reported in Virchow's 
 Archives, vol. cxxi. No. 3 ; also in tlie British Medical 
 Journal of December 6, 1890, and in the Satellite for 
 January, 1891. It is one of congenital absence of penis. 
 " Dr. Rauber records very briefly the case of a shoe- 
 maker, aged 38, who complained of pain and trouble in 
 the anus. On examining him, Rauber found a well- 
 formed scrotum containing two testicles, each With a 
 vas defei-ens and spermatic cord, but no trace of a penis. 
 The urethra opened apparently into the anterior wall of 
 the rectum. The man occasionally experienced sexual 
 excitement, followed by an emission into the rectum. 
 The burning pain complained of in the rectum and 
 about the anus was due to the irritation caused by the 
 urine. The man would not allow an ocular inspection 
 
Hermaphrodism and Hypospadias. 133 
 
 of the interior of the rectum. Unfortunatelj', the details 
 of this very rare condition are incomplete." 
 
 It would be interesting to know where the seat of 
 his sexual desire is situated, unless an aching testicle is 
 such. I once knew a Spiritualist who claimed to feel 
 the pains suffered by any friends with whom he was in 
 S3' mpatliy ; he once tried to argue with me that a certain 
 lady patient — a warm personal friend of my questioner 
 and a Spiritualist — had ovaritis, because he felt an 
 Intense burning pain in his right ovarian region when- 
 ever he went near to her. I tried to reason with him 
 that that pain should be in his right testicle, but he 
 would insist on having the sympathetic pain in his 
 ovarian regrion. 
 
CHAPTER XL 
 
 Religio Medici. 
 
 Sir Thomas Browne, in his " Religio Medici,"^ al- 
 ludes to the scandal that is generally attached to our 
 profession, we being accused of professing no religion. 
 That this opinion is still prevalent at the present day is 
 undeniable, — philosophers and physicians are believed 
 to be atheists and non-religionists, — while, at the same 
 time, by that strange contradiction that is so common, 
 philosophers and physicians are tlie known and recog- 
 nized sources of religions, such is the intimate relation 
 existing between physical and moral hygiene. Confu- 
 cius, the contemporary of Pythagoras, whose religion 
 was said to be nothing more than the observance of a 
 certain moral and political ethical code, and he who first 
 formulated the text "that one should do unto others as 
 one wislies others to do imto him," the founder of the 
 Confucian religion, the orthodox religion of China, was 
 a philosopher. Buddha, the founder of the second creed 
 recognized in China, and which forms the religion of a 
 great pa*rt of eastern Asia, was also a philosopher who 
 was endeavoring to reduce the Brahminical religion to 
 the simple principles of philosophical religion, based on 
 morality. Moses not only was the greatest philosopher 
 of his time, but also had an insight into medicine that 
 to us of the present day is simply incomprehensible. 
 The Great Master was both a philosopher and a phy- 
 sician, his disputes with the learned and his attention to 
 the sick having given him the titles of Great Master and 
 Divine Henler. 
 (134) 
 
Religio Medici. 135 
 
 To use the words of the " Religio Medici," the great 
 body of the medical profession can, without usurpation, 
 assume the name of Christians ; for no monk of the 
 desert convents of Asia Minor or religious knight of 
 the middle ages, either in their care of the sick, or giv- 
 ing food and shelter to the weary, or protection of sword 
 and shield to the oppressed pilgrim plodding his way to 
 the Holy Land, were more deserving of the name of 
 Christian than the medical man unwearily and unself- 
 ishly practicing his profession. To the true student of 
 his art there is that in medicine which makes of the 
 physician a practical Christian. Nor is there aught in 
 medicine, either in its traditions, history, study, or 
 practice, that in the lover of his art should ever make 
 him anything but a philosophical and practical religion- 
 ist. The physician, such as is activel}' engaged in the 
 daily practice of his profession, instead of having no 
 religion, is really a practical religionist, and, although he 
 may subscribe to no outer ceremonial form or dogma, 
 his life is such that a Confucian, a Buddhist, a Christian, 
 or a Hebrew can behold in him the practitioner of the 
 essence of either of their religious, — a conception car- 
 I'ied out by Lessing, in his play of " Nathau the Wise," 
 where the Jew, the Saracen, and Crusader teach the 
 impressive lesson that nobleness is bound by no confes- 
 sion of faith or religion ; showing the principle that 
 should guide true religion. 
 
 The Rev. Dr. Townsend, of Boston Universit}^ has 
 given a very interesting and intelligent relation of the 
 connections that exist between medicine and the Old 
 Testament, in the light of nineteenth-century science.** 
 The article in question is interesting in its logical 
 reasons as to whj^ the Bible was inspired by a superior 
 power, as well as in the comparisons it lays before us 
 
136 Hidory of Circumcision. 
 
 of the medicine of the Pagans and that of the Bible, 
 during the early history of the world. After reviewing 
 the false, crude, and senseless vagaries and superstitious 
 notions that passed for medicine from the period of the 
 Trojan war, in 1184 B.C., to the dissolution of the Pytha- 
 gorean Society, 500 B.C., — periods which existed after 
 the writing of the books of Moses, — and the period be- 
 tween 500 B.C. and 320 B.C., or the philosophic era of 
 medicine, during which flourished the father of our 
 present system of medicine, an era of advancement, but 
 which in our eyes is still full of errors and unscien- 
 tific conclusions. Prom these two periods we span over 
 centuries of darkness for science and medicine to the 
 ages of Ambroise Pare and the more modern fathers of 
 our art, who by perseverance finally extricated medicine 
 from the mass of magical and superstitious rubbish 
 which, like barnacles, had clung to it during its passage 
 through the dark and ignorant ages. After this review 
 our author turns to the Bible and discourses in this 
 wise: — 
 
 *' Turning our attention to the Bible, we take the posi- 
 tion that, though it was not designed to teach the science 
 of medicine, still, whenever by hint, explicit statement, 
 or commandment there is found in it anything relating 
 to medicine, disease, or sanitary regulation, there must 
 be no error ; that is, provided the Bible, in an excep- 
 tional sense, is God's book. Now, what are the facts in 
 this case ? They are these : though the Bible often 
 speaks of disease and remedy, yet the illusions, decep- 
 tions, and gross errors of anatomy, physiology, and 
 pathology, as formerly taught, nowhere appear upon 
 its pages. This, it must be acknowledged, is at least 
 singular. But more than this : the various hints and 
 directions of the Bible, its sanitary regulations, the 
 
Religio Medici. 137 
 
 isolation of the sick, tlie washing, the sprinkling, the 
 external applications, and the various moral and relig- 
 ious injunctions in their bearing upon health are con- 
 fessed to be in harmony with what is most recent and 
 approved. To be sure, the average old-school physician 
 of a century ago would have blandly smiled at our sim- 
 plicity^, had it been suggested to him that his methods 
 would be improved by following Bible hints. ' What 
 did Moses know about medical science?' would have 
 been his reply. But Moses, judged by recent standards, 
 seems to have known much, or, at least, to have written 
 well." 
 
 Tlie above statement is a truthful relation of facts, 
 from which it can well be conceived that even in the 
 Bible the physician finds something to inspire him with 
 the idea of its divine inspiration, as the very history of 
 medicine, with whicli it is connected, and with which he 
 is familiar, only lends him further support in that direc- 
 tion. Most intelligent physicians are also lovers of 
 philosophical histor3^ None is more entertaining than 
 Rawlinson, either in his " Seven Great Monarchies " or 
 his "Ancient Egypt." In his "Ancient Religions," in 
 his concluding remarks, he observes as follows, in re- 
 gard to the Hebraic religion : " It seems impossible to 
 trace back to any one fundamental conception, to any 
 innate idea, or to any common experience or observa- 
 tion, the various religions which we have been consider- 
 ing. The veiled monotheism of Egypt, the dualism of 
 Persia, the shamanism of Etruria, the pronounced poly- 
 theism of India are too contrariant to admit of any one 
 explanation, or to be derivative of one single source. 
 . . . It is clear that from none of the religions here 
 treated of could the religion of the ancient Hebrews have 
 originated. The Israelite people, at different periods 
 
138 Hidory of Circumciaion. 
 
 of its history, came and remained for a considerable 
 time under Egyptian, Babylonian, and Persian influence, 
 and there have not been wanting persons of ability 
 who have regarded Judaism as a mere offshoot of the 
 religion of one or the other of these three peoples. But, 
 with the knowledge that we have now obtained of the 
 religions in question, such views have been regarded as 
 untenable, if not henceforth impossible. Judaism stands 
 out from all other ancient religions as a thing sui generis, 
 offering the sharpest contrast to the systems prevalent 
 in the rest. of tlie East, and so entirely difiierent from 
 them in its essence that its origin could not but have 
 been distinct and separate. . . . The sacred boolis 
 of the Hebrews cannot possibly have been derived from 
 the sacred writings of any of these nations. No con- 
 trast can be greater than that between the Pentateuch 
 and the ' Ritual of the Dead,' unless it be that between 
 the Pentateuch and the Zendavesta, or between the 
 same work and the Vedas. . . .In most religions 
 the monotheistic idea is most prominent at the first, and 
 gradually becomes obscured, and gives way before a 
 polytheistic corruption. . . . Altogether, the theory 
 to which the facts appear on the whole to point is the 
 existence of a primitive religion, communicated to man 
 from without, whereof monotheism and expiatory sac- 
 rifice were parts, and the gradual clouding over of this 
 principle everywhere, unless it were among the He- 
 brews." ^^ 
 
 Medicine is indebted for its advancement to the 
 Hebraic religion to a greater extent than is generally 
 believed. In the early Christian centuries there existed 
 three great creeds : the Christian, Hebraic, and Moham- 
 medan. The Christian Church was in a perplexing 
 condition. As observed by Draper,'^ it was impossible 
 
Eeligio Medici. 139 
 
 to disentangle her from the principles which had, at the 
 beginning, entered into her political organization. For 
 good or evil, right or wrong, her necessity required that 
 she should put herself forth as the possessor of all 
 knowledge within the reach of the human intellect. But 
 the monk and priest were prohibited from studying 
 medicine,^' as by so doing the church saw that she 
 would have to relinquish the spiritual control of disease 
 were medicine a matter of scientific research ; she pre- 
 ferred to hold on to her spiritual dominion, and let 
 science slumber in darkness. On the other hand, the 
 Mohammedans, recognizing the principle of fatalism in 
 their religion, it. was not to be expected that the}- should 
 cultivate an art entirely opposed to that principle. In 
 this state of affairs the Jewish physician, led by the 
 teachings of his religion, alone presented the study of 
 medicine in a scientific manner, and its practice and its 
 result taught the Moslems that medical science placed 
 it within the power of man to keep himself out of the 
 grave, when either assailed by disease or laid low by the 
 wounds of war. The Arabs were not slow to avail 
 themselves of this discovery ; and to the learning and 
 skill of the Jewish physician, guided b}' the light of an 
 intelligent Deity and a liberal religion, does medicine 
 owe the existence of those able and learned Arabian 
 physicians that flourished during the eleventh and twelfth 
 centuries. 
 
 There has been more or less of fault-finding in regard 
 to certain rules and ordinances being sacramental, which, 
 from the nature of things, should have been merely 
 advisory or suggestive, as they pertained more to the 
 liygienic welfare of the people than to the spiritual. 
 Thus to reason, is neither philosophical nor in concert 
 with our knowledge of the structure of man, and of the 
 
140 History of Circumcision. 
 
 intimate relations that exist between mind and body, or 
 of good health and good morals. The writer has seen 
 violent catharsis produced b}^ bread pills, after podophyl- 
 lin, castor-oil, and phosphate of soda in the most gener- 
 ous doses — administered as one would drop a letter in 
 a mail-box — had completely failed ; it is all in the 
 manner and way we give a medicine or treat a disease. 
 Certain narcotic and irritant poisons or powerful seda- 
 tive agents have a physical action uninfluenced by the 
 mind, but an intelligent physician is hardly supposed to 
 drive at the small tack of disease with such powerful 
 sledge-hammers. Charcot, recognizing the power of 
 and availing himself of such a remedial agent as the 
 pilgrimages to the Notre Dame de Lourdes, is an evi- 
 dence of the intelligent and enlightened practitioner, 
 who has learned, what the Bible taught, long, long ago, 
 that human nature must be taken as it is found, and that, 
 like the homely saying of Mohammed, as the mountain 
 would not come to him, he must go to the mountain. 
 Moses and all the Scriptural writers were well aware 
 of this state of affairs, and their manner of using their 
 knowledge was adapted and timed to the general intel- 
 lectual development of the times. 
 
 There is one point in connection with the above that 
 should not escape our attention, this being that, while 
 the Hebraic creed and the people still subscribed to the 
 theological doctrine of the origin of disease, in common 
 with the religions then in vogue, here the connection 
 stopped. All other creeds — not excepting Christianit}- — 
 looked forward to a theological doctrine of the cure of 
 disease. With the Hebrew, disease was looked upon as 
 the result of some infraction on his part of some of 
 the laws, and the consequent expression of displeasure 
 on the part of the Deity. He was taught, however, 
 
Religio Medici. 141 
 
 that the observance of certain ordinances were both con- 
 ducive to health and to the prevention of disease, and 
 acceptable to God, as well as to rety upon his study and 
 skill to cure disease. This was equivalent to teaching 
 them that diseases arose from physical causes, and that 
 physical means were to be used to combat them. From 
 this arose the practice of exposing the sick in public 
 places, that they might receive the benefit of the advice 
 of such who might have had experience in a like case. 
 It is from their religion that Hebraic medicine has re- 
 ceived its foundation of intelligent philosophy that 
 carried it in its purity through all ages, free from magic, 
 superstition, and imposture. With other creeds and 
 religions, medicine, disease, as well as the physical phe- 
 nomena affecting nature, were believed to be the arbitrary 
 expression of anger of their gods, and that the cure of 
 disease, or alterations in physical phenomena, were to be 
 as arbitrarily effected, regardless of the existence or 
 action of physical laws. It is to be regretted that one 
 of the sects which has sprung from the Hebraic creed, 
 and which worships the same God, has been unable to 
 emancipate itself or its people from the idea of an 
 arbitrary theological doctrine of the origin and control 
 of disease. It is this creation of a narrow-minded 
 theology of a vaccilating, unintelligent, unphilosophical, 
 and arbitrary God, who would neither respect nor regard 
 the laws of his own creation , that has led the great body 
 of physicians out of the modern churches. They do not 
 deny the existence of the Deity, but the god of their con- 
 ceptioji is a higher and nobler god, — the Deity of Religio 
 Medici. 
 
 When the prize for the best essay on " the power, 
 wisdom, and goodness of God, as manifested in creation^'' 
 — a series of publications known as the Bridgewater 
 
142 History of Circumcision. 
 
 Treatises — has been nearly every other time won by 
 physicians, among whom we may mention Sir Charles 
 Bell, Dr. John Kidd, Dr. Peter M. Roget, and Dr. 
 William Prout, — not only won on their own merit, 
 bnt in competition with learned theologians and noted 
 divines,— we may truly say that physicians are by no 
 means atheists or agnostics, but that, on the contrary, 
 they are the real exponents of a pi*aetical and intelligent 
 religion, which they not onl}'^ practice, but fully and in- 
 telligently comprehend. 
 
CHAPTER XII. 
 Hebraic Circumcision. 
 
 The first mention that we meet concerning circum- 
 cision is in Grenesis. It is the command of God to 
 Abraham; in establishing the covenant with him, He 
 said to him : " Tliis is my covenant, which ye shall keep 
 between me and you, and thy seed after thee : every 
 man-child among you shall be circumcised. And ye 
 shall circumcise the flesh of your foreskin ; and it shall 
 be a token of the covenant betwixt me and you " (Gen. 
 xvii, 10, 11). It was also ordained that this should be 
 extended to servants belonging to Abraham and his 
 seed, as well as to their own children ; and that in case 
 of children it should be done on the eighth day after 
 birtli.^* This was appointed as an ordinance of perpetual 
 obligation on the Hebraic family, and its neglect or 
 omission entailed being cut off from the people (12, 14). 
 In compliance with this ordinance, Abraham, although 
 in his ninety-ninth year, circumcised himself and all his 
 slaves, as well as his son Ishmael. Slaves by purchase 
 were circumcised,^' as were any strangers, who were also 
 circumcised before being allowed to partake of the pass- 
 over or to become Jewish citizens. It was to be 
 observed by all heathens who became converted to the 
 Jewish faith. During the wanderings in the wilderness 
 circumcision was not practiced, but Joshua caused all 
 to be circumcised before they entered the promised 
 land.^^ 
 
 The old Hebrews strictly followed the injunction to 
 circumcise on the eighth day, and of such importance in 
 
 (143) 
 
144 History of Circumcision. 
 
 a religious sense was this rite in tlieir estimation that 
 CA'en when the eighth day fell on the Sabbath the eighth 
 day ordinance was observed. The ordinance, however, 
 was not blindly arbitrary, as rules were laid down for 
 exception. For instance, whenever a family had lost 
 two children through circumcision it did not become 
 obligatory on that family to circumcise the third child, 
 who was however considered as entitled to all the bene- 
 fits of the congregation or of the Hebraic religion, just 
 the same as if he had been circumcised. Again, Mai- 
 monides, or Moussa Ben Maimon, a celebrated ph3^sician 
 and rabbi, bom in Cordova in the year 1135 a.d., among 
 his works on medicine, has left directions in regard to 
 circumcision which have been the guides of the mohels. 
 Among the Hebraic physicians it was considered that 
 the child partook of the constitutional strength or 
 feebleness of the mother ; hence the rule above men- 
 tioned, in regard to exemption to circumcision, only 
 was in operation when the two who had formerly died 
 belonged to the same mother as the third one, who 
 would thereby be exempt ; but if the two children had 
 belonged to another woman, and this third child of the 
 father was not from the same mother, the rule did not 
 exempt. The third child of the mother who had pre- 
 viously lost two infants at the rite was, however, to be 
 circumcised when arrived at adult age, provided no 
 further counter-indication occurred. The opinion that 
 the mother gave the constitution to the child was 
 promulgated by Maimonides and became general. 
 
 The eighth day is believed to refer to the eighth day 
 after full term ; thus, a child born prematurely is not 
 supposed to be circumcised until eight days after it 
 would have reached its full term, and onl}' then if its 
 general good condition is settled. Maimonides looked 
 
Hebraic Circumcision. 145 
 
 upon infantile jaundice, general debility, and marasmus 
 as contra-indications to the performance of the rite ; any 
 erysipelatous inflammation, ophthalmia, anaemia, erup- 
 tion of any kind, fever, tendency to convulsive move- 
 ments — in fact, any observable departure from normal 
 health should be allowed to pass before performing the 
 rite. Aside from these general conditions that denoted 
 that the operation was contra-indicated, tlie local con- 
 dition of the organ itself also was to be examined, aud 
 if certain conditions existed the operation was to be pat 
 off. These conditions consisted in any irritation or red 
 appearance of the prepuce, due to either inflammation or 
 to the irritative action of the sebaceous matter undei'- 
 neath the prepuce, the acrid nature of these secretions 
 being at times sufficientlj^ virulent to produce an ulcera- 
 tion, even in the newborn.^^ 
 
 Among the Hebrews themselves there arerthose who 
 do not look upon circumcision in a favorable light ^ but 
 on something that has served its time in its own day, 
 and within the past 5'ear a prosel3'te has been accepted 
 into one of the New York synagogues without previous 
 or subsequent circumcision, these reformed Jews look- 
 ing upon adult circumcision as too painful an operation 
 to be gone through, as the}' claim, unnecessarily. It 
 must be said, however, that these persons look upon 
 circumcision purelj' in a sacramental light, and simply 
 as an arbitrary ordinance of God in the remote ages of 
 antiquity, but which in the present century has not 
 enough practical significance to warrant its performance 
 on the occasion of an adult joining the congregation. 
 These persons look upon it, as has been said, in a purely 
 theological light, and ignore any and all considerations 
 of hygiene in connection with it, claiming that if it is 
 a simple matter of hygiene, then it is not a sacrament, 
 
146 History of Circumcision. 
 
 and that, if it is sacramental, then the subject of hygi- 
 ene has notliing whatever to do with it. The force 
 of their reasoning and logic is very obscure and clouded, 
 to saj'^ the least. The covenant either exists or it does 
 not; to do away with one ordinance in any arbitrary 
 manner is to gradually begin to crumble down the whole 
 fabric of Judaism; for when exceptions are begun, one 
 tenet as well as another is liable to topple over. If the 
 rite is a sacrament, then it should be performed on all, 
 and a proselyte should not be admitted without being 
 circumcised, and, if a h3^gienic measure onl3^, the same 
 rule holds. These Jews evidently ignore the rationalism 
 that governed the promulgation of the Mosaic law, and 
 its recognition of the inseparability of the moral from 
 the physical natui'e of man. 
 
 Montaigne has left us a description of the perform- 
 ance of the rite, as witnessed by him in the city of Rome 
 in the sixteenth century. He relates it as follows : " On 
 tlie thirtieth of January was witnessed one of the most 
 ancient ceremonies of religion practiced by mankind, 
 this being the circumcision of the Jews. This is per- 
 formed at the dwelling, the most commodious chamber 
 being chosen for the occasion. At this particular time, 
 by reason of the incommodity of the house, the rite was 
 performed at the door of the domicile. The godfather 
 sat himself on a table, with a pillow on his lap. The 
 godmother then brought the child, after which she re- 
 tired. The godfather then undressed the child's lower 
 part so as to expose his person, while the operator and 
 his assistant began to chant hymns. This operation lasts 
 at least a quarter of an hour. The operator may or may 
 not be a rabbi, as it is considered a great blessing to 
 perform this operation ; so that it follows that man^'^ are 
 found who are anxious to exercise their faculty in this 
 
Hebraic Circumcision. 147 
 
 regard, there being a tradition that those who have cir- 
 cumcised a certain number do not suffer putrefaction in 
 their mouth, nor does their mouth become food for worms 
 after death ; so tliat it often happens that they make 
 presents of value to the chikl for the privilege of oper- 
 ating u})on it. On the same table on which the godfather 
 is seated all the required instruments and apparatus are 
 placed, while an assistant stands by with a flask of wine 
 and a glass. A warming-pan full of coals is on the floor, 
 at which tlie operator warms his hands. The child 
 being now read}', with its head toward the godfather, 
 the operator, seizing the member, draws the foreskin 
 toward him with one hand, while with the fingers of the 
 other he pushes back the glans ; he then places a silver 
 instrument, which fixes the skin, and which at the same 
 time holds back the glans so that the knife may not cut 
 it. The foreslcin is then cut off and buried in the little 
 basin of soil that forms one of the appurtenances to the 
 operation. The operator then tears with his nails the 
 skin which lies on the glans, which he turns back over 
 the body of the member. This seems the hardest and 
 most painful part of the operation, which, however, does 
 not seem dangerous, as in four or five daj'S tlie wound 
 has healed. The crying of the child resembles that of 
 an infant undergoing baptism. No sooner is the glans 
 uncovered than the operator takes a mouthful of wine; 
 he then places the glans in his mouth and sucks the 
 blood out of it; this he repeats three times. This done, 
 he applies a powder of dragons' blood, with which he 
 covers up all the wound, the parts being then done up 
 in expresslj'-cut bandages. He is then given a glass of 
 win over which he says some prayers ; of this he takes 
 a mouthful, and, after moistening his fingers in the same, 
 he applies the wine three times to the child's mouth. 
 
148 History of Circumcision. 
 
 The wine is tlien sent to the mother and the women, who 
 are in some other apartment, who all take a sip. An 
 assistant then takes a silver instrument, pierced with 
 little holes like a small strainer, which he first applies 
 to the nose of the officiating minister, then to that of 
 the child, and afterward to the nose of the godfather. "^^ 
 The above description of the performance of the rite in 
 the sixteenth centiuy answers to the methotl of its pei'- 
 formance as was witnessed some years ago in France. 
 
 In the " Biblical, Theological, and Ecclesiastical C}'- 
 clopaedia" of Drs. McClintock and Strong the following 
 description of the rite, as taking place in our modern 
 synagogues, is given : — 
 
 "The cei'emon}' of circumcision, as practiced by the 
 Jews in our own times, is thus : If the eighth day happens 
 to be on the Sabbath, the ceremony must be performed 
 on that da}^, notwithstanding its sanctity. When a male 
 child is born the godfather is chosen from amongst Ms 
 relatives or near friends ; and if the party is not in cir- 
 cumstances to bear the expenses, which are considerable 
 (for after the ceremony is performed a breakfast is pro- 
 vided, even amongst the poor, in a luxurious manner), 
 it is usual for the poor to get one amongst the richer, 
 who accepts the office, and becomes a godfather. There 
 are also societies formed amongst them for tlie purpose 
 of defraying the expenses, and everj' Jew receives the 
 benefit if his child is born in wedlock. 
 
 " The ceremony is performed in the following man- 
 ner, in general : The circumciser being provided with a 
 very sharp instrument called the circumcising-knife, 
 plasters, cummin-seeds to dress the wound, proper 
 bandages, etc., the child is brought to the door of the 
 synagogue by the godmother, when the godfather re- 
 ceives it from her and carries it into the sj-uagogue, 
 
Hebraic Circumcision. 149 
 
 where a large cliair with two seats is placed ; the one is 
 for the godfather to sit upon, the other is called the 
 seat of Elijah the Prophet, who is called the angel or 
 messenger of the covenant. As soon as the godfather 
 enters with the child, the congregation say, ' Blessed is 
 he that cometh to be circumcised, and enter into the 
 covenant on the eighth da^'.' The godfather being 
 seated, and the child placed on a cushion in his lap, the 
 circumciser performs the operation, and, holding the 
 child in his arms, takes a glass of wine into his right 
 hand, and says as follows : ' Blessed be Thou, Lord 
 our God, King of the U^iiverse, Creator of the fruit of 
 the vine ! Blessed art Thou, O Lord our God ! who hath 
 sanctified His beloved from, the womb, and ordained an 
 ordinance for His kindred, and sealed His descendants 
 with the mark of His holy covenant ; therefore, for the 
 merits of this, O living God ! our rock and inherit- 
 ance, command the deliverance of the beloved of our 
 kindred from the pit, for the sake of the .covenant 
 which He hath put in our flesh. Blessed art Thou, O 
 Lord, the Maker of the Covenant 1 our God, and the 
 God of our fathers ! Preserve this child to his father 
 and mother, and his name shall be called in Israel, A, 
 the son of B. Let the father rejoice in those that gb 
 forth from his loins, and let his mother be glad in the 
 fruit of her womb, as it is written : " Thy father and 
 mother shall rejoice, and they that begat thee shall be 
 glad." ' The father of the child then says the following 
 grace : ' Blessed art Thou, Lord our God, King of tlie 
 Universe I who hath sanctified us with His command- 
 ments, and commanded us to enter into the covenant of 
 our holy father, Abraham.' The congregation answer : 
 ' As he hath entered into the law, the canopy, and the 
 good and virtuous deeds,' "*^ 
 
CHAPTER XIII. 
 
 Mezizah, the Fourth or Objectionable Act of Suction. 
 
 Biblical and rabbinical traditions throw no light on 
 the origin of the details of the operation as now per- 
 formed. That it was anciently performed with a knife 
 of stone is certain ; an event common in its general 
 observance, and which seems to have pervaded all 
 nations or races, howsoever remote or scattered, that it 
 has induced Tylor^** to ascribe the origin of the rite to 
 the stone age. We are told that when Moses wixH 
 returning to the land of Egypt he had neglected 
 circumcising his son, and that because of that neg- 
 lect he nearly lost his son's life; his wife, Zipporah, 
 the daughter of tlie Midian king and priest, Jethro, 
 seeing the danger and knowing its cause, took her 
 little son Gershom and circumcised him with a stone 
 knife, and ottered the foreskin to God as a peace-offer- 
 ing. Just where tlie wine was first used we are not 
 told. Wine, however, was an emblem of thanksgiving, 
 and, being one of the fruits of the earth, was considered 
 an acceptable offering to God. It has since, in some 
 form or other, either as wine or as the representative of 
 either divine or human blood, been used in both the 
 Catholic and Protestant Churches in their ceremonials or 
 vicarious sacrifices, or imitations of old customs. Cir- 
 cumcision was by many connected with a blood sacri- 
 fice ; it was so suggested by the words of Zipporah at 
 the circumcision of Gershom : " And Zipporah, his Midi- 
 anitish wife, took up a sharp stone and cut off the fore- 
 skin of her son, and cast it at his feet and said, ' Surely 
 (150) 
 
Mezizah, Fourth or Objectionable Act of Suction. 151 
 
 a Khathan of blood art thou to me.' " Much specula- 
 tion lias followed the use of this word Khathan, whicij, 
 in the ordinary Arabian, may mean either husband or 
 son-in-law ; it also means a newly-admitted member of 
 a family ; a similar word means " to provide a wedding- 
 feast," and one otlier word from the same root and 
 branch means " to give or receive a daughter in mar- 
 riage." In our own day, the mohel, or ministerial cir- 
 cumciser, makes it a practice to draw a little blood from 
 the skin of such as are presented for the rite, but whom 
 nature has not furnished with sufficient foreskin for tlie 
 operation. The application, thrice repeated, of the 
 blood and wine to the lips of the child, is probably used 
 as a sign of the sealing of the compact. Wine is men- 
 tioned in connection with the High-Priest Melchisedeck 
 as the wine of thanksgiving at his meeting with Abra- 
 ham ; wine was presented to Aaron by the angel, who, 
 giving him a crystal glassful of good wine, said to him : 
 "Aaron, drink of this wine which the Lord sends you 
 as a pledge of good news." Originally, circumcision 
 must have consisted of the simple removal of the fore- 
 skin, and the elaboration of the ceremonial details must 
 have been a subsequent occurrence; persons wounding 
 their fingers will instinctively carry them to their mouth, 
 and it may be that the suction practiced by the Hebrews 
 had its origin in this natural haemostatic suggestion. 
 Wine as a haemostatic and as an emblem of thanksgiv- 
 ing and an acceptable ofiering naturally came in as an 
 accessory. 
 
 This practice — which, in the old, patriarchal days 
 of the simple shepherds, when men only lived on tlie 
 flesh of their own flocks, their diet, however, consisting 
 mostly of cakes of flour, milk, honej^, a few herbs, or 
 the flesh of the goat or sheep — could not have been as 
 
152 History of Circumcision. 
 
 objectionable as it is at the present day, with blood and 
 secretions in a continued ferment " through diet and 
 habits. Man, living in the open air of Armenia, Pales- 
 tine, or Arabia, sleeping in the open tents of our Bibli- 
 cal forefathers, living on the simple diet of a shepherd's 
 camp, with the abstemiousness that those climates 
 naturall^^ induce in man, could not help but be healthy. 
 In those early days, when neither passion, anxiety, nor 
 worry disturbed either digestion or sleep, man had no 
 vitiated secretions, wine was then a rarity, and water 
 was the drink. One of the early patriarchs on such 
 diet would have furnished a dainty and savorj^ dish to 
 the most fastidious cannibal, who is now tormented by 
 the komerhorg kawan, this being a term used by the 
 Australian cannibals to designate the peculiar nausea 
 that is induced in them when thej^ recklessly eat of 
 white man,^i — something which tiiey do not experience 
 from feasting on the savages who live on the simple 
 diet of a pastoral tribe. This primitive gastronomic 
 science in regard to cannibalism even reached such a 
 pitch of refinement that, as has been previously men- 
 tioned, some tribes even I'esorted to emasculation to 
 improve the flavor of the animal juices, which by this 
 procedure became less acrid. The Arabian and Oriental 
 traditions bring us down tales of how, on the same 
 principles, human beings intended to grace the festive 
 platter were fed exclusively on rice. The salivary' and 
 buccal secretions, under such a simple diet as that 
 indulged in b}' our Biblical forefathers, become bland 
 and harmless ; not only harmless, but even antiseptic 
 and positively beneficial, acting on the same principle 
 as local applications of pepsin. So that the practice, 
 at the time of the patriarchs and in their own family, 
 of this part of the rite could not have offered the 
 
Mezizah, Fourth or Objectionable Act of Suction. 153 
 
 same objection that it does at the present day. The 
 modern house-dweller, living on a mixed diet and in a 
 climate that induces him to eat grossh', both as to 
 quality and quantity, partaking more or less of vinous, 
 spirituous, or fermented liquors, as well as indulging in 
 tobacco, is quite another being from the Arabian or 
 Armenian shepherd of former days. Business anxieties 
 and worrj' also have a very pronounced efl'ect ; so that, 
 with the change in the conditions of man and the incep- 
 tion and multiplication of diseased conditions, as well 
 as the creation of constitutional and transmissible dis- 
 eases, this practice of suction should have been 
 stopped. 
 
 Intelligent rabbis, devoted to their religion, are 
 necessarily prone to defend any of the details in its 
 ceremonials that age and practice have sanctioned, and 
 even some of the later writings of Israelism seem to 
 maTce the mezizah, or suction, a necessary and ceremonial 
 detail In the " Guimara," composed in the fifth century, 
 Rabbi Rav Pope uses these words : " All operators who 
 fail to use suction, and thereb}' cause the infant to run 
 an}^ risk, should be destituted of the right to perform 
 the ceremony." In the "Mishna" it says, "It is permitted 
 on the Sabbath to do all that is necessary to perform 
 circumcision, excision, deimdation, and suction." The 
 "Mishna" was composed during the second centur}'. 
 The celebrated Maimojiides lent it his sanction, as in his 
 work on circumcision he advises suction, to avoid any 
 subsequent danger. Our modern Israelites are sup- 
 posed, as a rule, to have taken their authority, aside 
 from previous usage and custom, from the " Beth Yosef," 
 w^hieli was written by Joseph Karo, and subsequently 
 annotated by the Rabbi Israel Isserth. In all of these 
 sanctions, however, there is no reason expressed why it 
 
154 History of Circumcision. 
 
 should be performed .^^ Maimonides undoubtedly looked 
 upon this act as having a decided tendency or action in 
 depleting the immediate A'essels in the vicinity of the 
 cut surface, and that the consequent constriction in their 
 calibre would prevent an}' future haemorrhage. That 
 this is the natural result of suction is a fact readilj^ 
 understood by any modern physician. Tlie depletion 
 of the vessel for some distance in its length, -with the 
 contraction in the coat that follows, is certainly a better 
 preventive to consequent hsemorrhage than the simple 
 application of any styptic preparation that can only be 
 placed at the mouth of the vessel, but which leaves its 
 calibre intact. Hot water, or an extreme degree of cold, 
 will answer to produce this contraction and depletion, 
 but there is here a local physical reaction that is more 
 liable to occur than when the contraction has taken 
 place naturally, as when induced by depletion, instead 
 of by the stimulus of either heat or cold. So that if, in 
 the light of modern civilization and changed conditions 
 of mankind, and the existence of diseases -which for- 
 merly did not exist, we are now convinced that suction 
 is dangerous, we should not judge the ancients too 
 hastily or rashly for having adopted the custom, as it is 
 certainly not without some scientific merit ; although,, 
 authorities are not wanting who hold that suction or 
 depletion increases the danger of haemorrhage. 
 
 It can be understood that the results of suction 
 would be ill some measure analogous to those left by 
 the application of an Esmarch bandage on a limb. The 
 ancients, performing the operation with rude implements 
 and having no haemostatic remedies or appliances, natu- 
 rall}^ followed the best means at their command ; tliey 
 evidently feared haemorrhage, and their rule in regard 
 to exemption shows us that they recognized the exist- 
 
Mezizah, Fourth or Objectionable Act of Suction. 155 
 
 ence of hsemori-liagic diathesis or other transmissible 
 peculiarities of constitution. This same fear of bsemor- 
 rliage probably suggested the second step of the opera- 
 tion being performed, as it is by laceration instead of 
 b^' cutting instruments, showing in this an evident desire 
 to limit the cutting part of the operation to as small a 
 limit as possible. Against an infant who has decided 
 hsemorrhagic tendency, we are about as helpless as were 
 the ancient Hebrews, and, while the Turkish or some 
 of the Arabian methods of performing the operation 
 may be said in ordinar}^ cases — by the application of 
 cord and the consequent constriction — to limit the 
 danger from subsequent hgemorrhage, still, in the 
 haemorrhagic diathesis this would not be of any avail; 
 so, as already observed, we must not too rashly judge 
 those old shepherds of the Armenian plains for adopt- 
 ing a practice which to them was calculated to avert 
 subsequent dangers, or their descendants following in 
 their footsteps, until having learned better, even if that 
 practice is to us disgusting, primitive, and useless. 
 
 Cases occur, — happily not frequentl}',^ — of alarming 
 and uncontrollable haemorrhage. The following case is 
 suggestive of the alarming extent and persistence that 
 may attend one of those haemorrhagic cases, even when 
 recovery eventually takes place. It is reported by Dr. 
 Sannanel in the Gazetta Toscana delle science medicale 
 e fiaiche of 1844. The case was that of a Jewish in- 
 fant circumcised on the eighth day. Some hours after 
 the operation the child was observed to be bleeding ; the 
 haemorrhage would only cease for a few moments, and 
 then come on with increased force, and which proved 
 rebellious to ordinary remedies. Dr. Sannanel was 
 called during the night of the third day after the opera- 
 tion. A number of physicians had been in attendance, 
 
156 History of Circumcision. 
 
 and neither ice, astringents, pressure, nor any usual 
 haemostatic means had had the least effect ; cautery with 
 nitrate of silver, sulphuric acid, and the actual cautery 
 by means of heated iron were tried in succession, with- 
 out any good results. Ten days passed in this manner, 
 the haemorrhage only ceasing for a few moments at a 
 time, and the child was nearly exsanguinated from the 
 continued serous seepage and the paroxysmal haemor- 
 rliages, when a lucky application of caustic j^otassa 
 almost immediately stopped the haemorrhage. This 
 case was seen by nearly all the leading medical men of 
 Leghorn, who lent their aid and counsel to saA^e the 
 little life. The case is interesting from the length of 
 time it persisted, and that even after all the loss of 
 blood and suffering that the little fellow endured he 
 survived.^' 
 
 Dr. Epstein, of Cincinnati, in a letter of March 29, 
 18*72, to the Israelite of that city, mentions a nearly 
 fatal case from haemorrage after the rite of " 3Iilah,^^ 
 and gives the result of his experience in such cases. 
 He argues that Hiiouch or Hitooch alone, or the first step 
 or cutting off of the prepuce, performed with ordinary 
 care, could hardly be followed up with any more serious 
 results thnn can be controlled with the application of a 
 little acidulated water. The second act, or Periah, the 
 act of laceration, he looks upon as one that calls for 
 coolness, judgment, and skill, as the membrane should 
 only be torn so far and no farther, the thin, inner fold 
 of the prepuce being vascular only in the sulcus back 
 of the corona and at its lower attachment, where it 
 forms the frenum, or bridle; any carelessness or over- 
 anxiety on the part of the operator in tearing this mem- 
 brane too far back results in danger of haemorrhage ; 
 especially is this part of the operation liable to be 
 
Mezizah, Fourth or Ohjectionahle Act of Suction. 157 
 
 badly done if the inner preputial fold is thick and re- 
 sisting, as in that ease undue force may carry the lacera- 
 tion back into the vascular tissue. The means suggested 
 by Dr. Epstein to an-est haemorrhage are those ordinarily 
 used in haemorrhagic cases, such as will be given pres- 
 ently. The doctor regrets that the operators are not 
 as they should be, physicians, and that, when viohels are 
 employed, persons are not sufficiently exacting as to 
 their qualifications.®* 
 
 In France the government has managed to secure 
 more safety in the operation. By a royal decree of date 
 of May 25, 1845, in compliance with a desire expressed 
 b}"^ the Hebrew Consistory, it was ordered that no one 
 sihould exercise the functions of a mohel or of schohet, 
 without being duly authorized to perform said functions 
 by the Consistory of the Circ3nscription; and that all 
 mohels and schohets shall be governed in the exercise of 
 their functions by the Departmental Consistory and the 
 General Consistory. By virtue of this decree a regula- 
 tion was passed by the Consistories on the 12th of July^ 
 1854, ordering that thereafter circumcision should only 
 be performed in a rational manner, and b}'^ a properly 
 qualified person. Suction was likewise abolished, and 
 the wound directed to be sponged with wine and water. 
 This decree and the resulting regulations have been of 
 the greatest benefit to the French Israelites, and some 
 attention to the matter would not be amiss in the United 
 States. 
 
 This reformation has met with the approval of the 
 leading French Jews, whose General Consistory decided 
 that suction was not necessarily a part of the religious 
 rite, and that, as it was undoubtedlj'^ introduced into the 
 rite on the days of primitive surgery, it was perfectly 
 rational to suppress this operative accessory, now 
 
158 History of Circumcision. 
 
 that that same science, in its enlightenment, pronounced 
 it unsafe. The whole body of the Congregation did not 
 tnmely submit to what they considered an innovation, 
 and from some of the mohels all possible resistance was 
 opposed to prevent the abolishment of this part of the 
 operation from becoming a law. So determined was 
 this opposition in some instances that the Consistor3'^ of 
 Paris found it necessary to impose on all the moiiels an 
 obligation, bound by an oath, that they would respect 
 the law. Those who refused to take the obligation gave 
 up their vocation. 
 
 The Grand Rabbi of Paris, at the time of this 
 reformation, M. Ennery, was one of the most zealous 
 supporters of the new departure. The influence of the 
 French pervaded northward, and the mezizah was abol- 
 ished in Brunswick, Dv* Solomon, a learned Hebrew 
 of that State, being instrumental in having it done 
 legally. The discussion of this subject, in 1845, had 
 one very happy effect, — the supporters of the reformed 
 idea of the rite issued a circular letter to all the leading 
 continental surgeons and medical men asking for their 
 opinion on several points in relation thereto, especially, 
 however, on this part of the rite. The opinions of many 
 of these will be referred to in the medical part of this 
 work. 
 
 The after-treatment of the circumcised infant is gov- 
 erned more or less by local habits and the individual 
 intelligence of the mohel and his experience. After 
 turning back the inner fold of the prepuce, the parts 
 are covered with a small, square bandage, with an aper- 
 ture to admit the passage of the glans. This, and the 
 subsequent small bandage of old linen, which is calcu- 
 lated to hold it in place, are slightly coated with a 
 powder composed of lycopodium, with the slight 
 
Mezizah, Fourth or Objectionable Act of Suction. 159 
 
 addition, at times, of Monsel's salts, alum-powder, or 
 some vegetable astringent. Over these another compress 
 is placed, to prevent the friction of the clothes of the 
 infant or of the bedding. The infant then receives a 
 final benediction, and the godmother then receives the 
 child in her arms and carries it to its cot or crib. The 
 operator generally visits the infant in the afternoon of 
 the operation, and carefully inspects the dressings, to 
 see that no haemorrhage has supervened. 
 
 It is customary to place the child in a bath, either 
 the same evening or on the following morning, the 
 object of this being to remove and to facilitate the 
 removal of the dressings, which are more or less 
 saturated and clotted with blood. After the removal, of 
 these, the wound is redressed, as previousl3', except 
 that some cerate — ointment of roses or some other 
 mild ointment — is used. Som€ prefer the simple water 
 dressing from beginning to end. Since the introduction 
 of creasote, acid phenique, and carbolic acid, many 
 mohels are in the practice of washing the parts with 
 water impregnated with one of these before performing 
 the operation, and using subsequently the same form of 
 lotion at every dressing. In case of haemorrhage there 
 is an haemostatic water or lotion, which has been long 
 used by the German and Polish mohels with consider- 
 able success, and which, in ordinarj'' cases, has been 
 found to be all that was required. This water, called 
 by the French " Mixture d'arguesbusade," " Eau vul- 
 neraire spiriteuse de Theden," and by the Germans as 
 *' Spritzwasser " and " Schusswasser," is composed as 
 
 follows : — 
 
 Acetic acid, . . . . .10 grammes. 
 Rectified spirits of wine, . . 5 " 
 
 Diluted sulphuric acid, . . 2}4 " 
 
 Clarified honey, .... 8 " 
 
 6 
 
160 History of Circumcision. 
 
 This mixture is well mixed and filtered, and is then 
 kept in a tiglitly-stoppered vial. 
 
 Dr. Bergson uses a mixture composed of diluted 
 sulphuric acid, 1 part ; alcohol, 3 parts ; hone}', 2 parts ; 
 and 6 parts of wine vinegTar. 
 
 Hemostatic powders are also used by the Hebrews, 
 being more conveniently kept or carried than the 
 hseraostatic waters. In Russia and in Poland they are 
 composed of decomposed or decaj'ed hawthorn-wood 
 powder and 13'copodium. That of Berlin is composed 
 of Armenian bole, red clay, dragons' blood, powdered 
 rose-leaves, powdered galls, and powdered subcarbonate 
 of lead. In France a haemostatic fluid, composed of 
 dragons' blood digested in turpentine, is in vogue. 
 The Eau de Pagliari is also used ; it is composed of 
 a mixture of tincture of benzoin, 8 ounces ; powdered 
 alum, 1 pound ; and 10 pounds of water, boiled together 
 for six hours, and is considered a powerful stj^ptic. 
 In addition to these, burnt linen, spiders' webs, starch- 
 powder, powdered alum, and plaster-of-Paris powder are 
 used by different mohels. Touching the bleeding points 
 with a pointed pencil of nitrate of silver is also a prac- 
 tice understood by the Jewish circumcisers. 
 
CHAPTER XIY. 
 What are the Benefits of Circumcision? 
 
 There are those, eA'en among the Hebrews, "wlio 
 are so imbued with the purelj^ tlieological idea of the 
 origin, performance, and causes of circumcision, that 
 the^' cannot see an}- moral nor hj'gienic value in the 
 operation. Among many Christians the idea still pre- 
 A'ails that circumcision is the relic of some barbarous 
 rite, practiced in some epoch away in the remote ages 
 of the world, grafted on to the Jewish religion by some 
 accident or other; but that beyond the clinging of the 
 Jews to this custom, as being a remnant of their old re- 
 ligion, tliey neitlier see in the rite any other significance, 
 moral results, nor hj^gienic precaution ; and the fact of a 
 Jew being circumcised is too often made a subject of 
 merriment among the unthinking portion of the Chris- 
 tian world. Neither are physicians all of one accord on 
 the subject as to whetlier circumcision is a benefit, or, 
 being useless, a dangerous and an unnecessary opera- 
 tion. The writer is most emphatically in favor of cir- 
 cumcision, and has the fullest faith in the positive 
 moral and physical benefits that mankind gains from the 
 operation. 
 
 It may well be asked : What does the Jew receive 
 in return for all the suffering that he inflicts through cir- 
 cumcision on himself and his little children ? What 
 is there to repa}^ him or his for all the risks and annoy- 
 ances, besides branding himself and his with an 
 indestructible mark, which has been more than once the 
 sign by which they have suffered persecution, spoliation, 
 
 (161) 
 
162 History of Circumcision. 
 
 expatriation, and death? Are there any benefits en- 
 joyed by the Jew that the uncircumcised does not 
 enjoj' in equal proportion ? 
 
 The relative longevity between the Hebrew race and 
 the Christian nations that dwell together under like 
 climatic and political conditions indicates a stronger 
 tenacity on the part of the Jewish part of the nations 
 to life, a greatly less liability to disease, and a stronger 
 resistance to epidemic, endemic, and accidental diseases. 
 By some authorities it has been held that the occupa- 
 tions followed by the Jew are such as do not compel 
 him to risk his life, as he neither follows any labor re- 
 quiring any great and continued exertion, nor anj' that 
 subjects him to any great exposure ; that, as a rule, 
 when in business, by some intuition he follows some 
 branch that has neither anxiety, care, nor great chance 
 of loss connected witli it ; that he does not follow any 
 occupation that is attended with any risk of accident 
 for either life or limb. Besides all these, it is also urged 
 that in cities the careful inspection of their meat, and the 
 peculiar social fabric of the family, the love and venera- 
 tion for their aged, as well as their proverbial charitj^to 
 their own poor and sick, and their-provident habits and 
 h3^gienic regulations imposed upon them b}' the Mosaic 
 law, are all conditions that conspire to induce longevit3^ 
 
 That the Hebrew is generally found in such con- 
 ditions as above described is undisputed ; but it is 
 questionable if all these conditions are necessarily such 
 as are favorable to health and long life, and that, 
 therefore, the longevity of the Jewish race cannot 
 altogether be ascribed to the above conditions. Look- 
 ing at the subject of occupation, if we consult Lombai-d, 
 Thackrah, and the later works on the effects of occupa- 
 tion on life, we must admit that the Jew has no visible 
 
What are the Benefits of CircumcUion'? 163 
 
 advantage in that regard, as he follows hardly any out- 
 of-door occupation, being often in-doors in a confined 
 and foul atmospliere. To those who have closely ob- 
 served the race in this country, — coming as they do 
 from the cold-wintered climates of Germany, Austria, or 
 Poland, bringing with them the habit of living in small, 
 close rooms, for the sake of economy and comfort, — it 
 must be admitted that among the lower classes and the 
 poorer of the race, their shops being connected, as they 
 usually are, with their living-rooms, the toute ensemble 
 is anything but conducive to a long life. Their an- 
 aemic and undeveloped physical condition and weak 
 muscular organization are sufficient evidence that their 
 surroundings are not calculated to improve health. In 
 England, statistics sufficiently prove that the fisherman 
 on the coast, exposed to all kinds of weather, is not as 
 prone to disease as is his brother Englishman who deals 
 out the groceries in his snug shop. Exercise has been 
 held an important element in the factory of the long- 
 lived. From the time of Hippocrates down to Che^^ne, 
 Rush, Hufeland, Tissot, Charcot, Humphry, and all 
 authorities on the factors of old age, exercise has been 
 looked upon as favoring long life. Exercise cannot be 
 said to enter in any way as a factor in the longevity of 
 the Jew; but, on the contrary, his in-door life is known 
 to be very productive of phthisis in other races. His 
 recreations are, as a rule, of the home social order. 
 They visit and spend the time allotted to recreation in 
 social intercourse, which their hospitality always insists 
 on accompanying with a generous lunch, which, to say 
 the least, is not an element that is conducive to either 
 health or long life ; for no people excel the Jew in 
 home hospitality, and even among the poorer classes a 
 stranger is never allowed to depart without some re- 
 
164 History of Circumcision. , 
 
 fresliment being offered him. Among the class better 
 able to extend hospitality, social reunions and card 
 parties, with lunches of fruits, cakes, cold meats and 
 coffee, or wines, are among their regular occurrences. 
 Their great affection for the familj' and for their youth 
 and aged suggests these means of recreation, as then 
 they are enjoyed by all alike ; but, as observed, the 
 hj^giene of all this is very doubtful ; it produces too 
 much irregularity. 
 
 It is related that after the Roman conquest of 
 Palestine many of the Jews, becoming more or less 
 accustomed to Roman manners and customs, often 
 joined in the games which the Romans held in imitation 
 of the old 013'mpic games of the Grecians, Not to be 
 ridiculed, many resorted to the practices described in a 
 previous chapter, to efface all the marks of their cir- 
 cumcision, that they might enter the games with as 
 much freedom as the Romans or other uncircumcised 
 nations ; so that the present aversion to out-of-door 
 sports evinced by the Jew is not necessarily a racial 
 trait ; the persecutions and political inequality that 
 until lately he has been made to suffer have driven 
 him into retirement and seclusion. Although seeking 
 neither converts nor political power and influence, he 
 has been hunted down, massacred, and chased about as 
 a dangerous beast. As the children of the great Rabbi 
 Moses Mendelssohn asked of their father : " Is it a 
 disgrace to be a Jew ? Why do people throw stones at 
 us and call us names?" It may well be asked, why? 
 These actions haA'^e forced them into the social and 
 retired habits for which they are noted ; altliough it 
 cannot be said that it is from a lack of spirit, as one of 
 the Rothschilds is well known to have been present at 
 tlie battle of Waterloo, where from a spot in the vicinity 
 
What are the Benefits of Circumcision'} 165 
 
 of the British right-centre he observed the events of 
 the battle; and when, with the failure of Ney's last des- 
 perate charge with the formidable battalions of the Old 
 Guard, he saw the advance of the Prussians closing in 
 on the French right, he galloped to the sea-shore, and, 
 crossing the Channel in a frail boat, reached London 
 twentj'-four hours in advance of the news of the battle,®^ 
 but long enough for him to clear several millions from 
 off the panicky state of the money market. Marshal 
 Massena, one of Napoleon's bravest generals, the de- 
 fender of Genoa and the hero of Wagram, was of 
 Jewisli origin. 
 
 Athletic sports are not of necessity conducive to 
 long life, even if they are to temporar3' robust health; 
 but there is no mistaking the fact that the sedentary 
 and in-door life of the average Jew is a deteriorator to 
 health and life, and especiall}' among that class of fami- 
 lies who are poor and keep no servant ; from heredity 
 and home education having adopted unhygienic customs, 
 in which they have grown up, — in these a total disre- 
 gard for all ventilation forms a part. Were an uncii'- 
 cumcised race so to live, scrofula and phthisis would be 
 the inevitable result. This difference of results I have 
 witnessed more than once as existing among the two 
 races coming from the same European nationality, 
 where their disregard to ordinary' rules of hygiene, in- 
 duced b}^ climatic canses, especfally A^entilation, were 
 alike in both the Semitic and European descendants of 
 the one nation, the purely European being more prone 
 to consumption and scrofula. It is interesting to note 
 the difference in the moral, mental, and physical condi- 
 tions induced hj creeds ; it would seem as if it should not 
 make any difference. The generally accepted idea of 
 religion is that it should raise the moral standai-d of all 
 
166 History of Circumcision. 
 
 those nations Tvho practice religion ; but the results are 
 very peculiar, as we are forced to admit that reforma- 
 tion in religion has not always been a reformation in 
 morals. Take Great Britain for example ; if illegitimacy 
 is anj' criterion of the moral state of those professing 
 creeds, we find the least among the Jew ; next among 
 the Catholic ; next comes the Episcopalian ; then last 
 the Presbyterian. — the oldest creed showing the great- 
 est moral tendency, and that of poor Knox, wliich is 
 the youngest, showing the least. This has certainl}' its 
 phj'sical effects, that are not without its influence in 
 producing a greater or lesser length of life. The 
 eA'olutiou of religion has here induced a lower moral 
 tone and a resulting ph^'sical degeneracy. 
 
 As observed by alienists, religions of different creeds 
 have different tendencies in inducing insanity, both as to 
 ratio of population and as to manifestations;^ the 
 Protestant, when unbalanced b}' religious cause, is gen- 
 erally controlled with some idea that shows itself in wild 
 and erratic attempts at scriptural interpretation, caused 
 b}- want of fixed dogmas and the unending splittings 
 that are forever taking place in the new faith, and the 
 persistent, intrusive, and belligerent spirit of proselytisra 
 that controls each new brancli as it buds into existence. 
 The Catholic has a fixed dogma, ^which the church 
 attends to, and be neither feels called upon to make his 
 neighbors miserable or himself insane in hunting up new 
 interpretations. When he does go insane on the subject 
 of religion, the cause, as a rule, can be traced to some 
 real or imagined moral delinqueuc3', which has brought 
 all the terrors of the punishment of the damned forcibly 
 and persistently to his disordered imagination. In the 
 insane-asylums of Cork, in Ireland, with its overwhelm- 
 ing Catholic population, the ratio of inmates in regard to 
 
What are the Benefits of Circumcision'^ 167 
 
 creeds is as that of one Catliolic to ten of tlie Refurmed 
 religion, showing in the most conclusive manner the in- 
 fluence exerted by religion in this direction. On the 
 other hand, the Jew has the simplest of religious creeds; 
 he neither wastes useful time, robs himself of sleep, nor 
 becomes dyspeptic in hunting for hidden meanings in 
 some ambiguous scriptural phrase ; he is satisfied with 
 his creed, his dogmas are firmly anchored, and the 
 nature of his religion being a sort of famih* congrega- 
 tion, he is not called upon to go out in search of prose- 
 lytes, any more than the father of an already large 
 family feels called upon to go out and hunt up the 
 homeless, that he may convert his home into a promis- 
 cuous orphan-asylum. As before remarked, his creed is 
 of the simplest, and there exists a complete and explicit 
 understanding between his God and himself. There are 
 no m3'stical, hidden meanings in Scripture for the Jew; 
 nor does he dread any eternal, unheard-of, and inexplicable 
 torments. His laws are very clear, and the punishments 
 for their infraction very explicit. To the Jew it is a 
 straight and well-lighted road, as far as religion is con- 
 cerned. The writer has always felt that it took a mind 
 that was incapable of appreciating simple truths, but 
 that loved to hover on that m3^stical border-land on the 
 confines of -gloom}- insanit}* that would allow its owner 
 to seriousl}^ wander through and behold any theological 
 beauties in Bunyan. To the Jew there is none of the 
 gloomy, weird, mystical, mind-racking, ungodlj" theology 
 that some of our creeds torture the poor brains of their 
 professors with. As the wild Indian of the plains runs 
 sticks through his anatomy and capers wildly about to 
 torture his body, so some of the creeds delight in tort- 
 uring their devotees. The Jewish religion is the one 
 best suited to tranquilize the mind ; it is very philo- 
 
168 History of Circumcision. 
 
 sophical and rational. Were he to acknowledge Christ, 
 he would not have to change his ieourse of life to become 
 a most exemplarN' Christian. The celebrated letter of 
 Moses Mendelssohn to the Swiss clergyman, Lavater, in 
 answer to a dedication of the latter to Mendelssohn, is 
 probably the best exposition of the essence of the Jewish 
 faith that can be found. Therein he saj^s : " We be- 
 lieve that all other nations of the earth have been com- 
 manded by God to adhere to the laws of nature. Those 
 who regulate their conduct according to this religion of 
 nature and of reason are called virtuous men of other 
 nations, and are the children of eternal salvation." 
 Such a religion does not unsettle man's mind. 
 
 These apparent digressions are made to show what 
 additional factors exist, besides circumcision, to induce 
 longevitj^ in the Jewish race, and that the subject may 
 be better understood ; for these reasons the above com- 
 parisons have been made. Students of demographic 
 science are well aware that form of government, religion, 
 climate, diet, habit, and custom, — all have an important 
 bearing on the mental and physical as well as on the 
 moral nature of man. To the true student of his art all 
 these conditions are but factors in the ph3'^3ical scale, and 
 should so be considered without fear or favor ; to him the 
 whole world is but a unit, and the people upon its sur- 
 face are but as one people, alike subject to the leveling 
 laws of nature, which recognize neither royalty nor 
 vagrant, nationality nor creed, color, condition, nor 
 station in life or society. 
 
 Professor Bernoulli, of Bale, found the Israelite 
 less proliGc than the Christian f"^ subject to less mor- 
 tality, greater longevit}', less still-born, less illegitimacy, 
 less crime against the person, and less insanity and 
 suicide, when compared with his Christian brother — 
 
What are the Benefits, of Circumcision? 169 
 
 all of which he attributes not to a superior ph3'sique or 
 organism, but solely to the observance of the laws of 
 their religion and to the nature of tlie same, which exer- 
 cises a beneficial influence on the mind. 
 
 B. W. Richardson, in his " Diseases of Modern Life," 
 in speaking of the relation of race to disease, says : 
 " Through the valuable labors of MM. Legoyt, Hoff- 
 mann, Neufville, and Mayer, we have obtained, however, 
 some curious facts relative to the most widely dissemi- 
 nated of all races on the earth, the Jewish. These facts 
 show that, from some cause or causes, this race presents 
 an endurance against disease that does not belong to 
 other portions of the civilized communities amongst 
 which its members dwell. The distinctness of the Jews 
 in the midst of other and mixed races singles them out 
 specially for observation, and the history the^^ present 
 of vitality, or, in other words, of the resistance to those 
 influences which tend to shorten the natural cycle of 
 life, is singularly instructive. 
 
 " The resistance dates from the fii'st to the last 
 periods of life. Hoffmann finds that in Germany, from. 
 1823 to 1840, tlie number of still-born among the Jews 
 was as 1 in 39, while with other races it was 1 in 40. 
 Ma3'er finds that in Furth children from one to five 
 years of age die in the proportion of 10 per cent, among 
 the Jewish, and 14 per cent, among the Christian popu- 
 lation. M. Neufville, dealing with the same subject, 
 from the statistics of Frankfurt, gives even a mox-e 
 favorable proportion of natality to the Jewish child 
 population. Continuing his estimates from the ages 
 named into riper years, the value of life is still in favor 
 of the Jews, the average duration of the life of the Jew 
 being forty years and nine months and that of the 
 Christian being thirtj^-six years and eleven months. In 
 
no History of GircumcAsion. 
 
 the total of all ages, the half of the Jews born reach the 
 age of fifty-three years and one month, whilst half of 
 the Christians born only reach the age of thirty-six 
 years. A quarter of the Jewish population born is 
 found living beyond seventy-one years, but a quarter of 
 the Christian population is found living be3^ond fifty- 
 nine years and ten mouths onl3\ The Civil State 
 extracts of Prussia give to the Jews a mortality of 1.61 
 per cent. ; to the whole kingdom, 2.62 per cent. To the 
 Jews they give an annual increase of 1.73 per cent.; to 
 the Cliristian, 1.36 per cent. The effective of the Jews 
 require a period of forty-one 3'ears and a half to double 
 themselves ; those of other races, fiftj^-one years. In 
 1849, Prussia returned one death for every fortj'-one of 
 the Jews and one for every thirty-two of the remaining 
 population, 
 
 " The Jews escaped the great epidemics more readily 
 than the other races with whom they lived. Thus, the 
 mortality from cholera amongst them is so small that 
 the very fact of its occurrence has been disputed. 
 Lastl}^, that element of mortality, suicide, which we may 
 look upon philosophically as a phenomenon of disease, 
 is comi)uted by Clatter, from a proportion of one million 
 of inhabitants of Prussia, Bavaria, Wiirtemburg, Aus- 
 tria, Hungar}^, and Tranyslvania, to have been com- 
 mitted by rather less than one of the Jewish race to 
 four of the members of the mixed races of the Christian 
 population. Different causes have been assigned for 
 this higher vitality of the Jewish race, and it were 
 indeed wise to seek for the causes, since that race which 
 presents the strongest vitality, the greatest increase of 
 life, and the longest resistance to death must in course 
 of time become, under the influences of civilization, 
 dominant. We see this truth, indeed, actually' exempli- 
 
What are the Benefits of Circumcision ? 171 
 
 fied in the Jews ; for no other known race has ever 
 endured ,so much or resisted so much. Persecuted, 
 oppressed by every imaginable form of tyranny, they 
 have held together and lived, carr3'ing on intact their 
 customs, their beliefs, their faith, for centuries, until, set 
 free at last, they flourish as if endowed with new force. 
 They rule more potently than ever, far more potently 
 than when Solomon in all his glory reigned in Jerusalem. 
 They rule, and neither fight nor waste. "^^ 
 
 Richardson attributes the great benefits enjoj'ed in 
 this regard b}- the Jewish race to the soberness of their 
 lives. This position is, however, not altogether tenable, 
 if by that we mean abstemiousness ; they are extremely 
 temperate, but not abstemious. Tissot, Cornaro, Lessius, 
 Hufeland, Humphry, Sir Henry Thompson, as well as 
 the older Greek and Roman authorities, all are agreed 
 that an abstemious life is the one that is most conducive 
 to long life. There is no race that is more proverbial 
 for their good cheer and indulgence in the good things 
 of the table than the Jewish ; no race enjoys feasting 
 any more than they, and from childhood the}' are accus- 
 tomed to a generous and nutritious diet, as well as to 
 their share of the wines with which their tables are sup- 
 plied. Their greater thrift and application to business, 
 their habits of economy and carefulness in business 
 affairs enable them to better supply their tables. In 
 California there is no class that lives better or whose 
 tables are supplied so well either as to qnalit}^ or quan- 
 tity as those of the Jews, and yet no class is more 
 exempt than they from the class of diseases that origi- 
 nate in too good living. As before remarked, in relation 
 to the poor of that faith, who are unable to keep a 
 servant, and who live in a combination of shop and home 
 in the most unhygienic condition, disregarding ventila- 
 
172 History of Circumcision. 
 
 tion and eveiy other sanitary needs, but who, neverthe- 
 less, escape the evil results that would and do attend 
 such social conditions among those of other races, so in 
 this instance of good living : the better class of Jews do 
 not suffer in anything near a like proportion to the better 
 class Christians from diseases incident to too full habits 
 and an inactive life. Richardson observes that he drinks 
 less and that he eats better food than his Christian 
 brother. In regard to the drinking habit, overindul- 
 gence is not a Jewish failing ; they do not drink, to 
 excess, but total abstinence is not in their vocabulary. 
 It is inconsistent with their idea of wine as being a gift 
 of God, and something that is s^ymbolical of good faith 
 and thanksgiving. Nor is total abstinence consistent 
 with their idea of generous hospitality. On the eighth 
 day after birth the Jew tastes wine, and from the time 
 he is able to sit at table he becomes familiar with its use. 
 To him wine is not symbolical of either moral depravit}', 
 mental or phjsical deterioration, or of death. Their 
 females are all accustomed to its use from childhood, 
 but it does not cause them to become either immoral or 
 unchaste ; so that in neither sex does wine produce that 
 moral and mental wreckage which abbreviates the length 
 of human existence among those of other creeds. 
 Radical fanaticism, that drives a tack with a maul and a 
 twenty-penny spike with a tack-hammer, cannot be ex- 
 pected to study this or an}' other question in an}^ rational 
 manner ; but to the sociologist, the question as to what 
 produces this remarkable soberness, in the midst of the 
 habitual and continued use of wine in the race from the 
 time of its earliest history, is something worth}^ of calm 
 and careful consideration. How much circumcision may 
 have to do with this will be discussed in the medical 
 part of the volume. 
 
What are the Benefits of Circumcision'? 173 
 
 In London, according to Dr. Stallard, the mortality 
 among Jewish children from one to five years is only ten 
 per cent., while among the children of the Christians it 
 is fourteen per cent., the rate being analogous to that 
 observed by Ma3^er among those of these ages in Furth. 
 Among the London adults the average duration of life 
 among the Jews is forty- seven j^ears, while among the 
 Christians it is only thirty-seven. 
 
 Dr. Hough^^ has gatliered some interesting historical 
 and statistical matter bearing on the subject of Jewish 
 resistance to disease and the benefit possessed by the 
 race in relation to the immunity enjoyed by them in 
 prevailing epidemics. The plague of 1346 did not affect 
 them ; according to Fracastor the}^ escaped the typhus 
 of 1505; Rau remarks their immunity to the typhus of 
 1824 ; Ramazzini noticed their exemption to the fatal 
 iutermittents of Rome, in 1691 ; and Degner saj^s that 
 they escaped the epidemic dysentery at Nimegue, in 
 1736. Richardson truly observes that " from epidemics 
 the Jews have often escaped, as if they possessed a 
 charmed life." This racial difference and benefit, when 
 compared to other races, has more than once cost them 
 dear. In the dark and ignorant ages, when men 
 reasoned nothing from a physical basis, but attributed 
 all and every phenomena to some supernatural agency, 
 either heavenl}^ or diabolical, it was but natural for such 
 minds to associate this exemption with some purchased 
 compact made with the devil, who was often also held 
 accountable for tlie existence of the epidemics. The 
 rational and law-of-nature observing Jew supposed to be 
 in league with his satanic majesty could neither be seen 
 nor heard in his own defense ; consequentily, massacres, 
 pillaging, and such other barbarities that an insane 
 popular fury could suggest, were the humane manifesta- 
 
174 History of Circumcision. 
 
 tions with which a Christian people visited their Jewish 
 brothers, whose only sin consisted in worshiping the 
 God of their fathers, and in strictly observing His laws 
 and commandments. 
 
 In France, Dr. Neufville found that, of one hundred 
 children in the first five years of life, among the Jewish 
 population, 12.9 die; while from the same number of 
 tlie same aged class of Christians 24.1 die. One-half 
 of all the Christians die at thirt3'-six years, and one-half 
 of all the Jews at fifty-three 3'ears and one month. 
 
 Dr. John S. Billings has gathered statistics relating 
 to 10,618 Jewisli families, consisting of 60,630 persons,^" 
 living in the United States in December, 1889, mostly 
 descendants of Jews from the northern or middle nations 
 of Europe. For our purpose only the deductions as to 
 death-rate and tendency to longevity will be given. In 
 this valuable paper Dr. Billings says : " When we come 
 to examine the reports of deaths for five years furnished 
 by these Jewish families, we find that they give an aver- 
 age annual denth-rate of only 7.1 per 1000, which would 
 be about one-half of the annual death-rate among other 
 persons of the same average social class and condition 
 living in this countr3^" To this he adds that, provided 
 the deaths at different ages among the Jews have been 
 correctly reported, this race will, on comparison witli 
 those of other races, show a greater tendency to lon- 
 gevit}', as the Jewish expectation of life is at each age 
 markedly greater than that of the class of people who 
 insure their lives, the average excess being a little over 
 twent^'^ per cent. 
 
 In speaking of the death-rate among children, Dr. 
 Billings makes the following comparisons : " The low 
 death-rate among the Jews is especiall}' marked among 
 the children, and this corresponds to European experi- 
 
What are the Benefits of Circumcision ? 175 
 
 ence. Thus in Prussia, in 1887, tlie death-rate of the 
 Jews under fifteen j^ears of age was 5.63 for 1000, while 
 among the remainder of the people it was 10.46 per 
 1000." This result he accounts for partly to the fact 
 that among the Jews illegitimac}' is comparatively rare 
 and to the high rate of mortalitj^ among the illegitimate 
 born, which raises the average of the other classes. 
 
 In regard to the immunity of the race from consump- 
 tion or tubercular disease, the statistics of the above 
 Jewish families gives to the Jews less than one-third of 
 the number of deaths from these diseases than what 
 occurs among the others as to the male population, and 
 less than one-fourth as to the female population. These 
 statistics coincide with the observations of the writer on 
 this part of the subject, and are even more than corrobo- 
 rated by the French War-Office Reports from Algeria, 
 where the deaths from consumption among the Chris- 
 tians amount to 1 for each 9.3 deaths, and. among the 
 Jews to 1 in 36.9, while among the Mohammedans it is 
 only 1 in 40.7 deaths. In Algeria the relative mortality 
 from all causes is only about three-fifths of that of the 
 Christian, and the Turk, although seeming to enjoy a 
 greater exemption from phthisical or tubercular diseases 
 than the Jew, falls below the Jew in exemption from 
 deaths due to general causes, as his mortalit}^ is one- 
 eighth greater than that of the Jew. Dr. Billings gives 
 us some interesting food for thought in the course of his 
 article and some more particularly bearing on the sub- 
 ject of immunity from consumption. He asks: "Are 
 these differences due to race characteristics, properly 
 so-called, to original and inherited differences in bodily 
 organization, or are they, rather, to be attributed to the 
 customs, habits, and modes of life of the two classes of 
 people?" 
 
176 History of Circumcision. 
 
 Some years ago, Henry I. Bowditch, of Boston, put 
 on foot an extended sj^stem of inquiry in regard to 
 ascertaining the causes or antecedents of consumptioii 
 in the State of Massachusetts. In answer to some of 
 the questions of the circular, Rabbi Dr. Guinzburg, of 
 Boston, answered as follows, under date of October 29, 
 1872:— 
 
 1st. The number of Jews living in Boston is about 
 5000. 
 
 2d. There certainly have not died of consumption, 
 during the last five years, more than eight or ten Jews 
 in the various congregations. 
 
 To this Dr. Bowditch adds, as follows : — 
 
 " If Dr. Guinzburg's data be correct, they show a 
 ver}'^ great immunity from consumption on the part of 
 the Jews, compared with the citizens generally, as will 
 be seen b^' the following comparison between these 
 numbers and those procured from the Registration 
 Reports, published by the State. In the report pub- 
 lished in 1869, page 64, we find that for the five years pre- 
 ceding 1869 the annual average of deaths by consump- 
 tion was 338 for every 100,000 living. These data from 
 Dr. Guinzburg and the State Report give the following 
 table : — 
 
 Proportion of Deaths to 
 100,000 of Living. 
 
 All religions, 338 
 
 Jews, 40 
 
 " These statements from Dr. Guinzburg are confirmed 
 by the following letter from Dr. A. Haskins, of this city. 
 Dr. Haskins is connected with one of the Jewish benev- 
 olent associations for the benefit of the sick. I sent to 
 him similar questions and make the following extracts 
 from his repl}^ : — 
 
 '"I am generally em ploj'ed in about sixtj^ families 
 
What are the Benefits of Circumcision'^ 
 \^ T hn.vp hnrl thpsp fnTnilif'S niider mv f 
 
 177 
 
 (Jewish). I have had these families under 1113' care for 
 two and a half years. During this time I have seen but 
 one case of consumption. I haA^e averaged among these 
 sixty families about two visits daily. In m}' other Jewish 
 practice, which is not inconsiderable,! have in this time 
 (two and a half 3'ears) seen two cases of consumption. 
 . . . I am sorry I have no statistics wherebj' I could 
 compare the two peoples, viz., Jews and Christians. I 
 can, therefore, give you only my impressions. I should 
 say that I find consumption less frequent among the 
 Jews than among Christians. This would be my own 
 impression without an}- data to fortify it.' 
 
 " Dr. Waterman also sustains the same idea. The fol- 
 lowing extract will give some idea of his opportunities 
 for observation and the sources of his deductions : — 
 
 '" Boston, November 2, 1872. Dear Sir, — . . . . 
 First, I have attended four charitable associations ; 
 number about fort}', fift}", sixty, and one hundred fami- 
 lies. At present I only attend one, containing one hun- 
 dred families, and on which I average a fraction over one 
 visit a daj^ I have, besides, many private families among 
 the Jews. I have attended but few cases of consumption, 
 and I think the disease is not so prevalent as among 
 Christians.' " 
 
 The same report of Dr. Bowditch quotes from Stal- 
 lard's " London Pauperism Amongst Jews and Chris- 
 tians," as saying that there is no hereditary sj'philis, 
 and scarcely any scrofula to augment the mortality in 
 the Jewish families. 
 
 In relation to the liability of the Hebrew race to 
 phthisis, Richardson has the following at page 22 of his 
 " Diseases of Modern Life": "The special inroads on 
 vitality made on other races by disease are not easily 
 determined, because of the difficulties arising- from tem- 
 
178 History of Circumcision. 
 
 porary admixture of race. I tried once to elicit some 
 fiicts from a large experience of a particular disease, 
 phthisis pulmonalis, and, as the results of this attempt 
 may l»e useful, I put them briefl}' on record. 
 
 "At a public institution at which large numbers of 
 persons afflicted with chest diseases applied for medical 
 assistance, and at which I was for many j-ears one of the 
 phj'sicians, I made notes during a short portion of the 
 time of the connection that existed between race and the 
 particular disease I have instanced — phthisis pulmonalis, 
 or pulmonar^^ consumption. The number of persons 
 observed under the disease was three hundred, and no 
 person was put on the record who was not suffering 
 from a malady' pure and simple ; I mean without com- 
 plication with any other malad3^ They who were thus 
 studied were of four classes : (a) those who were hy race 
 distinctl}' Saxon ; (b) those who w^ere of mixed race, or 
 whose race could not be determined ; (c) those who were 
 distinctly Celtic ; (d) those who were distinctly Jewish. 
 
 " The results were, that of the three hundred 
 patients, one hundred and thirt3' -three, 44 33 per cent., 
 were Saxon ; one hundred and eighteen, 39.33 per cent., 
 were of mixed or undetermined race ; thirty-one, 10.33 
 per cent., were Celtic; and eighteen, 6 per cent., were 
 Jewish." 
 
 Although Dr. Richardson admits it would be unfair 
 to accept the above figures as a basis for general appli- 
 cation, he argues that the}' are, on the average, sufficiently 
 suggestive, as among the Saxons it was noticed that 
 there were more cases in whom the disease was heredi- 
 tar3% while among the others it was generally acquired. 
 
 In going over the subject of this question in regard 
 to phthisis, we must admit that, although the Jew in his 
 own home, synagogue, or in his social reunions, is not 
 
What are the Benefits of Cii'cunicision? 1T9 
 
 exposed to tubercular emanations, and that he has less 
 chance of contracting the disease from tuberculous 
 meats, he is, after all, a theatre-goer; a pretty con- 
 stant inhabitant of the sleeping-car and hotel, as a com- 
 mercial traveler and general merchant ; and that, on the 
 whole, he eats the same food, breathes the air and dust 
 of the same streets, and drinks the same milk and water 
 as the Christian, and, as observed by Dr. Billings, cook- 
 ing destroys the bacillus in meats. So that the compara- 
 tive exposure in this country — where the practice is not 
 as prevalent as in Germany of eating raw minced-meat 
 sandwiches — existing between the Jew and the Christian 
 to tubercular infection from meat are about equal. The 
 records of the Jewish Hospital of New York gives, out 
 of 28,750 persons admitted, only 44.17 per 1000 of its 
 admissions as being due to consumption ; while those of 
 the Roosevelt Hospital, out of 25,583 admissions, gives 
 a per 1000 of 67.93. 
 
 From what is known of the relation of syphilis to 
 consumption, not only as affecting the primary indi- 
 vidual, but the subsequent generations of the same, and 
 the known greater exemption of the Jew to sj^philitic 
 infection, owing to the protecting influence of circum- 
 cision, it is safe to assert that therein is to be found one 
 of the main reasons of the exemption of that race to 
 consumption. If we but look at the geographical dis- 
 tribution of phthisis and the historj^ of its progress, we 
 shall find that it has had s^-philis as its avant courrier on 
 more than one occasian. Lancereaux, in his " Distribu- 
 tion of Pulmonary Phthisis," points to the fact that 
 where consumption has made its greatest raA'ages, and 
 where it has nearly depopulated one of the great divi- 
 sions of the globe, — namel3',the groups of islands in the 
 Pacific Ocean, — the disease had no existence at the 
 
180 History of Cir-cumcision. 
 
 beginning of the present centuiy. Sj-pbilis, scrofula, 
 and a quick, galloping consumption have, since the last 
 ninety years, taken off the greater part of the popula- 
 tion. The same course of transition from the best of 
 physical conditions to racial deterioration and extinction 
 from the same relative condition of causes — syphilis, 
 scrofula, and phthisis — has been observed among the 
 open-air dwellers of the Ncav Mexican Plains, in the 
 mountains of Arizona, and on the arid wastes of the 
 Colorado Desert, where the ajjpearance of consumption 
 cannot be attributed to housing or incipient civilization, 
 as it is attributed to housing among the Chippeways, 
 Sioux, or Mandans in the regions that formerly formed 
 the Northwest Territory. The question is very plainly 
 answered as to how consumption was introduced or 
 ■whence it sprung that has so ravaged the Oceanic 
 Islands. The sailors who first visited those islands were 
 not, as a rule, a batch of consumptive tourists on a voy- 
 age in search of health or recreation ; but we can well 
 understand that the proverbially improvident mariner 
 has not alwa3'S had his health looked after by an Anson 
 or a Cook, and that man}' a festive tar who induced the 
 unsophisticated Indian maid to join him in worship at 
 the shrine of Venus Poi'cina carried in the innermost 
 recesses of the folds of his pendulous and sea-beaten 
 prepuce the remnants of former Bacchanalian festivities 
 performed in the questionable temples of Venus and 
 Bacchus in Portsmouth or London. Consumption, as 
 such, was neither imported nor propagated by Europeans 
 into those islands, its original entry being in the shape 
 of S3'^philis. Had it been the ancient mariners of old 
 Phoenicia in the days of its circumcision, or the circum- 
 cised marines of the ancient Atlantean fleets from the 
 sunken continent of Plato, instead of the uncircumcised 
 
What are the Benefits of Circumcision'? 181 
 
 sailors of modern England, that first and since visited 
 tliose islands, it is safe to saj- that consumption would 
 not now exist there. From this, it may be well to 
 inquire what would be the relation between the Jewish 
 race and consumption ; were circumcision among them 
 to be done away with, would it not be greatly on the 
 increase ? 
 
 The weiglit of testimony is evidently convincing that 
 the Jew has a greater longevit}^ and stronger resistance 
 to disease, as well as a less liability to physical ills, than 
 other races ; that all these exemptions or benefits are 
 not altogether due to social customs is evident; how 
 much circumcision ma}'^ have to do in inducing these 
 favorable conditions can be better appreciated by a con- 
 sideration of how circumcision affects those of other 
 races, and more particularly how its performance works 
 changes in the individual in his general health and con- 
 dition, and in doing away with many physical ailments 
 that the individual was previously subjected to. So 
 that the Jew cannot be said to be a loser b}^ his observ- 
 ance of this rite, and he and his race have been well 
 repaid for all the sufferings and persecutions that its 
 observance has subjected them to. As observed hy John 
 Bell, " The preservation of health and the attainment of 
 long life are objects of desire to every man, no matter 
 in what age or country his lot is cast, nor by what 
 arbitrary tenure he holds his life. They are the wish of 
 tlie master and the slave, of the illiterate and the learned, 
 of the timid Hindoo and the warlike Arab, of the natives 
 of New Zealand not less than of the inhabitants of New 
 England, — an indispensable condition for the greatest 
 and longest enjoyment of the senses and propensities; 
 for the widest range and exercise of intellect and grati- 
 fication of the sentiments, whether these be lofty or 
 
182 History of Circumcision. 
 
 ignoble, health, in any special degree, has ever been a 
 fit subject of contemplation and instruction by the phi- 
 losopher and legislator. Their advice and edicts on the 
 means of preserving it have frequently been enforced as 
 a part of religious duty, and, at all times, civilization, 
 even in its elementary forms, has been marked by laws 
 on this head. With the numerous and minute hygienic 
 enactments of the great Jewish lawgiver for the guidance 
 of the people of Israel we are all familiar. Prompted, 
 we may suppose, in part by the example of Moses, and 
 also by considerations growing out of the nature of the 
 climate in which he lived, Mohammed incorporated with 
 the mingled reveries, ethics, and blasphemies, which 
 composed his Koran, dietetic rules and observances of 
 regimen that are to this da^^ implicitl}' obeyed hy his 
 zealous followers." ^^ 
 
 If circumcision is not a factor in the difference that 
 exists between the Jewish race and other races, if it 
 goes for nothing as an exeraptor of disease and the pro- 
 moter of longevity, then there must exist some other 
 factor or cause that induces these conditions. What 
 this factor is, the legislator, the sociologist, and the 
 pjiysician should make it their business to find out. 
 
CHAPTER XY. 
 
 Predisposition to and Exemption and Immunity 
 FROM Disease. 
 
 The peculiar differences that exist between different 
 animals in regard to their susceptibility to the action 
 of drugs is even more remarkable than the differences 
 that exist in their susceptibility to certain forms of dis- 
 ease. We can understand and appreciate what Koch 
 tells us in regard to the different susceptibilities ex- 
 hibited by the house-mice and the field-mice to the 
 anthrax bacillus, or why a nursing child should offer 
 different results, when exposed to the diphtheria bacillus 
 or the contagious poison of any of the exanthemata, from 
 those witnessed in the meat or promiscuously dieted 
 child. We can also appreciate that different individuals 
 have different susceptibilities to disease, as well as we 
 understand that the same degree is not always in an 
 unvarying point of resistance or susceptibility in the 
 same individual. The investigation and study of these 
 conditions teach us, however, that there is a cause, 
 or that there are causes that induce and modify this 
 susceptibility. But there are conditions that are as 3'et 
 beyond onr comprehension. Take, for instance, two 
 animals, both vertebrates, mammals, and dwelling 
 together, eating the same food, and even having a mu- 
 tual understanding or sympathy of mind and affections, 
 having a like circulation, a like brain and nervous 
 system, it would naturally be supposed that these two 
 would exhibit a like susceptibility to the actions 
 of narcotic poisons ; but when we are told that one 
 
 (183) 
 
184 History of Circumcision. 
 
 dog has taken 21 grains of atropia with impuiiitj'- 
 "we are staggered. Atropia ma}' not affect rabbits (as 
 it does not), but the rabbit does not approach man in 
 the same close relationship as the dog. Richardson ad- 
 ministered to a health}' young cat 1 drachms of Batt- 
 ley's solution of opium, then 10 grains of morphia, and 
 a little later 20 grains more of morphia without render- 
 ing the cat unconscious. The same experimenter gave 
 to a pigeon 21, 30, and 40, then 50 grains of powdered 
 opium on succeeding daj's with no bad effect. S. Weir 
 Mitchell gave to three pigeons, respectively, 2Y2 drops 
 of black drop, 21 grains of powdered opium, and 3 
 grains of morphia without au}' effect.'^^ On the other 
 hand, horses show a like susceptibility to man to the 
 action of drugs. In the island of Ceylon, a sloth can 
 take 10 grains of strj'chnia with safety, — chickens pre- 
 senting a like immunity to the poisonous effects of this 
 alkaloid. While the dog offers such a contrast to the 
 action of drugs as compai^ed to man, he is as subject to 
 goitre, and they have been seen in a true state of 
 cretinism.'^' 
 
 An Apache, or Colorado Indian, will prefer a dessert 
 of decomposed gophers to one composed of the best 
 canned peaches or Bartlett pears ; he will devour the 
 mass without any resulting evil, while a German — after 
 many generations of training on all forms of sausages 
 in every degree of age and ripeness, and on every form 
 of cheese, from the refreshing cottage cheese from 
 curdled milk and the delicious cream cheese, down 
 through to all and every grade as far as Limburgher, or 
 maggoty, common cheese — has not, in ever}'^ case over- 
 come the tendency of the civilized intestine and con- 
 stitution to the action of sausage poison, something 
 that has no effect on the ordinary Indian, or on the un- 
 
Disease — Predisposition^ Exemption^ Immunity. 185 
 
 civilized dweller north of the arctic circle. Even the 
 house-dog, that faithful companion of man, in many 
 cases living on exactly the same fare as his master, is 
 insensible to the action of this poison. An Indian will 
 gorge and gormandize, after a prolonged fast, on such 
 quantities and qualities of food that, if the ordinary 
 white man were to indulge in a like feast, he would be 
 in imminent danger of literal rupture or explosion, or 
 liable to end in sudden apoplectic seizures, or, in case 
 of a too healthy and active digestion, liable, owing to a 
 lack of a correspondingly active condition of the excre- 
 tory organs, to go off in ur?emic coma. This sporadic 
 and fitful feasting has no perceptible effect on the Indian, 
 who either simply works it oif in exercise, or sleeps it 
 off in a long and prolonged period of sleep, during 
 which his lungs work with the deep and steady pull and 
 jjersistence that a tug-boat exhibits when towing in a 
 large ship against the tide and a head wind, — working 
 in and out more air in one respiration than the ordinary 
 white man will in a dozen. All these different con- 
 ditions are more or less plain to us and as easy of ex- 
 planation, — just as plain as to how and why some birds 
 eat gravel to improve their digestion. In the cases of 
 different susceptibility to the action of strychnia or of 
 narcotics, the explanation must of necessity, for the 
 present, be more or less speculative. But how are we 
 to account, even in the way of speculation, for the pecu- 
 liar immunit}^, lack of predisposition and hereditar}^ 
 tendencies to disease exhibited b}' the Hebrew, who, 
 since the history of the world, has beefi a civilized and 
 rational being, — even for decades of centuries before 
 the civilization of Europe? Living under the same 
 forms of government, climate, and shelter, practically 
 using the same varieties of food and drink, he exhibits 
 
186 History of Circumcision. 
 
 an entirely different vitality and resistance to disease, 
 decay, and death, — being, in fact, a puzzle to the demo- 
 graphic student. The only really marked difference 
 that exists between this race and the otliers lies in the 
 fact that the Hebrew is circumcised, other differences 
 not being sufficiently constant to be accounted as fac- 
 tors. Cii'cumcision is, in the opinion of the writer, the 
 real cause of the differences in longevitj'^ and faculty for 
 the enjo^^ment of life that the Hebrew enjoys in con- 
 trast to his Christian brother. Christian and uncir- 
 cumcised races may individually, or in classes, develop 
 some peculiar immunity or exemption, as, for instance, 
 the tolerance to arsenic exhibited by some German 
 mountaineers, or the peculiar safet^'^ enjoj^ed by the 
 butcher class from attacks of continued fever ; ^^ but 
 these exemptions are purchased at the expense of 
 the future, the effects of arsenic, long continued, 
 finally having its morbid effects, and the very plethora 
 which is the bulwark of resistance in the butcher, this 
 plethora being in the end a treacherous foe, diseases 
 result from it which make a sudden ending to this class 
 when it is least expected. 
 
 For an all around long-liver the Hebrew holds a pre- 
 eminence, and, as the factor in this pre-eminence, cir- 
 cumcision has no counter-claimant. Circumcision is 
 like a substantial and well-secured life-annuity; every 
 year of life 3'ou draw the benefit, and it has not any 
 drawbacks or after-claps. Parents cannot make a better 
 paying investment for their little boj's, 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 it increases their chances for an 
 euthanasian death. 
 
CHAPTER XVI. 
 
 The Prepuce, Syphilis, and Phthisis. 
 
 It is not alone the tight-constricted, glans-deforming, 
 onan ism-producing, cancer-generating prepuce that is 
 the particular variety of prepuce that is at the bottom 
 of the ills and ailments, local or constitutional, that may 
 affect man through its presence. The loose, pendulous 
 prepuce, or even the prepuce in the evolutionary stage of 
 disappearance, that only loosely covers one-half of the 
 glans, is as dangerons as his long and constricted counter- 
 part. If we look over the "world's history, since in the 
 latter years of the fifteenth century syphilis came down 
 like a plague, walking with democratic tread through all 
 walks and stations in life,la3-ing out alike royalty or the 
 vagrant, the curled-haired and slashed-doubleted knight, 
 or the tonsured monk, we must conclude that sj-philis 
 has caused morei families to become extinct than any 
 ordinary plague, black death, or cholera epidemic. 
 Without wishing to enter into a histor}- of syphilis, it is 
 not outside of the province of this book to allude to its 
 frequency and spread. 
 
 Sj'philis is not restricted to classes by any means ; 
 it is not those of the lower class alone who are its 
 victims. Dr. Fr. J. Behrend, in his work, " Die Prosti- 
 tution in Berlin," observes that abolition of the brothels 
 in that city in 184:5, '46, '47 and '48, trebled the number 
 of cases of syphilis treated at the Der Charite; in the 
 year 1848 the cases of syphilis treated at that hospital 
 numbered over 1800. It was also remarked during this 
 period of legally-enforced virtue, that, as inconsistently 
 
 (187) 
 
188 History of Circumcision. 
 
 as it might appear, the disease invaded the best of fami- 
 lies. From Dr. Neumann, in his brochure entitled " Die 
 Berliner Syphilisfrage," published in 1852, we learn 
 that, in the Trades and Mechanics' Benevolent Union of 
 Berlin, in 1849, 13.51 per cent, of the sick were so from 
 sjrphilis. 
 
 In the thirteenth volume of the British and Foreign 
 Medico-Chirurgical Review^ we find, in a review of the 
 control of prostitution, an estimate in regard to the 
 s3'philization of a nation. The estimates are made on 
 the most conservative figures, as, in the desire of the 
 reviewer not to overestimate, he starts by figuring out 
 the actual number of prostitutes in England, Wales, and 
 Scotland to be only 50,000, when they were estimated, 
 by those who had carefully studied the subject, as being 
 more than double that number ; the conservative esti- 
 mate is, however, suitable for our purpose ; so that we 
 cannot be accused of overestimating the results. The 
 portion of the review to which we wish to call attention 
 is as follows : — 
 
 " Though the result of the evidence* contained in the 
 first report of the commissioners on the constabulary 
 force of England and Wales was that at that time about 2 
 per cent, of the prostitutes of London were suffering 
 under some form of venereal disease, 3' et we will descend 
 even lower, and presume that of one hundred healthy 
 prostitutes, taken promiscuousl}'^ from England and 
 Scotland, if each submits to one indiscriminate sexual 
 act in twenty-four hours, not more than one would be- 
 come infected with syphilis, an estimate which is without 
 doubt far too low; yet, if admitted to be correct, the 
 necessary consequence will be, that of the fifty thousand 
 prostitutes five hundred are diseased within the aforesaid 
 twenty -four hours. 
 
The Prepuce^ Syphilis, and Phthisis. 189 
 
 " If we next admit that a fifth of these five hundred 
 diseased women are admitted to hospital on tlie da}' on 
 which the disease appears, it follows that there are every 
 day on the streets four hundred diseased women. Let it 
 be supposed tliat the power of these four hundred to 
 infect be limited to twelve daj's, and that of every six 
 persons who, at the rate of one each night, have con- 
 nection with these women, five become infected, it will 
 follow that there will be four thousand men infected 
 every night, and consequently one million four hundred 
 and sixty thousand in the year. Further, as there are 
 every night four hundred women diseased by these men, 
 one hundred and eighty-two thousand five hundred 
 public prostitutes will be syphilized during the year; 
 hence, one million six hundred and fifty-two thousand 
 five hundred cases of syphilis in both sexes occur every 
 twelve months. 
 
 " If, then, the entire population had intercourse with 
 prostitutes in an equal ratio, the gross population of 
 Great Britain, of all ages and sexes, would, during 
 eighteen years, have been afi^ected with primary syphilis. 
 Be it remembered, we do not assert that more than a 
 million and a half of persons are attacked every year, 
 but that that number of cases occurs annuall}^ in Eng- 
 land, Wales, and Scotland, though the same individual 
 may be attacked more than once. Although it is evi- 
 dent that all the estimates used for these calculations 
 are (we know no other word that expresses it) ridicu- 
 lously low, yet we find that more than a million and 
 a half of cases of sj-philis occur every j^ear, — an 
 amount which is probably not half the actual num- 
 ber. How enormous, then, must be the number of chil- 
 dren bom with secondary disease I How immense the 
 mortality among them I How vast an amount of public 
 
190 History of Circumcision. 
 
 and private money expended on the cure of this dis- 
 ease 1" 
 
 The same reviewer (P. S. Holland), in another article 
 on the " Control of Pi'ostitution," observes that among 
 the British troops sj'philis is one of the most frequent 
 of diseases, about one hundred and eighty cases occur- 
 ring annually among every one thousand soldiers. 
 
 The effect of syphilis in depopulating the islands of 
 the Pacific has been pointed out in a former chapter; the 
 nature and origin of the disease that takes them off is un- 
 mistakable. Scrofula and rapid phthisis are taking off" the 
 inhabitants at a rate that, in those islands most aflTected, 
 the native population will soon become extinct. Accord- 
 ing to Lancereaux, in the Marquesas group the women do 
 not live beyond the age of thirt}'^ to thirty-five years, 
 three or four months being the duration of the disease. 
 Ellis, in his " Polynesian Researches," published in 
 1836, remarks that at that date the disease, as above 
 described, had but recently appeared. In the nine- 
 teenth volume of the "Archives de Medecine Navale," 
 Rey mentions that at the Easter Island pulmonary 
 phthisis is the dominant affection with the adults, and 
 that scrofula is very prevalent with the children.^* 
 
 The eflTect of syphilization in inducing a scrofulous 
 taint and the appearance of a rapidly-marching con- 
 sumption among savage races has been well observed 
 among the Indians in the southwestern parts of the 
 United States, where the appearance of these fatal dis- 
 eases can easily be traced to that as a cause. There is 
 something peculiar about the Anglo-Saxon race that is 
 fatal to the Indian ; wherever they come in contact, the 
 savage race begins physically and morallj^ to crumble; 
 the habits of the Anglo-Saxon in the matter of in- 
 temperance and his lust soon end the poor Indian ; 
 
The Prepuce, Syphilis, and Phthisis. 191 
 
 while, on the other hand, the Latin races mix with them 
 without any physical detriment to the Indian. In what 
 was formerly the Northwest Territoi-y the French and 
 Indian intermarried, and syphilis did not begin to tell 
 on the Indian until the Americans settled the country. 
 From these observations it is very evident that in the 
 Polynesian Archipelago syphilis must have been the 
 precursor of tlie phthisis and scrofula, as we know it 
 to have been that which induced those diseases among 
 the Indians of the Mississippi or Missouri Valley's, or 
 of the Colorado and Mojave Deserts, or in the mountains 
 and vallej's of Arizona, 
 
 On the other hand, circumcised races, whose women 
 have not carried a svphilitic taint into the race, are as a 
 class free from an}' S3'philitic taint. Neither their teeth, 
 physiognomy, skin, nor general condition denote any 
 syphilitic inheritance. This is true of the Jewish de- 
 scendants of Abraham, who have more strictl}^ adhered 
 to the non-intercourse or marriage with other races, and 
 whose women have abstained from vice; the Arabian, 
 descendants of Islimael haA'e, in a great measure, also 
 retained their marked famil^^ individuality, except it be a 
 few tribes, who, hy contact with tlie soldier^^ of European 
 nations, have had their women corrupted and syphilis 
 introduced into the tribe tlirough this channel. 
 
 Richardson, in his " Preventive Medicine," observ- 
 ing on the effects of syphilis in inducing deterioration 
 of the organs of circulation and their degenerative 
 changes, says that, in his opinion, syphilis is the pro- 
 genitor of various diseases, and that those who give this 
 opinion the greatest range are, unfortunately, nearest 
 the truth. The breathing organs, he remarks, are dis- 
 tinctly susceptible to injury from this hereditarj' cause. 
 
 In 1854j at the Metropolitan Free Hospital, situated 
 
192 History of Circumcision 
 
 in the Jews' quarter in London, Hutchinson observed 
 that tlie proportion of Jcavs to Christians among the 
 out-patients was as one to three ; at the same time the 
 proportion of cases of syphilis in the former to the 
 latter was one to fifteen. Now, this result was not due 
 to any extra moralitj^ on the part of the Jews, as fully 
 one-half of the gonorrhoea cases occurred among those 
 of that faith. J. Royes Bell also observes the less 
 sj-philization among circumcised races.'^^ 
 
 The absence of the prepuce and the non-absorbing 
 character of the skin of the glans penis, made so by con- 
 stant exposure, with the necessary and unavoidably less 
 tendency that these conditions give to favor syphilitic 
 inoculation, are not evidently without their resulting 
 good effects. Now and then syphilitic primary sores are 
 found on the glans, or even in the urethra or on the 
 outside skin of the penis, or outer parts of the prepuce; 
 but the majorit}^ are, as a rule, situated either back of 
 the corona or on the reflected inner fold of the prepuce 
 immediately adjoining the corona, or they may be in the 
 loose folds in the neighborhood of the frenum,the reten- 
 tion of the virus seemingly being assisted by the topo- 
 graphical condition and relation of the parts, and its 
 absorption facilitated by the thinness of the mucous 
 membrane, as well as by the active circulation and 
 moisture and heat of the parts. It must be evident 
 that but for these favoring conditions the inoculation 
 or infection would and could not be either as sure or as 
 frequent. Any protecting mechanical aid that interferes 
 with these favoring conditions grants an immunity to 
 the individual, even when he is freely exposed ; this pro- 
 tection has often been obtained by applying to the glans 
 and penis a substantial coat of some tenacious oil like 
 castor-oil, which was afterward gently washed ofi", first 
 
The Prepuce, Syphilis^, and Phthisis. 193 
 
 in a shower of tepid water and afterward in a tepid bath 
 of warm water and borax. 
 
 Horner, formerly of the navy, in his interesting little 
 work on " Naval Practice," ^^ relates that it was cus- 
 tomary, in the older nav^- of the United States, to allow 
 public women to come on board at some of the ports 
 and to go down to tbe men between decks, the De- 
 partment of the Navy being probably actuated by the 
 same humane principle that used to induce some of the 
 West Indian cannibals to lend their wives to their pris- 
 oners of war who were intended, in the shape of roast 
 or fricandeau, to grace the festive board, as it was 
 deemed inhuman by these philanthropists to deprive a 
 man of his necessary sexual intercourse, even if they 
 were soon to roast him and pick his bones. Thej'^ naaj'-, 
 however, have been selfish in the matter, as by some au- 
 thorities it is represented that this was done to improve 
 the flavor of the prisoner, who was said to offer a more 
 savory dish through this considerate treatment, the 
 sti'ong flavor that the semen gives to flesh being well 
 eradicated by free fornication. Whether it was through 
 these motives of humanitarianism, or the feeling that an 
 American tar was the equal of the British tar, whose 
 praises and equalitj^ Sir Joseph Porter, K.C.B., writes a 
 song about in " Pinafore," who had as much right to 
 conti'act a left-handed marriage as any Prince of Wales 
 or any other prince or crowned head of Europe, the 
 women were, nevertheless, allowed to go down between 
 decks in preference to giving the men indiscriminate 
 liberty on shore, the government further providing for 
 their welfare by causing the assistant surgeon to ex- 
 amine the women at the gangwaj'^ or hatchway, to see 
 that they were not diseased. Horner relates the ludi- 
 crous appearance presented by a near-sighted assistant 
 
194 History of Circumcision. 
 
 fit one of the hatchways while mnking this professional 
 examination, surrounded bj' tlie sailors and marines, who 
 were greatlj- -interested spectators. Had the govern- 
 ment provided a pot of castor-oil wherein the tar could 
 dip his penile organ, as bridge piles are dipped into a 
 creasoting mixture, these humiliations to our profes- 
 sional brother could have been avoided. 
 
 In the conclusion to be reached, circumcision is not 
 put forward as the only exempting element or preventive 
 measure that deserves all the credit for the immunity 
 that the Jews enjoy from syphilis, or to the absence of 
 hereditary diseases that are secondary' or due to the 
 presence of that dise:>se in the pai'ents, as considerable 
 credit is to be given to the well-known chastity of their 
 females. This chastity is, in a great measure, due to 
 the inseparable conditions of their religion, — moral and 
 social fabrics which are welded into one. Their charity 
 assumes the most practical form, so that it is not pos- 
 sible for one of their females to haA-e to resort to a life of 
 prostitution to save herself or her children from starva- 
 tion, as, unfortunately, is too often the case in Christian 
 communities, where religion is put on and off with Sun- 
 day clothes. The temperance and sobrietj', as well as 
 the economy and industry' of the father, are not without 
 a good moral as well as a hereditary effect on the 
 daughters, who are neither rendered brutal nor demoral- 
 ized through the example and instigation of drunken 
 fathers. They have, therefore, a better average home- 
 life, to which they cling and which protects them. The 
 aid and. benevolent associations of the Jews are among 
 the most efficacious of charitable institutions, and no 
 class gives more freel}' or generously for this purpose. 
 The Home for Aged Hebrews in New York is an example 
 of the character with which they dispense charitj'. We 
 
The Prepuce^ Syphilis, and Phthisis. 195 
 
 need not, therefore, be suprised to find, in statistics 
 of illegitimacy by religious denominations taken in 
 Prussia, that the Jewish women are three times as 
 chaste as the Catholics and more than four times as 
 chaste as the Evangelists.'^^ The Jew has, therefore, 
 two avenues of infection from syphilis cut off, — the 
 lesser liability due to his circumcision and the chastity 
 of the women. 
 
 Richardson mentions the immunit}' of the Jewish 
 race from tubercular disease, and notices the well-known 
 relation existing between a syphilitic taint and a 
 phthisical tendency. The comparative statistics offered 
 b}' the Mohammedans, Jews, and Christians in regard 
 to deaths from consumption have already been men- 
 tioned in a former chapter, they being as four Christians 
 to one Jew, while the Mohammedan, from his greater 
 abstemiousness and temperance to assist him, shows a 
 still lower percentage than the Jew. There can be but 
 little doubt that to this particular and well-marked 
 less s3'philization the Hebrew race owes much of its 
 exemption from many other diseases and its greater 
 resistance to ordinary ailments and epidemic diseases. 
 
 The relative less frequency of syphilis among all 
 circumcised people is noticed b}' Dr. Bernheim, in 
 his brochure " De la Circoncision," he being the sur- 
 geon of the Israelitish Consistory of Paris. His utter- 
 ances on this subject are worthy of attention, he having 
 not only paid particular attention to this, but having 
 had imusual opportunities for the basis of his opinions. 
 Dr. Bernheim looks upon coition as a frequent source 
 of tubercular infection, and the sensitive and absorbing 
 covering of the uncircumcised glans as a ready medium 
 of transmission of the virus from one sj'stem to the 
 other. He calls attention to the frequent granular con- 
 
196 History of Circumcision. 
 
 ditioii of the uterine os, in confirmed cases of tubercu- 
 losis, as something that is too much overlooked. This 
 view of tiie case, from Dr. Bernheim's stand-point, is 
 worthy of greater considei'ation than it has generally 
 received at the liands of the profession. 
 
 The great number of examples that have recentlj'- 
 come to light in connection with the direct inoculability 
 of tubercular consumption, both in the later works on 
 phthisis and in the medical press, are not without in- 
 terest or without a lesson. The case recorded within 
 the past year of a healthy chambermaid, who was Imme- 
 diatel}'' inoculated with tubercular matter with rapidly- 
 following constitutional effects through a scratch on the 
 hand, received from the sharp edge of a broken china 
 cuspidor that a consumptive was using, is one of these 
 cases that are to the point ; so it is evident that the 
 uncircumcised need not always wait for the degenera- 
 tion of sj'philis into syphilitic phthisis or syphilitic 
 scrofula to become a consumptive, but it is within 
 the greatest range of possibility and probability that he 
 may become at once a consumptive through an excoria- 
 tion or abrasion received during coition with a tubercu- 
 lar woman. So many tubercular prostitutes ply their 
 trade, or, to be more definite, so many prostitutes be- 
 come tubercular, and in its different stages follow their 
 occupation as the onl3' means of keeping out of the 
 poor-house, that man runs as much if not more risk, in 
 consorting with the class, of contracting tuberculosis - 
 than that of contracting syphilis. 
 
 There is something about s^-philis that is not gen- 
 erall}^ noticed ; we are all well acquainted with the dire 
 results that usuallj^ follow s^-philitic infection, its course 
 through ever}' stage of suffering and miser}^ its trans- 
 mission and effects in tubercular meningitis or in syphi- 
 
The Prepuce, Syphilis, and Phthisis. 197 
 
 litic affections of the mesentery through heredity in 
 children, and of the many horrible cases of destruction 
 of tissue, in skin, mucous membrane, cartilage, or bone, 
 with their attending mutilations and disfigurations ; but 
 there is no record of the great number of cases, and 
 very few physicians of any extended practice but who 
 can recall some such cases, where, after undoubted 
 syphilitic infection, with the usual course of primary 
 sores and secondary eruption, the patient has suddenly 
 blossomed out into a state of robust health that 
 his system was an entire stranger to before the infec- 
 tion. The writer has, in the course of a long practice, 
 seen a number of such results follow both the infection 
 attended with a miliary eruption and that followed by 
 the large small-pox-appearing eruption, both kinds being 
 preceded by the primary sore ; and these results have 
 been observed in cases of both what are called the soft 
 and multiple and the hard or Hunterial initial sore. 
 Some of these cases rapidly gained in flesh, with an 
 evident increase in the redness of their blood, increasing 
 in vigor and strength with a ver}' perceptibly less tend- 
 ency to attacks from accidental or previously subject-to 
 diseases. 
 
 The same result has been observed to follow an 
 attack of small-pox with some individuals, and the 
 writer well remembers a similar result following a very 
 extraordinary event. The subject was a man well 
 known among his old comrades of the First Minnesota 
 Infantry as "Duke," and to many of the older prac- 
 titioners of Wabashaw County, of that State, as " Old 
 Duke." In early life he was sickly and weak!}', never 
 having fully recovered from a malarial fever contracted 
 in the Mexican war. Coming to Minnesota, he adopted 
 vhe life of a raftsman, with all the irregularities that 
 
198 History of Circumcision. 
 
 accompanied such a life. On one occasion, after a pro- 
 tracted spree, feeling the need of stimulation and not 
 having the wherewith to procure it, he secured a jar in 
 which a snake and several other reptiles were preserved 
 in spirits, and drank the fluid contents. He was, some 
 days afterward, taken A'iolentl}'^ ill with a liigh fever and 
 racking pains, ending in an eruption of boils that cov- 
 ered him from head to foot ; he made a slow and tedious 
 recovery ; but when recovered lie seemed to have become 
 imbued with a constitution resembling lignuvi-vitse, for 
 a more stubborn-twisted constitution never existed than 
 that of" Old Duke." The power of resistance that this 
 man developed was something wonderful. Dr. C. P. 
 Adams, of Hastings, Minnesota, and the St. Paul phy- 
 sicians who were connected with the regiment well re- 
 member, though, wi]-y, precise, and soldierly " Duke," 
 who, even in the old Army of the Potomac, immersed 
 up to his esrs like the rest of the arm}' in the mud and 
 dirt of the encampment of Falmouth, above Fredericks- 
 burg, came out on general inspection as prim as if he 
 had just stepped out of a bandbox, for which he received 
 a medal for soldierly conduct and bearing. 
 
 These apparent digressions are not made either to be 
 tedious or to weary the reader, nor without an object. 
 Thej' are made to show that, whereas syphilis is looked 
 upon as si;cli a deadh' disease, and it may be said to 
 be the sole cause of fear to the assiduous worshiper 
 at the shrine of Venus Porcina, there is another still 
 more fatal danger awaiting him, ambushed in the folds 
 of the vaginal mucous membrane, or coming along 
 silently out of the cervical canal, — like the legions of 
 Cyrus stealing along the dry bed of the Euphrates into 
 ancient Babylon, to fall unawares on the feasting Nebu- 
 chadnezzar on that fatal night. So, in like manner, the 
 
The Prepuce, Syphilis, and Phthisis. 199 
 
 virus of tuberculosis, either extruding from a granular 
 OS or from its neigliborhood, gradually moves down on 
 the unsuspecting, uncircumcised, and easily inoculable- 
 surfaced glans penis, to infect the sj'stem with a tuber- 
 cular poison that has no such exceptions as those above 
 noted, as at times are the followers of syphilis. It is not 
 alone the individual himself that may be the sufferer 
 from this poison, but his progeny for several generations 
 may have to suffer for the infection thus received, just 
 as much as they would were that infection to have been 
 sj^philitic. As before remarked, this has heretofore not 
 sufficiently occupied the consideration of the profession, 
 and, as it cannot certainly be denied that such a source 
 of tubercular infection is both possible and probable, the 
 subject is entitled to more serious and deliberate con- 
 sideration than tliat which has heretofore been paid to it. 
 Tuberculosis certainly has these two channels of en- 
 trance : either through direct infection or throus^h an 
 evolutionary process resulting from sj'philis. The ap- 
 pearance and vital statistics offered by the French War 
 Office in regard to the Algierine provinces, the report 
 of the United States Census, the opinion of Dr. Bil- 
 lings deduced from the census reports, the opinions of 
 Hutchinson, Richardson, Bernheim,and many other ob- 
 servers, as well as the personal but unrecorded observa- 
 tions of many practitioners, all tend to bear testimony 
 to the remarkable difference that exists between circum- 
 cised and uncircumcised races m regard to the ravages 
 of consumption. Is circumcision a factor in this differ- 
 ence, or is it not? If it is, then circumcision should re- 
 ceive more attention than it has; if it is not, then we 
 should not be idle in hunting up the cause of difference, 
 for an ounce of prevention is certainly" worth in this re- 
 gard a whole pound of Koch's lymph as a curative agent. 
 
CHAPTER XVII. 
 
 Some Reasons for Being Circumcised. 
 
 The surgical and medical histoiy of circumcision is 
 intimately connected with the remotest ages, this being, 
 in fact, the earliest surgical procedure of wliich we have 
 any record. From the same records we obtain hints as 
 to two conditions for which circumcision probably was 
 suggested, either as a preventive or as a remedy. 
 
 Jahn, in speaking of the people by whom the early 
 Hebrews were surrounded, mentions their idolatrous 
 practices, and that their peculiar forms of Pagan wor- 
 ship were accompanied by indulgence in fornication, 
 lascivious songs, and unnatural lust. Others of their 
 neighbors worshiped the " hairy he-goat^'''' with which 
 they also practiced all manner of abominations. Sodomy, 
 or pederasty, seemed a sort of religious ceremony with 
 some of these heathen nations ; from a religion it neces- 
 sarily became a social practice ; this, in connection with 
 the phallic practices and worship, necessitated frequent 
 exposure of the male member. The evil results, to say 
 nothing of the disgusting and demoralizing tendency of 
 these practices of the Pagan, were evidently well known 
 to the Jews. The contrast between the physique and 
 health of the pastoral habits, out-of-door life and simple 
 diet of the Jews, and the necessary opposite con- 
 dition of health and physique due to luxury and to 
 these practices among their neighbors, could not have 
 escaped their attention. How much onanism had to do 
 with the establishment of circumcision may well be con- 
 jectured. Again, the other hint is in reference to pro- 
 (200) 
 
Some Reasons for Being Circumcised. 201 
 
 creation, as some stress is laid to the connection between 
 the conception of Sarah and the circumcision of Abra- 
 ham. Here we have suggestions of a preventive to 
 onanism, and a cure to male impotence when due to 
 preputial interference.^* 
 
 Strange as it ma}- seem, these two important results, 
 due to circumcision, seem to have been lost sight of for 
 some thousands of years, as even the able w'orlis of the 
 physicians of the latter part of the last century have 
 nothing to say connecting onanism and circumcision. 
 Neither the works of Tissot on male onanism nor the 
 pioneer work of Bienville on nymphomania speak of the 
 presence of the prei)uce in the male, or of the nymphar 
 or clitorian prepuce in the female, as being causative of, 
 or their removal curative of, either masturbation, sat}'- 
 riasis, or nymphomania ; moral, hygienic, and internal 
 medication being by both these authors considered to 
 be all that our science could offer or do to alleviate or 
 cure this unfortunate class. It is onl}^ of late years that 
 circumcision, in its true relations to onanism, has re- 
 ceived full consideration. In regard to its being a cure 
 of impotence, its recognition has been of longer dura- 
 tion. 
 
 It is related by Leonard, in his " Memoires," — who, 
 in his capacity of hair-dresser in ordinary to her Majesty, 
 the unfortunate Marie-Antoinette, had ample oppor- 
 tunit}^ for picking up all the domestic small talk of the 
 royal family and their affairs, — that Louis XVI, in ad- 
 dition to all his troubles and the indignities which he 
 suffered, besides finally being beheaded, was afflicted 
 with a congenital phimosis which prevented the flow of 
 semen from properly discharging itself. It appears that 
 his Majesty was no little annoyed at not being able to 
 procure an heir to his throne. His royal sister-in-law, 
 
202 History of Circumcision. 
 
 the Countess d'Artois, had given birth to a prince, the 
 Dnke of Angoulenie, who was the heir presumptive 
 to the throne in case of tlie non-issue from Louis; 
 another sister-in-law liad been brought to bed with a 
 royal princess, and here was the king himself without 
 an}'^ prospective possibility of any heir. Like all kings, 
 he was more or less unreasonable; so he blamed his first 
 surgeon in ordinary for all these short-comings, — as if 
 it were the dut}" of these court surgeons, among their 
 many other tribulations, to furnish heirs to thrones. 
 The surgeon finally informed his Mtijesty that if he 
 wished to become a father it would be necessarj^ for 
 him to submit to the slight operation that was the sub- 
 ject of the church festival of the first day of January, 
 namel3% the Feast of tlie Circumcision. His most Chris- 
 tian Majesty entered a protest to this acknowledgment 
 that there was anything in Judaism worth imitating. 
 The surgeon insisted that the operation celebrated on 
 the first of January would put him in a way to have tlie 
 much-desired heir. The king finally waived all objec- 
 tions from any religious scruples, but could not be 
 brouglit to look at the prospective operation with any 
 sentiments of agreeable expectation. 
 
 The king finally became good-natured, and a touch 
 of that plebeian jollity wliich at times made him quite 
 agreeable spread over his features as he imagined the 
 liidicrousness of the spectacle that would be presented 
 by a king of France in the hands of these handlers of 
 the scalpel, treating him like an African savage. He took 
 some days to consider the matter. On the next day he 
 informed M. Louis, his first surgeon in ordinary, that 
 he had decided on submitting to the operation, and 
 the day and hour were fixed. The royal circumcision, 
 however, never took place, as it is most likely that 
 
Some Reasons for Being Circumcised. 203 
 
 in the privacy of his chamber his Majesty worlied, like 
 many a plebeian or man of low degree had done before 
 him and has done since, to bring a refractor}^ prepuce to 
 terms. Tlie king was somewhat of a mechanic, as his 
 skill as a locksmith has passed into histor}- ; so tliat it 
 is not unliliely tluit, with what little information he 
 had on the subject, he managed to sufficiently dilate, 
 by scarification and stretching, the preputial opening, 
 as from the year 1778 the queen had tliree children. 
 
 Cases of attempted self-circumcision are not rarities, 
 as people have some inex[)licable idea that a self-inflicted 
 cut is not as painful as one that is done by others. The 
 writer well remembers being called to assist one of these 
 domestic surgeons who had undertaken to circumcise 
 himself with his wife's great scissors. The man had a 
 very long but thin and narrow preimce that had always 
 been an annoj'ance to him. The writer had circumcised 
 two of his children for the same malformation, and the 
 father, seeing the benefit to these two, determined to 
 share in the general benefit ; but at the same time he ar- 
 ranged to do it all by himself, and give the family and 
 the surgeon a sample of his courage and a simultaneous 
 surprise p.'vrt_y. Securing the scissors, he wended his 
 way unperceived into the recesses of his wood-shed. 
 The mental and ph3'sical anguish the poor man under- 
 went, and what soliloquies he must have addressed to 
 the rafters of the wood-shed, while making up his mind 
 and screwing up his phj^sical courage for the last fell 
 act with the scissors, can hardl}^ be described, as, in all 
 probabilit}', they were of the most rambling and incon- 
 sistent order. At any rate, he must have reached a 
 climax in time and grasped the fated prepuce with a 
 revengeful glee, and, with all his powers concentrated 
 in his good right hand, he must have closed the re- 
 
204 History of Circumcision. 
 
 morseless blades of the scissors on the unluckj'' prepuce. 
 Wlien the surgeon arrived at the scene of carnage, he 
 was directed to the wood-slied, on tlie outskirts of whicli 
 hovered the family, frantic with fear and apprehension ; 
 within, in the darkest corner, with wildl^^ dilated ej^es, 
 and performing a fantastic pas seul, was a man with a 
 huge pair of scissors dangling between his legs, warning 
 all hands as they valued his life not to approach or lay 
 a hand on him. He had shut the scissors down so that 
 it clinched the thin prepuce, and there his courage 
 and determination had forsaken him ; he lost his pres- 
 ence of mind, and was not even able to take off the 
 scissors; he had simpl}^ given one wild, blood-curdling 
 3^ell — like the last winding notes from Roland's horn at 
 Roncevalles — that had brought his familj^ to the wood- 
 shed-door, and they had then sent for a surgeon. New 
 terrors here awaited the unluck}^ victim for self-circum- 
 cision. He dreaded lest the surgeon should accidentally 
 have it enter his mind to finish the operation with the 
 scissors, and in that case he would be helpless, as the 
 surgeon would, undoubtedly, have a sure and tender 
 hold of it. After executing a number of pas a deux on 
 the Magilton step, while the surgeon endeavored to re- 
 assure him and gain his confidence, i)romising to remove 
 the scissors without inflicting an}^ further harm, he was 
 finally allowed to approach, and, while the patient 
 assumed a Taglioni attitude on one foot, the other leg 
 being extended at right angles with the body and his 
 hands clawing the air, the scissors was removed. The 
 patient, thi-ough the aid of lead lotions and a week's rest, 
 made a good recovery with a whole prepuce, chagrined 
 at his failure, but happy to have escaped immediate 
 pain.^" 
 
 There is not much doubt but that the operation could 
 
Some Reasons for Being Circumcised. 205 
 
 have been suggested hy its, at times, spontaneous per- 
 forniauce, a case of which, b^^ Cullerier, and some other 
 additional cases liave been mentioned in a former chap- 
 ter. Cases occur at times, also, wherein the person 
 having a previously normal and uninterfering prepuce 
 has, through either herpetic inflammations or through 
 impure connection, spurious gonorrhcea, or the use of 
 some venereal-disease preventing- wash after connection, 
 produced some irritation resulting in the abnormal thick- 
 ening of the inner fold, or an interstitial deposit at the 
 function of the skin and mucous membrane, with con- 
 sequent constriction, this deposit finally forming a hard, 
 inelastic ring, which prevented a free exposure of the 
 glans and interfered in sexual connection. In such 
 cases, — like in stricture of the meatus, — any mechanical 
 interference short of cutting with a knife only aggra- 
 vates the existing difficulty, and it is not uncommon to 
 have such cases apply for assistance after they have in 
 vain tried to dilate the constricting preputial orifice. In 
 the early writings of the Greeks, it is mentioned that 
 among the Egyptians circumcision exempted them from 
 a certain form of disease that affected the penis. Philon 
 mentions particularly the immunity tliat the operation 
 conferred against a species of affection which Michel 
 Levy asserts to have been a gangrenous disease. So that, 
 outside of any religious significance, there is no doubt 
 that, in individual cases, circumeision has more than 
 once been suggested, although it cannot be said that 
 sucli individual eases would ever, or could, lead to its 
 becoming a national or racial, much less a sectarian, rite. 
 
CHAPTER XYIII. 
 
 The Prepuce as an Outlaw, and its Effects on 
 THE Glans. 
 
 RicoRD has well termed this appendage to civilized 
 man " a useless bit of flesh." Times were, however, 
 wlien — man living in a wild state, and when in imitation 
 of some of our near relatives with tails and hair^y bodies ; 
 when he still found locomotion on all-fours handier than 
 on his two feet; when in pursuit of either the juicy 
 grasshopj)er or other small game, or of the female of his 
 own species to gratify his Inst, or in the frantic rush to 
 escape the clutches, fangs, or claws of a pursuing enem}^ 
 he was obliged to fl}' and leap over thorny briars and 
 bramble-bushes or hornets' nests, or plunge through 
 swamps alive with blood-sucking insects and leeches— 
 Ricord's definition would certainly have been inappli- 
 cable. In those da}s, but for the protecting double fold 
 of the preputial envelope that protected it from the thorns 
 and cutting grasses, the coarse bark of trees, or the stings 
 and bites of insects, the glans penis of primitive man 
 would have often looked like the head of the prover- 
 biall}^ duel-disfigured German university student, or tiie 
 Bacclius-worshiping nose of a jolly British Boniface. 
 So that in those da3 s,luiless primitive man was intended 
 to have an organ tliat resembled a battle-scarred Roman 
 legionary, a prepuce was an absolute necessit}^ 
 
 Witii improvement in man's condition and his grad- 
 ual evolution into a higher sphere, the assumption of 
 the erect posture, and the great stride in civilization 
 that orginated the invention of the manufacture of the 
 (206) 
 
Prepuce as an Outlaw, and its Effects on the Glans. 207 
 
 perineal band, which not only protected the glans in its' 
 thorny passage through life, but also acted like a pro- 
 tecting aegis to the scrotum and its contents, the pre- 
 puce became a superfluity ; not only a feuperfluit}^ but, 
 now that its natural office had been replaced b^^ the peri- 
 neal cloth, it actually began to be a nuisance, as its 
 former free contact with the air had retained it in a 
 state of vigorous and disease-resistiug health which was 
 now fast departing. As Montesquieu observes, in the 
 causes that led to the decline and fall of the Roman 
 Empire, those seasons of trials, tribulations, and struggle 
 for existence are those of health and progress and 
 healthy life, and the periods of luxur^'^ and idleness are 
 those of degenerac}^ and decay. So with the prepuce, 
 the luxury and idleness, voluptuousness and consequent 
 feasting incident to its being supplanted in its original 
 functions by the perineal cloth, which left it thenceforth 
 unemplo,yed, led it in the pathway of disease and death. 
 This first innovation in civilization was to the prepuce 
 the beginning of its deca}^ and fall. Like Belshazzar in 
 his great banquet-hall in ancient Babj'lon, the prepuce 
 might have read the hand-writing on the wall, " Mene, 
 Mene, Tekel, Upharsm,''^ and foreseen the gory end that 
 awaited it. Like to other human affairs, however, even 
 in his fallen estate a kind word can be said for the pre- 
 puce. Puzey, of Liverpool, has found it of extreme 
 value, and even unequaled by an^^ other part of the 
 body, for furnishing skin-grafts,*^ these grafts showing 
 a vitalit}' that is simply phenomenal, considering the 
 laxity of its tissues and its seemingly adipose character. 
 Tliere is no doubt, however, that for skin-transplanting 
 there is nothing superior to the plants offered by the 
 prepuce of a boy, and where uny large surface is to be 
 covered this should undoubtedly be chosen, as offer- 
 
208 History of Circumcision. 
 
 ing the greatest and quickest success and the least 
 chances of failure. This is really the only disadvan- 
 tage that can be charged against circumcision, as in a 
 strictly circumcised community they would be debarred 
 from this great advantage. An uncircumcised individ- 
 iial could be procured, however, to supply the deficienc^^ 
 It is related that in the latter part of 1890, a Knight 
 Templar, in Cincinnati, required a great supply of grafts 
 or skin-plants to cover a largely-denuded surface, 
 and that the whole of his Commandery chivalrously and 
 generousl3^ supplied the needed skin-plants in a bodj''. 
 A few healthy prepuces would have been more effica- 
 cious. In advising the use of the prepuce for these 
 purposes it must not be overlooked that in case of a 
 white man it would not do to use skiu of any other 
 color besides his own. We have no data to base any 
 assertion as to the relative action of skin-grnfts taken 
 from Mongolians or Indians, but we liave very reliable 
 data in relation to the proliferating action of those of 
 the negro,^^ which induces a growth of epidermis of its 
 own kind ; so that preputial gi'afts from the negro, 
 combining the extra vitality and proliferation of the 
 preputial tissue with the strong animal vitality of the 
 negro, if applied to a white man, might not produce the 
 most desirable cosmetic effects, especially if on one side 
 of the countenance. 
 
 But, taken as a whole, when considered in its relation 
 to onanism, nocturnal enuresis, preputial calculus, 
 syphilis, cancer, and a lot of nervous and other ailments, 
 or induced abnormal physical conditions, we can really 
 conclude that the days of the prepuce are past and gone, 
 that it has outlived its usefulness, and that those whom 
 a religious or civil ordinance or custom happily makes 
 them rid of it are people to be greatly envied. As 
 
Prepuce as an Outlaw^ and its Effects on the Glans. 209 
 
 Sanclio Paiiza, remarked, " God bless the man who in- 
 vented sleep," so we may w^ell join in blessing the in- 
 ventor of circumcision, as an event that has saved some 
 parts of the human family from much ill and suffering. 
 
 Pliimosis is an ancient attendant on our inheritance 
 of the prepuce, we being, in fact, born with it ; this is 
 the rule. There are, however, exceptions to this rule, 
 which, singularly enough, are found to be hereditary'. 
 The writer has met with a number of such instances, and 
 they have alwaj's been found to have been family' traits. 
 Within the past year, after attending a confinement, his 
 attention was called to the child by the nurse, who 
 thought that the child was deformed ; the nurse, singu- 
 larly enough, never having seen a natural-looking glans 
 penis in all her life, was astonished at the size and 
 appearance of the member. On examination, the organ 
 showed a complete absence of prepuce. On inquiry, the 
 father and another son, born more than twenty years 
 previousl}^, — this comprising every male member of the 
 family, — were found to have been thus born, with the 
 glans full}' exposed. The family is now residing in San 
 Diego, and is naturally one of more than superior physi- 
 cal health and intelligence. I saw another family 
 similarly affected in the north of France, and of indi- 
 vidual cases, without knowing the history of the rest of 
 the family. I have seen a large number. As the prepuce 
 can be observed in everj' stage of disappearance among 
 mixed races, it would seem that in time it would disap- 
 pear altogether. Its effectual absence in so many cases 
 evidently'' belongs to some evolutionar}' process, and 
 shows beyond question that nature does not insist on 
 its presence either as a necessitj' or as an ornament. 
 
 The word or term " phimosis " is derived from two 
 Grreek roots, signifying "string" and "to tighten," or 
 
210 JSisto7'y of Circumcision. 
 
 "to tie with a string." Galen, from its signification, 
 accepted the word, and from him it has been transmitted 
 through the different epochs of medicine down to our 
 own times. In virtue of its etj'mological significance, 
 it was formerly applied to an}- stenosis or closure of 
 duct or aperture, but at present the term is used simply 
 to denote tliat constriction that aflfects the prepuce, and 
 whicli prevents the glans from being passed through the 
 preputial orifice. Phimosis is said to be congenital or 
 natural and acquired. The first of these is the common 
 lot of all, as a rule, and with some it remains so through- 
 out life. As babyhood advances in bojiiood and boy- 
 hood into 3^outh, the prepuce gradual]}^ becomes lax and 
 distensible, and in proportion to the existence of these 
 conditions it also loses in its length. Where, however, 
 the distal end persists in its constricted condition it is 
 drawn forward as the penis increases in bulk. 
 
 In many cases its tightness prevents the escape of 
 the sebaceous matter that collects in the sulcus back of 
 tlie corona, and the resulting irritation on the surface 
 of the glans and the inner mucous fold of the prepuce 
 ends in an inflammatorjr thickening of the latter, its 
 inner surface becoming thick, undilatable, hard, and un- 
 yielding, all the natural elasticity that should be present 
 having departed, with more or less inflammatory thick- 
 ening and adhesions between the two layers of skin that 
 form the prepuce. In this unyielding tube the glans is 
 imprisoned and compressed, often suff"eriug the tortures 
 that the "maiden" of the dungeons of the Inquisition 
 inflicted on the unhapp}^ heretics. It becomes elongated, 
 cyanosed, and h3'persesthetic ; the meatus of the urethra 
 is congested and liypertrophied ; the corona is unde- 
 veloped and often absent, the glans having, on the 
 whole, the long-nosed, conical appearance of the head 
 
Prepuce as an Outlaw, and its Effects on the Glans. 211 
 
 of a field-mouse. There are hardly five per cent, of the 
 uncircumcised but who suffer in some degree from this 
 constricting result of the prepuce, to a greater or less 
 extent. 
 
 On the other hand, the unconstricted glans penis 
 assumes the shape and appearance that is seen in the 
 circumcised. The head is shorter, the face flat and 
 abrupt, and the meatus, instead of being at the end of a 
 conical point, is situated on the smooth, rounded front 
 of the glans, and does not differ in color from the cover- 
 ing of the glans itself. From the superior commissure 
 of the meatus to the sulcus in the rear of the corona its 
 topographical outline may be said to describe two oppo- 
 site segments of a circle, as seen in the cuts representing 
 the glans in its natural shape. The corona is prominent 
 and well developed. 
 
 The opponents of circumcision base much of their 
 opposition to the fact that circumcision interferes witli 
 the natural condition of the parts. The question may 
 well be asked, which of these two shaped glans is the 
 natural product as nature intended it should be ? It is 
 a well-known fact that the most forlorn and mouse- 
 headed, long-nosed glans penis will, within a week or 
 two after its liberation from its fetters of preputial 
 bands, assume its true shape. We may naturally inquire 
 if nature made the glans of a certain shape, which seems 
 to be the proper shape for copulative purposes, onh?^ to 
 have the condition most effectually abolished by a con- 
 stricting, unnatural band ? How much the shape of this 
 glans, from meatus to corona, may have to do with 
 retaining the urethra to a health}' and normal calibre 
 and condition has not been inquired into, but, as far as 
 the writer has observed, a normal glans seems to liave 
 less abnormalities of the urethra, and in treating such 
 
212 History of Circumcision. 
 
 cases he has always found that when the urethra of one 
 of these iiormal-glans subjects was affected it was far 
 easier to manage ; while, on the other hand, secondary 
 and even a tertiary recurrence to an operation is often 
 the fate of a long, narrow, conical-pointed penis. 
 
 Phimosis is known to have been a cause of male 
 impotence by its direct interference with the outward 
 flow of the seminal fluid ; but, although we have cases 
 where impregnation has taken place by the aid of a 
 warm spoon and a warm syringe, as in the case related 
 in a former chapter, it must be admitted that the corona 
 is not without some functional office in the act of pro- 
 creation. Its shape indicates a valve action like that of 
 the valve in a syringe-piston, and if we examine the two 
 extremes of these conditions of glans — one devoid of 
 corona, as many are, and the other with the corona in 
 its most pronounced form, when in a state of erection — 
 the difference, either in the appearance of the two organs 
 or in the different philosopliical action and results that 
 must necessarily follow the use of these two differently 
 shaped glans, will at once be apparent. Unfortunately — 
 or, as many may consider it, most fortunate — the female 
 organs are not always so shaped as to be in themselves 
 wholly favorable to impregnation. The wearing of cor- 
 sets, the habitual constipation of females, the relaxed and 
 unnatural condition of the uterine ligaments and vagina 
 in civilized women, all favor uterine displacement, with 
 any or all forms of uterine ailments. To this we may 
 add tiie effect of repeated miscarriages, application of 
 astringent washes, irregular menstruation, etc., all of 
 which conditions often result in an elongation of the 
 neck, constriction of the cervical canal, with the externnl 
 OS placed on the depended point of the sharply pointed 
 cervix, which is liable to point in any direction. Just 
 
Frejyuce as an Outlaw, and its Effects on the Glans. 213 
 
 imagine one of these conditioned females and one of tlie 
 mouse-lieaded, covona-deficient, long-pointed glans males 
 in the act of coinilation ! The conical penis finds its way 
 in the reflected fold of the vagina, while the point of the 
 uterus ma^' be two or three inches in some other direc- 
 tion, making impregnation wholly impossible; besides, 
 in the normal-shaped penis, the corona acting as a valve, 
 behind which the circular muscular fibres of the vagina 
 close themselves, tends to retain the seminal fluid in 
 front, while the very shape of the organ assists in 
 straightening out tlie vaginal canal and to bring the 
 uterus in proper position. In the long, thin, narrow 
 and pointed glans, devoid of corona, there is no mechan- 
 ical means to retain the seminal discharge. Some years 
 ago some one introduced the idea of postural copula- 
 tion, to be tried in cases of sterility, and it has been 
 found that impregnation would take place in some cases 
 where it had formerly appeared impossible, this position 
 having the effect of righting malpositions during the act, 
 which were the cause of the sterility; but it stands to 
 reason that, where the shape of the organ is such that it 
 furtlier favors malpositions, as well as where it offers no 
 obstacle to the vagina immediately expressing or drop- 
 ping out all the seminal fluid, impregnation is more 
 difficult, and that, where the uterine deformity is coinci- 
 dent with this condition of penis to assist, it becomes 
 well nigh impossible. Fodere mentions a penis about 
 the size of a porcupine-quill on an adult male, and 
 Hammond mentions one of the size of a lead-pencil in 
 diameter and two inches in length. From total absence 
 of the penis, either through disease or accident, to the 
 diminutive organs mentioned by Fodere and Hammond, 
 and on up to tlie full-sized and normal-shaped organ, 
 we have ever}' degree of sizes and shapes, and with these 
 
214 History of Circuvicision. 
 
 go every conceivable degree of ability or faculty for 
 impregnation. 
 
 Aside from the foregoing considerations, there are 
 others equally important. Although Greece was involved 
 for 3'ears in war and ancient Troy was destroyed and all 
 its inhabitants slaughtered because of the seduction of one 
 woman ; and Semiramis, through her beautj', got all her 
 successive husbands in chancery ; and poor, susceptible 
 Samson, from firing Philistine vineyards and killing lions 
 bare-handed, and the Philistines by the thousands with 
 the jaw-bone of an ass, was reduced through Delilah to 
 bitter repentance and turning Philistine mill-stones; 
 and we know that the familiar infatuation of Antony for 
 Cleopatra ruined Antonj^ ; and we are familiar with the 
 well-known maxim of the French police-minister, that to 
 catch a criminal it was but necessary to first locate the 
 woman and the man would soon be found, — society has 
 determined to ignore the influence of the animal passions 
 as factors in our every-day life, or factors in the estrange- 
 ments, coldness, and the bickerings that end in divorces. 
 Not to shock the reader with detailed accounts as to 
 what an important factor the shape of the penis may be 
 in the domestic economy, I will refer the reader to 
 Bran tome's works. 
 
 Although the councils of the older church were not 
 above giving these conditions their calm and deliberate 
 consideration, which resulted in the foundation of the 
 present physical considerations in relation to divorce 
 laws, such studies or considerations are at present only 
 touched upon gingerly and with apologies for doing so, 
 as if the " study of man " was of any less importance 
 to-day from what it was in the days of Moses, the elder 
 church, or when Pope formulated his oft-quoted but 
 little-followed maxim, that " the proper study of mankind 
 
Prepuce as an Outlaw, and its Effects on the Glans. 215 
 
 is man." The present miscalled " delicacy of sentiment " 
 is about as misplaced a condition of disastrous and mis- 
 leading morality as was the out-of-place and untimely 
 bravery of poor old Braddock when refusing Washing- 
 ton's advice at the Monongahela. Tiie success and 
 beauty of the Mosaic law is its squarely facing the con- 
 ditions of actual life, and its absence from nonsense or 
 nauseating sentimentality. Were our present churches 
 to observe more of this plain talk, for which the good 
 old Anglo-Saxon is as fully expressive and convincing 
 as the old Hebrew, and deal less in rhetorical flourishes 
 and figurative mean-nothings to tickle the ears of our 
 modern Pharisees, mankind as well as womankind would 
 be infinitely so much the better off, mentally, morally, 
 and physically, and there would be less of the conflict 
 between science and religion. Luther's dream of restor- 
 ing religion to its primitive purity has come to but as 
 poor realization at the hands of his so-called followers, 
 which leads one to think that if the martyrs of the 
 Reformation could come back and see the fruits of their 
 martyrdom — suff"ered that pure religion might live — 
 they would conclude that, for all the resulting good 
 accomplished, they might as well have kept a whole 
 skin and a whole set of bones. 
 
 In cases of pronounced phimosis the aperture in 
 the prepuce may not be in a line with the meatus, and 
 the resulting discharge of urine or the ejaculations of 
 seminal fluid may from this cause be unable to find an 
 egress. The fluid escaping from the urethra will, in 
 case the opening is at the side or upper part of the pre- 
 puce, cause it to balloon out until a suflficient quantity 
 is thrown out so as to distend the opening as well as the 
 prepuce, before it can find its way out ; in such cases 
 impotency is liable to be as complete as in those cases 
 
216 History of Circicincision. 
 
 of stricture wherein tlie seminal fluid is forced backward 
 into the bladder. Having given this general view of 
 the effects of phimosis as it may affect man in the shape 
 of his organ, wliich ma3' have a serious result in his 
 domestic relations or in becoming a fatlier, we will pro- 
 ceed to the consideration of diseases and conditions 
 that phimosis encoui'ages and to which it renders man 
 more liable. In the consideration of these cases it must 
 not be forgotten that the sexual relations are much 
 more to man or woman than is generally acknowledged. 
 The da3s for the establishment of the Utopian republic 
 of Plato are not yet with us. That Platonic love does 
 exist is true, as it has in the past and will in the future. 
 Scipio, refusing to accept the beautiful betrothed bride 
 of an enem\^ as a present, or Joseph leaving his coat-tail 
 in the hands of the amorous bride of the eunuch Poti- 
 phar, with the suicide of Lucretia, in the past, are 
 events which virtue and modeini continence probably 
 duplicate every day ; but these are exceptions to the 
 rule. Physicians daily see evidences of the most 
 dovoted Platonic affection in either sex, but they also 
 see enough of the opposite side of the question to con- 
 vince them that in the majorit}^ of cases the sexual 
 relations are the bond of union, as well as the main- 
 spring of love. As observed by Montesquieu, the bride 
 of a first-class Turkish eunuch has but a sorry time, and 
 a woman of the same calibre of mind as that possessed 
 by the ordinary Circassian or Armenian bride cannot be 
 in a much happier condition with a husband partlj'^ 
 eunuchised b}^ a constricted prepuce. 
 
CHAPTER XIX. 
 
 Is THE Prepuce a Natural Physiological AppEriDAGE ? 
 
 By many surgeons the idea of circumcision, unless 
 connected with an immediate demand for interference, — 
 sucli as a phimosis unmanageable by any other means, 
 an induced phimosis from gonorrhoea or other irrita- 
 tion, S3'philis in its initiator}- sore, cancer or some such 
 cause, — is looked upon as an unwarrantable operation, a 
 procedure not onl}- barbarous, painful, and dangerous, 
 but one that directly interferes with the intentions of 
 nature. The prepuce is by many looked upon as a 
 ph3'siological necessit}' to health and the enjoj'^ment of 
 life, whicli, if removed, is liable to induce masturbation, 
 excessive venereal desire, and a train of other evils. 
 The question then resolves itself. What is the real 
 physiological status of this appendage, if it has any, and, 
 if it is a ph3'siological appendage, when does it merge 
 into a pathological appendage? As by some it is held 
 that the prepuce enjoys the same right to live and exist 
 as the nose, ear, or a limb, which are only subject to 
 amputation in case of a serious disease, they should be 
 reminded that they are not taking into consideration 
 that the nose and ear are calculated to warn us of 
 danger, and that our legs are very useful ; as even the 
 great orator Demosthenes, by the timely and rapid use 
 of his legs, was enabled to escape from a battle, where 
 his oratory w^as of no avail against the illiterate javelins 
 of the unscholarly Macedonians. If the prepuce only 
 was endowed with an olfactory sense, — as, for instance, 
 if a nervous filament from the first pair of nerves had 
 
 mi) 
 
218 History of Circumcision. 
 
 been sent down alongside of the pnenmogastric and 
 then, by following the track of the niammaiy and epi- 
 gastric arteries, had at last reached the prepuce, where 
 the olfactory sense could have been turned on at will, 
 like an incandescent lamp, — it might have been a very 
 useful organ, as in that sense it could have scented 
 danger from afar, if not from near, and enabled man to 
 avoid any of the many dangers into which he uncon- 
 sciously drops. But, seeing that the prepuce, to say 
 nothing of being neither nose, eye, nor ear to warn one 
 away from danger, or a leg to run awa}' on after once in 
 it, having not even the precautionary sensitiveness of a 
 cat's jnoustachios, it cannot, in any way that we can 
 see, be compared to anj- other useful part of the body. 
 
 All attempts to find reasons for its existence that 
 are of real benefit to man have so far proved unsatisfac- 
 tor}', and, unlike the reasons for its removal, are, as a 
 rule, founded on speculation. To further reason out the 
 why and wherefore of its existence or of its summary 
 surgical execution, we must consider its shifting posi- 
 tions as to the effects it produces, as well as to its con- 
 ditions at different ages, sitting on its case like an 
 impartial jury in the case of some unconvicted but 
 diabolicalh^ -inclined criminal. 
 
 As before remarked, we are, as a rule, born with this 
 appendage, just as much as we are with the appendix 
 vermiformis, which rises up, like Banquo's ghost, when- 
 ever we eat tomatoes or any small-seeded fruit. This 
 prepuce is then long, and the penis is found at the end 
 of an undilatable canal, which is formed by the con- 
 stricted prepuce ; at this early stage of our existence it 
 is often additionally^ bound down to the glans by a 
 greater or less number of adhesions. We are then in 
 what man}' term a state of physiological phimosis, that 
 
7s the Prepuce a Natural Physiological Appendage ? 219 
 
 being a perfectly natural condition, and one consistent 
 with health ; at least, we imagine it is normal. 
 
 Phimosis in childhood is generally considered a 
 ph^'siological state, onl}' to be taken as a pathological 
 condition under certain circumstances. Preputial ad- 
 hesions may, according to man}' observers, also be classed 
 as physiological at an earl}^ period of life, as it is by 
 them considered as congenital, and common enough to 
 warrant its being classed as normal. As to tlie first, or 
 phimosis, it undoubted I3' is a phj-siological condition 
 during infanc}' ; but why, we do not know ; and it is also 
 a fact that from birth to puberty it remains so in fully 
 over one-half of the cases. Out of 98 children, from one 
 week to sixteen j^ears of age, examined by Dr. Packard, 
 the prepuce was entirely unretractable in 64, partly so 
 in 3, and wholly so in 36 ; while in 1 it onl}' half-covered 
 the glans and in 4 the glans was wholly uncovered, 
 1 of these 4 being an infant only five weeks old. 
 
 Dr. Packard also gives the result of 172 examina- 
 tions by himself, of from twelve to seventj' -three years 
 of age, and 106 examinations by Dr. Maury, a total of 
 278, in whom 100 had a long prepuce, 97 a partly-covered 
 glans, and 81 (of whom 2 had been circumcised) in whom 
 the glans was exposed. ^^ As to adhesions, there is an 
 unaccountable diversity of opinion as to their constancy 
 as a natural condition, being frequent enough to class 
 them as phj'siological occurrences. Dr. A. B. Arnold, of 
 Baltimore, states that his experience in reference to pre- 
 putial adhesions leads him to conclude that the fre- 
 quency of its occurrence has been much overstated. In 
 the number of children that he has circumcised, which 
 exceeds 1000, he has met with it in less than four per 
 cent, of the cases. He also mentions that in the adult 
 the adhesions show greater firmness.^* 
 
220 History of Circumcision. 
 
 On the other hand, Dr. Bernheira,of the Paris Israel- 
 itish Consistory, observes that, of over 3000 newborn 
 whom he has examined, with but few exceptions he 
 found tlie presence of preputial adhesions. He remarks, 
 however, that in the majorit}^ these are detached or 
 broken by the first attempt at erection.^^ 
 
 Bokai, out of 100 children, found 8 who were over 
 seven years of age, who were perfectly free ; Avhile of 
 the remaining 92 under that age 6 more showed no ad- 
 hesions and 86 had various degrees of adhesions. ^^ 
 
 Dr. Holgate, of the out-door department of Bellevue, 
 considered that all phimosic cases have adhesions ; while 
 Dr. Moses, of New York, out of some fifty circumcisions 
 performed at the eiglith day, found only adhesions three 
 times.^'' 
 
 These observations are, however, in perfect accord. 
 If we connect the statement of Dr. Arnold, in regard to 
 the increasing character of the firmness in the adhesions 
 of the adult, with the statement of Dr. Bernheim, that 
 the first erection is often sufficient to break up the ex- 
 isting adhesions in the infant, we must conclude that they 
 are notliing more at first than a slight agglutination, 
 which the slight manipulation requii'ed to properly 
 locate the position of the glans, and to space out the 
 prepuce preparatory to the operation of circumcision, < 
 must, in the majority of cases, be sufllcient to liberate 
 the prepuce from the glans ; this is evident also from 
 the statement of Dr. Moses, who only found six per 
 cent, of the cases operated upon b}^ him as being so 
 affected. 
 
 The writer has been present at a large number of 
 Hebrew circumcisions performed on the eighth daj^and 
 from that up to the sixth month (as in many communi- 
 ties they wait until a number of children are collected, 
 
Is the Prepuce a Natural Physiological Appendage f 221 
 
 so to speak, before sending for the mobel, who ma}^ reside 
 at quite a distance), and in all of those witnessed he 
 has never seen an}^ complications from adhesions ; but 
 cases of adhesion have been often encountered from the 
 second to the eighth 3'ear, and it has always been the 
 case, as a rule, that the older the child the greater the 
 firmness of the adhesion. In these cases the practice 
 generally advised of using a probe is not practicable, as 
 the person is more apt to wound the sound prepuce 
 than to tear the adhesions ; the practice most effectual 
 is to hold the glans firmlj' but gently with the thumb 
 and forefinger of the right hand, and then to draw the 
 prepuce as firmly back with its fold held in the fore- 
 finger and thumb of the other. It is a more expeditious 
 mode, and the least painful; by this method extensive 
 adhesions can readily be broken up ; vaselin and a piece 
 of fine lint should then be interposed for a couple of 
 da^'S to prevent a re-adherence. 
 
 Another co-existing condition with phimosis, very 
 often found, is a shortening of the frenum. Dr. Jansen, 
 out of 3700 soldiers of the Belgian army, found 12.3 
 per cent, with this pathological condition and 2.5 per 
 cent, with a narrow prepuce. ^^ 
 
 Take the three conditions above enumerated, — phi- 
 mosis, preputial adhesions, and short frenum, — all are but 
 a departure from a normal, in a greater or less degree ; 
 and whether the resulting discomfort consists in mere 
 mechanical impediment to urination, erection, or as a 
 factor in nocturnal enuresis, dysuria, impotence, either 
 through reflex action or interference with emission, mal- 
 position of the urethral orifice during copulation owing 
 to any of these conditions, or in anj'^ of the nervous de- 
 rangements that may accompany this condition, or in 
 the more serious results, ending in positive deformity 
 
222 History of Circumcision. 
 
 of bod}^ oi- limb, or in the warping of moral sentiments, 
 or, even further, in inducing insanity, it cannot well be 
 seen how the conditions that will certainly produce 
 these results, in a more or less degree, can ever, in any 
 logical sense, be considered a physiological condition. 
 
 There are certain conditions to life, up to the time 
 of birth, which, unless the}^ then cease at once to exist, 
 immediatel}' become from a physiological into very 
 serious pathological conditions. These are well under- 
 stood, and have their reasons for existing during our 
 pre-natal existence ; but the prepuce has no known func- 
 tion during uterine life or subsequent!}'' ; and there being 
 no valid reason for its existence, there are certainly no 
 logical grounds for its being considered a phj'siological 
 condition, especially when the serious results attending 
 the most accentuated form of the above three conditions 
 are considered, and as its necessity, in cases of its 
 entire absence, has not yet been demonstrated. 
 
 It can well be said that about two-thirds of mankind 
 are affected in a greater or less degree with these patho- 
 logical conditions, causing them more or less annoy- 
 ance. Of these, a certain percentage suffer a life of 
 continued miser^^, as a direct or indirect result of these 
 conditions. 
 
 As to the actual necessity of a prepuce existing, or. 
 as to what annoyances or diseases persons are subjected 
 to who are born without it, there is a most singular and 
 expressive silence in medical literature. It stands to 
 reason that, if it is a necessit^'^, some one person should 
 have found it out long ago, and there should then be 
 some evidence to present in relation thereto. There are 
 cases reported in some of the older surgeries wherein 
 an attempt has been made, in the absence of a prepuce, 
 to restore or manufacture one by means of a plastic 
 
Is the Prepuce a Natural Physiological Appendage ? 223 
 
 operation. Yidal describes sucli an operation ,^^ but there 
 is no reason given as to why tlie operation was under- 
 taken ; there is no record of any diseased condition 
 which it was intended either to cure or to alleviate ; so 
 that we are left to infer that the person simply submitted 
 to the operation from purely cosmetic reasons. The 
 Hebrews of Palestine, after the Roman conquest, or 
 those in Italy or Spain, attempted a like operation, but 
 not from any reason of lessened health or to restore any 
 lacking physiological action, their aim having sirapl}' 
 been to hide their identit}^, for the purpose of escaping 
 persecutions, exactions, or annoyances, either from their 
 rulers or their fellow-citizens. 
 
 Dr. A. B. Arnold, in a paper on circnmcision, read 
 before the Academy of Medicine of Baltimore, argues 
 that it is not difficult to divine the purposes of the pre- 
 puce, holding that it is necessary to protect the tactile 
 sensibility of the glans, due to the presence of the 
 Pacinian bodies which Schweigger Seidel discovered in 
 the nerves, and that a better provision than the anatomy 
 of the prepuce cannot be conceived for shielding the 
 very vascular and sensitive strncture of the glans from 
 external sources of irritation and friction, that might 
 rouse the sensibility of this organ, which, on physio- 
 logical grounds, may cause early masturbation ; further 
 arguing that, the corona being undoubtedlj^ the most 
 excitable part of the glans, its denudation b}^ circum- 
 cision leaves it more apt to be affected by chance titil- 
 lations.^" In this latter view of the case the prepon- 
 derance of views is, however, in the opposite direction, 
 J. Roj'es Bell states that, owing to the induration of the 
 glans through the means of circumcision, masturbation 
 and syphilis are less rife amongst the circumcised than 
 amongst the uncircumcised.^^ M. Lallemand, whose 
 
 8 
 
224 History of Circumcision. 
 
 experience in tlie treatment of seminal emissions is of the 
 greatest value, looked upon circumcision as one of the 
 means of curing those diseases, looking on the dimin- 
 ished irritability of the glans resulting from the opera- 
 tion as the curative element.^^ Dr. Cahen, in a " Dis- 
 sertation sur la Circoncision," in 1816, before the 
 Faculty of Medicine of Paris, called the attention to 
 the diminished sensibility of the glans induced by 
 circumcision. Dr. Vanier, of Havre, looks upon the 
 prepuce as the most frequent cause of onanism. " If 
 the prepuce is lax, its mobility produces an irritation to 
 the highly irritable and sensitive nervous system of the 
 child by the titillation in its movements on the glans ; 
 if too tight and constricted, then it compresses the 
 glans, and by its irritation it leads the child to seize the 
 organ." ^^ So that in either case he looks upon the pre- 
 puce, through the sensitiveness it retains and induces 
 in the glans, as the principle cause of masturbation. M. 
 Debreyne, the Trappist monk and ph3^sician of La 
 Trappe,who has paid considerable attention to medicine 
 as applied to morality, practicall}'^ makes the same 
 observations. In children who have not yet the sug- 
 gestions of sexual desire imparted by the presence of 
 the spermatic fluid, the presence of the prepuce seems 
 to anticipate those promptings. Circumcised boj's may, 
 in individual cases, either through precept or example, 
 physical or mental imperfection, be found to practice 
 onanism, but' in genei'al the practice can be asserted as 
 being very rare among the children of circumcised 
 races, showing the less irritability of the organs in the 
 class ; neither in infancy are they as liable to priapism 
 during sleep as those that are uncircumcised. 
 
 Dr. Bernheim says that " the prepuce may be said in 
 general to be an appendage to man, if not positively 
 
7s the Prepuce a Natural Physiological Appendage ? 225 
 
 harmful in some cases, at least useless, requiring con- 
 stant care, the neglect of which is liable to entail disease 
 and suffering; the irritation it produces tlirough the 
 sebaceous secretion is a frequent cause of masturbation 
 which nothing short of circumcision will remedy." 
 
 I'hrough middle life, unless the prepuce be the sub- 
 ject of some vicious conformation, little inconvenience 
 may result from its presence, except it be from the 
 dangers to infections already pointed out during this 
 period of life; an ordinarily movable and retractable 
 prepuce will not acquire the condition of phimosis, 
 unless it be through disease or accident ; but with our 
 entrance into old age, or after having passed our vigorous 
 prime, the torment of the days of our infancy and 
 childhood come to harass us again. Persons given to 
 corpulency, with a long prepuce, are apt to become 
 affected with phimosis in their latter years, as such 
 persons are more subject to loss of their sexual vigor 
 and power of erection than lean and spare people ; in 
 these, the gradual diminution of the size of the erectile 
 tissues of the organ and its retraction allows of the 
 reconstriction of the preputial opening, which, in the 
 end, will not allow the prepuce to be drawn back OA'er 
 the gland. These conditions are followed by the irri- 
 tating affections incident to phimosis of our earlier life, 
 with the modification that age has induced in making 
 us subject to more serious and fatal ailments, both 
 locally and generally. 
 
CHAPTER XX. 
 
 The Prepuce, Phimosis, and Cancer. 
 
 In the British Medical Journal of Januarj^ 1, 1882, 
 there is an interesting article by Jonathan Hutchinson 
 on the " Pre-cancevous Stage of Cancer." In this arti- 
 cle he states that, whereas, twenty years previously, his 
 suggestion had been to treat all suspicious soi-es as 
 being clue to syphilis until a clearer diagnosis could 
 be made out, he " had more recently often explained 
 and enforced the doctrine of a pre-cancerous stage of 
 cancer. According to this doctrine, in most cases of 
 cancer, either of penis, lips, tongue, or skin, tliere is a 
 stage — often a long one — during which a condition of 
 chronic inflammation only is present, and upon this the 
 cancerous process becomes ingrafted. Phimosis and 
 the consequent balanitis lead to cancer of the penis. 
 . . . A general acceptance of the belief that cancer 
 usually has a pre-cancerous stage, and that this stage is 
 the one in wliich operations ought to be performed, 
 would save many hundreds of lives every year. . . . 
 Instead of looking on whilst the fire smoulderd, and 
 waiting till it blazed up, we should stamp it out on the 
 first suspicion. . . . What is a man the worse if 
 vou have cut away a warty sore from his lip ; and, when 
 all is done, a zealous pathologist demonstrates to you 
 that the ulcer is not cancerous, need j^our conscience 
 be troubled? You have operated in a pre-cancerous 
 stage, and you have probabl}' effected a permanent cure 
 of what would soon have become an incurable disease. 
 I do not wish to offer any apology for carelessness, but 
 I have not in this matter any fear for it." 
 (226) 
 
The Prepuce, Phimosis, and Cancer. 227 
 
 In view of the great frequenc}^ of the occurrence of 
 cancer of the penis, and the facts pointed out by Roux, 
 that, after the removal of the cancerous prepuce or a 
 portion of the penis for cancer, in case of a recurrence 
 the disease does not do so in the penis, but that it 
 attacks the inguinal glands, showing conclusively that 
 the prepuce is the inciting cause as well as the initial 
 point of attack, the sentiments in the foregoing para- 
 graph, taken from the words of Hutchinson, are worthy 
 of our most careful consideration. 
 
 M. Roux, Surgeon to the Gharite, during the second 
 decade of the present century, first called tlie attention 
 of the French profession to the intimate relation or de- 
 pendence that cancer of the penis bears to phimosis. 
 In England he was preceded in this field of surgical 
 investigation by William Hey, whom Roux met iu 
 London in 1814. He}' had then operated by amputation 
 of the penis on twelve cases of cancer, nine of whom 
 had had phimosis at the time of the development of the 
 cancer. Wadd at this time also published a work on 
 the subject, but, although he noticed that phimosis was 
 a cause of cancer, he did not fully grasp the subject as 
 He}' and Roux had done, as he believed a cancerous 
 diathesis a primary necessity, and did not then recog- 
 nize that the primary cause was fully to be found in the 
 prepuce itself, 
 
 Roux was probably the first to point out the peculi- 
 arly local character of penile cancer, as there is no 
 locality wherein a timely operation is less apt to be 
 followed by a recurrence. He records a number of cases 
 where the prepuce alone was affected when first seen, but 
 none wherein the glans was attacked and where the 
 prepuce wes exempt, giving ample evidence of the origi- 
 nal starting-point of the disease.^^ 
 
228 History of Circumcision. 
 
 Erichsen also remarks on the little liability to recur- 
 rence of cancer of the penis after a timely operation ; 
 he divides the cancer to which the penis is subject to as 
 being of two distinct kinds, — scirrhus and epithelioma. 
 The latter variet}^ commences as a tubercle in the pre- 
 puce, and, according to Erichsen, does not occur in the 
 body of the penis except as a secondary' infiltration or 
 deposit.^^ Travers states that Jews who are circumcised 
 are not subject to either form of cancer.^^ 
 
 Repeated attacks of herpes preputialis and some 
 consequent point of induration are looked upon b^"^ 
 Petit-Radel, Chauvin, and Bernard as frequent starting- 
 points for the cancerous affection of the prepuce. The 
 aged or persons of lax fibre being more subject to these 
 inflammatory attacks, are also the most frequent victims 
 of cancer in this situation. The celebrated Lallemand, 
 in regard to the tendency to cancer induced by the 
 presence of the prepuce, observes as follows : — 
 
 " Besides simple balanitis . . , there also result 
 various indurations, which are proportionate in their 
 degree to the length of time and intensity with which 
 the inciting inflammatory conditions have existed. I 
 have repeatedly found the mucous lining of the prepuce 
 thickened, hardened, ulcerated, and nodulated ; at other 
 times converted into a fibrous or even into cartilaginous 
 tissue of excessive thickness ; in others, still, in which it 
 had assumed a scirrhous and cancerous nature. I have 
 repeatedly operated on such cases, wherein the prolonga- 
 tion of the prepuce was the only recognized primar^'^ 
 cause, the subjects being often countr3anen of from fifty 
 to sixty years of age, who had never known an}^ women 
 except their own, but who had, nevertheless, been long 
 sufferers from balanitic attacks, accompanied b^' abund- 
 ant acrid discharges, swellings of the prepuce, with 
 
Tlie Prepuce, Phimosis, and Cancer. 229 
 
 more or less consequent excoriations and narrowing of 
 tlie preputial orifice."^' 
 
 Claparede sums up the inconveniences and dangers 
 to wliich the possessor of a prepuce is liable to suffer 
 from, as follows : " The retention of the sebaceous secre- 
 tion is liable to alter its character, converting it into an 
 acrid, irritating discharge, which induces more or less 
 burning, smarting, itching, excoriations, and swelling, 
 which, affecting the little glands situated about the 
 corona and sulcus, induces them to secrete an altered 
 and vicious secretion. In this manner a simple elonga- 
 tion of the prepuce will produce an inflammation of the 
 surface of the glans (balanitis), or that of the prepuce 
 itself (posthitis), or the two conjoined (balano-posthitis), 
 complicated possibly with phimosis. By an extension to 
 the mucous membrane of the urethra of the same con- 
 dition of the inflammatory process, we have blennor- 
 rhagia ; blennorrhagia is liable to be followed by inguinal 
 swellings or tenderness, orchitis, stricture, and prostatic 
 disease ; the formation of preputial calculus, from reten- 
 tion of the urine in the prepuce ; and cancer is apt to be 
 the end of any of these conditions." ^^ 
 
 J. Royes Bell, in Ashhurst's " International Ency- 
 clopsedia of Surger}^," observes as follows : " Carcinoma 
 attacking the genital organs usually assumes the form 
 of epithelioma ; the other kinds are rarel3^ met with. 
 Epithelioma may invade the prepuce, or the whole penis, 
 or any part of it. The most common age for it is fifty 
 3'ears or over. In the great majority of cases there has 
 existed a congenital or acquired phimosis. A contusion 
 or a urinary fistula may be the exciting cause. With a 
 phimosis the parts are not kept clean, but the gland is 
 macerated and rendered tender and excoriated by re- 
 tained secretions, and the irritation causes an epithelioma 
 
230 History of Circumcision. 
 
 to grow in those predisposed to the disease, as is found 
 to be the case when the tongue is irritated by a brolcen 
 tooth, or the scrotum by the presence of soot in its 
 folds. Syphilis has no direct influence in inducing the 
 disease, but a syphilitic chap or ulcer may be the starting- 
 point of an epithelioma. Two kinds of epithelioma 
 affect tlie penis, — the indurated and the vegetating, or 
 cauliflower growth. . . . The nature of the disease, 
 in either the prepuce or the glans, is masked hy a phi- 
 mosis. . . . The prognosis in these cases is much 
 more hopeful than in epithelioma in other situations. 
 Sir William Lawrence operated on a patient who 
 was quite well years afterward, and Sir William Fergu- 
 son amputated the penis of a man of note in the political 
 world, who lived many years after the operation, and 
 died at an advanced age." 
 
 Agnew, of Philadelphia, describes an epithelioma of 
 the prepuce occurring in persons past middle life, begin- 
 ning as a tubercle, crack, or wart, for which he advises 
 an early circumcision ; he admits, however, to not hav- 
 ing sufficient data to determine whetlier Jews and 
 circumcised persons are exempt from carcinoma of the 
 penis ; but as its usual starting-point he evidently 
 admits to be in the prepuce, circumcision must cer- 
 tainly^ be a preventive to its appearance. Gross gives 
 substantial!}' the same opinion as Agnew in this regard. 
 Dr. John S. Billings, in his article on the " Yital Statis- 
 tics of the Jews," in the January North American 
 Review^ of 1891, on the subject of cancer, observes as 
 follows : — 
 
 " As regards cancer and malignant tumors, we find 
 that the deaths from these causes among the Hebrews 
 occur in about the same proportion to deaths from 
 other diseases as they do in the average population. 
 
The Prepuce, Phimosis, and Cancer. 231 
 
 But fis the ratio of deaths to population is less among 
 the Jews, so the ratio of deaths from malignant diseases 
 to population is also less. Among the living population 
 the proportion found affected with cancer among the 
 Jews was 6.48 per 1000, while of those reported sick by 
 the United States census of 1880, for the general popu- 
 lation, the proportion was 10.01 per 1000." 
 
 There are no convenient data as to the prevalence 
 or percentage of cases of cancer among the Arabian or 
 Mohammedan population of Asia and Africa, but the 
 above comparison of 6.48 per 1000 among the Jews of 
 the United States, against 10.01 per 1000 of the general 
 population, shows that the circumcised race does, in the 
 instance of cancer, certainly enjoy a certain amount of 
 immunity, having in this regard not quite such an 
 exemption as the}' enjo}^ from consumption, but still 
 sufficient to assist in making them longei'-lived and 
 more able to enjoy life and die a less lingering and 
 painful death. 
 
 It is surprising that, in view of the fact that carci- 
 noma of the penis, starting with such frequencj' in the 
 prepuce, should have left any doubt but that with the 
 absence of this appendage there would follow less 
 liability to cancer. Cullerier informs us that he had 
 several times amputated the penis for cancerous diseases, 
 but that he is unable to tell us whether the persons 
 were affected with phimosis, remarking that on the last 
 case he had observed the indurated remains of the pre- 
 puce; he had, however, recognized the necessity of 
 freely exposing the gland in cases where, from con- 
 tinued irritation and inflammation, there was danger of 
 cancer formation. 
 
 Nelaton describes two varieties of cancer that affect 
 the penis, — that which attacks the integument and that 
 
232 History of Circumcision. 
 
 ■which attacks the gians. The first of these varieties he 
 observes as geuerallj' beginning as a hardened nodule in 
 the prepuce, which becomes at once more or less thick- 
 ened and indurated. He gives Lisfranc the credit of 
 pointing out the fact, that, even in the most hopeless- 
 looking case, the glans and body of the penis ma}^ 
 be siniplv pushed back and compressed, but otherwise 
 sound, and that before resorting to an amputation of 
 the whole organ it is better to make a careful explora- 
 tory- dissection in search of the penis, as it oftentimes 
 happens that the prepuce and integument can be dis- 
 sected oft', leaving the organ intact. He also mentions 
 that elephantiasis of the penile integument generally 
 begins in the prepuce. 
 
 Baron Boyer believed that the vitiated preputial 
 secretion allowed to remain beneath the prepuce was 
 one of the causes of cancer of the penis, observing that 
 it would be interesting to know whether cancer of the 
 penis was a rarit}' among circumcised people, such as 
 the Jews and Mohammedans.^^ 
 
 It is easy to perceive why or how Agnew, Gross, 
 Cullerier, and manj- of those who have written on the 
 subject, have failed to appreciate the existence of the 
 prepuce as an exciting cause, or as being, in the majority 
 of instances, the part primarily attacked. The nodule, 
 excoriation, or abrasion that develops into a cancer 
 generall}- produces more or less local disturbance ; in 
 man}^ it produces a phimosis that is only relieved by the 
 uIceratiA'e process that exposes the gland, which may by 
 that time itself be attacked or even destro^'ed. They 
 are then seen by either the rural practitioner or the family 
 ph^-sician, but before submitting to an operation thej' 
 run the gauntlet of manv physicians, and, when it comes 
 to operating, they generally apply to some one of great 
 
The Prepuce, Phimosis, and Cancer. 233 
 
 skill and reputation. B3- this time there is little left 
 of the organ, and, as a rule, the party is unable to tell 
 where the disease originated, whether in the prepuce or 
 glans, to them the swollen prepuce seeming to be the 
 whole organ. Of late j-ears, however, it has been pretty 
 well established that it generally begins in the preiDuce, 
 and the great number of amputations of the penis on 
 record for this disease does not lead one to believe that 
 it is as rare a disease as was formerl}'^ believed. In 
 Langenbeck's Archiv, Bd. xii, 1870, Dr. Zielewicz re- 
 ports fifty cases of amputation of the penis by the 
 galvano-cauteiy loop, mostly for carcinoma, one of the 
 fifty being for gangrene and one other for a large papil- 
 lar3' tumor. That one surgeon was able to report fortj'- 
 eight cases of carcinoma or cancer that were treated by 
 one special sj'stem of operating tells us plainly enough 
 that the unfortunate possessor of a prepuce, no matter 
 how normal or unolrjectionable it ma}^ seem to be in the 
 prime of man's existence, or however physiologically 
 necessary it may be deemed, runs too many risks in 
 holding on to his possessions. 
 
 The views set forth b}' Hutchinson in the beginning 
 of this chapter are precisely those that are held by the 
 writer, who would even go further, by adA'^ising all such 
 as have, in their youth or since, suffered with balano- 
 posthitis in anj^ degree or form, or whose prepuce shows 
 a tendency to elongation with age, to have the same re- 
 moved at once; where the prepuce is not redundant, 
 but only tight, a slight operation, such as slitting, will at 
 once remove the possibility of any future danger, without 
 keeping a man from his business a single day. 
 
 It may here be remarked that, although always fa- 
 vorabl}' impressed with the great benefits arising out of 
 circumcision, nothing ever resulted in such a serious 
 
234 History of Cii^cumcision. 
 
 eonsideratiou of the subject as seeing a professional 
 brother dying with a cancerous affection of the penis. 
 The disease had originated in the mucous lining of the 
 prepuce, and when seen in consultation with his attending 
 physicians the gland had alreadj^ disappeared and the in- 
 guinal glands were affected. The man was in the prime 
 of life, and, aside from the local trouble, a specimen of 
 perfect health and plij^sique. He informed lis that while 
 a youth he had suffered from repeated attacks of herpes 
 preputialis ; that he had suggested circumcision more 
 than once to his father, who also was a physician, 
 but who, unfoi'tunatel}^ for the son, could not see any 
 merit In circumcision. To his ej'es there was nothing 
 that circumcision could do but what could be accom- 
 plished b}'^ washing and personal attention to cleanli- 
 ness. When older, the prepuce gave him less trouble, 
 and for a long time after his marriage it ceased to trouble 
 him altogether. The idea of the necessity of circum- 
 cision did not occur to him again until the appearance 
 of the cancerous disease; even then, not appreciating 
 the danger, and looking upon the trouble as a simple 
 transient result of some inflammatory action, he waited 
 until the parts would be in a better state or condition 
 of health before resorting to an operation, — that time 
 never came. 
 
 Although to Koux, Wadd, and He}^ the credit must 
 be given for bringing the subject of cancer of this organ 
 so prominently before the profession, the knowledge of 
 the existence of the disease has long been a matter of 
 record. Patissier, in the fortieth volume of the " Diet, 
 des Sciences Medicales," quotes from the third volume 
 of the " Memoires de I'Academie Royale de Chirurgie," 
 that in 1724 an officer, aged fifV? "^^s attacked hy a 
 cancerous atTection originating underneath the prepuce ; 
 
Tlie Prepuce^ Phimosis, and Cancer. 235 
 
 at the time he consulted MM. Chicoineau and Sonlier 
 the disease had existed for two years, the inguinal 
 glands were implicated, and even the suspensory ligament 
 was affected. These surgeons, nevertheless, determined 
 upon an operation, and, after a long chapter of haemor- 
 i'hagic accidents, the patient finally made a recovery. 
 Another case, quoted by Patissier, was operated upon 
 by M. Cej'rac de la Coste, the patient a man of sixty, 
 the disease originating, like the preceding case, under- 
 neath the prepuce. 
 
 Warren, in his " Surgical Observations on Tumors," 
 observes that cancer of the penis begins by a warty 
 excrescence on the glans or prepuce. Walshe, in his 
 work on the " Nature and Treatment of Cancer," says : 
 " The disease may commence in almost all parts of the 
 organ, but the glans and prepuce are by far its most 
 common primary seats. It may originate either from 
 a warty excrescence or a pimple, or it may infiltrate 
 the glans, or appear as a complication of venereal 
 ulceration. Phimosis, either congenital or acquired, 
 is an exceedingly common accompaniment, and it 
 appears probable that the irritation occasioned by this 
 condition of the parts may act as an exciting cause of 
 the disease in persons predisposed to cancer. Circum- 
 cision is, therefore, an advisable prophylactic measure, 
 where the constitutional taint is known to exist." 
 
CHAPTER XXI. 
 The Prepuce and Gangrene of the Penis. 
 
 Another accompaniment of that preputial append- 
 age is gangrene of the penis, which, like carcinoma, 
 starting in at the prepuce, may invade the pubes and 
 scrotum. This disease is not so rare as to merit the 
 little attention it has received from our text-books. 
 M. Demarquay has collected the history of twenty-five 
 cases; from him we learn that the prepuce is the most fre- 
 quent seat of the start of the affection, from whence, 
 according to Astruc, it rapidly spreads to the skin of 
 the whole organ, and then attacks the corpora caver- 
 nosa; it may even extend as high as. the umbilicus. 
 This disease spares no age ; it attacks young and old 
 alike. 
 
 There is not a case recorded of this disease that 
 particularized any other starting-point than the swell- 
 ing, tension, active or passive congestion that takes 
 place in the integument of the penis. By this it must 
 not be understood that the initial disease or inflamma- 
 tory action that produces the gangrene must necessarily 
 have its seat in the integument, but that it is the in- 
 tegument of the penis (and especially that of the pre- 
 puce) in which, through the laxity of its tissues, pas- 
 sive congestion is favored that the gangrenous action 
 begins. That this is the actual case there can be but 
 little doubt about, as, even where the gangrene invades 
 the body of the penis itself, even where the inflamma- 
 tor}^ action may have started from a violent urethritis, 
 that condition of blood which favors gangrenous results 
 (236) 
 
J7)e Prepuce and Gangrene of the Penis. 237 
 
 will be found to have begun during its state of stasis, 
 where it has parted with much of its watery element, as 
 well as considerable of its vitality, while in its slow, 
 tedious, and obstructed passage through the prepuce. 
 Some of this dark, thickish blood, finding its way from 
 the integumentary return circulation to that of the 
 deeper structure, becomes there a mechanical as well as 
 a pathological cause for that impediment to the free 
 circulation of the parts, through its altered physiologi- 
 cal condition. The deeper structures of the penis, 
 besides tlieir own blood-suppl}^, carry back into the 
 deeper or S3-stemic circulation a large supply from the 
 integumentary tisses, when in the latter, owins: to the 
 greater supply due to any inflammatory action, the 
 blood-current is delayed and impeded in its lax and 
 easily -dilatable tissues, and blood-changes occur favoring 
 the gangrene in the deeper tissues ; so that, whether the 
 gangrene first takes place in the body of the penis or 
 in the scrotum, it will be in the prepuce or adjoining in- 
 tegument that its real originating causes will be found. 
 Baron Boyer, in speaking of the inflammation of 
 the penis, observes that the intensity of tlie swelling, 
 great pain, and difficulty of urination that follow have 
 led many to believe that the inflammation of the deeper 
 structures really always formed a part of the disease. 
 In otherwise healthy and vigorous subjects it does not, 
 however, extend beyond the skin, as has been demon- 
 strated where the resulting gangrene from excess of 
 inflammatory action has ended in resolution, the deepei' 
 tissues not having been found to be injured. It is 
 only where the tone of the general sj'stem is lowered, 
 through disease, age, or other deteriorating conditions, 
 that the whole organ is liable to become aflected or 
 to break down. 
 
238 History of Circumcision. 
 
 Bo3'er, in the tenth volume of his " Treatise on Sur- 
 gical Affections," gives several examples of this affec- 
 tion not due to age : one case was a person, simultane- 
 ously attacked by an adynamic fever and a blennor- 
 rhagia, who suffered from gangrene of the penis ; the 
 local and constitutional disturbance was not high, how- 
 ever, and the patient escaped with the simple loss of 
 the prepuce. 
 
 Another case admitted to the Charite, aged thirty-six, 
 was afflicted with a blennorrhagia, upon which an attack 
 of low fever supervened. The penis inflamed, became 
 engorged and livid, and soon gangrenous symptoms pre- 
 sented themselves, making rapid progress ; at first the 
 integument alone was affected, but later all the structures 
 became implicated and the penis was completely de- 
 stro^^ed, the sloughs detaching themselves in shreds, 
 leaving a conical stump that healed but slowly. 
 
 One case, a young man of twenty, also at the Charite, 
 was admitted with adynamic fever ; a few days after 
 admission the prepuce was observed to be somewhat in- 
 flamed ; in spite of all treatment this progressed so 
 rapidl}^ that the purple discoloration presaged a gan- 
 grene, which was not slow in following ; the focus 
 seemed to be at the superior and back portion of the 
 prepuce; an incision evacuated a quantity of purulent, 
 serous fluid ; the disease, however, extended up the 
 organ as far as its middle before its actions ceased ; the 
 sloughs were then cast off, when it was found that part 
 of the gland and a portion of the cavernous body had 
 followed the' integument in the general wreck, subjecting 
 the patient to intolerable pain during micturition. 
 After the recovery from the fever, the remaining portion 
 of the glaiKl and the mutilated parts of the cavernous 
 body were amputated to remedy this condition; the 
 
The Prepuce and Gangrene of the Penis. 239 
 
 patient subsequently admitted to have had a blennor- 
 rhagia at the time of his admission to the hospital. 
 
 The gangrenous action may, in proportion to the low 
 condition of the patient, be as proportionately rapid. 
 Another case from Boyer, quoted from the works of 
 Forestus, relates how the whole organ underwent such 
 speedy disorganization that its liquefied remains were 
 found in a poultice, which had been applied with a view 
 of relieving the congestion, — a ver}' dear price to pay 
 for retaining the prepuce, that the exquisite sensitiveness 
 of the tactile faculty for enjo3^ment, resident in the 
 corona of the gland, might not be interfered with. 
 
 Gross does not mention this affection in his work on 
 surgery, dut Agnew devotes considerable space to its 
 description, dividing the disease into two forms : the 
 inflammatorj^, such as may follow venereal primary spres 
 or operations on the penis, not excepting circumcision ; 
 and the obstructive variet}^, such as may follow embo- 
 lism or any mechanical obstruction, either purposely or 
 accidentally applied. Of the latter he gives a number 
 of quoted instances ; he only admits seeing one case, 
 tliat of an aged man in the Pennsylvania Hospital, in 
 whom the disease was caused by embolism of the dorsal 
 artery. 
 
 J. Roj^es Bell, in the " International Encyclopaedia of 
 Surgery," pays more attention to it than any of our 
 American authors ; mentioning, among the causes which 
 may give rise to it, the exanthemata, especially small- 
 pox, and the poisoning by ergot of rye and erysipelas. 
 Among the local causes he mentions phimosis, para- 
 phimosis, and balano-posthitis. 
 
 Bell quotes the case reported by Mr. Partridge, in 
 the sixteenth volume of the " Transactions of the Patho- 
 logical Society- of London," wherein a sober man, aged 
 
240 History of Circumcision. 
 
 fort}'^, lost the whole of his penis up to the root, during 
 the course of a typhus fever. Also the case reported by 
 Mr. Gay, in the thirtieth A'olunie of the same " Trans- 
 actions," wherein a cabinet-maker, aged thirty-one, lost 
 his penis through the probable results of rheumatic 
 phlebitis, and due to the presence of a plug in the in- 
 ternal iliac vein. In the twelfth volume of the " Trans- 
 a(;tions" of the same society he finds the record of the 
 case of a soldier who lost his penis through gangrene 
 induced by syphilitic phagedena. 
 
 In the consideration of the subject of the prepuce 
 as connected with penile gangrene, it must not be over- 
 looked that the presence of a prepuce rsMiy be the inciting 
 cause of some rheumatic affection (the writer has re- 
 peatedly seen such), just as such cases are often the 
 result of stricture ; as cases of rheumatism that have 
 resisted all remedial means, but that have readilj' given 
 way to the dilatation of a stricture, are by no means 
 uiicommon ; not a mere muscular reflex rheumatic pain, 
 but even when accompanied hy a rheumatic blood con- 
 dition. So that even in such a case as above reported 
 as being due to rheumatic phlebitis, or the case reported 
 in the fortieth volume of the " Dictionaire des Sciences 
 Medicales" by Patissier, wherein a man lost penis and 
 scrotum through gangrene, induced by urinous infiltra- 
 tion, ma}- all in the origin be due, if not to the immediate, 
 to the remote eflfects of the presence of the prepuce. 
 
 In the first volume of the Journal of Venereal and 
 Cutaneous Diseases the writer reported a case of the 
 complete loss of penis in a j'oung man as a result of 
 ])hagedena due to sj^philis. The man had had a long 
 and pendulous prepuce ; in his case, had circumcision 
 ))een performed in early childhood, it would have les- 
 sened the chances of primar}^ infection ; and had it been 
 
Tlie Prepuce and Gangrene of the Penis. 241 
 
 performed after his infection, it "would have removed 
 one cause — if not the principal cause — of the ease with 
 which the phagedenic action was inaugurated. The case 
 already mentioned as an example of spontaneous and 
 natural circumcision belongs to tlie gangrenous results 
 following phimosis, ending witli the loss of the pre- 
 puce. In Maclise's " Surgical Anatomy " several speci- 
 mens of deformity are figured, showing the results of 
 this mildest of the effects of a phagedenic action. The 
 beginning of the interference in the return preputial 
 circulation undoubtedly always takes place over the 
 superior aspect of the corona, where the pressure of the 
 glans is most sharpl}^ defined against the inner fold of 
 the prepuce. 
 
 There are milder conditions, wherein the circulation 
 of the prepuce is materially interfered with, both through 
 the lax tissues of the parts and the peculiar anatomical 
 construction and shape of the neighboring parts, wherein, 
 without going as far as gangrenous breakdown, the 
 person suffers considerably nevertheless, and is placed 
 in danger of losing Ms penis ; for, as observed by Patis- 
 sier, whenever a person affected with a gonorrhoea is 
 attacked by a putrid or any low-grade fever, he runs 
 the greatest danger of losing his virile member through 
 gangrene. 
 
 Even where phimosis does not exist, but only the 
 long,, lax, and retractable prepuce, that is considered a 
 perfectly physiological condition, the prepuce is liable 
 to cause very distressing and complicating annoyances 
 during the progress of other diseases. The writer has 
 noticed that cases with a thick, leathery, and redundant 
 prepuce, even when perfectly retractable, are more liable 
 to require the use of the catheter during the course of 
 a continued fever. Such a condition is also a very fre- 
 
242 History of Circumcision. 
 
 quent accompaniment of prostatic obstruction. So often 
 lias this been noticed that its association with prostatic 
 trouble or disease tends to the belief tliat the irritation 
 produced by this condition of prepuce often lays the 
 founda,tion for prostatic disease in not a few cases,^"" 
 In elderly people, with the atrophied penis and elongat- 
 ing prepuce, the constant moisture from the urine on 
 the innner fold and glans adds greatlj^ to the irritation 
 as well as to the discomfort of the patient. 
 
 A number of affections are accompanied hy oedema, 
 especially toward the latter stages of the disease ; such, 
 for instance, as the ending of cases of mitral insuf- 
 ficiencj'. lu these, the distension of the prepuce and 
 the resulting balano-posthitis is at times a source of 
 great distress, and at times the resulting engorgement 
 produces a retention of urine. It w^as after an attend- 
 ance on one such case that required dailj' and frequent 
 puncturings for its relief, but which, in spite of all care, 
 finally became gangrenous, that a fellow practitioner 
 cheerfully submitted to circumcision, to avoid the pos- 
 sil)ilit3^ of any such complication occurring to embitter 
 his closing illness. ^"^ 
 
 The prepuce is the starting-point of many of the 
 cases of penitis and retention of urine that often 
 accompany attacks of gonorrhoea ; especially can this 
 result be anticipated where the prepuce is long, pendu- 
 lous, and with its veins in a varicose condition. Why 
 it should be so is self-evident. Anything that will add 
 to the interference of the return circulation only exag- 
 gei'ates the tendency to penis engorgement ; this 
 increases the difficult}'^ of urination, which, by the reten- 
 tion that results, in turn increases the constriction at 
 tlie root of the penis, and adds to the already difficult 
 return circulation. The bladder by its urine, and the 
 
Tlie Prepuce and Gangrene of the Penis. 243 
 
 penis by its blood, actually form, by their rautual press- 
 ures, an Impassable dam at the root of the organ. That 
 this is the true condition has been more than once 
 verified from the instant relief given to the whole con- 
 dition b}'' the prompt employment of the supra-pubic 
 puncture or aspiration, as catheterization in such cases 
 is altogether out of the question, and should never be 
 attempted or employed unless a soft catheter can be 
 inserted. 
 
 A person laboring under a continued fever has his 
 blood in a condition to favor sphacelus ; with the slow- 
 moving current of vitiated blood and its retention in such 
 las. tissues as those of the prepuce, through the medium 
 of the enlarged preputial veins, coupled with the lessened 
 sensibilities of the bladder and his perhaps semi-conscious 
 or unconscious condition, and an equally unconscious 
 bladder, he is, to saj^ the least of it, — if in possession of 
 a prepuce, — also the unconscious possessor of a certain 
 degree of percentage, no matter how small or fractional 
 that ma}^ be, of recovering from his fever without his 
 penis. Dr. W. "W. McKay, of the U. S. Marine Hos- 
 pital Service of San Diego, attended a case of typho- 
 malarial fever in consultation with me, where, but for 
 the persistent, intelligent, but delicate use of the 
 catheter for nearly three weeks the penis would 
 have become gangrenous. The subject was an ursemic, 
 irritable, nervous, leatherj^-prepuced individual; the 
 organ was unusuall3' large, the skin of the penis thick, 
 and it was only by keeping the bladder empty that pre- 
 vented a state of engorgement that would have effect- 
 ually interfered with further catheterization. As it was, 
 the penis was often dank, livid, and discolored from the 
 passive engorgement. 
 
 The writer saw a similar case with the late Dr. F. H. 
 
244 History of Circumcision. 
 
 Milligan, of Minnesota. The congestion in this case was 
 due to a gonorrhoeal inflammation involving the skin of 
 the whole penis, retention having followed painful mic- 
 turition, and the swelling of the penis following the reten- 
 tion ; the prepuce was enormously distended, and the penis 
 seemed in a state of erection as far as dimension and 
 rigidity were concerned. The man, a steam-boat cook, in- 
 formed us that it was fully twice as large as when rigidl}' 
 erect in health. All eflTorts to reduce the swelling were 
 unavailing; neither punctures, leeches, nor scarifications 
 were of any avail ; catheterization was impossible, but, 
 after relieving the bladder by the supra-pubic aspiration, 
 the patient experienced some relief. He, nevertheless, 
 lost the whole skin of the penis, with that of the pubis 
 and on the front of the scrotum. The man ran into a 
 low form of fever, with ursemic symptoms ; the stench 
 was so great that it was almost impossible to remain in 
 the same room with him ; but he finally made a slow 
 and very tedious recovery. In healing there was con- 
 siderable downward curvature of the penis, which, 
 however, did not prevent him from following his old, 
 dissolute course of life. 
 
 A calm, unprejudiced consideration of the subject of 
 the liability of the uncircumcised races dwelling in the 
 temperate and semi-tropical countries to cancer, gan- 
 grene, and elephantiasis might well lead one to ask : Why 
 are we afflicted with a prepuce ? We can understand 
 how a man may become gouty, and become a subject in 
 the end for a gangrene of the extremities ; or how senile 
 gangrene may, through a series of pathological proc- 
 esses and blood changes, with the aid of age, finally be 
 reached ; or how, by a like course of diseased pi'ocesses, 
 we reach the apoplectic stage. These conditions, how- 
 ever, can be put off, or partly, if not wholly avoided, by 
 
The Prepuce and Gangrene of the Penis. 245 
 
 a proper course of life, and, at the worst, it is only after 
 tlie fires of our youth and prime have complete!}^ burned 
 out, that these conditions are liable to claim us as their 
 lawful victim. Not so, however, with some of these con- 
 ditions that may end in penile gangrene ; that are liable 
 to pounce upon us unawares, like an Apache in an Ari- 
 zona canon ; or as the hired mercenaries of old Canon 
 Fulbert did upon poor Abelard in his study, and, without 
 further ado or cei'euiony emasculate man as effectuallj- 
 as the most exacting Turk could demand, with a veri- 
 table taille a fleur de ventre operation. 
 
 Nature has her own ways of protecting what there is 
 of any utility ; there is a law of the survival of the 
 fittest that we all appreciate. If, then, this penile ap- 
 pendage is of any utility, why is it that, unlike the 
 rest of the body, it falls such an easy Aactim to gan- 
 grene ? The procreative function seems to be, in a sense, 
 one of the main cares of nature in its relation to the 
 animal as well as the vegetable kingdom ; but here is a 
 useless bit of skin, adipose tissue, mucous membrane, 
 and some connective tissue, that on the least provoca- 
 tion is liable to go off into a gangrene and drag one of 
 the main generative, or even all the procreative, appa- 
 ratus into the general wreck. Nature certainly never 
 intended anj^thing of the kind. To be generous, and not 
 libel nature, we must conclude that the prepuce is a 
 near relative to the fast-disappearing climbing-muscle; 
 very useful in our primitive, arboreal days, when we 
 needed such a muscle to reach our perch for the night, 
 and a prepuce or something of the kind, in default of 
 a breech-cloth, to protect the glans penis from being 
 scratched by the briars or thorny and rough bark of the 
 trees in our ascent. The prepuce was well enough in 
 our primitive and arboreal days,^-ages and ages ahead 
 
246 History of Circumcision. 
 
 of our cave and lake dwellings, — wlien the noteli in a 
 tree and its rough bark formed our couch ; but in these 
 days of plush-cushioned pews and opera-seats, cosy 
 office-chairs, car-seats, and upholstered furniture or 
 polished-oak seats, it serves no intelligent purpose. 
 
 Emasculation has never been looked upon with favor 
 by its victim, and it would be but natural to suppose 
 that man would take every precaution against the acci- 
 dental occurrence of such an undesired condition. The 
 writer well remembers that, in his "Tom Sawyer" days 
 on the banks of the upper Mississippi, in the bappy days 
 of the crack rafting crews, before the introduction of 
 the towage steamer, when the river towns were more or 
 less terrorized by wild gangs of these men, some of 
 whom were alwa3^s fighting and quarreling and di'inking 
 when not at work. In the lot there was one man witli 
 a great reputation at a rough-and-tumble fight. His 
 main hold was that he generally tried to emasculate his 
 adversary by destroying the physiological condition of 
 the testicle. The man was not a large or powerful man, 
 nor was he a great boxer or wrestler, but this reputation 
 made him feared by all the bullies on the rivei*. The 
 report that not a few who had tackled him had subse- 
 quently been of no value, either as fornicators or feeun- 
 dators, or had to be castrated on account of the resulting 
 testicular degeneration, seemed in no wa}^ to encourage 
 any one to wish to meet him in a personal encounter. 
 It would seem as if the desire to avoid such an accident 
 — provided persons knew the dangers that lurk in a 
 prepuce — would induce many to submit to circumcision. 
 That many more do not do so can only be attributed to 
 the general human wish to escape a less present evil for 
 a greater unknown one, being evidently deterred hy the 
 prospective pain that must be suffered immediately. 
 
The Prepuce and Gangrene of the Penis. 247 
 
 There is a question that should interest man above 
 that of the simple loss of penis. It appears that there 
 is a powerful moral effect that follows this loss, as 
 might, in the majority, be anticipated. According to 
 the experience of Civiale, many who have lost the penis, 
 through amputation for disease or through disease 
 itself, end in suicide. He mentions particularly a 
 patient at the Charite who liad lost his penis, who, find- 
 ing no other means to take himself off, saved up suf- 
 ficient opium, from that given him to calm his pains, to 
 take all at one dose and commit suicide. In the London 
 Lancet for March 27, 1886, there is reported a discus- 
 sion on this subject, to which the reader is referred, as 
 it fully covers the moral and physical effects of castra- 
 tion and penis amputation for disease. M. Roux, who 
 amputated the penis of a brother of Buffon, in 1810, 
 reported that, in that case, M. Buffon lost none of his 
 customary gayety. 
 
CHAPTER XXII. 
 
 The Prepuce, Calculi, and Other Annoyances. 
 
 From an article published in the New York Medical 
 Times of March, 1872, from the pen of Dr. J. G. Kerr, 
 of Canton, China, we learn that phimosis is not an 
 uncommon occurrence among the Chinese. As has been 
 demonstrated by C. H. Mastin, of Mobile, climate is a 
 great factor of calculus. (" Transactions Internationc'il 
 Medical Congress" of 1876, page 609.) That of China 
 seems a most favorable climate in this regard ; so that, 
 between the prevalence of phimosis among the Chinese 
 and the calculus-producing tendency of the climate, China 
 ma}^ be said to be the classic land of preputial calculi, as 
 England is that of the gout, or the TJnited States that 
 of delirium tremens. From Dr. Kerr we learn that the 
 occurrence of these concretions were, as a rule, multiple, 
 and that in two cases that fell under his observation 
 the number of stones from each individual exceeded 
 one hundred. In one case there were fort}^, and in three 
 cases there were between twenty and thirt}'. These 
 were of different sizes and weiglit, some being an inch 
 and five-eighths in diameter, and from that size down to 
 where one hundred and sixteen taken from one indi- 
 vidual case onl}'- weighed one ounce. The tendency to 
 calculous disease in that climate may wey be imagined, 
 when the same observer relates a case of urinary infil- 
 tration into the skin on the under side of the penis that 
 gave rise to the formation of a collection of calculi in 
 that localit}', four of which were the size of pigeons' 
 eggs ; and another case in which a urinary fistula 
 (248) 
 
The Prepuce^ Calculi, and Other' Anrioyances. 249 
 
 induced the formation of a calculus in the groin, near 
 ■ the scrotum, the calculus weighing two and a half 
 drachms and measuring one and a half inches by three- 
 quarters of an inch in diameter. 
 
 Claparede mentions a case in the practice of M. 
 Dumeril, in which tlie stone extracted from the prepuce 
 weighed two hundred and twentj'-five grammes, or 
 about eight ounces. Civiale speaks of a young man of 
 twenty with phimosis, who, after practicing sexual con- 
 nection for the first time, experienced pain and a puru- 
 lent discharge, from whom, on examination, he removed 
 five stones as large as prunes. The patient had felt 
 them in their position, but had imagined the condition 
 to be a natural one. 
 
 E. L. Ke^'es gives their composition as being of 
 calcified smegma, urate of ammonium, triple and earthy 
 phosphates and mucus, and as symptoms and results : 
 pain, purulent discharges, interference with urination 
 and the sexual act, involuntar}' emission, ulceration of 
 the preputial cavitj', and impotence. 
 
 Enoch mentions a child of two years in the Charite, 
 who, being operated upon for phimosis, was found to 
 have a preputial calculus occluding the urethral meatus. 
 At the autopsy a calculus as large as an egg was found 
 in the bladder. 
 
 The presence of these formations, although not 
 necessarily dangerous in themselves, may, by their 
 effects and in the irritation the}' induce, be the means 
 of producing serious mischief. The only preventive or 
 remedy for this condition is circumcision. 
 
 Acquired phimosis has been mentioned as a result 
 of inflammatory action, such as is connected with balano- 
 posthitis ; it sometimes happens that, the act of coitus 
 being done forciblj-, especially with public women, who 
 
250 History of Circumcision. 
 
 are apt to use very astringent and constricting waslies, 
 tlie prepuce becomes injured, with the result of pro- 
 ducing a phimosis. One man will produce the same 
 results through the means of some vaunted wash or dip 
 which is supposed to act as a proph3'lactic to any vene- 
 real infection. One patient had developed a chronic 
 herpetic affection by the constant use of an iodized 
 ointment which he regarded as an infallible prophylactic. 
 Many cases of phimosis result from the attending in- 
 flammation that follows on the liberal domestic applica- 
 tion of nitrate of silver to an abrasion after connection, 
 in the mistaken idea that the party labors under, that 
 he is destro}' ing some venereal virus. 
 
 By the irritation that all these applications and acci- 
 dents induce, warts and vegetations are the but too 
 frequent results. These I have never seen in a circum- 
 cised individual, and their occurrence and frequency, as 
 well as persistency, are directly proportionate with the 
 degree of tightness, thickness, or redundancy of the pre- 
 puce and the irritability of the gland. As remarked by 
 Lallemand, in reference to the victim of nocturnal enu- 
 resis becoming a future victim of nocturnal emissions, so 
 it may be said of the person subject in early life to either 
 warts, excoriations or vegetations on the penis, that it 
 is this class that furnishes in after life the subjects for 
 cancerous disease as well as furnishing the easiest victims 
 for venereal infection. These warts, although easily re- 
 moved, have a tendency to recurrence, especially as long 
 as the moist bed that has once grown them there is still 
 vegetating. 
 
 The prepuce is liable to indurations and hj-pertrophy. 
 Of the first anonial}^ the London Lancet of 1846 has a 
 record of two cases in which paraphimosis was induced 
 in elderly subjects, and of one in which it induced phi- 
 
The Prepuce, Calculi, and Other Annoyances. 251 
 
 mosis. Since then a number of cases of thickening and 
 induration have been reported. Hypertrophy may take 
 place in any degree, varying from the mere leatliery and 
 overpendulous but unobstructive prepuce to the case 
 recorded by Yidal, in the fifth volume of his " Pathologic 
 Externe et Medecine Operatoire," which happened in 
 the practice of M. Rigal,de Gaillae. The hypertrophied 
 prepuce was something enormous, and hung down to 
 below the patient's knees ; it was pear-shaped, with the 
 base hanging downward ; this base was as large as a 
 man's head. This prepuce was successfully removed by 
 M. Rigal, who presented the specimen before the Paris 
 Surgical Society, who were then discussing a somewhat 
 similar but not so extensive a case, presented by M. 
 Lenoire. Vidal mentions having operated on a number 
 of cases of this deformity of the prepuce in various 
 degrees of growth. 
 
 As a rule, simple hypertrophic disease of the penile 
 integument does not interfere with the sexual func- 
 tions of the male organ after its removal ; it being sus- 
 ceptible of complete removal in exaggerated cases, 
 even without touching the body of the organ. There 
 are exceptions to this rule, however, when cA^en this 
 otherwise non-malignant disease may entail the loss 
 of all the genitals. In the London Lancet of Jul}' 11, 
 1846, at page 46, there is a record of a remarkable case 
 of this nature reported hy F. H. Brett, Esq., F.R.C.S. 
 The case was that of a locksmith of forty years of age, 
 who was naturally much phimosed. The penis was 
 enormously enlarged, as well as the scrotum, which was 
 more or less ulcerated and full of sinuses filled with a 
 serous pus ; some six months prior to the final operation, 
 a part of the prepuce was removed to facilitate urina- 
 tion, but the whole mass had to be subsequently re- 
 
252 History of Circumcision. 
 
 moved, including the whole of the skin of the penis and 
 the scrotum, the testicles having been carefully dissected 
 out and recovered witli some skin flap. 
 
 In this case the disease was believed to have origi- 
 nated from a perineal fistula. The pathological investi- 
 gation in the case, however, by Mr. Quekett, who 
 submitted the mass to a microscopical examination, 
 confirmed Mr. Brett in his original opinion that the dis- 
 ease had the same pathological conditions as the similar 
 disease found in India, where it originates from local 
 inflammatory causes. In this case the preputial irrita- 
 tion was, in all probability, the precursor of the condi- 
 tions that led to the perineal fistula, the patient having 
 had a stricture for some twelve years. Mr. Brett states 
 that the man had been abandoned by his wife on account 
 of his previous sexual disability, and on account, as 
 well, of his having been incapacitated from following 
 any vocation. After the operation all his functions 
 were restored and his organs were sound. 
 
 Nelaton records a case reported by Wadd, in 1811, 
 of an African negro so affected, whose penis measured 
 fourteen inches in length and twelve and a half inches 
 in circumference; also the case reported by Gibert, of 
 Hospital St. Louis, of a subject " with a penis the size of 
 a mule's." 
 
 Mr. Brett attributes the recovery of his case as being 
 due in a great measure to the moral support given to the 
 patient from the knowledge that his procreative organs 
 were not interfered with, and on the same grounds he 
 attributes the great fatality previously attending the 
 operation to the fact that it previously had been the 
 custom in many cases to make a clean general taille a 
 fleiir de ventre^ sacrificing all the genital organs. In 
 simple hypertrophy, he considers that the body of the 
 
The Prepuce, Calculi, and Other Annoyances. 253 
 
 penis and the testicles will always be fonnd to be in a 
 normal condition ; a careful dissection of the parts will 
 invariably save not only the man's sexual functions, but 
 his moral stamina, which he sadly needs in such an 
 emergency. In the discussion on this subject heretofore 
 mentioned as taking place in the London Medical Society, 
 Mi\ Pye, Mr. John A. Morgan, and others insisted on 
 the necessity of retaining the testicles, whenever pos- 
 sible, in all these sweeping operations upon the genitals, 
 they being actually necessary for the moral and physical 
 support of man, Mr. Morgan observing that their re- 
 moval would depress parts controlled by the sympathetic 
 system. 
 
CHAPTER XXIII. 
 
 Reflex Neuroses and the Prepuce. 
 
 We have seen in the previous chapters what the im- 
 mediate effects of the prepuce may lead to ; we have 
 followed its local effects in childhood to youth, thence 
 into what it does in our prime, and we have seen how, 
 when we are on the down grade, owing to the in- 
 crease of 3'ears, then, like the minute-men of Concord, 
 wakened up by Paul Revere's classic ride, hanging on to 
 the rear of the retreating and disheartened British, it 
 harasses, worries, and downs a man here and there, 
 striking down the man as if it had some undying, irre- 
 mediable spite, which nothing but his misery and death 
 could alleviate. Some authorities will argue that all 
 that is required is cleanliness ; that all men need do is 
 to be like a true American, with the old Continental 
 watchword of" eternal vigilance is the price of liberty " 
 in continued active practice. A bowlful of some anti- 
 septic wash and a small sponge should alwaj^s be at 
 hand, and he should be as industrious as if haltered in a 
 tread-mill ; he should make this a part of his toilet, and 
 his dailj^ and hourly cai-e. This will, we are told, lessen 
 his chances of becoming a victim to the many ills that 
 lie in wait for him, all on account of the glory, honor, 
 and comfort of wearing a prepuce, which is a perfectly 
 physiological appendage. 
 
 From these visible and apparently easily understood 
 
 conditions and results we are now to enter abroad field, 
 
 wherein the prepuce seems to exercise a malign influence 
 
 in tlie most distant and apparently' unconnected manner; 
 
 (254) 
 
Rejiex Neuroses and the Prepuce. 255 
 
 •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 un- 
 accountable manner;, making him a victim to all manner 
 of ills, sufferings, and tribulations ; unfitting him for 
 mai'riage or the cares of business ; making him miserable 
 and an object of continual scolding and punishment in 
 childhood, through its worriments and nocturnal enure- 
 sis ; later on, beginning to affect him with all kinds of 
 physical distortions and ailments, nocturnal pollutions, 
 and other conditions calculated to weaken him i)h3'sic- 
 ally, mentallj^, and morall}'^ ; to land him, perchance, in 
 the jail, or even in a lunatic asylum. Man's whole life 
 is subject to the capricious dispensations and whims of 
 this Job's-comforts-dispensing enemy of man. 
 
 As strange as it may seem, this fieM of knowledge, 
 tills field of misery- and suffering, disease and distortion, 
 of physical and mental obliquit^^ presided over by this 
 preputial Afrit of malignant disposition, was an un- 
 known, undiscovered, and therefore unexplored region 
 for some thousands of years, and it remained for an 
 American to discover and describe this vast territorial 
 acquisition, and to annex it to the domain of medicine, 
 which, through its skill, could modify the influence of 
 the evil genius that there presided and spare humanity 
 much of the ills to which it had been subjected. 
 
 In this regard, Louis A. Sayre was to medicine what 
 Columbus was to geograph}'. Neither Strabo nor Hero- 
 dotus had anj'thing to say regarding what existed 
 beyond the pillars of Hercules, and neither Hippocrates 
 nor Galen had anything in regard to this preputial 
 Merlin, which in their day, even, had its existence. 
 Neither did Tissot nor Bienville, the two pioneers in the 
 field of our knowledge regarding onanism and nj-mpho- 
 
 9 
 
256 History of Circumcision. 
 
 mania, dream of the existence of this one cause of the 
 diseases to which they gave so much time and study. 
 It is only some twenty years since Louis A. Sayre read 
 his paper, entitled " Partial Paralysis from Reflex Irri- 
 tation Caused by Congenital Phimosis and Adherent 
 Prepuce," liefore the American Medical Association. 
 This was the starting-point from whence the profession 
 entered into what had previously been a veritable 
 " Darkest Africa." 
 
 When we read that only some fifty years before the 
 times of Columbus Christian Europe had no lunatic 
 asylum, — not that there was a lack of lunatics or that the 
 existence of lunacy was entirely ignored, but that the 
 then state of medicine and the general intelligence was 
 not emancipated from the idea of demoniacs, — and we 
 are told that the lunatics were in man}^ instances hung, 
 quartered and burned, hooted and chased about the 
 streets, or chained in gloomj^ dungeons ; until, as related 
 1)3' Leckv, a Spanish monk named Juan Gilaberto Joffe, 
 filled with compassion at the sight of the maniacs who 
 were hooted by crowds through the streets of Yalencia, 
 founded an asylum in that city. His movement in this 
 direction called the attention of the Church and people 
 to this class in a practical light, and from Spain a more 
 enlightened idea in regard to this class swept onward 
 throughout Europe. As observed, it seems strange to us 
 of the present day that such ignorance in these matters 
 should, or could, have so long existed. It seems im- 
 possible for us to conceive how these conditions of in- 
 coherent action and of mental derangements could have 
 existed and their causes have not been fully appreciated ; 
 and yet we were not above, some twenty years ago only, 
 subjecting children to punishment and scoldings for 
 being addicted to nocturnal enuresis, or of accusing 
 
Reflex Neuroses and the Prepuce. 25t 
 
 cases of iioctnvnal and in voluntaiy emissions as being due 
 to masturbation. The child was allowed then to grow up 
 paralytic, or with a deformed limb, or continually pun- 
 ished to correct what was imagined to be a condition of 
 willful carelessness, irritability, or willful moral perver- 
 sion. Perversion, stupidity', and irritabilitj'^ of the mind 
 or temper were not known to depend, in manj^ instances, 
 on preputial irritation ; children were, accordingly, 
 worried and punished for something over which they 
 had no earthly control or the least volition. Humanity 
 cannot, at present, sufficiently appreciate what Louis A. 
 Sayre has done in its behalf. It is here that we realize 
 the hidden wisdom of the Mosaic law and the truth of 
 the assertion of the late Dr. Edward Clarke, that, " The 
 instructors, the houses and schools of our country's 
 daughters, would profit by reading the old Levitical law. 
 Tiie race has not 3'et outgrown the physiology of Moses." 
 These irritations from the preputial irritability are 
 not always so slow moving as to span over either months 
 or years in their fell work. Instances of their sudden 
 action have been sufficiently recorded as to warrant 
 them as being classed as causative agents in acute 
 affections that instantly threaten life. In the London 
 Lancet of May 16, 1846, there is a record of a ver}' 
 peculiar case reported to the London Medical Society 
 by Dr. Golding Bird : " The case was that of a child seven 
 or eight weeks old onl3^,an out-])atient of Guy's Hospital. 
 The child had become almost lifeless immediatel3^ after 
 nursing, and to all appearances looked as if under the 
 influence of some narcotic. It had not, however, had 
 anything of the kind given to it, nor had it si-stained a 
 fall, nor was the head so large as to lead to suspicion of 
 congenital hydi'ocephalus. On inquiring if the child 
 passed water, the answer led to an examination of the 
 
258 History of Circumcision. 
 
 prepuce, wliicli was found to be elongated, and liad an 
 aperture only of the size of a pin-hole, like a puncture 
 in the intestines. The urine was dribbling out; it was 
 evident that the child had never completely emptied its 
 bladder. Mr. Hilton slit up the prepuce, and all the 
 symptoms were immediately relieved and soon entirely 
 removed." Dr. Bird referred to a case which he had 
 related to the Society some years before, which was re- 
 ported in the Lancet at the time, of a child who fell a 
 victim to a malformation of this kind, and after death 
 the bladder and ureter were found like those of a man 
 wlio had long suffered from stricture. Mr. Hilton has 
 seen many cases similar to the one mentioned by Dr. 
 Bird. The greatest benefit resulted from slitting up 
 the prepuce. In this case the benefit was A'ery remark- 
 able, a partial paralysis of the left side, under which 
 the little patient labored, being quite removed in 
 twenty-four hours. 
 
 In this case the difficulty was evidently both the 
 result of mechanical pressure and reflex irritation. A 
 somewhat similar case as to its results is given by Dr. 
 Sayre, to whom the case was reported by Dr. A. R. 
 Mott, Jr., of Randall's Island, in January of 1880 : 
 "John English, aged 46, native of England, widower, 
 clerk; admitted to workhouse hospital. Patient had 
 been at work for a week as a prisoner ; on the 23d of 
 December was noticed to be restless and uneasy, and 
 finally, in the evening, he fell from his bunk in a fit. 
 During the next fort^y -eight hours he had several con- 
 vulsions, and -during the intervals lay in a semi-comatose 
 condition, showing no consciousness except to stir a 
 limb when pinched. Pulse, 120 ; temperature, 101^° ; 
 respiration, 18. Swallowed nothing, and passed fteces 
 in bed. Continued in this condition until December 25th 
 
Reflex Neuroses and the Prepuce. 259 
 
 (temperature having fallen to 100°), when a string was 
 discovered passed twice around the penis behind corona 
 and tied, the long prepuce serving to conceal it from ob- 
 servation. While not sufficiently tight to occlude the ure- 
 thral canal, still a firm, indurated band remained after the 
 string was cut, and did not disappear for four or five days. 
 
 " Within one hour after the removal of the string 
 the man sat up and asked for milk, and from this time 
 remained perfectly well (was under observation for 
 three months). He declared that he remembered nothing 
 that had taken place during the past three days ; had 
 never had fits, denied venereal diseases, was moderately 
 addicted to drink, but had led a ' virtuous life since the 
 death of his wife, two years before.' " 
 
 The following case in the practice of Dr. F. J. 
 Wirthington, of Livermore, Pa., was also reported to 
 Dr. Sayre : " When the child was born, he was consid- 
 ered the biggest and finest boy that had been born in 
 the communitj' for a long time, until, when he was about 
 two and a-half years old, and being sick, a doctor was 
 called in, who told them that their child was paralyzed, 
 the paralysis being in his lower extremities, and who 
 treated him with 'the usual nerve-tonic and with elee- 
 tricit3\ Notwitlistanding all this, the boy went steadily 
 down, and the paralysis continued until he was seen by 
 Dr. Wirthington. The child was then unable to walk; 
 on examination, the prepuce was found to be adherent 
 almost all the way around the glans penis. Behind the 
 corona was a solid cake of sebaceous matter. The case 
 was promptly operated upon, and, although the previous 
 attendant had not found an}"^ cause to account for the 
 paralysis, a rapid recovery took place, the boy being 
 able to walk even before the complete cicatrization of 
 the wound, and was soon the picture of health." 
 
260 History of Circumcision. 
 
 Dr. T. P. Leech, of Attica, Fountain County, Ind., 
 reports a case of a fourteen-montb-old cliild, who liad 
 been the terror of all that part of the town for over six 
 months, as he cried constantly. Except when asleep or 
 nursed by his mother, he would lie perfectly still and 
 squall, not showing any disposition to sit up ; nor did he 
 like to be raised up. He was very nervous, and would 
 have times when his limbs would be rigid. This state 
 of things grew worse, until the child was accidentally 
 seen by Dr. Leech, who, on examination, found a con- 
 tracted and adherent prepuce, the child being at the 
 time in a high fever and suffering great nervous excite- 
 ment. An operation by slitting and breaking up the 
 adiiesion afl'orded immediate relief; the spinal irritation, 
 partial paralysis of the lower extremities, spasms during 
 urination, and all trouble disappeared as if by magic. 
 
 Prof, J, H. Pooley, of Columbus, Oliio, reported 
 the case of a fine, healthy boy who, up to three months 
 before being seen professionally, had always been well and 
 in perfect liealth. His condition was found bj^ Professor 
 Pooley to be one of localized chorea, manifesting itself 
 in constant convulsive movements of the head. Tliey 
 were nodding or antero-posterior 'movements, alter- 
 nating with lateral or shaking and twisting motions; 
 these movements had become almost constant during 
 the waking hours of the child. There was no distortion 
 of the features nor any choreic movements of the ex- 
 tremities ; indeed, the whole affection consisted in the 
 nodding and shaking movements of the head referred to. 
 These were almost incessant, sometimes slow and almost 
 rhythmical, then for a minute or two rapid and irregular, 
 seeming to fatigue the little fellow, and accompanied b^'^ 
 a fretful, whimpering cr3^ The child had been subjected 
 to a variety of treatment, but without any benefit or 
 
Reflex Neuroses and the Prepuce. 261 
 
 effect of any kind. Upon the most careful examination 
 of the patient and his history, Professor Pooley could 
 not discover anything that seemed to throw any light 
 upon the case, except a condition of well-marked phi- 
 mosis. Acting upon this, the Professor immediately 
 circumcised the child, and from the very day of the 
 operation the spasmodic action began to diminish, and 
 in two weeks he was entirely well, without any other 
 treatment of any kind. 
 
 Dr. W. R. McMahon, of Huntington, Indiana, has 
 reported three cases of epilepsy in children caused by 
 congenital phimosis that were entirely relieved by an 
 operation without anj'^ subsequent return of the diffi- 
 culty. One of the cases was in a boy ten years old, with 
 very firm preputial adhesions and a high grade of 
 inflammation of the parts. 
 
 Dr. J. D. Griffith, of Kansas City, Mo., operated on a 
 case of phimosis on a child nearly three years of age, who 
 was afflicted with repeated attacks of convulsions and 
 paralysis of the hips and lower extremities ; the little 
 fellow had as many as fifteen convulsions in a day ; the 
 patient was greatl}' troubled with painful urination and 
 priapism. On examination at the operation, a firmly 
 adherent prepuoe and a large roll of caseous matter was 
 found just back of the corona. A complete recovery 
 followed the removal of these conditions. 
 
 The above cases are taken from the paper read 
 before the Section of Diseases of Children at the Inter- 
 national Medical Congress of 1887, b}' Dr. Sayre. It 
 contains a number of additional cases of an analogous 
 character to the above, reported to him by physicians 
 in different parts of the country. They show the variety, 
 extent, and far-reaching character of the diseases in- 
 duced by any preputial irritation. Dr. G. L, Magruder, 
 
262 History of Circumcision. 
 
 of Washington, D. C, in the same papei*, has a record 
 of twenty-five cases of various nervous disturbances 
 which he had entirely relieved by circumcision or 
 dilatation, without any medication whatever. Dr. 
 Magruder, in concluding his report, in which he quotes 
 the authority of Brown-Sequard, Charcot, and Leyden, 
 as having noticed serious nervous disturbances result- 
 ing from reflex irritation due to affections of the genito- 
 urinary organs, observes as follows : — 
 
 " From the foregoing, I think that we are justified in 
 the conclusion that phimosis and adherent prepuce give 
 rise to varied troubles of more or less gravity, manifest- 
 ing themselves either in the muscular, osseous, or ner- 
 vous systems ; and that the removal of these abnormal 
 conditions of the penis frequently affords marked relief, 
 and, at times, perfect and permanent cure." 
 
 In the discussion that followed the reading of Dr. 
 Saj-re's paper. Dr. De Forest Willard, of Philadelphia, 
 remarked that he had operated by simply stripping 
 back the prepuce and that he did not circumcise, but 
 that he looked upon the subsequent cleanliness of the 
 parts as the greatest safeguard, not only as against 
 reflex irritation, but also against masturbation. Re- 
 tained filth and smegma are far more likely to call a 
 boy's attention to his penis by their unrecognized irri- 
 tative effects than washing can possibly do. His prac- 
 tice is in accordance with the belief that young children 
 can be relieved by the simpler methods, such as dilata- 
 tion ; but he also observes that when a child has reached 
 eight or ten years of age, and has never been able to 
 expose the glans, contraction is almost certain to be 
 present, and circumcision must be performed. In adults 
 there is rarely any escape when the prepuce is tight. 
 
 Dr. I. N. Love, of St. Louis, said : " It has been my 
 
Reflex Neuroses and the Prepuce. 263 
 
 judgment and my practice for maj' years, in these reflex 
 irritations, to pursue tlie radical course of circumcision. 
 I believe tlioroughly in tlie Mosaic law, not only from a 
 moral but also from a sanitary stand-point. All genital 
 irritation should be thoroughly' removed. It is all very 
 well to instruct the mother or the nurse to keep the 
 parts within tlie prepuce clean, but they can not or will 
 not do it. Complete and proper removal of the covering 
 to the glans takes away all the cause of disturbance. 
 Dr. Sayre takes a more pronounced position on this 
 subject than the majority of those who have discussed 
 his paper. An improper performance of a surgical pro- 
 cedure is no argument against the operation, but rather 
 against the operator. For the reasons I have given, I 
 am in favor of the radical application of the Mosaic rite 
 of circumcision." 
 
 Dr. J. Lewis Smith, the president of the Section, 
 believed in the evil results of the reflex irritation due to 
 abnormality of the prepuce. In many instances the 
 causative relation of the preputial disease to the S3-mp- 
 toms which it produces is not so apparent as it may be 
 in others, but after correct treatment of the prepuce 
 they disappear. There was one result of phimosis 
 which, he observed, neither Professor Sayre nor those 
 who contributed to his paper noticed. The expulsive 
 efforts accompanj'ing urination sometimes cause pro- 
 lapsus of the rectum, and frequently produce inguinal 
 hernia. In a lecture before the Harveian Society 
 {British Medical Journal, February 28, 1880), Edmund 
 Owen, Surgeon to St. Mary's Hospital and to the Hos- 
 pital for Sick Children, says : " Perhaps the commonest 
 cause of hernia in childhood is a small preputial or 
 urethral orifice, and next to that I would put the 
 smegma-hiding or adherent prepuce." Arthur Kemp 
 
264 History of Circumcision. 
 
 (London Lancet, July 27, 18T8), Senior House-Surgeon 
 to the Children's Hospital, says : " Phimosis is a com- 
 mon occurrence, and numerous ill effects can undoubt- 
 edly be attributed to it ;" and he alludes to the obser- 
 vation of Mr. Bryant, as published in his book on the 
 " Surgical Diseases of Children ": " In tift}^ consecutive 
 cases of congenital phimosis, thirtj^-one had hernia, five 
 had double inguinal hernia, and many had umbilical 
 hernia besides. In no one was the hernia congenital, 
 its earliest occurrence being at three weeks. Circum- 
 cision was performed in these cases, and all were much 
 benefited." i»3 
 
 During the session of the Ninth International Con- 
 gress, where the above paper was read and remarks 
 made, which appear in the third volume of its " Trans- 
 actions," another paper was also presented by Dr. Saint- 
 Germain, of Paris. The Doctor fully recognized the 
 dangers from a narrow or adherent prepuce, but did not 
 think tha* more than one case in three hundred really 
 required circumcision ; he believed in dilatation, as em- 
 ployed by Nelaton, with the exception that, whereas 
 Nelaton employs three branches to his dilator, Saint- 
 Germain preferred only a two-branch dilator. 
 
 Dr. Lewis, the president of the Section, related a 
 number of cases where the use of uncleanly instruments 
 had resulted disastrously. But, for that matter, the 
 same objection can be offered against dilatation, as a 
 filthy instrument is as liable to infect the patient as a 
 knife. There is no earthl}' excuse why a knife that has 
 been used on a case of diphtheritic croup should be 
 used some hours afterward to circumcise a child. As 
 to the operation of dilatation practiced 1\y Dr. Holgate, 
 it can reall}^ be said to answer the immediate demands, 
 but how far its utility is efficient as to permanent re- 
 
Reflex Neuroses and the Prepuce. 265 
 
 suits Dr. Holgate has not given the profession any 
 information. 1*** 
 
 One of the most interesting and instructive papers 
 that it was ever the fortune of the writer to listen to, 
 touching on the subject of reflex nervous diseases or 
 neuroses due to preputial adhesions, was one prepared 
 by Dr. M. F. Price, of Colton, California, and read 
 at the semi-annual meeting of the Southern California 
 Medical Societ3^, at its Pasadena meeting in December, 
 1889. In the course of the paper he gives a considerable 
 number of examples, of which some extracts are here- 
 with given : One case was a boy aged seven, who for two 
 years had had frequent attacks of palpitation of the 
 heart ; when seen by Dr. Price the little heart was labor- 
 ing hard, beating at a furious rate (far bej^ond counting), 
 with a loud blowing or splashing sound, and the pulse 
 at the wrist a mere flutter. The breath was inspired in 
 a series of jerks, the face flushed and somewhat swollen. 
 The chest-wall was visibly moved at every thump of 
 the heart. The doctor attended the child for a month 
 without the little patient making any appreciable im- 
 provement. Some time during this period of observa- 
 tion the father happened to mention that the boy some- 
 times complained of his penis hurting him at the time 
 of an erection. This led the doctor to examine the 
 parts, when he found a long prepuce, with a mucous 
 membrane adherent to the glans, about a line beyond 
 the corona, the whole circumference of the organ. With 
 the use of cocaine and a blunt instrument the adhesions 
 were removed, with an immediate amelioration of all the 
 reflex symptoms. The veiy next paroxj-sm was lighter 
 and less exhausting ; the improvement was continuous. 
 The child soon went to school and had no further 
 trouble; but, in the doctor's opinion, the two years' 
 
266 History of Circumcision. 
 
 bard struggle have not been without its evil results on 
 the constitution and organism of the child. 
 
 The next case was born November 2, 1888 ; a large, 
 healthy boy at birth. By June of the following year 
 the. child was afflicted with what the mother called 
 "jerky spells;" up to this time the boy seemed list- 
 less, did not care to sit up, and seemed from some cause 
 to be in more or less pain, with his ej'es turned to tiie 
 left. The parents dreaded that the child, their only 
 one, would turn out idiotic. The spasmodic spells al- 
 luded to were of a tetanic nature, the body being thrown 
 backward ; his head and eyes continued to be turned 
 to the left, and nothing could attract the child's atten- 
 tion. The boy cried night and day, but he was in good 
 flesh, had all the teeth he should have, bowels were regu- 
 lar, and the appetite good. Whatever the doctor did in 
 the medical way seemed to be of no avail. One day, 
 however, he thought of examining the prepuce, think- 
 ing, perhaps, that it might be contracted and that the 
 convulsive movements might be reflexes from the parts. 
 On examination the prepuce was found elongated and 
 distended, with a very minute opening ; this was dilated 
 with difficult}', when the inner fold was found adhering 
 almost the whole extent of the glans ; the dilatation 
 and breaking down of these adhesions was slowly per- 
 severed in, until sufficient dilatation was obtained and 
 the glans was freed. From the very first operation the 
 convulsions commenced to diminish, both in force and 
 frequency', and a constant and rapid improvement of the 
 child took place. Six months afterward the boy was 
 perfectly normal, stood by himself, played with play- 
 things, and was an interested member of the fainilj- 
 circle. 
 
 Case No. 3 was a repetition of Case No. 2, except 
 
Be/lex Neuroses and the Prepuce. 267 
 
 that, with the experience of the latter case, the doctor 
 wasted no time with medication, but pi'oceeded at once 
 to examine the prepuce, which was found to be very 
 long, and with a pin-hole opening. The dilatation of 
 this and the breaking up of the adhesions gave imme- 
 diate relief. During the course of the paper lie quoted 
 the case related by 13 rown-Sequard, and recorded in tiie 
 New York Medical Record, vol. xxxiv, p. 314, where he 
 " related a very interesting case that presented all the 
 rational signs of advanced cerebral disease, a case tliat 
 he considered quite hopeless, that was relieved by an 
 operation for phimosis and the treatment of an inflam- 
 matory condition of the glans penis." To use Brown- 
 Sequard's own words, "So rapid was the recover}^ that 
 within six weeks from the da}^ of the operation he pre- 
 sented himself at my office perfectly well in every 
 respect." 
 
 In the early part of this book, in speaking of female 
 circumcision, it was mentioned that when the medical 
 part of the volume should be reached some medical 
 reasons for its necessity would be given. Dr. Price, in 
 his paper, gives some information on this subject, which 
 is of the greatest interest. In the course of the paper 
 he says as follows : " Nor do I think these reflex neu- 
 roses from adherent prepuce wholl3' confined to the male 
 sex. The preputium-clitoridis may be adherent and 
 produce in the female similar reflexes. During the ses- 
 sion of the American Medical Association, held in 
 Chicago in 1874, I think, I ttended one afternoon a 
 clinical lecture by Dr. Sayre. A little girl, fourteen 
 3'ears of age, but about the size of a seven-year-old 
 child, was brought in, who had never walked nor spoken, 
 but with quite an intelligent countenance, who was in 
 constant motion, and who presented very manj- nervous 
 
268 History of Circumcision. 
 
 symptoms. Dr. Sayre examined her, and found the 
 prepuce adherent the whole extent of the clitoris. He 
 gave it as his opinion that here was the primary and 
 sole cause of the sjanptoms, and that appropriate treat- 
 ment shortly after birth would have prevented all the 
 serious consequences so painfully apparent, and which 
 was then too late to remedy. 
 
 " I once had occasion to pass a catheter into the 
 bladder of a lady who presented an innumerable train 
 of nervous symptoms, often bordering on insanity, but 
 was unable to do so without exposing the parts. Al- 
 though the meatus could be distinctly felt, the catheter 
 would not enter. On exposure to view, an opening was 
 seen in the clitoris, which was firml3- bound down by 
 preputial adhesions near the extremity of the organ. 
 Entering the catheter at this point, it readily passed 
 through the clitoris, then down through a passage 
 under the mucous membrane to the natural site of 
 the meatus, on into the urethra, and through into the 
 bladder. In the light of recent experience, my opinion 
 now is, that here was the cause of all the nervous symp- 
 toms in this case." 
 
 The relative disposition in regard to the irritability 
 of the external sexual organs as existing in the female, 
 when contrasted with the male, is, for some reason, not 
 sufficiently considered or understood. The idea of 
 masturbation or of irritation from the genitals ending in 
 reflex neuroses is alwa3's, as a rule, associated with the 
 male, and that it has not been more associated with the 
 female has deprived her of the same benefit that the pros- 
 ecution of the stud}' in this regard has been to the male 
 sex. Masturbation among the feeble-minded, which is 
 so common, must, of necessit}^ have for its determining 
 cause a foundation of morbid irritability of the sexual 
 
Reflex Neuroses and the Prepuce. 269 
 
 organs. This is well known to be so among the males, 
 whose hands seem instinctively to be drawn to those 
 parts. Dr. C. F. Taj^lor, of New York, in an article on 
 the "Effect of Imperfect Hygiene of the Sexual Func- 
 tion," published in the American Journal of Obstetrics for 
 Januarj^ 1882, gives us an account of his investigations 
 in tliis regard, with the following results : " In an asylum 
 for the feeble-minded of both sexes, it was found that the 
 habit was about equal in the two sexes, there being only 
 this difference : that the females began to masturbate 
 one or two jears earlier than the males, and that the 
 habit, once established, was found to be more persistent 
 than in the males. It was, further, ascertained that the 
 habit came naturally', without the aid of precept or 
 example to either sex." 
 
 It may well be a question as to whether the feeble- 
 mindedness be not a reflex condition from this exces- 
 sive morbid irritability of the sexual organs. There is 
 not much doubt but that, if one of the cases reported 
 by Dr. Price had not been circumcised, the expres- 
 sionless, listless infant would have grown, in time, into 
 a masturbating, feeble-minded, idiotic creature, as many 
 others, so situated, have done before it. Now, would it 
 have been logical to have laid the morbid irritability of 
 its generative organs to its feeble-mindedness, when its 
 feeble-mindedness was full}' demonstrated to have been 
 wholl}' dependent on the sexual irritation ? From these 
 premises we might take another step forward, and ask 
 whether, under a proper hygienic prophylaxis, — which 
 would in,volve a thorough inspection of the genitals 
 of all children reported to be either ph3'sically or 
 mentally deficient,— such a course would not greatly 
 diminisli the number of paralytics, feeble-minded, and 
 generally deficient of both sexes ? If the results in 
 
2t0 History of Circumcision, 
 
 private practice are any criterion, it is safe to assert 
 tliat a strict adherence to the Mosaic law for the males 
 and to some of the African customs for the females 
 would most assuredly relieve all these cases that might 
 come under the caj)tion of results of reflex neuroses. 
 Twenty years ago this subject was, to the bod^' of the 
 profession, a terra incognita in regard to the male, and, 
 as the female is similarly subject to the same morbid 
 influence, it is to be hoped that in the present decade 
 she will receive the same attention which the profession 
 is now beginning to pay to the male sex."^ 
 
 In the foregoing parts of this chapter, examples of 
 reflex neuroses have been given to show the ditferent 
 effects that genital irritation will produce. The cases 
 given were chosen for the diversity of variety of s^nnp- 
 toms, and as cases representing the aflfectio'n, without 
 any other complication. Many more could have been 
 added, but they are unnecessar}'. In the writer's prac- 
 tice there has been a number of cases in the adult that 
 have exemplified that this form of ailment is by no 
 means restricted to children, as has been shown in the 
 case reported b}'^ Dr. Mott to Dr. Sayre, in regard to the 
 middle-aged man with a string about his penis. One of 
 these cases was that of a young man, six feet in stature, 
 broad-shouldered, and well built. He applied for relief 
 for a d3'^spepsia that affected his stomach and also his 
 heart. The man had an apparentl}^ feeble and irri- 
 table heart; cold, clammy skin ; disturbed digestion, and 
 uneasy sleep ; was constipated and flatulent. No treat- 
 ment seemed to make any impression upon his case. 
 At last he began to emaciate and look haggard. His 
 mind was also becoming visiblj' weaker, was attacked 
 by dizziness, and on several occasions he fell in a fit. 
 With this condition he at last began to have frequent 
 
Rejiex Neuroses and the Prepuce. 271 
 
 nootui'nal emissions. On account of the latter his gen- 
 ital organs were examined, and the penis was found 
 smaller than the average, with a long and narrow pre- 
 puce. The glans could easily he uncovered, but the 
 tightness of the prepuce and its unyielding qualities . 
 made paraphimosis a possibility ; so that the young man, 
 having once or twice had considerable difficulty in re- 
 turning the prepuce to its place, never attempted its 
 retraction again. There were no adhesions, but the 
 inner fold of the prepuce had been thickened by bala- 
 nitis. Seeing the need of circumcision for the local 
 benefit, the operation was suggested with a view of 
 relieving the pressure on the glans, which was looked 
 upon as the probable cause, in his broken-down . con- 
 dition, of the advent of the nocturnal emissions. He 
 gladly submitted, and, to the surprise of both physician 
 and patient, all his troubles disappeared, and he at once 
 became a changed man. So impressed was he with the 
 result, that, on his return to his home, he examined his 
 younger brother, and, finding him with a like long, 
 narrow prepuce, he immediately brought him in and had 
 him circumcised, as a prophj'lactic against his being 
 subjected to the risk of lost health as he himself had 
 suffered. 
 
 Another case, a man of forty -five, also a farmer, was 
 afflicted with d3'spepsia, palpitation of the heart, general 
 debilit}', constipation, constant headache, etc. He could 
 not cut up an armful of wood without bringing on palpita- 
 tions and gaseous eructations, or being upset for tlie day ; 
 and after having connection with his wife he generally 
 had a terrific headache, lasting for two or three days;^"® 
 he could stand no protracted mental effort, even such as 
 is. required to make an addition of a long line of figures, 
 or the least business worry, without the supervening 
 
2*72 History of Circumcision. 
 
 headnehe. All treatment against these conditions was 
 useless ; the colon was kept empty, the diet was changed ; 
 .pepsin and bismuth, tonics, frictions, Turkish baths, 
 and all hygienic observances and moral treatment were 
 all of no avail. One day, on consulting the writer, he 
 complained of a pruritus at the head of the penis. On 
 examination it was found that he had a narrow, long 
 prepuce, a congenitally-contracted meatus, and was then 
 stitfering with a slight balanitis. He was very careful 
 to keep the parts clean, but, he informed me, that in spite 
 of all precautions, these attacks would come on. The 
 mucous covering of the inner fold of the prepuce and 
 glans was so irritable that connection often brought it 
 about. The glans was small and elongated, with the 
 meatus red, and with lips cedematous and congested. To 
 free him from this tormenter, circumcision was advised. 
 The part3' could not, however, remain away from home 
 for the time required for the operation ; so that a com- 
 promise operation was performed, — one that would not 
 keep him from business, and, at the same time, relieve 
 the contracting pressure on the glans. This was by 
 Clouquet's operation and bandaging back the prepuce 
 over the penis, back of the corona, — an operation that, in 
 my hands, has often filled all the desired purpose. The 
 meatus was also incised. After the operation all of his 
 troubles disappeared, as tliey had done in the preceding 
 case, and he was soon a hearty and well man, able to chop 
 wood, attend to business, and, in case of need, do family 
 duty for a Turkish harem without recurrence of his old. 
 tormenting, dj'speptic palpitation or sick-headache. 
 
 The writer has resorted* to circumcision in many 
 cases to improve the temper and disposition of children, 
 with the best of results, and in one case, in association 
 with another physician, performed tlie operation on a 
 
Reflex Neuroi^es and the Prepuce. 2Y3 
 
 lunatic, whose lunacy ran to women and girls, with 
 whom he would fall desperately in love, without any 
 encouragement or provocation, or even acquaintance ; 
 finally reaching spells of such incoherence of action 
 and speech that confinement would be required. The 
 peculiarity of his hallucinations called attention to the 
 genital organs. This man had never masturbated, and 
 was, when well, a compactly-built, active, and intelligent 
 man. By occupation he was a contractor, and a man 
 of more than usual executive ability besides. On 
 examination it was found that he was a subject of con- 
 genital phimosis, never having been able to uncover the 
 glans. He had been in the habit of washing out the 
 preputial cavity by the aid of a flat-nozzled syringe. 
 The prepuce was long, but not thick ; nevertheless, it was 
 inelastic and very firm. The examination seemed to 
 have a good mental effect upon the man, as it made him 
 quite rational for the moment. He entered into the 
 idea that this condition had some connection with his 
 derangement very intelligently, even suggesting many 
 sj'mptoms and attacks that he had suffered from child- 
 hood up as probably gradual-stepping processes through 
 which his present condition had been reached. He 
 cheerfully submitted to a thorough circumcision, which 
 had the effect of ameliorating his condition. He was 
 subsequently sent to an asylum, where, after a short 
 time, he was discharged well. Some years afterward, 
 conscious of feeling a return of the mental derange- 
 ment, he voluntarily applied for admission to the same 
 institution and remained until better. 
 
 This case is \Qxy instructive. The patient readily 
 connected his mental trouble, by a retrospective view 
 through a series of gradually -increasing troubles, that 
 originated in the preputial condition, to the phimosed 
 
274 History of Circumcision. 
 
 condition of that appendage, and he was certain that this 
 prepuce had been at the bottom of all the ph3'sical and 
 mental trouble he had experienced. The reflex nervous 
 train of affections had undoubtedly produced some local- 
 ized lesion in the brain-structure. The natural sound, 
 healthy organism of that organ, and the bright, active 
 nature of his mind, however, prevented a total wreck- 
 age of the mental faculties. It is safe to assume that, 
 had he had the ordinary listless, unresisting mind, dis- 
 posed to brood, and easily cast down, he would, from 
 the first derangement, have become a hopeless and 
 demented lunatic. The circumcision could not undo all 
 the mischief that had been accomplished, some of which 
 had certainly left a permanent taint, but the mildness 
 of his future attacks and the better exercise of his 
 volition were the undoubted results of the operation. 
 
CHAPTER XXIY. 
 
 Dysuria, Enuresis, and Retention of Urine. 
 
 Any dissertation on circumcision and its man}' uses, 
 eitlier prophylactic or curative,, would be incomplete 
 without a reference to enuresis ; another reason for 
 making a somewhat full reference to the subject would 
 be the undecided position that this morbid condition 
 seems to occupy in medical literature, as well as the 
 meagre and unsatisfactor3' treatment it has received by 
 the majority of those who have mentioned it. It is 
 anomalous, to say the least, to find, in general or special 
 literature, enuresis mentioned as a diseased condition 
 peculiar from bab3'hood to pubert}' ; to find it fully 
 described and to have it stated that it is a wideh-preva- 
 lent distemper, aflfecting both sexes alike ; to know that 
 it is an anno3'ing, intractable, persistent condition, 
 wearing to the child in everj^ sense, subjecting it to a 
 demoralizing mortification as well as to unmerited scold- 
 ings, humiliations, and punishments, and that its habit, in 
 badly-ventilated quarters, will breed other diseases,^''^as 
 well as that its continued action tends to the development 
 of onanism, with its long and widel3'-ramifying trains 
 of physical and social ills; and to find works especially 
 devoted to children's diseases silent on the subject. 
 Knowing all these things, and also that Ultzmann, Lalle- 
 mand, and others who have treated this affection, men- 
 tion it as a children's disease, it is unaccountable to reason 
 out why most of our text-books and treatises on chil- 
 dren's diseases should be so remarkably and unreasonably 
 silent. It certainly cannot be laid to its lacking in 
 
 (275) 
 
276 History of Circumcision. 
 
 study matex'ial, as the author of" Quain's Dictionary of 
 Medicine " saj^s : " It is one relative to which much 
 might be written without exhausting the subject, the 
 patliology of which has wide and manifold relations. 
 . . . There appears to be something analogous be- 
 tween this condition and that which determines in 
 after life the seminal emissions under similar circum- 
 stances," Our American works are notably deficient in 
 this regard ; although Stewart, of Xew York, in his 
 "Diseases of Children," published over fifty years ago, 
 devotes a chapter to dysuria and one to retention of 
 urine, treating the subject quite full}^, even down to the 
 description of preputial calculi ; he, however, failed to 
 notice that the irritation of preputial constriction or 
 a;dhesions will produce both conditions, and, following 
 many of the authors of the time, as has been done 
 since, he adopted the urino-digestion theory of acid and 
 irritating urine, due to faultj^ digestion, of Prout and 
 Magendie, who looked to regulating the digestion of the 
 child, or the mother who nursed it, as the onl}' method 
 of cure; the lithic-acid diathesis being, in their opinion, 
 the main thing to be guarded from. 
 
 Other works that mention these conditions are 
 equally on the wide sea of speculation, as the}^ all, more 
 or less, look upon the treatment that the}' advise as in- 
 definite and unsatisfactory, showing an equal want of 
 •sound anchorage-grounds for their etiological reason- 
 ings. Dillnberger, of Vienna, in his hand-book of chil- 
 dren's diseases, mentions enuresis, but has nothing better 
 to offer for its relief than that advised by Bednar, wlio 
 followed a systematically^ -timed period of awakening, 
 gradually lengthened out, from the time of putting the 
 child to bed. In addition, he advises internal medica- 
 tion, and, like TJltzmann, he recoguizes the possibility 
 
Dysuria, Enuresis, and Retention of Urine. 217 
 
 of a local cause in little girls, in whom he advises the 
 local application of nitrate of silver. Edward Ellis 
 mentions dj'suria, and a long prepuce is noticed among 
 its numerous causes. The works that give the subject 
 the most intelligent treatment (the word "intelligent" is 
 here used advisedl}^, and is in reference to the results 
 obtained) are those of West, of London, and Henoch, 
 of Berlin. .West, in his "Diseases of Children," sa3''s : 
 " In the child, however, we sometimes find the symp- 
 toms produced by difficult}^ in making water owing to 
 the length of the prepuce and the extreme narrowness 
 of its orifice, which may even be scarcely large enough 
 to admit the head of a pin. This congenital phimosis 
 is, I may add, not an infrequent occasion of incontinence 
 of urine in children, and is also an exciting cause of the 
 habit of masturbation, owing to the discomfort and 
 irritation which it constantly keeps up. In every case, 
 therefore, where any difficulty attends the passing or the 
 retention of the urine, or where the practice of mastur- 
 bation is suspected, the penis ought to be examined, 
 and circumcision performed if the preputial opening is 
 too small. This little operation, too, ought never to be 
 delayed, since, if put off, adhesions are very likely to 
 form between the glans and the foreskin, which render 
 the necessaiy surgical proceeding less easy and more 
 severe." 
 
 In the " Lectures on Diseases of Children," Henoch, 
 of Berlin, says : " I need scarcely- add that an examina- 
 tion of the external genitals should never be omitted 
 in any case of dj^suria during childhood. You will not 
 infrequently discover a phimosis which interferes more 
 or less with the discharge of urine and retains portions 
 of the latter behind the foreskin, where it may decom- 
 pose and give rise to an inflammatory condition of the 
 
278 History of Circumcision. 
 
 prepuce, with painful dysuria. . . . This is also true 
 of the occasional adhesion of the labia minora in little 
 girls, like the similar adhesion of the foreskin in boj'S. 
 ■It is almost constant in the first period of life, but some- 
 times persists to the end of the first year; can usually 
 be torn by the handle of the scalpel, and rarely requires 
 an incision. In a few cases this adhesion appeared to 
 me to be the cause of .the d3'suria, which disappeared 
 after the separation of the labia from one another." 
 
 Henoch, however, does not seem to have grasped the 
 full relation that the natural phimosis of young chil- 
 dren bears to dysuria, as he here follows the preA'ailing 
 opinion, that where by dint, push, hauling, and hard 
 ■work the prepuce can be pushed back phimosis does 
 not exist, as well as the general apathy to the isxct 
 that a prepuce can exert a very injurious influence by 
 its pressure, even when not adherent and very retract- 
 able ; such a prepuce is often attended by balanitis and 
 posthitis, with an accompanying difficult, frequent, and 
 painful urination. In a case wliich will be related far- 
 ther on, in the discussion of the systemic effects of a 
 long, contracted prepuce, as it induces diseased action 
 by continuity of tissues, there is an account of a death 
 of a two-year-old child which we can assume to have 
 had its original starting-point in a condition of phimosis. 
 Henoch, however, rather attributes the death in that 
 case to what may well be considered tlie result of a 
 cause, leaving the original cause more to appear as a 
 final accessory condition. 
 
 M_y reasons for this view of the subject are simply 
 owing to the fact that I do not believe that a child can 
 long be afflicted with the ischuria phimosica of Sauvages 
 without having tlie urinary organs beyond more or less 
 seriously aflected. from the mere retention alone, irre- 
 
Dysuria^ Enuresis^ and Retention of Urine. 279 
 
 spective of an}^ reflex irritation from tlie pressure on the 
 glans or of any fromtlie irritation of the peripheral nerves ; 
 the dilatation of the adjacent cavities or channels and 
 the deposit of calcareous matter being facilitated by the 
 retention of urine and its naturally altered condition 
 owing to tliat retention. So tliat dysuria in young chil- 
 dren, beginning in a slightly phimosed condition, or in 
 the irritability of the glans and meatus, due to its pre- 
 putial covering, it is safe to assume, maj' produce a train 
 of symptoms ending in permanently -injured health, or 
 even death. The irritating urine of a slight access of 
 fever may, by its passage over the irritable mucous lining 
 of the prepuce, be the initial starting-point of a serious or 
 fatally-ending disease. In all of these, it must be ad- 
 mitted, the presence of the prepuce is either actively or 
 passively the cause of the most serious disease processes 
 that may follow. 
 
 Ultzmann, of Vienna, in his work on the " Neuroses 
 of the Genito-Urinary Organs," gives the subject of 
 enuresis considerable attention. It is not a work oiv 
 diseases of children, but it, nevertheless, goes into the 
 subject as if it were, and furnishes the profession with 
 considerable information. He defines enuresis to be 
 the passage of urine of a normal quality in a child who, 
 with the exception of this involuntary urination, is 
 healthy. In the first periods of life, a slight vesical or 
 intestinal expulsive effort is sufficient to overcome the 
 guarding sphincter muscles at their outlet ; the child 
 first obtains a voluntary control of the rectal sphincter; 
 and, generally, with the second year it gains control of 
 the vesical. Those who pass their second j^ear without 
 obtaining this control, but in whom the organs and urine 
 are normal, maj^ be said to be afflicted with enuresis. 
 He divides enuresis into three varieties ; that iuvolun- 
 
280 History of Circumcision. 
 
 tavy urination which takes place at night during sleep 
 he terms the nocturnal; that which takes place while 
 climbing, laughing, coughing, or in the course of any 
 violent muscular exercise is the diurnal; and that 
 wherein the involuntary evacuation takes place day and 
 night alike he terms as the continued. This last is 
 again subdivided into the continuous and periodical. 
 As a cause, he cites anaemia, scrofula, rachitis; but adds 
 that physical debility is not necessary for its presence, 
 as well-developed, vigorous, pufly children are as liable 
 to be affected as thin and scrawny ones ; while not all 
 scrofulous or rachitic children are so affected, only a 
 small portion being enuretic. Sex has no influence on 
 the liability that tends to being attacked, the proportion 
 between the sexes being about equal. As to age, he 
 finds the greatest proportion to be between three and 
 ten years, but he has often treated those of either sex 
 even at the age of fourteen and up to seventeen years. 
 It is absolutely necessaiy to examine the external geni- 
 tals and the urine of those affected by this disease, as 
 phlegmasiae of the vagina, of the vestibule or uretlira 
 in girls, or the practice of onanism, or lithiasis, cystitis, 
 or pyelitis may be the cause of the disease. Girls are 
 apt to be found affected with polypoid excrescences at 
 the meatus, which when removed will cause the enuresis 
 to disappear. 
 
 From the above It will be observed that Ultzmann has 
 paid much attention to these neuroses; but it will also 
 be remarked that neither the balanitis, collection of in- 
 fantile smegma, preputial adhesions nor ii'ritations are 
 taken into any account as possible factors of either 
 dysuria or enuresis ; he has followed more or less an 
 electrical form of treatment for genito-urinarj'^ neuroses, 
 the rectal rheophore being one of his favorite modes "of 
 
Dysuria^ Enuresis, and Retention of Urine. 281 
 
 treating enuresis; in his etiological views of these dis- 
 turbances he has adhered more or less to the views of 
 Trousseau, Bretonneau, and Dessault, who looked upon 
 a debilitated or anomalous condition of the vesical neck 
 as the cause of the majority of neuroses in that region. 
 It may be asked why these celebrated and observing 
 physicians have neglected the preputial condition, if, as 
 it is claimed, it is, in itself, so important and sure a 
 factor of the derangements at the vesical neck ? To 
 answer this, or to explain an}' marked discrepanc}' that 
 may occur in medicine between minds equally as acute 
 and febserving, it is but necessary to observe that there 
 is, in medicine, to a certain extent, a like rule of inherit- 
 ance, education, with fashion or custom of habit of 
 thought and practice, as we find in religion. Canon 
 Kingsley and Froude are equally as acute and discerning 
 as the late Cardinal Newman, but that did not necessi- 
 tate their following that prelate into the foremost ranks 
 of the Catholic Church ; and Pere Hyacynthe was 
 equally as intelligent as Cardinal Newman, but that 
 did not prevent him from leaving the fold into which the 
 Cardinal had entered from out of the Reformed Churcli. 
 Some are born Catholics or Protestants, and are so with 
 vehemence ; others are born in these religions, but are 
 only lukewarm in their doctrinal observance; while 
 others reason and jump the traces in either direction. 
 The followers of the destructive theories of Bronssais 
 could not see the errors of their wa3'S, and neither 
 could they be made to see the merits of a less interfering 
 form of medical practice. Trousseau was himself at 
 one time tainted with Bronssaisism, but, like Paul of 
 Tarsus, he was made to see the error of his way, as he 
 relates, througii a case of gout that he nearly laid out 
 in trying to lay out the disease antiphlogistically. 
 
282 History of Circumcision. 
 
 I do not assume that preputial irritation is at the 
 bottom of all cases of dysuria or enuresis, any more 
 than it would be rational to den}^ that cases of circura- 
 cision performed in some cases of diabetic enuresis have 
 proved fatal as a result of the operative interference; 
 but it is safe to assume that, in the great number of 
 cases in whom some irritating conditions were found 
 and removed, the enuresis or dysuria was due to 
 such preputial irritation. It is also logical to assume, 
 with West and Henoch, that tlie organ should in all 
 cases be examined, and its condition rendered as harm- 
 less as possible. That the condition of preputial irri- 
 tation has not been fully recognized by all parties as 
 a cause of enuresis does not do away with the fact that 
 it does exist, an^'^ more than tlie refusal of the prelates 
 and doctors of Salamanca to listen to Columbus did 
 awaj' with the fact of the existence of the American 
 continents. 
 
 A. L. Ranney, in his " Lectures on Nervous Dis- 
 eases," pages 174, 175, speaks of enuresis in children as 
 being a reflex cachexia, " excessive stimulation of the 
 centripetal nerves connected with the so-called ' A'esical 
 centres ' of the spinal cord," — a condition which may be 
 produced by eitlier worms in the intestines or b}' preputial 
 irritation. Ranney advises a careful exploration of the 
 urethra and rectum in these cases, and the elimination 
 of all local causes of the conditions. 
 
 Probably the most remarkable case of the immediate 
 continuous effects resulting from phimosis is the one 
 recorded by Yidal, in the fifth volume of the third 
 edition of his " Surgery." This was a young man with 
 a congenital phimosis, having but a \Qvy small aperture ; 
 on an operation to relieve the phimosis there was a 
 gush of water, but this only fell at the feet of the 
 
Dysuria, Enuresis^ and Retention of Urine. 283 
 
 patient, without being ejected at any distance ; the 
 urethra was found to have undergone precise!}" the same 
 dilatation back of this preputial orifice that it usually 
 undergoes back of a stricture ; the whole urethra from 
 the meatus backward was found to have exceeded the 
 calibre of that of the vesical neck ; the bladder was 
 greatly dilated. 
 
CHAPTER XXY. 
 
 General Systemic Diseases Induced by the Prepuce. 
 
 Aside from all the local affections or reflex neuroses, 
 either mental or physical, that a prepuce may induce, 
 there are an innumerable train of diseases that may 
 originate in this one cause that at first sight would 
 seem to have no connecting-link with any preputial 
 condition. 
 
 It has already been suggested that the prepuce does 
 not at all ages bear the same analogous relation to man. 
 In childhood, especially during our earliest j^ears, it is 
 out of all proportion in size when compared to the rest 
 of the organ, or to any use it may have placed to its 
 credit. Man does not, then, certainly need that refine- 
 ment of nervous sensitiveness in the corona that is 
 useful in after life in inducing the flow or ejaculation of 
 the seminal fluid ; neither is there at that age much of a 
 corona to protect. In middle life, or what might be 
 called the procreative period of man, when the corona 
 would seem to require all its excitability or sensitive- 
 ness, seems to be the very season in life when the glans 
 is most apt to remain uncovered ; so that nature and 
 this h3'pothetical idea of the use of the prepuce are 
 evidently at variance. So we go through childhood 
 with this long funnel-shaped appendage into manhood, 
 when the increasing size of the body of the penis re- 
 stores a sort of equilibrium between the size and bulk 
 of the organ and its integumentary covering. At this 
 period, as we have seen, although it does not, from the 
 equilibrium restored, and the more or less use to which 
 (284) 
 
General Systemic Diseases Induced by the Prepuce. 285 
 
 it is subjected, induce any great immediate or uncom- 
 plicated troubles, it nevertlieless endangers the existence 
 of the penis through the accidental course of some 
 putrid or continued fever, or it subjects man to the 
 manifold dangers of A^enereal or tubercular infections. 
 
 In advanced age, owing to the diminution in size of 
 the organ, the prepuce resumes the proportionate bulky 
 dimensions of childhood, and as the organ recedes and 
 becomes more and more diminutive, the prepuce again, 
 like in childhood, begins to tend to phimosis ; the urine 
 of the aged is also more irritating and prone to decom- 
 position or putrefaction, and the constant state of moist- 
 ure that the preputial canal of the aged is necessarily 
 kept in, either by frequent urination or the incomplete 
 emptying of the urethra that is peculiar to old age, and 
 which results in more or less dribbling, is a powerful 
 fector in inducing the many attacks of posthitis and bal- 
 anitis, as well as those attacks of excoriation and eczema 
 which are so annoying to the aged. I have often seen such 
 cases happening to men past fifty, who, being widowers, 
 and never having had anything of the kind, as well as 
 being in the most complete ignorance of the nature of 
 the disease, have, from delicacy and fear that the disease 
 might induce some suspicions as to their conduct in the 
 minds of those whose good opinions they A^alue above all 
 else, gone on suffering untold miseries, especially if the 
 urine were in the least diabetic. 
 
 One such case that fell under my observation not 
 only produced such miserj^ as to entail a loss of rest 
 and of appetite, but even induced such a disturbance of 
 assimilation and nutrition that the resulting h3'pochon- 
 driacal condition that developed from these enervating 
 causes ran the patient into a low condition, ending in 
 complete prostration of all vital powers and death, 
 
286 History of Circumcision. 
 
 without the intervention of any other disease. The 
 subject was a timid, retiring man of about lifty-five 
 years, and this was the first and only time tliat the 
 prepuce had ever caused liim any anno^^ance, — a circum- 
 stance whicli greatly preyed upon his mind, as he could 
 not disconnect it with the idea that it must be suspected 
 as venereal, although he had always led a most continent 
 life since the death of his wife. This is, of course, an 
 extreme case; but as it is a result beginning in a certain 
 condition, be it an extreme, erratic, or infrequent occur- 
 rence, it is, nevertheless, an example of what may 
 happen in advanced life, even where the prepuce has 
 never before been a source of the least disturbance or 
 annoyance. Persons who, with the increase of years, 
 are also liable to an increase of adipose tissue, are more 
 subject to this dwindling down of the penis and conse- 
 quent elongation of the prepuce, with all the attendant 
 annoyances, than thin or spare people. 
 
 In this irritation that the prepuce is liable to cause, 
 we have not only to encounter the dangers that its 
 thickenings or indurations may bring on in their train, 
 in the shape of cancer, gangrene, or hj^pertrophies, but 
 other and no less serious results are liable to follow a 
 herpetic attack, or in consequence of an attack of 
 balanitis or posthitis. The d^^suria attending any of 
 these conditions may be the initial move for such a seri- 
 ous complication that life may be brought to a sudden 
 end, even in infanc}'^, to say nothing of the ease with 
 which life is taken off in after j^ears and in old age ; with 
 debilitated and imperfect kidney action, it takes very 
 little to hustle us off from life's foot-bridge. 
 
 A case as occurring in Henoch's clinic, already men- 
 tioned or referred to in a previous chapter, shows what a 
 simple phimosis is capable of inducing. In the history 
 
General Systemic Diseases Induced by the Prepuce. 281 
 
 of the cuse the phimosis and the resulting retention in 
 the preputial cavity no doubt were the causes of the cal- 
 culus found there ; and the succeeding calculi and 
 abnormal condition of the urinarj' organs, we can safely 
 assume, were a snbsequent creation to that in the 
 prepuce. The case is taken from" Henoch's " Lectures 
 on Diseases of Children," Wood Libraiy edition, page 
 256, and is as follows : — 
 
 "A. L., aged two, admitted November 28, 1877. 
 Quite well nourished, but pale. Complete retention of 
 urine for two da}' s ; slight redness and marked oedema 
 of penis, scrotum, and perineum. The foreskin cannot 
 be retracted, on account of phimosis. Abdomen dis- 
 tended, hard, and sensitive, the dilated bladder extend- 
 ing a few fingers' breadth above the symphysis. In 
 order to introduce the catheter, it was first necessary to 
 operate upon the phimosis, during which a calculus, 
 which completely occluded the meatus, was removed. 
 The catheter, when introduced into the bladder, removed 
 a quantit}' of cloudy urine. The oedema rapidl}' disap- 
 peared under applications of lead- wash, but on Novem- 
 ber 29tli A'omiting and diarrhoea occurred daring the 
 night, with rapid collapse; December 1st, death. Au- 
 tops}^ : In the bladder, a sulphur-yellow stone, as large 
 as a hen's egg, completely filling the organ ; similar cal- 
 culi, from the size of a pea to that of a bean, in the 
 pelvis of the left kidney ; right kidnej- normal." 
 
 In the above case, the oedema of,the penis, scrotum, 
 and perineum was as much a result of the distension of 
 the bladder by the retained urine interfering with the 
 return circulation from the oedematous parts as the dif- 
 ferent appearances of diseased conditions were a result 
 of the primary phimosis ; yet this case, if seen during its 
 early infancy, when probably the contraction of the 
 
 10 
 
288 History of Circumcision. 
 
 preputial orifice was as j'et not so well marked, would 
 have been pronounced one in which it would be needless 
 and barbarous to perform circumcision upon. We 
 would most assuredly have to wander aimlessly and 
 unprofitably in the region of speculation to build up the 
 etiology of the abov'e-related case and reach the cul- 
 mination there found, unless we accept the one that it 
 was all, from first to last, the result of the phimosis. 
 
 Jonah, pitched overboard at sea to appease the tem- 
 pest and swallowed by the whale, became convinced 
 finally that he had better return to Nineveh to preach 
 reform ; while Pharaoh would not let the children of 
 Israel depart even after Moses had so frightened him — 
 as it is related in the rabbinical traditions compiled 
 by the Rev. T. Baring-Gould, M.A. — that the royal 
 bowels were completely relaxed at the sight of the 
 snakes turned loose about the royal throne, — a circum- 
 stance which nearly lost him his claim to divinity, which 
 was based on the fact that his bowels moved only once 
 a week, as in this case they not only moved out of time 
 and in the most unkingly manner, so that the noble king 
 hid underneath the throne, but before even Pharaoh 
 could disengage himself from the royal robes, which 
 event could hardly have raised him in the estimation of 
 the gentlemen eunuchs of the bed-chamber. Those who 
 unwound the mummy of Pharaoh tell us that he had the 
 appearance of a self-willed, despotic, but intelligent, old 
 gentleman; but the above rabbinical relation, from 
 Baring-Gould's " Legends of the Patriarchs and Pro- 
 phets,." seems to have had no convincing effect on 
 Pharaoh ; so we must not be surprised if even a case 
 like the one from Henoch's clinic would, with many. 
 carrry no conviction. 
 
 In the second volume of Otis on " Geni to-Urinary 
 
General Systemic Diseases Induced by the Prepuce. 289 
 
 Diseases," of the Birminghain edition, at page 380, there 
 is an interesting account of a physician who, in 3'onth, 
 was troubled with an annoying prepuce, which, from 
 frequent attacks of balanitis, had finally become more 
 or less adherent to the glans penis ; up to the age of 
 nineteen he had been unable to completely uncover the 
 glans. B}^ six months of hard and persistent labor he 
 had finally broken up these adhesions. At the age of 
 twenty-two he married, and he then ruptured the frenum, 
 which bled profusely and left him sore for some days. 
 Then for twent^^-seven years he had no further trouble, 
 but at the end of that time he began to experience what 
 he believed were attacks of dumb ague, and the scrotum 
 began to swell and felt sore on firm pressure. Heavy, 
 aching pains then followed. This condition of things 
 lasted for over five years, varied by the appearance of 
 carbuncles on the nose and elsewhere, to relieve the 
 monotony of the thing. From this time on, abscesses 
 began to form in the scrotum and into the integument 
 of the penis, burrowing forward into the prepuce, which 
 was much swollen and painful. A gangrenous opening 
 effected itself in the dorsal surface, which relieved him 
 somewhat. The patient was finally examined by Dr. 
 Otis, who found a badl}' strictured urethra, the strict- 
 ui'es beginning at the meatus, and at intervals extended 
 down as far as two and three-fourths inches. The ca,se 
 had no venereal history, the patient never having had 
 any disease or anything of the kind. The strictures 
 were plainly the result of the balano-posthitic attacks 
 as much as they were the cause of the degeneration of 
 the mucous membrane in the lower urethra, that allowed 
 of the infiltration of urine into tlie tissues, which caused 
 all the systemic disturbances, abscesses, miserj', and 
 agony of the patient, depriving him of comfort, sleep, 
 
390 History of Circumcision. 
 
 ov ability for labor, and which sent him here and there 
 In search of health and relief. 
 
 It would seem really as if a prepuce was a danger- 
 ous appendage at any time, and life-insurance companies 
 should class the wearer of a prepuce under the head of 
 hazardous risks, for a circumcised laborer in a powder- 
 mill or a circumcised brakemen or locomotive engineer 
 runs actually less risk than an uncircumcised tailor or 
 watchmaker. They recognize the danger that lurks in 
 a stricture, but what a prepuce can and does do, they 
 entirelj'^ ignoi*e. I have not had any opportunities for 
 comparison, but it would be interesting to know, from 
 the statistics of some of these companies, how much 
 more the Hebrew is, as a premium-payer, of value to 
 the company than his uncircumcised brother. Were 
 thej^ to offer some inducement, in the shape of lower 
 rates, to the circumcised, as they should do, ihey would 
 not only benefit the companies by insuring a longer 
 number of j^ears, on which the insured would pay 
 premiums, but they would be instrumental in decreas- 
 * lug the death-rate and extending longevit3^ 
 
 I have seen so man}^ cases of stricture whose origin 
 could be traced to balanitis that it can almost with 
 confidence be assumed that, wherever there is a long 
 prepuce with a red and inflamed meatus in a child, 
 that unfortunate child will be a victim of fossal stric- 
 tures when arrived to manhood, and that, moreover, he 
 will be a surer victim to the reflex neuroses which so 
 often accompany strictures, and which have been so 
 ably described by Otis, than the victim of uncompli- 
 cated strictures acquired in the worship of Yenus. 
 There is no end to the miser}' that these poor fellows 
 have to suffer, besides the habitual hypochondriacal 
 qonditiou into which the accompanying physical depres- 
 
General Systemic Diseases Induced by the Prepuce. 291 
 
 sion thi'ows them ; it unfits them for business, any 
 undertaking, or even for social enjoyment or enter- 
 tainment ; they keep themselves and their families in 
 continued hot water. These subjects are, also, more 
 prone to gout\' and rheumatic aflPections, asthma, and 
 other neuroses. 
 
 Among the manj^ cases of nervous disorders simu- 
 lating other diseases that I have seen relieved were two 
 Jewish lads with an imperfection of the meatus. They 
 were two brothers, and from the history of the cases, 
 and that given me by the mother of the lads in regard 
 to the father, the malformation must hiive been hered- 
 itar}' and congenital. It consisted of a partial occlusion 
 of the meatus by a false membrane, which divided the 
 meatus in two, horizontally, but which was closed at the 
 posterior end of the lower passage, which readily ad- 
 mitted a probe from the front as far as the occlusion, 
 about a third of an inch to the rear. The restoration, 
 or rather the making the anterior urethra and meatus to 
 their normal condition, relieved both boys of asthma, 
 under which they had labored for years. 
 
 The many cases simulating the general disturbances 
 that accompany many kidney disorders, that are simply 
 the result, in their primary causes, of preputial irritation 
 and the disturbances to the kidney function due to the 
 same cause, have long induced me to look upon the pre- 
 puce as a great and avoidable factor to some of the many 
 forms of kidney diseases, prostatic enlargements, vesi- 
 cal diseases, and many other diseases of the urinary 
 organs, which we know full well can result from stric- 
 tures, as the latter need not always act in a purely 
 mechanical mode to do its full extent of mischief. 
 
 One result of these preputial irritations not generally 
 or particularly mentioned in any of our text-books — a 
 
292 History of Circumcision. ■ 
 
 condition far-reaching as regards its own results, and 
 more annoj'iug and serious tlian it appears at first sight 
 — usually begins with a reflex irritability of the anal 
 sphincter muscle, or a rectal irritation of the same 
 order, which in time produces such organic change that 
 an h^'pertrophied and irritable, indurated, unyielding 
 muscle is the result. Agnew, of Philadelphia, describes 
 the condition, but does not mention tliis frequent cause 
 under the name of sphincterismus ; once this is estab- 
 lished, tlie train of resulting pathological or diseased con- 
 ditions that may follow are without end.^"^ This is no 
 fancy sketch, nor will the student of the pedigree and 
 origin of diseases feel that the case is exaggerated or 
 imaginative. These are some of those cases that are 
 always ailing, never well and really never sick, but who 
 are, nevertheless, gradually breaking down and finally 
 die of what is termed " a complication of diseases," 
 before living out half their term of life. 
 
 How this happens is simple enough — the straining 
 required to produce an evacuation is out of all proportion 
 with the character of the discharge; such patients often 
 complain of being constipated when the evacuations are 
 semi-fluid ; this straining is followed by a dilatation and 
 consequent loss of power of the rectum, which becomes 
 pouched and its mucous membrane thickened ; the 
 whole intestinal tract sympathizes and digestion is in- 
 terfered with, and the forcible expulsive efforts affect 
 all the abdominal and thoracic organs in a more or less 
 degree, laying the foundation for serious organic dis- 
 eases. Now, this condition, which may be said to be no 
 more than one of obstinate constipation, is a far more 
 reaching condition and a far more injurious state than 
 can be imagined at a first glance. Constipation is not, 
 as a rule, always accompanied by the indigestion, either 
 
General Systemic Diseases Induced by the Prepuce. 293 
 
 stomachic or intestina,!, that goes with this condition ; 
 the contents of the intestines in simple constipation may 
 simply lack fluidity without undergoing putrefactive fer- 
 mentation, but in this condition the undigested and 
 retained intestinal contents do undergo that change, re- 
 sulting in the generation of material whose re-absorp- 
 tion produces a toxic condition of the blood, from 
 whence begins a series of serious organic changes in the 
 blood, and from this in the organs. 
 
 To the practical physician these changes are evident 
 and their cause just as plain, and it is just here where 
 the laity lack the proper education, and where they 
 should understand that the intelligent ph3'sician general- 
 izes the disease and only individualizes the patient; 
 and it is this ignorance on the part of the \si\ty that 
 gives to empiricism and quackei'y that advantage over 
 them, as thej^ look upon all disease as a distinct indi- 
 vidual ailment, that should have an equally distinct and 
 individual therapeutic agent to cope singly with. The 
 laity know very little of these things, and in their 
 happy ignorance care still less for the finer definitions 
 of or of the clinical importance of toxaemia, or the 
 processes of abnormal conditions that lead up to such 
 a state, or the results that may follow when that 
 condition is once reached. To them, dyspepsia is an 
 indigestion ascribable to the stomach, and a sick-head- 
 ache is ascribed to something wrong about the stomach 
 or liver. 
 
 The laity have never been called upon to answer the 
 questioning of the late Prof. Robley Dunglison : "What 
 do you mean, sir, by biliousness? Do you mean, sir, 
 that the liver does not secrete or manufacture a suflfl- 
 ciency of bile, or not enough ? Do you mean that the 
 bile-material is left in the blood, or too much poured in ? 
 
294 History of Circumcision. 
 
 Do 3'ou mean that there is an excess in the alimentary 
 canal, and a deficiency elsewhere ? Please, sir, explain 
 what you really mean by the term ' bilious 1' " The 
 Professor had a waj'^ about him that at least made one 
 stop and seriously inquire, before adopting any random 
 notion in regard to medicine. It is to be regretted that, 
 in the humdrum tread-mill work of many phj^sicians, 
 they even have to drop into the commonplace way 
 of treating dyspepsias and such ailments without any 
 further inquiry. A farmer knows better than to drive 
 a dishing wheel, or with merely having a nail clinched 
 in the loose shoe of a valuable horse ; but he is fully 
 satisfied to do so in a metaphorical sense, as regards his 
 own constitution, and the mere hint from his physician 
 that he had better lay up for repairs, or that there is 
 ' something wrong about him that will require investiga- 
 tion, and that there is an ulterior cause to his feeling 
 tired, headachj?^, or dyspeptic, or an allusion that there 
 is something sj^stemic, as a cause, to his momentaiy 
 attacks of disordered vision or amaurosis, will generally 
 make him look on the doctor with mistrust. 
 
 The merchant, banker, and mechanic are not up to 
 Professor von Jaksch's ideas of toxaemia, — that toxsemia 
 may be exogenous or endogenous, or that the latter is 
 further subdivided into three more varieties, — and, what 
 is worse, he cares still less. The above three classes of 
 humanity, when sick, simply would want to know if Pro- 
 fessor von Jaksch was good on dj'spepsia, the measles, 
 or typhoid fever. They care ver3' little that he divides 
 endogenous or auto-toxsemia into that produced by the 
 normal products of tissue-interchange, abnormally re- 
 tained in the body, giving rise to uraemia, toxssmia from 
 acute intestinal obstruction, etc., the above being the first 
 division. The second depends on the outcome of patho- 
 
General Systemic Diseases Induced by the Prepuce. 295 
 
 logical processes, which change the normal course of 
 assimilation of food and tissue-interchange ; so that, in- 
 stead of non-toxic, toxic matter is formed. The second 
 group he names noso-toxicoses, which he subdivides into 
 two principal divisions : — 
 
 (a) The carbohydrates, fats, or albuminous matter, 
 which may be decomposed abnormall}' and give rise to 
 toxic products, e.gr., diabetic intoxication, coma carcino- 
 matosum. 
 
 (6) A contagium vivum enters the body through the 
 skin, or the respiratory or digestive tract, and develops 
 toxic agents in the tissues on which it feeds, as in infec- 
 tious diseases. 
 
 In the tliird group the toxic substance results from 
 pathological non-toxic products, which again produce a 
 toxic agent, only under certain conditions. This group 
 he calls auto-toxicoses, and includes in it poisonous sub- 
 stances, resulting from decomposition of the urine in 
 the bladder, under certain pathological conditions, and 
 giving rise to the condition called ammoniaemia. (Medi- 
 cal News of January Y, 1891 ; from Wiener klinische 
 Wochenschrift of December 25, 1890.) 
 
 As observed above, unfortunately the patients know 
 nothing, nor can they be made to understand these con- 
 ditions, that are onl}^ reached through labj'rinthic patho- 
 logical processes, and, what is still worse, this way of 
 looking at disease is incompatible with the idea of spe- 
 cific-disease treatment, which to them looks more prac- 
 ticable and quick, and which is also more to their 
 liking. They cannot see any sense in such reasoning, 
 which to them is something eminently impracticable ; 
 neither can they see a reasonable being in the doctor 
 who practices on such, as they call tliem, theories. 
 
 The practical physician, however, sees in Professor 
 
21)6 History of Circumcision. 
 
 Von Jaksch's summary the turning-point of manj' a poor 
 fellow's career, — from one of comparative health into 
 one of organic disintegration, decay, and dissoluti(>n, — 
 all the required processes starting visibly from the very 
 smallest of beginnings ; any obstruction in the urinary 
 tract or intestinal canal being sufficient to start an3^ of 
 the conditions which end in toxaemia; and, from a care- 
 ful observation running over several years, I do not 
 think that I am assuming too much in saying that a 
 balanitis is often the tin}^ match that lights the train 
 that later explodes in an apoplectic attack or sudden 
 heart-failure due to toxaemia ; the organic and vascular 
 s^'^stems being gradually undermined until, unannounced 
 and unawares, the ground gives way and the final catas- 
 trophe occurs, — unfortunately, an occurrence or ending 
 looked upon as unavoidable by the friends of the 
 victim. The}^ cannot see any danger ; the idea that dis- 
 eases have the road paved, not only for an easy entrance 
 biit an easy conquest, b}'^ the action of these toxic 
 agents on the tissues, is something that the}' cannot 
 grasp. These blood changes or blood conditions are 
 things too intricate, and the physician who understands 
 them is, to them, a visionary and unpractical man. 
 These conditions are, however, neither new nor unknown, 
 and there is really no excuse for the ignorance exhibited 
 in these matters by the general public, as it i*s through 
 the blood that this mischief takes place. They can 
 reason in their impotent way, that they should drench 
 themselves with " blood tonics " and all manner of 
 nauseous compounds to " purif}' " their blood, but the 
 simple, scientific truth is something beyond their under- 
 standing, as well as something that they steel themselves 
 against. 
 
 Sir Lionel Beale, in observing the immense impor- 
 
General Systemic Diseases Induced by the Prepuce. 29T 
 
 tance he attaches to blood composition and blood change 
 in diseases of various organs, truly remarks that " blood 
 change is -the starting-point,, and may be looked upon as 
 the cause, of what follows," the other factor being the 
 " ' tendency ' or inherent weakness or developmental 
 defect of the organ which is the subject of attack;" to 
 which he adds that he feels convinced that, if only the 
 blood could be kept right, thousands of serious cases of 
 illness would not occur ; while the persistence of a 
 healthy state of the blood is the explanation of the fact 
 that many get through a long life without a single 
 attack of illness, although they may have several weak 
 organs ; and that an altered state of the blood, a depart- 
 ure from the normal ph3'siological condition, often 
 explains the first step in many forms of acute or chronic 
 disease. Sir Lionel has been a pioneer in the field of 
 thought that looks for the cause of the disease, which, 
 however remote it may be, should not be overlooked as 
 a really primary affection. His extensive labor in the 
 microscopic field has fully convinced him that many of 
 the pathological changes in the different organs are due 
 to what might be called some intercellular substance 
 that is deposited from the blood. (Beale : " Urinary 
 and Renal Disorders.") 
 
 Toxic elements in the blood affect the kidneys in a 
 greater or less degree, and there produce changes at 
 first unnoticed, — at least, as long as the kidney can per- 
 form its function, — but the day arrives when, as 
 described by Fothergill, blood depuration is imperfect, 
 and we get many diseases which are distinctly ursemic 
 in character, and ending in any of the so-called kidney 
 diseases, Bright's disease being one of the most com- 
 mon. As observed b}' Fothergill, however, the kidne}' 
 is not the starting-poiut, the new departure only taking 
 
298 History of Circumcision. 
 
 place when the structural change on the kidney has 
 reached that point that it is no longer equal to its func- 
 tion — the " renal inadequacy " of Sir Andrew Clarke. 
 (J. Milner Fothergill, in the Satellite, February, 1889 ) 
 
 During the Bradshawe lecture, Dr. William Carter 
 made the following remarks : "According to Bouchard, 
 one-fifth of the total toxicitj' of normal urines is due to 
 the poisonous products re-absorbed into the blood from 
 the intestines, and resulting from putrefactive changes 
 which the residue of the food undergoes there." In 
 the course of the lecture, Dr. Carter fully explains that 
 one of the benefits derived from milk diet in Bright's 
 disease is the small residuum deficient in toxic proper- 
 ties, and lays great stress on the employment of intes- 
 tinal disinfectants or antiseptics that exercise their 
 influence throughout the whole tract, suggesting naph- 
 thalin as peculiarly efficacious, thereb}^ cutting off one 
 source of blood contamination at its source. Although 
 these are recent developments in medicine, Bouchard 
 mentions that in the practice of M. Tapret cases treated 
 on this principle did well. (Braithwaite's Retrospect, 
 January, 1889.) 
 
 Persons laboring under this toxic condition of the 
 blood, with a consequent deterioration in the texture 
 and the physiological function of the vital organs, 
 are of that class that easily succumb to injuries or 
 serious sickness, and of that class to whom a surgical 
 operation of even medium magnitude is equal to a 
 death-warrant. 
 
 The above conditions are an almost constant attend- 
 ant on that condition of the sphincter described by 
 Agnew as sphincterismus, which also is productive of 
 haemorrhoids and fissure, and often of fistula. That 
 sphincterismus is caused in many cases b^' preputial 
 
General Systemic Diseases Induced by the Prepuce. 299 
 
 irritation is as evident as that the same affection, or 
 haemorrhoids or any other rectal or anal aflection, will, 
 in its turn, produce vesical and urethral reflex actions, 
 and primarily functional and secondaril3' organic changes 
 in those parts. Besides, the great number of cases 
 wherein the gradual and progressive march of each 
 pathological event could be traced with accuracy has 
 convinced me of the true cause of the difficulty being 
 the result of reflex irritation. 
 
 Delafield, in his " Studies in Pathological Anatomy," 
 gives, as the first form of pneumonia, that from heart 
 disease ; in the days of Broussais this would have 
 sounded absurd, but, to-day, some forms of heart disease 
 are known to be the regular sequences of some particu- 
 lar form of kidney disease, just as some form of pneu- 
 monia attends an affected heart and that some forms of 
 pneumonia degenerate into phthisis. When the blood 
 change is an established fact, it is only a question as to 
 which is the weak organ, and the organism of the 
 individual will decide whether it will be a simple sick- 
 headache or the beginning of a pneumonia ending in 
 phthisis. 
 
 I have purposely dwelt on this part of this subject, 
 owing to the recent origin and publication of man}^ of 
 the views connected with it ; also on account of the 
 greater ease of making the subject plain by fully dis- 
 cussing each step of the process; and if the views of 
 Sir Lionel will be recalled, that a toxic element in the 
 blood is the starting-point, and that an irritable or weak- 
 ened organ invites destruction, — the induction of serious 
 and fatal kidney disorder by the transmitted irritability 
 and consequent injury to the kidney produced by pre- 
 putial irritation in the first instance, and the supple- 
 mental blood-poisoning by intestinal absorption of septic 
 
300 History of Circumcision. 
 
 matter, wliicli soon brings about Sir Andrew Clarke's 
 *' inadequacy of kidne^^," — all will be readily understood. 
 "When this point is reached, a too hearty meal, exposure 
 to variable weather, or a little extra care or anxiety, 
 are sufficient, as determining causes, to bring life into 
 danger. 
 
 As pointed out, many cases of Bright's disease or 
 other renal difficulty have their origin in this distant but 
 visible source, and, although malarial poisoning and a 
 great number of other causes will produce the same 
 particular organic changes and diseases, this condition 
 must be admitted as one of the frequent causes. The 
 influence of the genito-urinary tract on the rest of the 
 economy, and the importance of the sympathy it excites, 
 or how quickl^'^, by its being irritated, some apparently 
 dormant pathological condition will be awakened to life 
 and activit}'^, is not sufficiently appreciated. As observed 
 by Hutchinson, a patient who has once been the subject 
 of intermittent fever is more prone, on catheterization, 
 to have a urethral chill and fever tlian one who had never 
 had the fever. (Hutchinson : "Pedigree of Diseases.") 
 
 Ralfe observes, in his " Kidne}'^ Diseases," that long- 
 standing disease of the genito-urinary passages must be 
 reckoned as among the chief etiological factors of chronic 
 interstitial nephritis (page 221). The condition of the 
 kidneys in cases of strictures of long standing is known 
 not to be a reliable one, and any incentive to dysuria or 
 to retention, no matter how slight, is apt to lead, eventu- 
 ally — and that even in very young subjects — to that 
 toxic condition mentioned in a former part of this chap- 
 ter as one of von Jaksch's subdivisions of toxaemia, the 
 animoniaemia of Frerichs ; this condition being the fatal 
 ending of the case of the two-j^ear-old child mentioned 
 b}^ Henoch, who died after the relief of a retention due 
 
General Systemic Diseases Induced by the Prepuce. 301 
 
 to phimosis and calculi resulting- from the phimotic 
 occlusion. Having seen so many cases wherein the con- 
 ditions described in this chapter were so apparently — 
 whether from ammonisemia due to infection, or toxaemia 
 from the urinary tract, or ursemic toxaemia from the 
 intestinal tract — all due to some preputial interference 
 or irritation, I cannot help but feel that in these con- 
 ditions — which, singularly, are not so prevalent with the 
 Hebrews as with Christians — we have one factor in the 
 cause of the shorter and more precarious vitality of the 
 latter. 
 
 Morel, in his " Traite des Degenerescenees Phisiques," 
 ably discusses the degenerative and morbific influences 
 and results of toxaemia, as well as he clearly defines 
 their sources. The connection between toxaemia and 
 mental affections has already been shown, and Prof. 
 Hobart A. Hare, in his instructive and interesting 
 prize essay on " La Pathogenic et la Therapeutique de 
 I'Epilepsie (Bruxelles, 1890), mentions that convulsive 
 disorders resulting from the presence of some toxic 
 substance are of frequent occurrence. How mucli this 
 may enter as a partial factor into many of the cases of 
 epilepsy which are classed in the order of " reflex " may 
 well challenge our consideration. Hare lays great stress 
 on the necessity of circumcision wherever there is an 
 indication of preputial local irritation. " If practicable, 
 circumcision should be performed; it is an operation 
 with but small risk or danger, and easy of performance. 
 In such circumstances it is always permissible to cir- 
 cumcise, were it for no other end than an acknowledged 
 attempt to reach a cure." 
 
CHAPTER XXYI. 
 
 Surgical Operations Performed on the Prepuce. 
 
 In operative interference tliere is one point which 
 should not be lost sight of, this being that the length 
 and bulk of the prepuce in a great measure depends on 
 the constriction at its orifice ; if the orifice is small, the 
 prepuce tight and inelastic, every erection, b}' putting 
 the penis-integument on the stretch, adds to its bulk, — 
 nature naturally trj- ing to make up the deficienc}', — the 
 two points of resistance being where the glans pushes 
 it ahead, having the constricting orifice for a hold or 
 purchase, and the skin at the pubes, which is called 
 upon to furnish the extra tissue for the time being 
 needed during erection, which should be supplied by the 
 pi-epuce — tliis being the onl}- ofiice which I have been 
 able to assign to this otherwise useless but ver}- mis- 
 chievous appendage. In cases where preputial irritation 
 produces more or less priapism, the continued stretching 
 of this integument causes a marked increase in its 
 growth, which is mostly added forward. It was on this 
 principle or its recognition, that Celsus devised his 
 operations, and on which the persecuted Jews under- 
 took to recover their glans by manufacturing a prepuce; 
 and, although the trial was not reported as being very 
 successful, I do not doubt but that, if the skin could have 
 been drawn sufficiently over so as to constrict it ante- 
 riorly so as to give the glans a purchase, as in the 
 case of phimosis with an inelastic prepuce, the opera- 
 tion could be more of a success; all that is required is 
 the continued extension and the prepuce might be made 
 (302) 
 
Surgical Operations Performed on the Prepuce. 303 
 
 to rival in length the labia majorse of the females of 
 some African tribes, or the pendulous buttocks of the 
 Hottentot Venus. 
 
 I have employed the knowledge of this elasticity 
 and source of supply of the penis-integument, on more 
 than one occasion, in recovering the denuded organ with 
 skin. A number of cases are on record where, owing 
 to the want of that artistic and mechanical knowledge 
 without which no surgeon is perfect, the operator 
 has drawn forward the skin too tight in circum- 
 cising, after which, owing to the natural elasticity of 
 th« skin, the integument has retracted, leaving the penis 
 like a skinned eel or sausage. This accident is even 
 liable to occur where the skin has not been tightly 
 drawn, but where subsequent erections have torn 
 through the sutures, and where the natural retraction 
 of the skin has laid the organ bare for some distance. 
 I liave seen a number so recorded, but do not remember 
 seeing any remedy suggested, it seemingly being ac- 
 cepted that the recovery must take place by gradual 
 granulation, — a necessaril}'^ "^'ery slow process, owing to 
 the constant interference by — the always present in such 
 cases — unavoidable erections. 
 
 Several years ago I advised circumcision to a gentle- 
 man owing to a contracted condition of the muscles of 
 one hip and thigh, which was threatening to render him 
 a deformed cripple; he had a congenital phimosis and a 
 very irritable glans penis. The operation was per- 
 formed in a proper manner by a surgical friend, but this 
 friend, unfortunately, was a great believer in antiseptic 
 and wet dressings. A few da3's after the operation he 
 called upon me to ask me to go and see the patient, as 
 they were both in a pickle, the patient being exceed- 
 ingly angr^^, being in constant miserj', and the penis so 
 
304 History of Circumcision. 
 
 denuded by the giving way of tlie sutures — owing to 
 the erections — that it looked to the patient as if he 
 never could have a whole penis again, and the doctor 
 saw no way out of the difficulty ; the penis was, in 
 reality, a dilapidated and sorrowful-looking append- 
 age, and anything else but a thing of beauty or pride ; it 
 was raw, angry -looking, and bleeding at every move; the 
 first wink of sleep was followed by an attempt at erec- 
 tion that raised the patient as effectually as an Indian 
 would in scalping him ; so that, taken altogether, the 
 penis, anxious countenance, and the flexed position of 
 the whole body to relieve the tension on the organ, 
 the man looked about as battered, cast down, and sor- 
 rowful as Don Quixote did in the gari'et of the old 
 Spanish inn, with his plastered ribs and demolished 
 lantern-jaw. 
 
 Luckily, the patient was seen before the retracted por- 
 tion of the penile integument had had acbance to condense 
 and indurate. The bed was slopping wet with the drench- 
 ings of carbolized water that the penis had undergone, 
 the man's clothing was necessarily damp, and the wliole 
 bedding and clotlies were steamy, — all of which greatly 
 added to his discomfort and tendency to erections. The 
 man was washed, placed in a new, clean, and dr}^ bed, 
 and his clothing changed. The organ was then forced 
 backward until the preputial frill or edge was approxi- 
 mated to the cut end of the penis-skin, where it was 
 made fast by an uninterrupted suture around the whole 
 of the circumference. A short catheter, about three 
 inches in length, — the catheter being as full size as the 
 urethra would comfortably hold, and of the best and 
 thickest of the red, stiff" variety, — was introduced into 
 the urethra. This protruded about half an inch be3'ond 
 the meatus. A stiff", square piece of card-board was 
 
Surgical Operations Performed on the Prepuce. 305 
 
 pierced and slipped over tliis, and then adhesive rubber 
 straps were brought from the integument to this little 
 platform, the first being from the median line of the 
 scrotum, lifting the sac forward and upward. The 
 pubes were shaved and the next four straps started 
 from the root of the penis, each strap being split at the 
 glans-end so as to encircle the protruding end of the 
 catheter. By these means the sk.m was brought back 
 and firmly supported over the penis, toward the glans ; 
 and, in case of any erection, the act would only assist 
 in drawing the covering farther over the penis, as the 
 pasteboard platform and adhesive straps formed the 
 distal end of an artificial phimosis. The catheter allowed 
 of free urination, and the scrotum was further held up 
 in position by a flat suspensorj'^ bandage passed under- 
 neath the scrotum and fastened over the abdomen neat 
 each hip. The penis wound was then dressed with a 
 very little benzoated oxide-of-zinc ointment passed 
 between the adhesive straps ; a bridge-supiwrt placed 
 over the hips to support the bed-clothes, and all was 
 finished, and full doses of bromide of sodium and 
 chloral were ordered at bed-time. When the dressings 
 were removed, five days afterward, all was healed, the 
 sutures removed, and the suspensory alone replaced. 
 The patient had not been troubled with any more erec- 
 tions or annoj'ances of any kind. These are the points 
 which often do more or less mischief : wet dressings are 
 uncomfortable and favor erections, while the effect of 
 the weight and action of the scrotum in drawing back- 
 ward on the integument should not be overlooked ; in 
 addition, it should not be overlooked that we have it in 
 our power to produce, so to speak, an artificial phimotic 
 action, which has the same traction on the penis-integu- 
 ment that the natural phimosis induces. 
 
306 History of Circumcision. 
 
 The foregoing method, to be used in these cases, has 
 proved \evy serviceable in my hands, and it is here given 
 that it nia}' assist others ; as there is no need of waiting 
 for granulations or of allowing the patient to undergo 
 so much miser}', which, besides the local injury, cannot 
 help but affect the general health very injuriously. The 
 penis can stand any amount of forcing backward ; it 
 stands tliis in cancer or hypertrophy of the prepuce, or 
 ill the inflammatory thickenings that precede gangrene 
 of the prepuce, in any extended degree ; becoming, for 
 the time being, more or less atrophied. As has been 
 shown by Lisfranc, the penis can be made nearly to dis- 
 appear into the pubes ; so that we are not as helpless in 
 these cases as our text-books would have us believe. 
 
 In infants, and in young children below the age of 
 ten or twelve, the Jewish operation, as modified and 
 done in accordance Avith the dictates of modern surgery, 
 will be found the most expedient. By this method we 
 avoid the need of any anaesthetic agents, which are 
 more or less dangerous with children, as Avell as the 
 need of sutures, which are painful of adjustment and 
 verv annoying to remove in those little fellows who 
 dread new harm ; there is also much less risk of haemor- 
 rhages, as the frenal artery is not wounded. In children 
 of a year or over, a very good result will be found often 
 to follow Cloquet's operation, care being taken to carry 
 the slitting well back, as well as care in taking it on one 
 side of the frenum, so as to avoid any wound of that 
 artery, the subsequent dressing being a small Maltese- 
 cross- bandage, pierced .so as to admit the glans to pass 
 through ; the prepuce is retracted and the tails folded 
 over each other and held there by a small strip of rubber 
 adhesive plaster ; a little vaselin prevents tlie soiling 
 by urine underneath. This last operation is short and 
 
Surgical Operations Performed on the Prepuce. 307 
 
 very easj^, is not painful, nor does it require much 
 manipulation ; it is only one quick cut on the grooved 
 director and it is over ; by the retraction of the prepuce, 
 the longitudinal cut becomes a transverse one, making 
 the prepuce wider and shorter at once ; the glans soon 
 develops and remains uncovered. As there is a very 
 small wound to heal over, the repair is very prompt. 
 
 In adults with a very narrow, thin, not overlong 
 prepuce, a very good result often follows a combination 
 of the dorsal slit with the inferior slit alongside of the 
 frenum of Cloquet, The narrower and tighter the pre- 
 puce, the better the result, as the cuts are at once con- 
 verted from longitudinal into transverse wounds, and 
 the organ at once assumes the shape and condition of a 
 circumcised organ, without having suffered any loss of 
 substance ; three' stitches or sutures in each cut (silver 
 or catgut) adjust the cut edges; a small roller of 
 lint and adhesive plaster, placed so as to shoulder up 
 against the corona, completes the dressing. Where this 
 operation is practicable, by the thinnes and narrowness 
 of the prepuce, it has many advantages. I have re- 
 peatedly performed it on lawyers, book-keepers, clerks, 
 and even laboring men, who have gone from the office 
 to the courts, counting-rooms, or stores without the 
 least resulting inconvenience or loss of time. In labor- 
 ers it is better to perform the operation on a Saturday 
 evening, which gives tliem a rest of thirty-six hours be- 
 fore going to their labor again. The operation is com- 
 paratively painless and almost bloodless, as there need 
 not be more than half a teaspoonful of blood lost during 
 the operation ; there is no danger of any subsequent 
 haemorrhage, and, with proper precautions against the 
 occurrence of erections, from seventy-two to ninety-six 
 hours is sufficient for a complete union ; the sutures are 
 
308 History of Circumcision. 
 
 then removed and a simple lint and adhesive-plaster 
 dressing worn for a few days more. In many, no more 
 dressings are required. In many cases, with a properly- 
 adjusted dressing, that comes forward underneath so as 
 to include the frenum,tiie simple dorsal slit is suflicient ; 
 but if any of the prepuce depasses the dressing under- 
 neath, it will puff and become (Edematous and require 
 frequent puncturing. To avoid it, it is better to make 
 the Cloquet slit at once. This operation is of no value, 
 and perfectly impracticable in a thick, pendulous pre- 
 puce. Absorption will often remove considerable pre- 
 putial tissue, but where there is too much its very bulk 
 interferes with its removal by an}^ natural means. 
 
 Dilatation is recommended by a number of surgeons, 
 but, I must admit, in my hands it has always proved a 
 failure ; it may be, that if the subsequent history of the 
 cases reported as so operated upon had been carefully 
 traced, the reports would not have been so good. 
 iS^elaton, whose dilating instrument is generally recom- 
 mended, seems, himself, to prefer some of the circum- 
 cising methods, as in the volume on '' Diseases of the 
 Geiiito-Urinary Organs," in his " Surgery," being the 
 sixth volume of the revised edition of 1884, by Despres, 
 Gillettte, and Horteloup, the subject of dilatation is dis- 
 missed in two short lines. St. Germain, of Paris, uses, 
 as has been before observed, a two-bladed forceps, used 
 after the manner of Nelaton, and reports good results. 
 Dr. J. Lewis Smith agrees in his statements with Dr. 
 St. Germain. Dr. Holgate, of New York, reports a like 
 experience. In my own practice the prepuce has often 
 been made temporarily \siX. and retractable, but with the 
 usual results of the return of the contraction, with a pos- 
 sible thickening of the inner fold, as a result of the inter- 
 ference ; so that only in case of any immediate demand, 
 
Surgical Operations Performed on the Prepuce. 309 
 
 where the tight prepuce is producing irritation, either 
 through pressure or adhesions, or retained sebaceous 
 matter, do I ever resort to dilatation ; always, however, 
 even then, not as a final operation, but merely as pre- 
 paratory procedure toward a future operation of a more 
 efficient order. 
 
 In cases of timid adults, who refuse all kinds of 
 operative interference, good results may be obtained by 
 the use of a mild lead-wash or cold tea-baths and the 
 introduction of flat laj^ers of dry lint interposed between 
 the prepuce and the glans ; this has a very good effect 
 in keeping the parts apart and dry, and may in time 
 produce a certain amount of dilatation ; but even when 
 this is done, unless it will render the foreskin sufficiently 
 loose to allow of its being kept finally back of the corona, 
 it is, after all, but a temporary makeshift. The corona 
 should be exposed and kept clear of the preputial cover- 
 ing ; anything short of this will not give all the good re- 
 sults to be desired. I have more than once performed 
 a secondary opera.tion on Jews, who had been imper- 
 fectly circumcised by not having the prepuce removed 
 sufficiently, and in whom the subsequent contraction 
 of the preputial orifice had re-covered part of the glans, 
 and only lately visited a four-year-old boy, circumcised 
 when eight days old, in whom the prepuce covered 
 half of the glans, the corona acting as a tractive point 
 from which the penile integument was being drawn for- 
 ward. In this case the simple pierced-lint Maltese cross 
 was used, with an adhesive band to hold the tails down 
 behind and around the penis just back of the corona. 
 
 These means, although not circumcisioft either in a 
 surgical or in the Hebraic religious sense, are, nevei'the- 
 iess, sufficient in a medical sense for all desired purposes ; 
 provided, however, that there is no resulting constric- 
 
310 History of Circumcision. 
 
 tion, or a mild condition of paraphimosis, back of the 
 corona, and that the whole of the glans is sufficiently un- 
 covered, and that no abnormal dog-ears are left to garnish 
 each side of the penis like an Elizabethan frill or collar ; 
 although Agnew holds that, in slitting, the practice 
 adopted by many of rounding oflf the corners is mostly 
 superfluous, as nature will do so itself in time. 
 
 The ordinary way of performing the operation by 
 modern surgeons is by what is known as the Bumstead 
 circumcision. It was not an invention of Bumstead, 
 but was adopted by him in preference to all others. 
 The requisites are a sharp-pointed bistoury, blunt- 
 pointed scissors, and a pair of Henry's phimosis forceps, 
 with fine needles and fine oculists' suture silk. The 
 penis is allowed to hang naturallj'' and the position of 
 the corona glandis marked on the outer skin with a 
 pen and ink, which is to serve as a guide for the incision. 
 The prepuce is now drawn forward until this line is 
 brought in front of the glans and grasped between 
 the blades of the forceps. The prepuce is now trans- 
 fixed, and, with a downward cut, that portion is severed ; 
 the knife's edge is now turned upward and the excision 
 finished. The forceps are now removed and the integu- 
 ment allowed to retract ; with the scissors the inner 
 mucous fold is now split along the dorsum and trimmed 
 oflT so as to leave about half an inch in front of the 
 corona. The parts are then brought together with the 
 continuous suture and dressed according to the fancy 
 of the surgeon. Care must be taken not to bruise the 
 parts with the forceps, as, in such cases, sloughing of the 
 sutured edges will be the result instead of union, I 
 have' seen this accident happen more than once, in one 
 case being followed by a penitis that seriously compli- 
 cated matters. 
 
Surgical Operations Performed on the Prepuce. 31 1 
 
 It has been in}^ practice to use fine silver-wire and 
 catgut sutures in all operations on the prepuce ; they 
 excite less suppuration as well as less irritation. In 
 case of need, the silver can be left in longer, and they 
 are much easier of removal than the silk ; besides, they 
 have the advantage of not cutting. In the after-treat- 
 ment the same general plan can be followed as with any 
 amputated stump, except that it must not be forgotten 
 that at the end of this organ dwells what has been 
 termed the sixth sense, and that heat and moisture are 
 very apt to awaken the dormant energies of the organ, 
 even after it has undergone cruel mutilation, and even 
 has suffered considerable loss of blood ; for that reason 
 it is best always to avoid wet or sloppy dressing, or too 
 much ointment, as thej- are more apt to cause erection 
 than to do any good. Besides, I find water does here, 
 as elsewhere, interfere with the deposited plastic matter, 
 properly organizing into cicatricial tissue ; so that I 
 prefer a snug, dry dressing, which is left on for four or 
 five daj^s without being interfered with, and light cover- 
 ing, plain diet, quiet, with fifteen grains each of bromide 
 of sodium and chloral hydrate at bed-time to insure rest 
 and freedom from annoying erections. Where the organ 
 is large in its flaccid state, it is better to support it on 
 a small oakum-stuffed pillow, made for the purpose, than 
 to let it hang downward. Should the stitches give way 
 and the skin tend to retract, the plan proposed on a 
 previous page can be followed to advantage. In uri- 
 nating, care must be taken not to soil the dressings ; 
 some patients are very careless about this if not warned. 
 The penis should hang nearly perpendicular while in the 
 act, and all dribbling should have ceased and the meatus 
 and underneath be mopped dry with some soft cotton 
 before raising the organ ; nothing so irritates the parts, 
 
312 History of Circumcision. 
 
 retards union, or is more offensive than a urine-saturated 
 dressing. 
 
 Dr. Hue, of Rouen, uses an elastic ligature, which 
 he introduces into the dorsal aspect of the prepuce by 
 means of a curved needle. This he ties in front, and in 
 three or four days it cuts its way through. Although 
 Hue reports a large number so operated upon, the tedi- 
 ousness of the procedure and the swelling and oedema, 
 as well as the active pain that must necessarily accom- 
 pany the operation, will hardly recommend the ligature 
 in preference to the incision by the knife. 
 
 Dr. Bernheim, the surgeon of the Israelitish Consis- 
 tory of Paris, has operated on over eleven hundred cir- 
 cumcisions, besides the cases of phimosis occurring in his 
 general practice. His opinion of the procedure of M, de 
 Saint-Germain by dilatation is not favorable. He has em- 
 ployed it in a number of cases of phimosis, at the time 
 unfit for a more radical operation. He has, however, 
 observed that cicatricial thickenings and recontractions 
 are very apt to occur, and, as to the septic accidents 
 mentioned in connection with circumcision, he has noted 
 that they are as liable to occur in hands that are as 
 careless and slovenly with what they do with their 
 dilating forceps as they are with what they do with their 
 bistouries. Dr. Bernheim prefers the circumcision for- 
 ceps of Ricord, as modified by M. Mathieu. This 
 instrument he prefers by reason of its gentler pressure, 
 which, at the same time, is all-sufficient to properly fix 
 the prepuce. In applying the forceps, he includes as 
 little as possible of the lower part, keeping away as 
 much as possible from the frenic artery. The dorsum 
 of the inner fold he cuts with the scissors. In children 
 under two years of age, he simply turns this back over 
 the free edge of the integument ; in children over two 
 
Surgical Operations Performed on the Prepuce. 313 
 
 years of age, be uses serres-fines. In children, he uses 
 a piece of lint .dressing steeped in a water}^ solution of 
 boracic acid ; in adults, he uses iodoform-gauze dress- 
 ings. He finds cases unite in from three to ten days. 
 Dr. Bernheim warns us against using antiseptics on 
 infants or young children, in connection with the after- 
 dressing of circumcision. Neither plienic acid, cor- 
 rosive sublimate, nor iodoform are well borne by these 
 young subjects, and he has seen serious results follow 
 upon as light an application as a^^g^ solution of phenic 
 acid. In a number of cases he reports operating with 
 the galvano-cautery of Chardin, instead of the knife. 
 These operations were bloodless, and cicatrization was 
 as rapid as when the knife was used. He has in several 
 cases operated by the dorsal incision, owing to disease 
 of the prepuce not allowing any other operation. 
 
 In France, the Bumstead operation is known under 
 the title of Ricord's procedure. Lisfranc, Malapert, M. 
 Coster, and Yidal all have operations which are not as 
 useful as Ricord's, and have not, therefore, come into 
 general use. M. Sedillot condemns the dorsal incision 
 as leaving two unsightl}' -looking flaps. The reverse, or 
 Inferior incision of M. Jules Cloquet is likewise not in 
 favor with either Malgaigne or Ricord. This inferior 
 incision or section, alongside of the frenum was first 
 advised by Celsus. M. Cullerier contented himself with 
 slitting the inner preputial fold, longitudinally, from its 
 junction with the skin backward to the corona. M. 
 Chauvin, by the aid of a complicated instrument with 
 barbed points, drew out the mucous fold as far as pos- 
 sible before excising. 
 
 There is something unaccountable in the difference 
 in results that various operations give in the hands of 
 diflferent surgeons. It must be that all methods are 
 
314 History of Ci7'Cumcision. 
 
 correct with properly-chosen cases and when properly 
 performed, as well as properly looked after subsequently 
 to the operation. It must not be expected, however, 
 that, in operations where the kindl}- assistance of nature 
 is a thing contemplated in absorbing superfluous tissue, 
 the case will at once give satisfaction to all. These 
 cases must have the required time before judgment can 
 be passed upon the merits of the operation, just as 
 required time in cases of dilatation or in the method of 
 M. Cullerier will often demonstrate that the benefits are 
 but transient, and that often even cases that have been so 
 operated upon will require a complete circumcision, a la 
 Ricord or a la Bumstead, owing to the resulting thick- 
 ening induration and overconstriction, when, if left 
 alone, the dorsal slitting or the inferior incision of 
 Cloquet would have previously given satisfactory 
 results. 
 
 The final cosmetic results in the combined Cloquet 
 and dorsal-slit operation, for instance, depend on, first, 
 properly choosing the case. One on whom the operation 
 is unadaptable it is useless to attempt it on, as a future 
 circumcision or tedious and annoying re-operation of 
 trimming would be required. The next care is to prop- 
 erly cut through all constricting bands, wliicli, like 
 fine, tough strings, will be found to encircle the penis. 
 These must be carefully clipped with a fine pair of 
 strabismus scissors, as these bands do not give way, 
 either then or afterward, of their own accord, but form 
 the nucleus for stronger constricting bands for the 
 future. Then 3'Ou must be sure to cut far enough back, 
 either above or below, until j^ou have reached where 
 you obtain the normal and largest calibre of circumfer- 
 ence of the penis. The adaptation of the edges of th6 
 parts and the proper application of a smooth, equal press- 
 
Surgical Operations Performed on the Prepuce. 315 
 
 lire, by means of the lint strap, is of the next impor- 
 tance ; and then comes the strapping of the whole surface 
 for about an inch and a half back of the corona, which 
 should and must include all the tissues of the preputial 
 part of the frenum. A neglect or careless perform- 
 ance of any of the details, or the carelessness of the 
 patient in not keeping the dressing clean, necessitating 
 its change before the fourth day, all tend not only to 
 interrupt the union, but to mar the future cosmetic re- 
 sults as well. It may be asked why all this care and 
 trouble, and not circumcise at once ? As already ob- 
 served, this operation admits of the patient following 
 his business ; whereas circumcision, on the male, will 
 assuredly lay him up for four or five days, and perhaps 
 ten days, — something that many, be they rich or poor, 
 cannot afford, and will not submit to. 
 
 The cosmetic condition of the penis as a copulating 
 organ is a thing of some importance, and this should 
 not be overlooked ; for, although the particular dimen- 
 sion, shape, or peculiarity of the penile end never figures 
 prominently in the complaints of women who apply for 
 divorce, — the charges being everything else under the 
 sun, — it can safely be assumed that this organ and its 
 condition is the original, silent and unseen, as well as un- 
 conscious power behind the throne that is at the bottom 
 of the whole business in more than one case. Like the 
 fable of the poor lamb that the wolf wished to devour: 
 the real reason of his wishing to kill him was that he 
 might eat him, the pretext set "forth by the wolf that the 
 lamb had encroached on his pasture, muddied his brook, 
 or kept him awake by his bleating having been dis- 
 proven by the lamb. Besides, it is well not to leave 
 any distinctive or distinguishing mark, like an indi- 
 vidual baronial crest, on the head of the organ. 
 
316 History of Circumcision. 
 
 To return, however, to the operative procedures, we 
 find that Dr. Yanier finds that the operation of Cloquet 
 by incision alongside of the freniim has the advantage 
 of not leaving an}^ deformity — contrary to tbe opinion 
 of Ricord and Malgaigne. He, in fact, holds this pro- 
 cedure in such high esteem that he considers that Clo- 
 quet deserves great credit for reviving this old Celsian 
 operation. H. H. Smith, in his " Operative Surgery," 
 coincides with Yanier in his favorable opinion of this 
 method, as he there saj'S : " Frequent opportunities of 
 testing the advantages of the plan of Cloquet having 
 satisfied me of its value, I do not hesitate to recommend it 
 as that best adapted to the adult, because it fuU}^ exposes 
 the glans and leaves little or no lateral deformit}', as is 
 frequently the case with the dorsal incision," — an opin- 
 ion that I can fully agree with, from the results of the 
 same operation in my liands, although I have used the 
 method even on infants. Yanier does not approve of 
 the dorsal incision unless it is made V-shai3ed, as it 
 otherwise leaves the unsightly lateral flaps, but thinks 
 well of the modification of Cloquet's practiced by M. 
 Yidal de Cassis, which is performed in the following 
 manner : The patient stands before the operator, who 
 remains sitting ; the operator seizes the prepuce on its 
 dorsum and draws it toward him ; he then introduces a 
 narrow, sharp-pointed bistoury, with its point armed 
 with a small waxen bullet, down alongside of the 
 frenum until he reaches the pouched extremity of the 
 preputial cavity at this point ; the point of the bistoury 
 is now made to transfix the waxen bullet and out 
 through the skin, which from this point is divided from 
 behind forward. Yanier very sensibly suggests that the 
 operation that is effectual, and wliich can be accom- 
 plished in the least number of movements or temps, as 
 
Surgical Operations Performed on the Prepuce. 317 
 
 being the least likely to cause extensive pain and agon}-, 
 should be the one preferred, and that the aim of the 
 surgeon should be to simplify the operation hy reducing 
 the number of necessary movements. For this reason, 
 where an excision of considerable amount of tissue is 
 required by the nature of the case, he prefers another 
 operation, performed by Lallemand, — that of making a 
 dorsal transfixion and cutting off the two lateral flaps, 
 which can all be done in three movements. 
 
 It makes but little difference as to which operation 
 is performed on the adult, but that the subsequent 
 dressing will exercise a good or evil influence, and 
 greatly assist not only in the present comfort or dis- 
 comfort of the patient, but in the ultimate result as 
 well. Bearing these points in view, Charles A. Ballance, 
 of St. Thomas's Hospital, has adopted the following 
 procedure : — 
 
 "When the patient is etherized, the outline of the 
 posterior border of the glans is marked on the skin 
 with an aniline pencil. The skin of the prepuce is slit 
 and removed up to the aniline line. The mucous mem- 
 brane is next cut away, leaving only a free edge of about 
 one-eighth of an inch in width. Any bleeding which- 
 occurs should be entirely arrested, and asepsis must be 
 insured by frequent sponging with carbolic or sublimate 
 solution. Numerous coarse-hair stitches are then in- 
 serted;, so as to bring accurately together the fresh-cut 
 edges of the skin and mucous membrane, and subse- 
 quently, after a further sponging and dr3'ing, a piece \)f 
 gauze two laj'ers of thickness, and wide enough to reach 
 from the root of the penis nearly to the meatus, is 
 wrapped loosely around the penis and secured by several 
 applications of the collodion-brush. The setting of the 
 collodion is hastened by the use of a fan, so that the air 
 
318 History of Circumcision. 
 
 is kept in motion, and the patient should not be allowed 
 to recover from the ansesthetic until the dressing is quite 
 firm and hard. This dressing forms a carapace for tiie 
 penis, protecting it from the bedclothes and effectually 
 preventing the anno3'ing and distressing erections. Mr. 
 Ballance reports excellent results from this dressing." 
 (Braithwaite's Retrospect^ J"ly, 1888.) 
 
 In applying the above dressing, the shrinking inci- 
 dent to the drying of the collodion must not be over- 
 looked, and the gauze layers must be loosely applied, as 
 they would otherwise become too tight. The dressing 
 is a very ingenious and serviceable one. 
 
 Mr. A. Gr. Miller, at a meeting of the Edinburgh 
 Medico-Chirurgical Society, reported a new method of 
 dressing after circumcision. " It consisted in first closely 
 suturing the skin and mucous membrane by numerous 
 catgut sutures, then painting the surface with Friar's 
 balsam and covering it over with two or three layers 
 of cotton wadding, on which the balsam is poured. The 
 glans penis was left sufficiently free to allow of water 
 passing. The band or ring of dressing should be at 
 least one inch broad. The dressing was not suitable 
 for young infants who were frequently wetting. In the 
 case of older children, they might be allowed to go 
 about on the second or third day, when the dressing 
 would be quite dry, and would not be I'equired to be 
 changed or renewed." (Braithwaite's i?e<rospecf, Januar}^, 
 1888.) 
 
 Any constricting or immovable and inelastic dress- 
 ing is subject to the same objections as plaster-of-Paris 
 dressings in thigh-fractures, — that of being dangerous 
 and not expedient, unless the patient is constantly 
 under your eye. 
 
 Dr. Neil Macleod, in the Edinburgh, Medical Journal 
 
Surgical Operations Performed on the Prepuce. 319 
 
 for March, 1883, advises a procedure that has alwa3's 
 looked favorably to me, and which I once put in prac- 
 tice through the means of the ordinar_y ptosis fenes- 
 trated forceps, in place of the ordinary circumcision 
 forceps, the sutures being introduced through the fenes- 
 tra and the prepuce cut off on the outer side of the 
 forceps, the thickngss of the steel arm on the outer side 
 of the fenestra allowing of the properly-sized border 
 for the hold of the sutures. Dr. Macleod places his 
 sutures all in position before making any incisions, — a 
 procedure which will be found to save the patient con- 
 siderable pain ; as with many the seizing and holding of 
 the edges of the skin and mucous membrane and the 
 forcible pressure exerted by the fingers or forceps while 
 the needle is being forced through is the most pain- 
 ful part of the operation. In doing this, care must 
 be taken to allow sufficient length to each thread to 
 make two sutures, as well as care must be taken to 
 properl}' pull out the thread in the centre between the 
 four folds of tissue and to cut it equidistant, after the 
 ablation of the prepuce, a blunt hook being used to fish 
 up the threads from the preputial opening. 
 
 Erichsen favors the Jewish operation in young chil- 
 dren, as being the easiest and safest of performance. 
 Slitting, or the inferior or superior incision, he thought, 
 left too much of the prepuce, which, wherever there is a 
 tendency to phimosis, should be entirely removed, " with 
 a view of preserving the health and cleanliness of the 
 parts in after life." In the phimosis that is acquired by 
 old men, he found dilatation with a two-bladed instru- 
 ment to be sufficient, provided the indurated circle was 
 made to yield. For the circumcision of adults he has 
 invented an adjustable shield, something like the Jewish 
 spatula, with which he protects the glans. 
 
320 History of Circumcision. 
 
 Gross (the elder) used both slitting on the dorsum 
 and circumcision. He found neither objection nor 
 deformity in the flaps left by the dorsal incision, as 
 thej' were only temporarj^ ; in some cases, he simply fol- 
 lowed the practice of Cullerier, of making multiple slits 
 in the constricting and inelastic mucous membrane. 
 
 Agnew believes in circumcision in the treatment of 
 reflex troubles. He relates a case, in the second volume 
 of his " Surger}^," of eczema extending over the abdo- 
 men, of over a year's standing, cured in a child by cir- 
 cumcision ; he operates by incision on the dorsum, in 
 which he leaves nature to make away with the flaps, or 
 he circumcises by the Bumstead method. 
 
 Yan Buren and Ke3res recommend both the incision 
 on the dorsum and the operation of Ricord ; where the 
 mucous membrane alone is tight and constricted, they 
 follow Cullerier's method of either single or multiple 
 incisions of the inner coat. They Lny great stress on 
 the necessity of keeping the patient quietly in bed. to 
 insure rapid and complete union. 
 
 My friend, Dr. Robert J. Gregg, of San Diego, has 
 lately operated on a number of cases, the operation 
 being perfectly painless, the little patients submitting 
 to it and feeling no more pain than if it were having its 
 toe-nails trimmed, the local anjesthesia being produced 
 by the hj-podermatic injection of cocaine. This pro- 
 cedure is now used to a considerable extent throughout 
 the country, and it is a far safer and more comfortable 
 performance than either etherizing or cliloroforming, as 
 the sudden and spasmodic filling of the lungs of young 
 children — who will resist and hold their breath for a 
 long time, then suddenly inhale — with aufesthetie vapor 
 is almost unavoidable, having in two instances nearly 
 lost two children from such an accident. 
 
Surgical Operations Performed on the Prepuce. 321 
 
 Dr. Gr. W. Overall, in a late Medical Record^ wbicli 
 is quoted in the Journal of the American Medical Asso- 
 ciation of February 21, 1891, gives the description of a 
 very good and painless method of producing this local 
 anaesthesia; for it need hardly be said tliat with a 
 nervous, irritable child the introduction of the h3'poder- 
 matic needle is as formidable an operation as either 
 slitting or the Jewish operation. Dr. Overall is in the 
 habit of holding a solution within the preputial cavity 
 and then to introduce the needle in the mucous fold, 
 having previously applied a light rubber band back of 
 the corona, on the outer integument, so as to act like a 
 tourniquet and limit the action of the anaesthetic effect 
 to the prepuce. By this procedure he avoids all pain 
 and the operation can be performed while the child is 
 even amusing itself, care being taken that it does not 
 see it. Sutures that require removal should not be 
 used, according to the Doctor, and the operation thereby 
 becomes a perfectl}'' painless and unalarming perform- 
 ance to the patient in all its details. ^ 
 
NOTES TO TEXT. 
 
 1. " Letters of Certain Jews to Monsieur Voltaire, Containing an Apology 
 
 for their own People." Pages 451-476. Translated by Dr. Lefann. 
 Philadelphia, 1848. 
 
 2. "CirconcisionchezlesEgyptiens." Brochure by F. Chabas. Paris, 1861. 
 
 3. "Atlantis." By Ignatius Donnelly. P£tge 472. 
 
 4. Ibid., page 115. 
 
 5. Ibid., page 234. 
 
 6. Ibid., page 178. 
 
 7. "Circumcision." A. B. Arnold. New York Med. Record, Feb. 13, 1886. 
 
 8. "Atlantis," page 178. 
 
 9. This word is, in the Mandan, Maho-peneta ; in the Welsh, Mawr- 
 
 pencethir. "Atlantis," page 115. 
 
 10. "Cyclopedia of Biblical, Theological, and Ecclesiastical Literature," 
 
 vol. viii. page 58. Article, Phallus. 
 
 11. "Origine, Signification et Histoire, de la Castration, de I'eunuchism, et 
 
 la circoncision." Par. F. Bergmann. Published in the " Archivio per 
 le Tralditione Populaire," 1883. 
 
 12. " Dictionaire des Sciences Medicales." Par une Societe de medecins et 
 
 de Chirurgiens. Paris, 1826, 60-volume edition. 
 
 13. Dr. Delange mentions a peculiar social habit or custom among a tribe 
 
 of Arabians that in a sociological sense is worth mentioning. He 
 observes that for these dances females are preferred, but owing to 
 the peculiar habit about to be related it is impossible to have any of 
 the village women in Algeria assist at this part of the festivities ; 
 hence the men have to do the dancing. It appears that the females 
 of one tribe— this being the tribe of Ouleds-Nails, who live on the 
 southern borders of Algiers— are in the habit, when young, of emi- 
 grating to the oases of the Sahara, which are occupied by the French 
 and traveling Arabs, where they give themselves up to a life of 
 prostitution. After having exercised this life for some years they 
 return to the tribe with a dowry in money, besides an ample supply 
 of clothes and jewelry,— the result of their economy,— which enables 
 them to contract favorable marriages. This practice is so common 
 in this one particular ti-ibe, and so much have they monopolized the 
 profession of courtesan, that the name of the tribe of Ouleds-Nails is 
 in Arabia synonymous with that of courtesan. These young women 
 dance every evening in the Arab cafes, and are At times employed 
 to do the dancing at Arab feasts. For this reason no self-respecting 
 Arab woman ever allows herself, to dance in public, or why the 
 practice of both sexes dancing together is not practiced in Algerian 
 villages, as a man would thereby consider himself disgraced. — Dr. 
 Delange, in Receuil de Memrdres de Medecine de Chirurgie et de 
 Pharmade Militaire, No. 105, August, 1868. 
 
 (323) 
 
324 Notes to Text. 
 
 14. "Tractatus, Albert! Bobovii, Turcarum Imp. Moliammedis IV olim 
 
 Interpretis piimarii, De Turcarum Liturgia, peregrinationeMeccana, 
 Circumcisione, ^grotorum Visitatione," etc. Oxonii, 1690. 
 
 15. Michel L.e Feber. " Le Theatre de la Turquie." Paris, 1681. 
 
 16. "La Circoncisiou, Sa Si giiiti cation Social et Religieuse." Par M. Paul 
 
 Lafargue, in the Bulletins de la Societe d' Anlhropologie de Paris. 
 Tome X, 3d fascicule, Juin a Octobre, 1887. 
 
 17. "Circumcision." By A. B. Arnold. NewYork Med.Record,¥e\y.\i,V^. 
 
 18. Bancroft's " Native Races," vol. ii, page 278. 
 
 19. " Recherches Philosophiques sur les Americains, ou Memoires Inter- 
 
 essants pour servir a I'Histoire de I'Espece Humaine." Par M. 
 de P. Edition par Dom Pernety. Tome ii. Article, Circoncision. 
 Berlin, 1774. 
 
 20. " The Family, a Historical and Social Study." By Charles Franklin 
 
 Thwing. Boston, 1887. 
 
 21. The "Recherches Philosophiques sur les Americains" and Virey, in the 
 
 24th volume of the "Dictionaire des Sciences Medicales," are very 
 full on this subject, and for fuller information the reader is referred 
 to those works. 
 
 22. " Cause Morale de la Circoncision des Israelites, Institution Prevent- 
 
 ive de rOnanisme des Enfants." Par le Docteur Vanier, du Havre. 
 Paris, 1847. 
 
 23. "Annual Report of the Bureau of Ethnology." By J. "W. Powell. 
 
 Washington, 1881, 1882. 
 
 24. "Among Cannibals, or Four Years' Travels in Australia." By Carl 
 
 Lumholtz. Page 46. Charles Scribner & Son, 1889. 
 
 25. These interesting historical facts in relation to the holy prepuce were 
 
 published in the Journal V Exconimunier in January of 1870, when 
 the writer was in France. They were contributed by A. S. Morin, 
 of Miron, a learned historiographer and antiquary. Europe has not 
 recovered from its love of the supernatural tliat it had so strongly 
 in the middle ages. The blood of St. Gennaro still liquefies once a 
 year, and many churches still claim to possess the identical winding 
 slieet that served our Lord prior to his resurrection, as well as more 
 than one church has the holy cloth that St. Veronica used on the 
 way to Calvary, which has an impression of the face of the Saviour. 
 
 26. This church has a remarkable history connected with its foundation. 
 
 The tradition relates that in the dark ages some sacrilegious soldier 
 had robbed a church in the neighborhood of its holy vessels of gold 
 and silver. In the vessel in the Tabernacle there happened to be a 
 consecrated wafer. The soldier journeyed on to Turin to dispose 
 of his plunder, when, on arriving at the spot on which the church 
 now stands, the wafer is said to have ascended miraculously to some 
 distance above the soldier's head, while at the same time the mule 
 he rode, being imbued with more religious piety than his master 
 reverently knelt down on his front legs. The holy wafer was now 
 encircled by a halo of shining light ; this, with the kneeling donkey 
 and the soldier raining blows on the pious animal, while he himself 
 was unconscious of the presence of the host above him, attracted 
 the attention of the populace, who apprehended the soldier, on 
 whom the stolen vessels were found. The bishop in his pontiflcial 
 robes, in solemn procession, received the consecrated wafer, which 
 promptly descended into pious hands. The donkey was adopted by 
 
Notes to Text. 325 
 
 the bishop and the soldier was promptly hanged, in accordance with 
 the general treatment of thieves in those days. The writer has more 
 than once seen a flagstone inclosed within a railing that occupies 
 the central spot of the floor or pavement of the church, it being the 
 identical spot on which the donkey knelt. 
 
 27. Rush's " Medical Inquiries," vol. i, page 217. 
 
 28. Fothergill. " Gout in its Protean Aspects," page 158. 
 
 29. "Philosophy of Magic," from the French of Eusebe Salverte, vol. ii, 
 
 page 143. 
 
 30. " Dictionaire des Sciences Medicales." Cullerier. Article, Phimosis. 
 
 Vol. xli. 
 
 31. Bergmann has gone into this subject at length, and the writer has 
 
 drawn freely from his brochure on "Castration and Eunuchism," 
 reprinted from the " Archivio per le Traditione Populaire" of 1883. 
 
 32. "The Hermit." By the Rev. Cliarles Kingsley. See Introduction. 
 
 33. "Dictionaire des Sciences Me'dicales," vol. li v, page 570. 
 
 34. Ibid., page 567. 
 
 35. Ibid., page 570. 
 
 36. "Cyclopedia of Biblical, Theological, and Ecclesiastical Literature," 
 
 Vol. iii, page 351. 
 
 37. Smollett gives a good account of the Carthagena expedition in his 
 
 "Roderick Random," and for a good satisfactory detail of the 
 blundering Walcheren expedition the reader is referred to Harriet 
 Martineau's "History of England," vol. i, pages 269, 272, 273, and 354. 
 
 38. Schoopanism, or paederastia, is at times practiced by the Omahas, and 
 
 the man or boy who suffers as the passive agent is called min-qnga, 
 or hermaphrodite.— "Third Annual Roport of the Bureau of Eth- 
 nology." By J. W. Powell. Washington, 1881, 1882. 
 
 39. "When the missionai-ies first arrived in this region they found men 
 
 dressed as women and performing women's duties who were kept 
 for unnatural purposes. From their youth up they were treated, 
 instructed, and used as females, and were even frequently publicly 
 married to the chiefs or great men. — Bancroft's works, vol. i, 
 "Native Races," page 415. 
 
 40. " Recherches Philosophiques sur les Americains," tome ii. 
 
 41. "The History of the Hebrew Commonwealth." From the German of 
 
 John Jahn, D.D. Page 25. Oxford, 1840. 
 
 42. " L'Hermapbrodite devant le Code Civil." Par le Docteur Charles 
 
 Debierre. Bailliere et Fils. Paris, 1886. 
 
 43. "Recherches Philosophiques sur les Americains," tome ii, page 78. 
 
 44. " L'Hermapbrodite devant le Code Civil." Debierre. 
 
 45. Occidental Medical Times, Sacramento, Cal., October, 1890, page 543. 
 
 46. "Dictionaire des Sciences Medicales," vol. xxxi, page 41. 
 
 47. British and Foreign Medico-Chirurgical Review, vol. xviii, 1856. 
 
 48. " L'Hermaphrodite devant le Code Civil." Debierre. 
 
 49. Sir Thomas Brown's works, vol. ii, " Religio Medici." 
 
 50. " The Bible and other Ancient Literature in the Nineteenth Century." 
 
 L. T. Townsend, D.D. Chautauqua press, 1889. See pages 32-45. 
 
 51. "The Religions of the Ancient World." George Rawlinson, M.A. 
 
 Alden edition of 1885. Page 174. 
 
 52. "The Intellectual Development of Europe." John W. Draper. Vol, 
 
 ii, page 113. 
 
 53. Ibid., vol. ii, page 122. 
 
326 Notes to Text. 
 
 54. In "Clarke's Commentary," vol. i, page 113, the reason of choosing 
 
 the eighth day is given. Circumcision was not only a covenant, but 
 an ottering to God ; and all born, whether human or animal, were 
 considered unclean previous to the eighth day. Neither calf, lamb, 
 or kid was offered to God until it was eight days old. — Lev., xxii, 27. 
 
 55. A father circumcised his children and the master his slaves. In case 
 
 of neglect the operation was performed by the magistrate. If its 
 neglect was unknown to the magistrate, then it became the duty of 
 the Hebrew, upon arriving of age, to either do it himself or have it 
 done. — "Clarke's Commentary," vol. i, page 113. 
 
 56. Bishop Newton points out the remarkable analogy that marks the 
 
 Hebrew race as descendants of Isaac and the Arab race as the de- 
 scendants of Ishmael, from whom sprung the Saracenic people. 
 These are the only two races that have gone on in their purity from 
 their beginning. They intermarry only among themselves and have, 
 alike, the same customs and habits as their fathers. The sculptured 
 faces of the Hebrew on the Babylonian monuments are the same 
 faces that are met in the synagogues of Paris or New York. So 
 with the descendants of Ishmael, in whom there flows partly the 
 blood of the dominant element of ancient Egypt ; neither custom, 
 habit, nor physiognomy have changed. In these two races, as ob- 
 served by Bishop Newton, we have an ocular demonstration of the 
 Divine origin of our faith, if verification of Scripture history is any 
 criterion. — "Clarke's Commentary," vol. i, page 114; also, Hosmer's 
 " Story of the Jews," page 5. 
 
 57. " Cause Morale de la Circoncision." Vanier, du Havre. Pages 40-45. 
 
 58. " De la Circoncision." Par le Dr. S. Bernheim. Page 7. Paris, 1889. 
 
 59. "Cyclopedia of Biblical, Theological, and Ecclesiastical Literature," 
 
 vol. ii, page 350. 
 
 60. Among the Semitic race, however, it seems possible to bring forward 
 
 better evidence than this of an early Stone Age. If we follow one 
 way of translating we find, in two passages of the Old Testament, 
 an account of the use of sharp stones or stone knives for circum- 
 cision, — Exodus, iv, 25: "And Zipporah took a stone"; and Joshua, 
 V, 2: "At that time Jehovah said to Joshua. Make thee knives of 
 stone." .... The Septuagint altogether favors the opinion that 
 the knives in question were of stone, by reading, in the first place, a 
 stone or pebble, and, in the second, stone knives of sharp-cut stone. 
 These are mentioned again in the remarkable passage which follows 
 the account of the death and burial of Joshua (Joshua, xxiv, 29, 30), 
 — "And it came to pass, after these things, that Joshua, the son of 
 Nun, the servant of Jehovah, died, being a hundred and ten years 
 old, and they buried liim in the- border of his inheritance in Tiranath 
 Serah, which is in Mount Ephraim, on the north side of the hill of 
 Gaash." Here follows, in the LXX, a passage not in the Hebrew 
 text, which has come down to us : " And there they laid with him in 
 the tomb, wherein they buried him there, the stone knives where- 
 with he circumcised the children of Israel at the Gilgals, when he 
 led them out of Egypt, as the Lord commanded. And they are there 
 unto this day." The rabbinical law, in connection with this subject, 
 reads as follows : " We may circumcise with anything, even with a 
 flint, with crystal (glass), or with anything that cuts, except with 
 the sharp edge of a reed, because enchanters made use of that, or it 
 
Notes to Text. 327 
 
 may bring on a disease ; and it is a precept of the wise men to cir- 
 cumcise with iron, whether in tlie form of a knife or scissors, but it 
 is customary to use a knife." This mention of the objectionable na- 
 ture of the reed as a circumcising medium is attributed to the dan- 
 ger that may arise from splinters. The Fiji Islanders use both a 
 rattan knife and a sharp splinter of bamboo in performing circum- 
 cision and in cutting the umbilical cord at child-birth. Herodotus 
 mentions the use of stone knives by the Egyptian embalmers. Stone 
 knives were supposed to produce less inflammation than those of 
 bronze or iron, and it was for this reason that the Cybelian priests 
 operated upon themselves with a sherd of Samian ware (Samia 
 testa), as thus avoiding danger. There seems, on the whole, to be a 
 fair case for believing that among the Israelites, as in Arabia, Ethi- 
 opia, and Egypt, a ceremonial use of stone instruments long sur- 
 vived the general adoption of metal, and that such observances are 
 to be interpreted as relics of an earlier Stone Age. — "Researches 
 into the Early History of Mankind." By Edward B. Tylor. Pages 
 217-220. London, 1870. 
 
 61. The cannibals of Australia do not eat white people, as the flesh of 
 
 these produces a nausea, which the flesh of the vegetable-fed blacks 
 does not do. The rice-fed Chinese arc considered a treat, and these 
 are slaughtered in great number, ten Chinamen having been served 
 up at one dinner. — "Among Cannibals." By Carl Lumholtz. Page 
 273. 
 
 62. "Cause Moral de la Circoncision." Par le Dr. Vanier. Page 266. 
 
 63. Ibid., page 288. 
 
 64. Cincinnati Clinic, vol. ii, page 165. 
 
 65. "The Story of the Jews." Hosmer. Page 263. 
 
 66. "Traite d' Hygiene, publique et privee." Michel Levy. 2d. edition, 
 
 vol. ii, page 754. 
 
 67. Ibid. 
 
 68. "Diseases of Modem Life." B. W. Richardson. Page 19. 
 
 69. "Longevity and other Biostatic Peculiarities of the Jewish Race." 
 
 By John Stockton Hough, M.D. New York Med. Record, 1873. 
 
 70. "Vital Statistics of the Jews." By Dr. John S. Billings. North, 
 
 American Review, No. 1, vol. 152, page 70, January, 1891. 
 
 71. " On Regimen and Longevity." By John Bell, M.D. Page 13. 
 
 72. British and Foreign Medico-Chirurgical Review, vol. xliii, page 539. 
 
 73. Ibid., vol. xlii, page 17. 
 
 74. In "Influence of the Trades on Health," Thakrah mentions the pecu- 
 
 liar exemption enjoyed in this regard by the butcher class. He 
 quotes Tweedie in saying that he never saw a butcher admitted to 
 the fever hospital. 
 
 75. Lancereaux. " Distribution de la Phthisic Pulmonaire." 
 
 76. Ashhurst. "Int. Enc. Surgery." 
 
 77. Horner. " Naval Practice." 
 
 78. Cincinnati Lancet and Observer., vol. xvi, 1873. 
 
 79. It may well be a question of some interest whether the atrophy of the 
 
 testicle in the aged may not at times be partly due to the compres- 
 sion exercised by the prepuce on the glans through reflex action, 
 and whether at times the virility that is departing cannot be restored 
 by circumcision in such cases. I have seen such results, being guided 
 to the idea by the Biblical relation in the case of Abraham. 
 
328 Notes to Text. 
 
 80. This patient subsequently died of a uraemic complication following 
 
 on an attack of fever. The man was in his prime, and had been of 
 most exemplary habits. The fever that he had was, I had every 
 reason to believe, directly due to the results of imperfect blood de- 
 puration incident on the irritability of his kidneys, which, retroact- 
 ively, again allowed the uraemic condition to assume that dangerous 
 degree that suddenly and very unexpectedly to his friends and 
 family ushered the patient into eternity. This man had only been 
 merely inconvenienced by his prepuce up to the time that it cai;sed 
 his death. It is interesting to observe what little trifles bring about 
 the end of some men. The unlucky habit of putting the royal 
 countenance on paper brought Louis XA'I to a sudden halt at 
 Varennes, and his head to the scaffold. The lucky meeting of the 
 aides of Bonaparte and Desaix between Novi and Marengo gave to 
 France its empire and to Europe the enlightenment that was diffused 
 by that event. If such trifles afi'ect individuals and nations, we must 
 not be astonished that the little useless prepuce should be endowed 
 with the mischief-working power of the historical old cow and 
 kerosene lamp that reduced Chicago to ashes. 
 
 81. In the London Lancet for 18S5 there is a very interesting communica- 
 
 tion at page 46 on this subject. There is no doubt but that the pre- 
 puce offers the best skin-grafting material. 
 
 82. In the seventeenth volume (third series) of "Guy's Hospital Reports " 
 
 there is a most interesting report at page 243 of a case of skin-grafting 
 that was performed by Thomas Bryant. The case was an extensive 
 ulcer resulting from an injury. Bryant took some skin-grafts from 
 the man's arm and some from a colored man in an adjoining bed. 
 The account gives the dally report as taken from the note-book of 
 Mr. Clarke, and is accompanied by a colored plate to illustrate the 
 subject; the proliferation of the black skin is astonishing. In 
 closing the report Mr. Clarke says : "But in the figures depicted the 
 amount of increase in the black patclies will be well seen. In ten 
 weeks the four or five pieces of black skin, which together were not 
 larger than a grain of barley, had grovTn twentyfold, and in an 
 another month the black patch was more than one inch long by half 
 an inch broad, the black centres of cutiftcation having clearly grown ' 
 very rapidly by the proliferation of their own black cells." 
 
 83. American Journal Med. Sciences, vol. Ix. 
 
 84. "Circumcision." By Dr. A. B. Arnold, of Baltimore. 
 
 85. "De la Circoncision."' By Dr. S. Bernheim. Paris. 
 
 86. The reader is referred to a very interesting paper detailing conditions 
 
 of adhesions in the American Journal Med. Sciences for July, 1872. 
 It is taken from the Hungarian of M. Bokai. 
 
 87. JVeiv York Med. Journal, vol. xxvi. 
 
 88. Avierican Journal Med. Sciences, vol. Ix. 
 
 89. Dr. Vanier describes this operation of Celsus mentioned by Vidal in 
 
 bis work on " Circumcision," at page 294, which consisted in making, 
 by a circular incision immediately back of the glans, like in a circu- 
 lar amputation, a complete detachment of the integument from back 
 of the corona. The penis was then made to retreat into the sheath 
 thus made and a short catheter introduced into the urethra, to the 
 end of which the free end of the new preputial fold was made fast, 
 a piece of oiled lint being interposed between the raw inner surface 
 
Notes to Text. 329 
 
 and the glans. Another operation consisted in forcibly drawing the 
 integument forward and in making a number of transverse incisions 
 in the integument so as to assist its extensibility. By these means it 
 was drawn sufficiently forward so as to fasten it to a canula or 
 catheter made fast in the urethra. But it can well be imagined that 
 a person must possess the most exalted idea of the physiological 
 needs of a prepuce and feel the most sensitive need of such an ap- 
 pendage to submit to the first of these operations, although it is 
 more than probable that many Jews submitted to the operation in 
 the days of Celsus to avoid being exiled or plundered of all their 
 possessions. The resulting prepuce could not have been a much 
 more unsightly appendage than that which ornaments the over- 
 burdened virile organ of many Christians, and there is no doubt but 
 that in many cases they passed muster. 
 
 90. "Circumcision." Dr. A. B. Arnold. 
 
 91. Ashhurst. "Int. Enc. Surgery," vol. vL 
 
 92. " Pertes Seminales." 
 
 93. "Circoncision." Dr. Vanier, du Havre. 
 
 94. "Dictionaire des Sciences Medicales." 
 
 95. Erichsen's "Surgery," page 1144. Edition of 1869. 
 
 96. Medical News of Philadelphia, page 11-5. Vol. for 1860. 
 
 97. "Pertes Seminales." In the fourth American edition of the English 
 
 translation of ^NIcDougall of Lallemand we find that he fully appre- 
 ciated the dangei-s that lurk in a prepuce. At page 216 he says : 
 "Such is the condition which the parts present in cases of recent 
 balanitis, and these are the inflammations and ulcerations that cause 
 more or less extensive adhesions of the prepuce to the glans. Such 
 adhesions are generally cellular, but sometimes fibrous or even carti- 
 laginous, according to the severity and frequent repetition of the in- 
 flammation. Various degrees of induration also results according to 
 the intensity, the duration, and the frequency of the phlogosis. Thus, 
 1 have often found a mucous membrane hardened, thickened, and 
 covered with numerous papillae, sometimes fibrous or cartilaginous, 
 with thvee times its natural thickness. I have also met with cases in 
 which the prepuce has become cancerous. I have operated in several 
 cases of cancer of the penis, too, which certainly arose from no other 
 cause. The patients were generally peasants between fifty and sixty 
 years of age, who had never known other than their own wives, but 
 who had frequently suffered from balanitis attended by abundant 
 discharge, swelling of the prepuce, and excoriation of its opening, 
 which was so contracted as to prevent the passage of the glans. I 
 have seen one case, also, in which balanitis, irritated by a forced 
 march and the abuse of alcoholic stimulants, passed into gangrene, 
 by which the greater part of the glans was destroyed. Such have 
 been the accidents which I have observed on those whose prepuce 
 was too narrow to permit the glans being uncovered; accidents which 
 I can only attribute to the long retention of the sebaceous matter 
 in a kind of cul-de-sac, into which a certain quantity of urine passes 
 every time the patient makes water." 
 
 98. Claparede. " La Circoncision." 
 
 99. Baron Eoyei-. "Traite des Maladies Chirurgicales," vol. x, page 370. 
 100. I have practiced considerably among the Jewish people, but I have 
 
 never seen their elderly men suffer with prostatic troubles like our 
 
330 Notes to Text. 
 
 own people who are unclrcumcised. From having observed the 
 tendency to prostatic complications in young people with trouble- 
 some prepuces, and that the great number of the elderly people who 
 are affected with prostatic disease or enlargement are the unlucky 
 possessors of long or large prepuces, I have arrived at the conclu- 
 sion that the prepuce can be entered as a factor in the etiology of 
 enlarged prostate. 
 
 101. I have now under my care a poor consumptive who has all the appear- 
 
 ance of having always been as virtuous as Joseph, but who, unlike 
 Joseph, has from infancy had as a constant companion a long, miser- 
 able, smegmanous, and annoying prepuce. The young man has an 
 oedema which first affected his feet, but one day, owing to the irrita- 
 tion of a slight balanitis, the prepuce swelled at once ; it proceeded 
 through the penis integument to the scrotum ; the penis itself re- 
 tracted, leaving the integument and scrotum to assume a translu- 
 cent, puffy, cork-screw appearance and attitude ; from its labyrinthic 
 passage the urine slowly dribbles during urination in a scalding 
 stream. In addition to the physical sufferings, he is tormented by the 
 knowledge that his friends attribute all his disease and troubles— 
 since the occurence of the penile oedema — to the fact that his earlier 
 manhood must have been indiscreet, as well as sinful. The laity can- 
 not connect any penile, scrotal, or testicular disease with anything 
 except venereal disease ; and if the physician attempts to explain 
 ■ matters, they simply look upon it as the good-natured and well- 
 intentioned efforts of the doctor to deceive them and to cover up 
 the shortcomings of some frail mortal. Many a poor fellow lias to 
 leave this world under a cloud of mistrust and a bad odor of past 
 devilti'y to which he is not entitled, and suffer all this in addition to 
 all his physical ills, owing to his having been ornamented through life 
 with an annoying prepuce, — the luckless heritage of having been 
 born a Christian. Columbus in chains moralizing on the ingratitude 
 of this world is nothing to the poor invalid with a swollen prepuce, 
 innocently acquired, silently "cussing " the ignorance of his relatives 
 and friends. 
 
 102. This patient, on convalescing, suffered considerfible from the action 
 
 of numerous small carbuncles, resulting from the toxsemic con- 
 dition induced by the partial suppression of urine that he at times 
 suffered from, and, when nearly well, brought on a serious relapse 
 by the mail-bag appendage at the penis working up the organ into 
 a state of erection. While so situated he had intercourse, and from 
 99° his temperature immediately rose to 104H°i where it remained 
 for several days, lengthening out his illness by several weeks, into 
 along-protracted convalescence. The man is not yet circumcised, 
 and, from the knowledge that I have of his tendency to uraemia, I 
 feel that, although in his prime, a fever or an accident may take him 
 off at any moment. 
 
 103. In looking over the literature of reflex neuroses and more direct 
 
 injurious results, I find that George Macilwain, in a work on "Sur- 
 gical Observations on the More Important Diseases of the Mucous 
 Canals of the Body," published in London in 1830, calls special atten- 
 tion to the case of a man aged thirty-eight, admitted to the Finsbury 
 Dispensary, and who was in the cai'e of Mr. Hancock. The patient 
 was suffering from excruciating pain in different joints, the pain 
 
Notes to Text. 331 
 
 being so great that he was confined to his bed and unable to stand 
 on bis feet. He was unable to rest at nights, and neither rheumatic 
 nor any other apparently suitable treatment was of any service. 
 Rigors were soon added to his other troubles, and during their con- 
 tinuance the pain in his joints was greatly aggravated. He was 
 referred to Mr. Macilwain for treatment, who promptly relieved 
 him by the removal of a urethral stricture, which had quietly been 
 the cause of all the disturbance. It is particularly interesting that 
 even at that early day the reflex neuroses and complications that 
 may arise from the irritability of the genito-urinary organs were so 
 well understood. How well Dr. Macilwain appreciated the nicety 
 of these relations can be seen from his remarks in connection with 
 the above case, in which he says : "It may be observed that the se- 
 verity of the symptoms is not always commensurate either with the 
 duration of the disease or the degree of stricture, and that, although 
 the progressive development of them varies considerably in rapidity, 
 in different individuals, it is, nevertheless, in the latter stages, always 
 more rapid." Macilwain also graphically describes the insidious 
 approach of these genito-urinary troubles. In speaking of stricture 
 he says: "Although minute inquiry generally informs us that the 
 stricture has been of some standing, and in some instances has ex- 
 isted for years, yet it may happen that it is only a few months or a 
 year since the patient's attention has been directed to the disease. 
 This is very intelligible ; for, in conformity with what we observe in 
 other parts of the body, the bladder has a power of accommodating 
 itself to a change of circumstances. Its strength, for a long time, 
 may increase so correctly in proportion to the increase of the ob- 
 stacle which opposes the ejection of its contents that a very consid- 
 erable period elapses before the difficulty in making water becomes 
 cognizable to the patient, or it occasions an annoyance so trifling as 
 scarcely to excite his attention. This increase of strength in the 
 bladder frequently renders the formation of stricture so insidious 
 that the urethra at the affected part is very narrow before the indi- 
 vidual is aware of the existence of any contraction whatever ; the 
 bladder, however, at length becomes unable to empty itself, and the 
 abdominal muscles and diaphragm powerfully act as coadjutors, so 
 that each effort to make water is accompanied by a straining which 
 is very distressing, and the complete evacuation of the bladder is 
 often not accomplished even by these combined forces. The strain- 
 ing which accompanies stricture, and which seems necessary to evac- 
 uate the bladder, although it be occasionally exceedingly annoying 
 to the patient at the time, is more important with reference to the 
 results which are its consequence. I am firmly of opinion that there 
 are a great number of patients laboring under hernia which has been 
 produced by no other cause. I must confess that I had seen a great 
 number of instances of stricture in ruptured patients before I drew 
 any inference from^ the observation of their co-existence." The 
 foregoing observations of Macilwain, made in 1830, are here repro- 
 duced for their clearness of expression and explanation, as well as 
 to show what injuries can be produced on the young child afflicted 
 with phimosis. "We are, as surgeons, familiar with the anatomical 
 and pathological changes there are undergone by the bladder and 
 its lining membrane, as well as in the ureters and kidneys, in many 
 
332 Notes to Text. 
 
 cases of stricture, as well as of the great amount of prostatic irrita- 
 bility autl enlargemeut that is due to the same cause. How simi- 
 larly these results can be and are actually produced by phimosis is 
 undeniably expressed by the post-mortem appearances in the poor 
 infant described by Golding Bird to the London iNIedical Hociety, 
 and mentioned in the London Lancet of May 16, 184(5. The bladder 
 and ureter were like those of a man who had long suffered from 
 stricture. From the remarks of Dr. J. Lewis Smith, that phimosis 
 may be productive of inguinal hernia and prolapsus of the rectum, 
 and the observations of Edmund Owens and Arthur Kemp, both 
 high authorit.es on children's diseases, being both connected with 
 children's hospitals, as well as the remarks of Mr. Bryant in his 
 "Surgical Diseases of Children," who all concur in looking upon 
 phimosis as a great factor in hernia, Bryant having observed tliirty- 
 one in tif ty consecutive cases of phimosis, we are certainly warranted 
 in assundng that phimosis is not only a mere local timely inconveni- 
 ence that will disappear with the approach of puberty, but a con- 
 dition which, in the more easily affected organism of the child, — 
 lacking, as it does, that resistance that comes with our prime, — is 
 productive of serious harm ; as even the first few years of life, even 
 a few months of infant life, with a phimosis, are sufficient to so 
 change the structures of parts that the poor child will grow into a 
 man with an impaired kidney or sacculated ureter. The strain re- 
 quired to induce a prolapsus of the bowel or a rupture into the in- 
 guinal canal is exerted as much on the bladder, ureter, and kidney 
 as on the other localities. Physicians who have taken the pains to 
 observe must have noticed, more than once, how the child afflicted 
 with a phimosis has not only at times to wait for the stream of urine 
 to appear, there seemingly being some obstruction to its starting, 
 but how often such a case is afflicted with a stammering, halting 
 urination. A child thus started out into life, with a defective kidney 
 or kidneys, is sadly handicapped in his usefulness, comfort, or in 
 properly competing in the race of life. No parent would for a mo- 
 ment think of starting his son in life by giving him a business that 
 is heavily nnn-tgaged at the start, but many a parent unconsciously 
 launches the unsuspecting child into a life of such ill health — result- 
 ing from a simple narrow prepuce — beside which a heavy mortgage 
 or a heavy yearly tribute would be but a mere trifle. I have seen 
 such men, who in after life, broken-down and perfectly physical 
 wrecks, would gladly have given all their wealth and been willing to 
 have some genii set them down in the middle of the Sahara, shirt- 
 less and pennyless, provided they had their health. To say nothing 
 of the trifling loss of the prepuce, these parties would gladly have 
 had a foot or a leg go with the prepuce if necessary, and have their 
 health. 
 104. 1 have often performed dilatation where, for some reason, either the 
 timidity of the parents or the health of the child seemed to contra- 
 indicate any more radical procedure. It is customary to advise 
 mothers or the nurses to retract the skin daily, but even after a 
 good dilatation I have found as sudden a recontraction, and even in 
 the majority of cases, where daily drawing back the skin might have 
 been practicable, the cries and struggles of the child are a positive 
 prohibition to these instructions being carried out ; it is not once in 
 
Notes to Text. 333 
 
 ten times that it can be carried out. I have seen two verv annoying 
 cases of paraphimosis resulting from this procedure, the struggles 
 of the child having prevented the return of the prepuce to its proper 
 place, and the violent cryuig and sobbing of the child having assisted 
 to congest the organ. 
 
 105. It may well be a question, considering the well-established fact that 
 
 nervous injuries and affections are easily transmissible and become 
 hereditary, how much feeble-mindedness is due to an heredity origi- 
 nally induced in either parent through reflex neuroses from the 
 genital organs. The Jews have a very small percentage of feeble- 
 minded ; it is true that they have not any inebriates to assist in their 
 manufacture, but still the absence of these well-pronounced cases of 
 reflex neuroses among the race must be largely ascribed to their 
 practice of circumcision, as that operation cures the gentiles so 
 afflicted. 
 
 106. I have seen precisely similar conditions resulting from a sphincter- 
 
 ismus being relieved by anal dilatation. I had one such case who 
 had fallen into the hands of a quack, who made him believe that he 
 was being affected with incipient softening of the brain ; systematic 
 dilatation or a rupture of the sphincter a la Van Buren is the 
 appropriate remedy. 
 
 107. In the first volume of the "American and English Encyclopedia of 
 
 Law" there is an interesting account of a young child (who had been 
 bound out by the parish officials) who murdered his little bed-fellow 
 and, on trial and conviction, was sentenced to be hanged, but who was 
 reprieved by roj'al favor on account of his tender years, the sentence 
 being changed to imprisonment for life. The little fellow was only 
 eight years of age. On the trial the boy said he was driven to commit 
 the crime because the other child soiled the bed. The two children 
 being both paupers, it may well be imagined that their bedding was 
 none of the cleanest at the best, or that their bed-room had the best 
 of ventilation. As at the time the murder was committed English 
 paupers were not treated in the most humane manner, it is not sur- 
 prising that a nervous, sensitive child would, under such a combi- 
 nation of circumstances, be converted into au insane murderer. 
 
 108. The study of prematurely acquired impotence in the male Is a most 
 
 interesting one. I have frequently seen it result from the presence 
 of anal or rectal irritation, from haemorrhoids. I have seen cases 
 who could not have erections, and in whom all sexual desire was 
 extinct at a very early age, who have informed me that, although 
 unable to have sexual intercourse because of the total absence of 
 sexual desire, the flaccidity of the organ, and the want of sound 
 physiological organic functional activity to suggest the thought, 
 they had, nevertheless, frequently been the victims of nocturnal 
 emissions before the totel extinction of the function. As a rule, 
 much of this premature impotence— induced by either irritation of 
 the genital organs or rectal or anal troubles— runs its unfortunate 
 possessor through such a course of physical incidents as described 
 by Hammond, as the wild Indians of the Southwest induce in the 
 mujerado. At first the sound organ responds in a natural manner 
 to any stimulus that may affect it, but soon a local satyriacal con- 
 dition is set up, which, running a more or less rapid period of intense 
 
334 Notes to Text. 
 
 activity, soon leaves its victim completely, permanently, and hope- 
 lessly impotent, even as much so as if eunuchized in the most ap- 
 proved manner. Hammond's description of the manner in which 
 these unfortunates are manufactured is an interesting addition to 
 the facts contained in the natural history of man, and is as follows : 
 "Amtyerado is an essential person in the saturnalia, or orgies, in 
 which these Indians, like the ancient Greeks, Egyptians, and other 
 nations, indulge. He is the chief passive agent in the pederastic 
 ceremonies which form so important a part in the performances. 
 These take place in the spring of every year, and are conducted with 
 the utmost secrecy, as regards the non-Indian part of the population. 
 For the making of a mujerado one of the most virile men is selected, 
 and the act of masturbation is performed upon him many times 
 every day ; at the same time he is made to ride almost continuously 
 on horseback. The genital organs are thus brought, at first, into a 
 state of extreme erethism, so that the motion of tlie horse is suf- 
 ficient to produce a discharge of seminal fluid, while at the same 
 time the pressure of the body on tlie animal's back — for the riding 
 is done without a saddle — interferes with their proper nutrition. It 
 eventually happens that, though an orgasm may be caused, emis- 
 sions can no longer be effected, even upon the most intense degree 
 of excitation. Finally, the accomplishment of an orgasm becomes 
 impossible ; in the meantime the penis and testicles begin to shrink, 
 and in time reach their lowest plane of degradation. But the most 
 decided changes are at the same time going on, little by little, in the 
 instincts and proclivities of the subject. He loses his taste for those 
 sports and occupations in which he formerly indulged, his courage 
 disappears, and he becomes timid to such an extent that, if he is a 
 man occupying a prominent jilace in the council of the pueblo, he is 
 at once relieved of all power and responsibility, and his influence is 
 at an end. If he is married his wife and children pass from under 
 his control, — whether, however, through his wish or theirs, or by the 
 orders of the council, I could not ascertain. They certainly become 
 no more to him than other women and children of the pueblo." 
 Hammond examined one of these men, who had, as he himself in- 
 formed him, formerly possessed a large penis and testicles " grande 
 como huevos,"— as large as eggs. The penis was in its flaccid state 
 and about an inch and a half in length, with the glans about the size 
 of a thimble, which it very much resembled in shape. The glandu- 
 lar structure of the testicles had disappeared ; they were atrophied, 
 little besides connective tissue remaining. He examined another 
 mujerado in the pueblo of Acoma, who had been so made when at 
 about the age of twenty-six. The penis was not more than an inch 
 in length and about the diameter of the little finger, and of the tes- 
 ticles there was apparently nothing left but a little connective tissue. 
 Both of these men had high-pitched voices. The last one examined 
 was then thirtj'-six years of age. (Hammond : "Male Impotence.") 
 The foregoing detailed description shows an extreme degree of re- 
 sults produced by an equally extreme degree of intense and persist- 
 ent irritation applied to the genital organs, purposely employed to 
 obtain certain results. In the cases cited the irritation or excitation 
 is directly applied, but it is safe to assume that reflex irritability 
 
Notes to Text. 335 
 
 from the anus or rectum, or from that of a stricture or of a prepuce, 
 will in some cases produce a certain degree of excitation in the tes- 
 ticles that may result in their functional or organic derangement, in 
 a degree proportionate to that of the amount of excitation from 
 which they have suffered. That the testicles are very apt to suffer 
 from the existence of a stricture is a well-known fact. I have my- 
 self worried over a case of stricture, in whom the attempted passage 
 of a filiform bougie was always immediately followed by a severe 
 attack of epididymitis, and who had always been afflicted with a 
 tenderness and a tendency to inflammation of the testes. I have 
 also noticed a much greater tendency to orchitis in the wearer of an 
 irritating prepuce than where it was absent ; so that the presence of 
 a satyriacal tendency, no matter in what proportion of a degree it 
 may be present, can safely be assumed to result in a corresponding 
 degree of apathy, due to an actual physical degeneration of the 
 parts. That these conditions, when present in any degree of perma- 
 nency or persistence, will in the end induce earlj^ impotence, I have 
 no reason to doubt. In this regard we must not overlook the fact 
 that persons with phimosis, stricture, or other genital irritants and 
 impediments, are more liable to be afflicted with liaimorrhoids, pro- 
 lapsus ani, or other anal and rectal irritation, which retroactively 
 assist in bringing about the condition v\nder question. How much 
 this may have to do with certain prolific peculiarities among the 
 Jews may well be questioned ; it is a well-known fact that in London 
 the Jewish excess of male births has been as high as eighteen per 
 cent., while among the Christian or Gentile population it is only six 
 and one-half per cent., — a somewhat analogous condition of propor- 
 tion being also observable in the United States. Here, it is accounted 
 for, in a measure, by Dr. Billings, in the following words: "This 
 comparatively large proportion of males among the Jews is probably 
 due to the fact that the death-rate of their infants is less for males, 
 as compared with females, than it is among the average population." 
 Children gotten during the prime of life of the parents are naturally 
 more virile and have better stamina than those gotten before full 
 maturity is reached. If the father is on the verge of inipotency just 
 about the time he is expected to beget his best offspring, that off- 
 spring cannot be expected to present an extra amount of vitality, 
 virility, or physical stamina ; hence, the prepuce can be brought in 
 as directly tending — in no matter how small the degree it may be, 
 but nevertheless a factor— to the physical degeneracy of the race, as 
 ■well as it demonstrates the existence of some law for the production 
 of the sexes which we do not as yet fully comprehend. Aside from 
 the above considerations, there are those of the actual bar to the in- 
 crease of population which the prepuce induces, either by primarily 
 being the cause of impotence or by direct interference, as already 
 mentioned, and the impotence that naturally results from the causes 
 set forth in this note. The results of a prepuce are certainly such 
 as must act like a moist, warm, and oily poultice to the irritability 
 induced in the most confirmed Malthusian when contemplating the 
 — to him — rapid and unwarranted increase of population. 
 
WORKS AND AUTHORITIES QUOTED. 
 
 These pour le doctorat en Medecine, par J. B. B. Edmond Nogues, sur la 
 
 Anatomie, Physiologic, et Pathologic du Prepuce. Paris, 1850. 
 These a la faculte de Medecine de Strasbourg. Par J. B. A. Chauvin. 
 
 Consideration sur le Phimosis et Operation de la Circoncision par un 
 
 precede nouveau. Strasbourg, 1851. 
 De la Circoncision chez les Egyptiens. F. Chabas. Paris, 1861. 
 Cause Morale de la Circoncision des Israelites. Vanier, du Havre. Paris, 
 
 1847. 
 La Circoncision, son importance dans la Famille et dans I'Etat. Par le 
 
 Docteur Claparede. Paris, 18(51. 
 Dissertation sur la Circoncision, sons les rapports rellgieux, hygieniques, 
 
 et Pathologiques. Par le Docteur Moyse Cahen. Paris, 1816. 
 Origine, Signification, et Histoire, de la Castration, de I'Eunuchisme, et 
 
 de la Circoncision. Par le Docteur F. Bergmann de Strasbourg. Ar- 
 
 chivio per le Tradizioni Populari, vol. ii. 
 Darstellung der Biblichen Krankheiten. Von Dr. J. P. Trusen. Posen, 
 
 1843. 
 Archives Israelites de France, No. 9, 4em annee, Septembre, 1843. 
 Bulletins de la Societe d' Anthropologic de Paris. Tome x (serie iii), 3d 
 
 fascicule, .Juin a Octobre, 1887. 
 ■Recueil de Memoires de Medecine, de Chirurgie, et de Pharmacie Mili- 
 
 taires. Tome xxi (serie iii). No. 105, August, 1868. 
 Traite d'Hygiene, publique et privee. Michel Levy. 2d ed. Paris, 1850. 
 Neuroses des Organes Genito-Urinaires de I'homme. Ultzmann. Paris, 
 
 i8a3. ^ 
 
 L'Hermaphrodisme, sa Nature, son Origine, ses Consequences Sociales. 
 
 Par le Docteur Charles Debierre. Paris, 1886. , 
 L'Onanisme. Tissot. Lausanne, 1787. 
 
 Traite de la nymphomanie. Dr. Bienville. Amsterdam, 1784. 
 La Folic Erotique. Par Prof. B. Ball. Paris, 1888. 
 Des Pertes Seminales Involontaires. Lalleraand. Paris, 1836. 
 Spermatorrhoea. Lallemand and Wilson. Philadelphia, 1861. 
 The Philosophical Dictionary. Voltaire. London, 1765. 
 CEuvres Completes, avec notes, etc. Montesquieu. Paris, 1838. 
 Dictionaire d'Hygiene, publique et de salnbrite. Tardieu. Paris, 1862. 
 Guide du Posthetomiste. Par le Docteur li. Terquem. Paris. 
 La Circoncision et ses suites. Par A. S. Morin. Ext. du Journal I'Excom- 
 
 munie, .Tanuary, 1870. 
 La Circoncision. Par le Docteur S. Bernheim. 
 Circumcision. By Dr. A . B. Arnold, of Baltimore. Reprint from the New 
 
 York Medical Journal of February 13, 1886. 
 Among the Cannibals. By Carl Lumholtz. New York, 1889. 
 
 (336) 
 
Works and Authorities Quoted. 337 
 
 Recueil de Questions provioses par une Societe de savants voyageant an 
 
 Ai-abie. Michealis. Amsterdam, 1774. 
 Tractatus, Albert! Bobovii, Turcarum Imp. Mohammedis IV olim Inter- 
 
 pretis primarii, De Turcarum Liturgia, peregrhiatione Meccaiia, Oir- 
 
 cumcisione, ^grotorum Visitatione, etc. Oxonii, 1690. 
 Le Theatre de la Turquie. Michel Le Feber. Paris, 1681. 
 Recherches Fhilosophiques sur les Americains, ou Memoires Interessants 
 
 pour servir a I'Histoire de I'Espece Humaine. Par M. de P. Augu- 
 
 mentee par Dom Pernety. Berlin, 1774. (Also the first edition of the 
 
 same work printed at Cleves in 1772.) 
 History of the Hebrews' Second Commonwealth. Wise. Cincinnati, 1880. 
 History of the Hebrew Commonwealth. Jahn. Oxford, 1840. 
 Jews' Letters to Voltaire. Philadelphia, 1848. 
 The Jewish Nation. Revised by Kidder. New York, 1850. 
 The Jews Under Roman Rule. By W. D. INIorrison. New York, 1890. 
 The Story of the Jews. By James K. Hosmer. New York, 1887. 
 The History of the Jews. By the Rev. H. H. Milman. New York, 1843. 
 Early Oriental History. By John Eadie, D.D., LL.D. London, 1852. 
 The Bible and the Nineteenth Century. By L. T. Townsend, D.D. New 
 
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 Legends of the Patriarchs and Prophets. By the Rev. S. Baring-Gould. 
 
 New York, 1884. 
 The Religions of the Ancient World. By George Rawlinson, M.A. New 
 
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 The Hermits. By the Rev. Charles Kingsley. New York, 1885. 
 Letters on Demonology and Witchcraft. Letters addressed to J. G. Lock- 
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 The Philosophy of Magic, Prodigies, and Apparent Miracles. From the 
 
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 The Intellectual Development of Europe. By John W. Draper, M.D. 
 
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 History of European Morals. By W. E. H. Lecky, M.A. New York, 1884. 
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 Vital Statistics of the Jews. By Dr. John S. Billings, in Nortli American 
 
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 Genito- Urinary Diseases. Otis. New York, 1883. 
 
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 Urinary and Renal Disorders. Beale. 
 
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 Venereal Diseases. Bumstead and Taylor. Philadelphia, 1883. 
 
 Traite sur les Maladies des Organes Genito-Urinaires. Civiale. Paris, 
 1850. 
 
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 Guy's Hospital Reports, 3d series, vol. xvii. London, 1872. 
 
 Transactions of the Ninth International Medical Congress, vol. Hi. Wash- 
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 On the Reproductive Organs. Acton. Philadelphia, 1883. 
 
 Operative Surgery. Smith. Philadelphia, 1852. 
 
 Operative Surgery. Stephen Smith. Philadelphia, 1887. 
 
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 Principles and Practice of Surgery. Agnew. Philadelphia, 1881. 
 
 International Encyclopedia of Surgery. Ashhurst. Philadelphia, 1886. 
 
 Science and Art of Surgery. Erichsen. Philadelphia, 1869. 
 
 Diseases of the Kidneys. Ralfe. Philadelphia, 1885. 
 
 The Clinic. Cincinnati, 1872. 
 
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 1884. 
 
 Western Journal of Medicine and Surgery. Louisville, 1846. 
 
 Native Races of the Pacific Coast. Bancroft. San Francisco, 1875. . 
 
 Encyclopedia Britannica, 9th edition. 
 
 Classical Dictionary. Lempriere. New York, 1847. 
 
 Commentary on the Bible. Clark. 
 
 Satellite for February, 1889, and January, 1891. Philadelphia. 
 
 Pedigree of Diseases. Hutchinson. 
 
 Medical Inquiries. Rush. Philadelphia. 
 
 Half-Yearly Abstract of the Medical Sciences, vols, xli and Ix, Philadel- 
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 Cincinnati Lancet and Observer, vol. xvi. 
 
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 Dictionary of Medicine. Quain. New York, 1884. 
 
INDEX. 
 
 Abolishment of circumcision by 
 Christians, 18 ; by the Romans, 
 66 
 of eunuchism in Italy, 91, 96 
 
 Abraham, 32 
 
 Absence of penis, 13 
 of testicles, 105 
 
 Abyssiniaus, carry ofifthe male mem- 
 bers of slain enemies, 30 ; cir- 
 cumcised bishop among the, 61 
 
 Acosta, Rev. Father, on Mexican 
 circumcision, 47 
 
 Adams, Dr. C. Powell, of Hastings, 
 Minn., 198 
 
 After-treatment of circumcised 
 Hebrews, 158 
 
 Agnew, D. Hayes, on penile can- 
 cer, 230 ; on eczema as a reflex 
 neurosis from phimosis, 320 
 
 Albutt, T. Clifford, on primary 
 cause of disease, 13 
 
 American circumcision, 47; infibu- 
 lation and muzzling, 48 
 
 Amputation of penis, 230, 233, 247 
 
 Androgynes, 118 
 
 Augleria, Pierre d', on American 
 circumcision, 47 
 
 Apis, the white bull, sacred to the 
 Egyptians, 39 
 
 Apollo Belvidere, as evidence of 
 exactness of ancient sculp- 
 ture, 62 
 
 Apure Indians and their circum- 
 cision, 48 
 
 Arabian circumcision, 38 ; prosti- 
 tutes, 323 
 
 Arias Montan, on Mexico, 46 
 
 Arnold, Dr. A. B., of Baltimore, 
 25, 219, 220, 223 
 
 Asthma as a reflex neurosis from 
 genital irritation, 291 
 
 Australian circumcision, 44; opera- 
 tion on the urethra, 56 
 
 Author's modification of circum- 
 cision, 307 
 
 Aztec circumcision, 46 
 
 Ballance, C. W., dressing after cir- 
 cumcision, 317 
 
 Bamboo stick worn in vagina as a 
 chastity protector, 52 
 
 Baptismal ceremonies of Omaha 
 Indians, 56 
 
 Barbarous Arabian marriage cus- 
 tom, .54 
 mutilations of Guamo and Otho- 
 maco Indians, 48 
 
 Bas-relief representing Egyptian 
 emasculation, 31 
 
 Bassouto circumcision, 43 
 
 Battos circumcision, 45 
 
 Baumgartner's devout and chaste 
 dervish, 49 
 
 Beale, Sir Lionel, on blood changes, 
 296 
 
 Bell, Dr. John, on Jewish hygiene, 
 181 
 Dr. J. Royes, 191, 223, 229, 239 
 
 Bells, jingling of, under the skirts, 
 denotive of Judean virginity, 
 52 
 
 Belt of brass mail to insure female 
 chastity, 51 
 
 Berbers, mutilations of their prison- 
 ers, 30 
 
 Bergmann, of Strasburg, 20, 27 
 
 Bergson, Dr., 160 
 
 Bernheim, Dr., on freedom of Jews 
 from syphilis, 195 ; on prepu- 
 tial statistics, 220 ; on circum- 
 cisial operation, 312 
 
 Bernoulli, Prof., of Bale, 168 
 
 "Beth Tosef" of Joseph Karo, 
 153 
 
 Biblical vouching for homoeopathy, 
 113 
 
 Billings, Dr. John S., U. S. Army, 
 on Jewish vital statistics, 174 ; 
 on cancer amongst Jews, 230 
 
 Bird, Dr. Golding, on phimosis, 257 
 
 Bishop of Abyssinia accused of 
 heresy on account of circum- 
 cision, 64 
 
 (339) 
 
340 
 
 Index. 
 
 Blood of prepuce spiliikled on 
 bride's veil, 55 ; spriukled on 
 ears of corn, 5(5 
 changes as starting-points of dis- 
 ease, 293, 298 
 
 Bobovii, Alberti, on Mohammedan 
 circumcision, 39 
 
 Bogera, or African circumcision, 
 44 
 
 Bokai, on preputial statistics, 220 
 
 Bornean circumcision, 45 
 
 Bowditch, Henry I., on Jevyish vital 
 statistics, 176 
 
 Boyer, Baron, on cancer of the 
 penis, 232 ; on gangrene of the 
 penis, 237 
 
 Brett, Dr. F. H., case of hyper- 
 trophy of prepuce, 251 
 
 Bryant, Thomas, on skin-grafting, 
 328 
 
 Bumstead, on circumcision, 310 
 
 Burial of Algerine prepuces in the 
 sauds of the deserts, 39 
 
 Cahen, Dr., on diminished sensi- 
 bility of glans after circumcis- 
 ion, 224 
 
 Calculus, liability of the Chinese 
 to preputial, 248; Dr. J. G. 
 Kerr, on preputial, 248 ; C. H. 
 Martin, of Mobile, on climatic 
 influence on, 248 ; Prof. Enoch, 
 of Berlin, on preputial and 
 vesical calculi, 249; Clapar^de's 
 case, 249 ; composition of pre- 
 putial, 249 ; Civiale's case, 249 ; 
 induced by phimosis, 287 
 
 Canarj' Islands, remaius of an ante- 
 diluvian world, 25 
 
 Cancer of the penis, 232 ; views of 
 Jonathan Hutchinson as to its 
 origin, 226 ; precancerous stage 
 of, 226 ; views of LallemaTid, 
 228, 329 ; statistics of, 231 ; Cul- 
 lerier on, 231 ; fifty cases re- 
 ported by Dr. Zielewicz, 233 ; 
 early mention of, 234; views 
 of Prof. John C. Warren, 235 ; 
 views of Walshe, 235 
 
 Canon of St. John Lateran and his 
 profane doubts, 74 
 
 Carter, Dr. Wm., on toxic urines, 
 298 
 
 Casalis, M., on Bassouto circum- 
 cision, 42 
 
 Cases of spontaneous circumcision, 
 58 
 
 Castration, etymology of the term, 
 80 ; as a self-sacrilice to dei- 
 ties, 89 
 
 Celsus, on Roman inflbulation, 50; 
 on operations on the prepuce, 
 302, 313, 328; originator of 
 Cloquet's operation, 313 
 
 Chabas, M., description of Egyp- 
 tian bas-relief, 23 
 
 Charlemagne endows an abbej' 
 with a holy pi-epuce, 72 
 
 Charles V sacks Rome, and robbery 
 of the holy prepuce, 73 
 
 Chastity among Egyptian der- 
 vishes, 49; belt of brass mail 
 of the Ethiopians. 51 ; plug of 
 bamboo of Soudan, 51 ; ring', 
 to insure chastity in the mal'! 
 mentioned by Nelaton, 54; 
 enforced among the Hindoo 
 bonzes by inlibulation, 54; 
 among the Cybelian priest- 
 hood, 89 ; Greek monks, ideas 
 of, 89; comparative, among 
 the different religious creeds of 
 Prussia, 195 
 
 Chinese, peculiar liability of, to cal- 
 culous disease, 248 ; considered 
 a delicate diet by Australian 
 cannibals, 327 
 
 Chippeway Indians and circumcis- 
 ion, 23 
 
 Caivalry of the male Hottentot, 60 
 
 Christian abolishment of circum- 
 cision, 18; circumcision in 
 Abyssinia, 63 
 
 Circumcised phallus as a religious 
 and civic symbol, 35; races 
 peculiarly exempt from syphi- 
 lis, 192 
 
 Circumcising knife (see Knife). 
 
 Circumcision, abolished by Chris- 
 tians, 18 ; among Chippeway 
 Indians, 23; among the Atlan- 
 teans of Plato, 23 ; among the 
 Phoenicians, 34; among the 
 Egyptians, 34; Arabian, 35, 
 54 ; during the reign of Psam- 
 metich, 34; civil and religious 
 symbol of ancient Egypt, 35; 
 Aztec, 46 ; amona- the Mijes, 
 46 ; Mexican, 46 ; Totonac, 46 ; 
 among the Orinoco Indians, 47 
 
Index. 
 
 341 
 
 Circumcision, the climatic limits 
 of, as a general rite, 47 ; in the 
 Island of Cosumel, 47 ; in Yu- 
 catan, 47 : in old Florida, 47 ; 
 Apure IndianSj^48 ; among the 
 Amazons, 56 ; accidental case 
 of, mentioned by Cullerier, 57 ; 
 spontaneous, 58 ; abolished b}' 
 the Eomaiis, 6(3; destroying 
 marks of, 68 ; of Abraham, 143 ; 
 Hebraic, 143 ; not practiced in 
 the wilderness, 143 ; physical 
 conditions that exempt Jewish 
 children from, 144, 145 ; de- 
 scription of Hebraic, by Mon- 
 taigne, 146 ; as a cure for epi- 
 lepsy, 261 ; as a preventive of 
 hernia or rupture, 363 ; as a 
 preventive to prolapsus of the 
 bowel, 263 ; as a preventive of 
 idiocy, 266; as a cure for dys- 
 pepsia, 270, 271 
 
 Civiale, on moral effects of penis 
 amputation, 247; case of phi- 
 mosis and preputial calculi, 349 
 
 Claparede, on evils i-esulting from 
 the prepuce, 229 ; ou preputial 
 calculi, 249 
 
 Clarke, Sir Andrew, on renal in- 
 adequacy, 300 
 
 Clavigero, on Mexican circum- 
 cision, 46 
 
 Climatic limits of circumcision, 65 
 
 Cloquet operation, 306, 316 
 
 Colchis, colony of, 33 
 
 Constantine punished circumcisers 
 with death, 66 
 
 Constipation as a divine attribute, 
 288 ; as a result of phimosis 
 and its results, 292 
 
 Consumption, relation of, to Jewish 
 race, 178, 179 
 
 Controversy about the holy pre- 
 puce, 73 
 
 Convent of St. Corneille and the 
 holy knife, 78 
 
 Convulsions induced by phimosis, 
 260, 261 
 
 Cullerier, accidental circumcision, 
 57 ; on penile cancer, 331 
 
 Cybelian priesthood and castration , 
 
 Dakotas, the white bull sacred 
 among the. 36 
 
 David and the Philistine prepuces, 
 31 
 
 Debreyne, trappist, monk, and phy- 
 sician, 324 
 
 Delange, on Arabian circumcision, 
 37 
 
 Delpech, on female circumcision, 
 36 
 
 Demarquay, on penile gangrene, 
 236 
 
 Dervishes, holy and chaste, 49 
 
 Ditference between Turkish and 
 Buddhist heaven, 116 
 
 Dilatation of prepuce, 308, 313, 333 
 
 Donnelly, Hon. Ignatius, on Atlan- 
 teau circumcision, 23 
 
 Dressing in cases of retraction of 
 penile skin, 304; C. W. Bal, 
 lance's, after circumcision, 317 ; 
 A. G. Miller's, 318 
 
 Du Bisson, on Soudanese harems, 
 53 
 
 Dyspepsia induced by preputial irri- 
 tation, 270, 271 
 
 Ebers, Dr., ou Karnac bas-relief, 
 23 
 
 Eczema induced by phimosis, 320 
 
 Effect of the holy prepuce on the 
 hands of a lady, 74 
 
 Effects of age on the prepuce, 385 
 
 Egypt, uncircumcised persons not 
 allowed to study in ancient, 34 
 
 Egyptians emasculated their prison- 
 ers, 30 
 
 Emasculation, its early practices 
 and evolutions, 29 ; of Uranos, 
 83 
 
 Emperor Adrian forbids circum- 
 cision, 66 
 
 Endurance and fortitude of Arabs, 
 55 
 
 Enforced continence and its effects 
 on the penis, 61 
 
 Ennery, M., Grand Rabbi of Paris, 
 158 
 
 Enoch, Prof, of Berlin, on prepu- 
 tial calculi, 249 ; on results of 
 phimosis, 266 ; on enuresis, 277 
 
 Enuresis, 275 
 
 Epilepsy, induced by the prepuce, 
 258, 261, 301 
 
 Epstein, Dr., of Cincinnati, 156 
 
 Erichsen, Prof., on cancer of the 
 penis, 338 
 
342 
 
 Index. 
 
 Ethics at the battle of Fontenoy, 76 
 
 Ethiopian infibulatlon of infant 
 females, 51 
 
 Eunuchism, beneficial to guardians 
 of public funds, 84 ; as ex- 
 cluding from the priesthood, 
 90 ; in Italy, 91 ; in China, 91, 
 93; in India, 92; in the Sou- 
 dan, 99; and music, 94; as a 
 punishment, 97; mortality at- 
 tending its manufacture, 91, 92, 
 93, 99, 100, 107 ; does not pre- 
 vent copulation at all times, 
 92, 100, 101, 102, 103 ; manner 
 of procedure among the Pagan 
 priesthood, 106 ; prices of eu- 
 uuchs, 99 ; numbers annually 
 made, 91, 98 ; fecundating eu- 
 nuch of Mecca, 100 ; Velutti, 
 the opera-singer, 102 ; eunuchs 
 as possessors of harems, 90 ; 
 eunuch warriors and statesmen, 
 90 
 
 Evidence of circumcision on Egypt- 
 ian monuments, 23 
 
 Extraordinary results of phimosis, 
 283 
 
 Female circumcisers in Arabia, 36 
 
 Females subject to preputial reflex 
 neuroses, 267, 268 
 
 Flaccourt, M. Martin, account of 
 the Madecasses, 54 
 
 Fothergill and the unlicensed prac- 
 titioner on renal pathology, 77 
 
 French war-office records, on Jewish 
 vital statistics, 175 
 
 Frenum, statistics relating to ab- 
 normalities of, 221 
 
 Frerichs' ammonisemia, 300 
 
 Fresnel, M., on marriage circum- 
 cision, 54 
 
 Full-moon rites among the Bassouto 
 maidens, 44 
 
 Galen, on the flaccid virile member, 
 
 60, 61 
 Gangrene of the penis, 236 
 Golden padlocks worn on prepuce 
 
 for five years, 54 
 Greek and Roman statuary and the 
 
 penis, 60 
 Greek monks' object in infibula- 
 
 tions, 54 ; extreme ideas of 
 
 chastity, 89 
 
 Gregg, Dr. Robert J., operative 
 procedure, 330 
 
 Grifiiith, Dr. J. D., cases of reflex 
 irritation, 261 
 
 Gross, Prof. S. D., on penile can- 
 cer, 230 ; operations, 320 
 
 Grotius and the origin of the Peru- 
 vians, 46 
 
 Guimara, the, 153 
 
 Guinzburg, Dr., on Jewish vital 
 statistics, 176 
 
 Gumilla and his South American 
 voyages, 47 
 
 Haemostatic powders, 160 
 
 Hai-e, Prof. Hobart A., on circum- 
 cision, 301 
 
 Haskins, Dr. A., on Jewish vital 
 statistics, 176 
 
 Heaven, Turkish, 115; Buddhist, 
 116 
 
 Hebraic idea of parental origin of 
 constitution of the child, 144 
 
 Hebrew Consistory of Paris, 157 
 
 Hebrew words in Central America 
 languages, 24 
 
 Hebrews, attempts to efi"ace signs 
 of circumcision, 69; secretly 
 circumcise their dead, 68 ; 
 Hebrew vital statistics, 169 to 
 179 ; as proverbial good livers, 
 171 ; escape epidemics, 173 ; 
 peculiarly free fi-om syphilitic 
 taint, 191 ; their circumcision 
 suitable to young children, 306 
 
 Heliogabalus, Emperor, M'as cir- 
 cumcised, 66 
 
 Henry III of France as a Moslem 
 godfather, 64 
 
 Henry V of England and the holy 
 prepuce, 71 
 
 Heraclius, Emperor, persecuted the 
 Jews, 67 
 
 Hermaphrodiles, earliest mention 
 of, 117 ; pederasty causes be- 
 lief in their existence, 118, 119, 
 120 ; Debierre on, 123 ; notable 
 cases of, 124, 125, 127, 128 
 
 Hernia induced by phimosis, 263 
 
 Herodotus, his views adopted by 
 Voltaire, 22 ; visits Egypt, 34 
 
 Herrera, on Mexican circumcision, 
 47 
 
 Hey, Dr. William, on preputial 
 cancer, 227 
 
Index. 
 
 343 
 
 Hindoo devotee wears a six-inch 
 riug in prepuce, 54 
 
 Hitouch, 156 
 
 Holgate, Dr., of New Tork, on pre- 
 putial adhesions, 220 ; on pre- 
 putial dilatation, 308 
 
 Holy circumcision, 70, 78 
 prepuces, 70, 72 
 
 vinegar and its miraculous 
 effects, 79 
 
 Horner, Surgeon U. S. Navy, on the 
 worship of Venus Porcina, 193 
 
 Horrible marriage performance, 5i 
 
 Hottentot restriction on making 
 twins, 60 
 
 Hough, Dr., on Jewish longevity, 
 173 
 
 Humphry, Geo. Murray, on "Old 
 Age," 14 
 
 Hutchinson, Dr. Jonathan, ou the 
 precancerous stage of cancer, 
 226 ; on urethral child, 300 
 
 Hypospadias, as a heredity, 129; 
 artificially made, 56 ; formerly 
 led to belief in hermaphro- 
 dism, 129 ; fecundation in, 129 ; 
 difficulty in determining sex 
 owing to, 131 
 
 Idiocy induced by phimosis and 
 preputial adhesions, 265, 269 
 
 Impious wretch steals the holy 
 prepuce, 74 
 
 Impotence, holy vinegar and shri- 
 nal observances in, 71 to 81 
 
 Indians and circumcision, 46 to 48 
 
 Induration of prepuce, 250 
 
 Infibulation practices, 48 to 52 
 
 Isis inaugurates Osirian rites, 29 
 
 Isserth, Rabbi Israel, 153 
 
 Jansen, Surgeon of the Belgian 
 Armies, on frenum deformi- 
 ties, 221 
 
 Jews' letters to Voltaire, 22; Jews 
 (see Hebrews). 
 
 Judaism unfavorable to religious 
 insanity, 166 
 
 Justinia, Emperor, persecuted the 
 Jews, 67 
 
 Karo, Joseph, and the " Beth 
 
 Yosef," 153 
 Kemp, Dr. Arthur, on phimosis as ' 
 
 a cause of hernia, 264 I 
 
 Kerr, Dr. J. G., on Chinese prepu- 
 tial calculi, 248 
 
 Keyes, Dr. E. L., on composition 
 of preputial calculi, 249, 264 
 
 King David, the first homoeopathic 
 patient, 113 ; secui-es two hun- 
 dred Philistine prepuces, 31 
 
 Knife, circumcising, used in ancient 
 Egyptian rite, 23 ; of shell used 
 by Tonga Islanders, 45 ; of 
 stone used by Australians, 45 
 of the holy circumcision, 78 
 made of rattan among the Fiji 
 Islanders, 327 
 
 Lafargue, on Australian circum- 
 cision, 44 
 
 Lallemand, on masturbation, 223; 
 on tendency to preputial can- 
 cer, 328, 339; on circumcision, 
 317 
 
 Las Casas, on Aztec circumcision, 
 46 
 
 Leech, Dr. T. F., on preputial irri- 
 tation, 260 
 
 Letenneur, Prof., on the knife of 
 the holy circumcision, 78 
 
 Life-insurance and the circumcised, 
 290 
 
 Lisfranc, rules for operations on 
 the penis, 232; on recession of 
 the body of the penis, 306 
 
 Livingstone, on Bassouto circum- 
 cision, 44 
 
 Longevity of Hebrews. 162, 169, 179 
 
 Lonyer-Villermay, M., on female 
 circumcision, 36 
 
 Louis XVI as a candidate for the 
 rite, 301 
 
 Love, Dr. I. N., on the Mosaic law, 
 363 
 
 Lumholtz, on Australian hypospa- 
 dias, 56 
 
 Macilwain, on reflex neuroses, 330 
 Magruder, Dr. G. L., on reflex irri- 
 tation, 261 
 Maids as heat radiators, 114 
 Maimonides, Jewish i-abbi and 
 
 physician, 32, 144, 153 
 Malay circumcision, 45 
 Malgaigne, operative views, 313,316 
 Mapato, or mystery hut, 42 
 Marriage preceded by circumcision^, 
 54 
 
344 
 
 Index. 
 
 Martius and Spix, on circumcision 
 
 on the Amazon, 56 
 Mastin, Dr. C. H., on calculous 
 
 disease, 248 
 Masturbation, 224 
 Maury, Dr. Frank, on preputial 
 
 statistics, 219 
 McLeod, Dr. Neil, circumcision 
 
 operation, 318 
 McMahon, Dr. W. R., on reflex epi- 
 lepsy, 261 
 Mendelssohn, Rabbi Moses, 164, 
 
 168 
 Mexican circumcision, 46 
 Mezizah, or act of suction, 150 
 Milah, 156 
 Miracles performed by the holy 
 
 prepuce, 70 to 74 
 Mishna, the, 153 
 Mohammed, 65 
 Mohel, 157, 158 
 Moses, Dr., of New York, preputial 
 
 statistics, 220 
 Moses circumcises his son, 150 
 Mott, Jr., Dr. A. R., cases of reflex 
 
 iri'itation, 258 
 Music, first schools of, 94 
 Music at Algerine circumcision, .39 ; 
 
 at Mohammedan, in Asia, 39 ; 
 
 at Turkish feast, 41 
 
 Nelaton, case of infibulation, 54; 
 on penile cancer, 231 ; on 
 penile liypertrophy, 252 
 
 Nelson, Lord, disregard for red 
 tape, 77 
 
 New Caledonian circumcision, 45 
 
 Newton, Sir Isaac, and the storm- 
 predicting cow, 77 
 
 Nicaraguan baptism of blood, 56 
 
 Oath of mohel, 158 
 
 Oath. Egyptianmanner of making 
 oath, 35 
 
 Ohod, Battle of, 36 
 
 Operations on the prepuce, 302 ; 
 Cloquet's, 306 ; Bumstead's, 
 310 ; Hue's, 312 ; Bernheim's, 
 Sedillat's, 313; Chauvin's, 313; 
 Cullerier's, 313 ; Vanier's, 316; 
 Vidal de Cassis', 316 ; Lalle- 
 mand's, 317; A. G. Miller's, 
 Neil McLeod's, 318; Ericlisen's, 
 319 ; Gross's, 320 ; Van Buren 
 and Keyes', 320 ; D. Hayes 
 
 Agnew's, 320; Overall's pro- 
 cedure, 321 . 
 Origin of phallic worship, 29 
 
 of human slavery, 29 
 Orinoco, circumcision on the, 47 
 Orloth, penis or prepuce? 31 
 Osiris vanquished by Typhon, 28 
 Othomacos Indians and their bloody 
 
 rite, 48 
 Owen, Dr. Edmund, on phimosis, 
 263 
 
 Packard, Dr., on preputial statis- 
 tics, 219 
 
 Papal indulgences to worshipers 
 of holy prepuce, 72 
 
 Paralysis induced by phimosis, 259 
 
 Penis, absence of, 132 ; diminutive 
 specimens, 213 ; amputation of. 
 230, 233, 234, 247; cancer of^ 
 232 ; gangrene of, 236 ; hyper- 
 trophy of, 248, 251, 252 
 
 Periah, 156 
 
 Persecutions on account of circum- 
 cision, 66 
 
 Phoenician origin of circumcision, 
 22 
 
 Phimosed penis on ancient statues, 
 60 
 
 Phimosis, 218, 221 ; as a cause of 
 hernia, 263 
 
 Physicians as practical Christians, 
 141 
 
 Pooley, Prof. J. H., case of pre- 
 putial irritation, 260 
 
 Popfe, Rabbi Rav, and the Ouimara, 
 153 
 
 Portuguese sailors as Mohammedan 
 proselytes, 40 
 
 Potentia generandi, 103. 
 coeuudi, 104 
 
 Prepuce, iufibulated, 64; swallowed 
 by mother, 54 ; fired off in gun, 
 54; holy, 71; useful for skin 
 grafts, 207; absence of, 209; 
 influence on man at diflfei-ent 
 ages, 225; induration of, 250 ; 
 warts of, 250 ; reflex neuroses 
 from, 2.56 
 
 Preputial miracles, 72 ; statistics, 
 •219 ; adhesions, 219, 220 ; cal- 
 culi, 248 
 
 Price, Dr. M. F., on reflex neuroses, 
 265 ; on female preputial irrita- 
 tion, 267, 268 
 
Index. 
 
 345 
 
 Primitive phallic rites, 28 
 homcEopaths, 113 
 
 Procedure in retraction of skin of 
 penis after circumcision, 304 
 
 Proselytes, Mohammedan, how cir- 
 cumcised, 40, 41 
 
 Public women between decks in 
 U. S. Navy, 193 
 
 Puzey, Dr., of Livei-pool, on pre- 
 - putial skin grafts, 207 
 
 Pythagoras 32 ; visits Egypt, 34 
 
 Ralfe, on causes of interstitial 
 
 nephritis, 300 
 Rameses II, circumcision of his 
 
 sous, 23 
 Ranuey, Prof. A. L., on enuresis, 
 
 282 
 Reconstruction of a prepuce, 68, 69, 
 
 328 
 Rectum, prolapsus of, induced by 
 
 phimosis, 263 
 Reflex neuroses from preputial ii-ri- 
 
 tation, 2.54, 330, 331 
 Regulations of French Hebrew con- 
 sistories of 1854, 1.57 
 Religion, its connection to insanity, 
 
 166 
 Resectricis nympharum, profession 
 
 of, 36 
 Restriction on impregnation, .57 ; 
 
 on twins, 60 
 Retraction of skin of penis after 
 
 circumcision, 303 
 Richardson, Dr. B. W., on relation 
 
 of race to disease, 169, 170, 171, 
 
 177 
 Ricord's definition of the prepuce, 
 
 206 ; operations on the prepuce, 
 
 313 
 Roman infibulation, .53 
 Royal decree of 1845 in France, 157 
 Roux, on cancer of the prepuce, 227 
 Rush, Benjamin, and the cancer 
 
 quack, 77 
 
 Saint-Germain, Dr., on preputial 
 
 abnormalities, 264 
 Saint Foutin and his shrine, 78 
 Saint Guerluchon at Bourg-Dieu, 
 
 79 
 Saint Guignole and the miraculous 
 
 phallus, 80 
 Saint Coulombs and the miraculous 
 
 prepuce, 70 
 
 Saturnus the first eunuchiser, 83 
 
 Sayer, Prof. Lewis A., contribu- 
 tions to medical science, 255 
 
 Scythians carry ofl' heads of the 
 slain, 30, 
 
 Self-circumcision, attempt at, 203 
 
 Semiramis first employs eunuchs, 85 
 
 Severus Sulpicius, on effects of cli- 
 mate, .50 
 
 Sham battles at circumcision feasts, 
 37, 41, 42, 44 
 
 She-circumcisers, 36 
 
 Shrine for the recovery of impotent 
 males, 79 
 
 Smith, Dl-. J. Lewis, on preputial 
 irritation, 263 
 
 Solomon, Dr., of Brunswick, on 
 suction, 158 
 
 Soudanese chastity protector, 52 
 
 Sphincterismus due to phimosis, 
 292 
 
 Spiked chastity belt in Naples 
 museum, 52 
 
 Stallard, Dr., on Jewish vital statis- 
 tics, 173 
 
 Sterility cured at sacred shrines, 
 71 to 81 
 
 Stricture of urethra and phimosis, 
 289, 290 
 
 Styptics used by mohels, 1.58, 159 
 
 Syphilis, statistics relating to, 187 
 to 199 
 
 Syphilis and scrofula, 190 
 
 Taylor, Dr. C. F., on masturbation, 
 
 269 
 Totonac circumcision, 46 
 Tonga Islanders' rite, 45 
 Toxtemia. resulting from phimosis, 
 
 293; of von Jaksch, 294 
 Tube, penis carried in, 56 
 Tunca Indian circumcision, 56 
 Turkish circumcision, 39 to 41 
 Tylor, on the Stone Age and circum- 
 cision, 336 
 
 Van Buren and Keyes, on circum- 
 cision, 320 
 
 Vanier du Havre, Dr., 54, 224; on 
 operations, 316 
 
 Venus, birth of, 84 
 
 Vidal de Cassis, on preputial opera- 
 tions, 316 
 
 Virey, account of Hindoo bonze, 
 54 
 
346 
 
 Index. 
 
 Virgins' chain of bells in ancient 
 Judea, 52 
 
 Vital statistics of Jews, 169 to 179 
 
 Voltaire, on origins of circumcision , 
 22 
 
 Von Jaksch's definition of Tox- 
 aemia, 294 
 
 Wadd, Dr., on preputial cancer, 227 ; 
 
 on hypertroph_y of penis, 252 
 Walslie, on preputial cancer, 235 
 Warren, on preputial cancer, 235 
 Warts of penis and prepuce, 250 
 Waterman, Dr., on Jewish vital 
 
 statistics, 177 
 Wax images of penis deposited on 
 
 shrines, 79 
 
 Welsh words in Mandan language, 
 24 
 
 Wet dressing objectionable after 
 circumcision, 304, 311 
 
 White Bull, sacred among Sioux 
 and Eg}'ptians, 26 ; origin of 
 sacredness, 29 
 
 Willard, Dr. De Forest, observa- 
 tions on the prepuce, 262 
 
 Wine at circumcision feasts, 151 
 
 Wirthington, Dr. F. J., on prepu- 
 tial irritation, 259 
 
 Wise, Dr. I. M., on St. Paul the 
 apostle, 19 
 
 Worm an, Prof., of Brooklyn, on 
 circumcision, 26 
 
THE THREE FOLLOWING PAGES ARE REDUCED 
 FAC-SIMILES OF PAGES FROM 
 
 STANTON'S 
 
 Practical r^ Scientific Physiognomy; 
 
 OB, 
 
 HOW TO READ FACES. 
 
 BY 
 
 MARY OLMSTED STAKTON. 
 
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FACSIMILE PAGE FROM "STANTON'S PHYSIOGNOMY"— Reduced. 
 
 HOW TO REDUCE SIZE WITHOUT LOSING STRENGTH. 1109 
 
 vpjce. A thorough-bred person may belong to the artistic, me- 
 chanical, or scientific classes, either appreciatively or executively ; 
 lie nuist exhibit both gentleness and spirit, as occasion requires; he 
 must be governed by the law of justice; he must make the com- 
 fort of his associates his concern, and do what is right in order to 
 cnliance tlieir happiness. 
 
 Tlie facial indications of thos^ wlio are not thorough-bred, - 
 speaking physiologically, are as follow: A coarse, thick skin ; a 
 "muddy" complexion, or one permanently blotched, pimpled, or 
 discolored; dull eyes, ^ery small or very large and bulging; 
 coarse hair, or that which is very light or colorless, — that is to say, 
 of no ileckled hue. I regard very light colored, pallid people as 
 morbid varieties; also those witli irregular teeth, a very small or 
 iil-shapcn .lose, small nostrils, perpendicular jaws, exposed gums, 
 open mouth, receding chin, or one that projects greatly forward, 
 ending in a point; thin, pallid, dry lips; hollow cheeks, flat upper 
 cheeks, ugly or ill-shapen ears; a voice weak, thin, hoarse, shrill 
 or nasal; a long, cylindrical neck; a high, narrow forehead. 
 
 The undue development of certain organs and systems of the 
 body induces abnormal conditions, as, for example, an excessive 
 disposition of fatty tissue. "When the appetite is voracious, or the 
 nutritive system uncommonly active, too much of the carbonaceous 
 elements of tlie food are eliminated, or, as it often occurs, too much 
 carbonaceous food, such as white bread, potatoes, etc., is consumed 
 for tlie needs of tlie body; tlie consequence is an excess of fat, 
 which, in many subjects, impedes respiration, prevents activity, 
 and gives a generally uncomfortable feeling. For this condition a 
 spare diet is often prescribed, but as this is felt to be a hardship, 
 and as few who attempt it succeed in continuing it long enough to 
 produce satisfactory results, it is pronounced a failure. 
 
 For this class of people there is a very agreeable and sure 
 method of reducing the bulk without reducing strength and with- 
 out compelling too great a sacrifice of the appetite. 
 
 HOW TO REDUCE THE SIZE WITHOUT LOSING STRENGTH. 
 
 A diet which will attain this result is easily obtained, and of 
 it the subject can use a quantity sufficient to allay the craving 
 for food. 
 
 This dirt consists of absolutely raro foods, nothing cooked 
 being allowed. This diet, of course, must consist mainly of fruits, 
 nuts, grains, milk, and, \^hen flesh-meat is desired, a Hamburg 
 beefsteak may be partaken of; this steak is raw beef chopped fine 
 and seasoned with onion, salt, pepper, or other condiments; to 
 this may be added raw oysters and clams. Every kind of fruit 
 
FACSIMILE PAGE FROM '^STANTON'S PHYSIOGNOMY' —Reduced 
 
 SYSTEMS AND FACULTIES REQUIRED EOE A SURGEOK. 1143 
 
 is a dangerous being) ; he should develop his friendliness, love of 
 cliildven, and of tlie opposite sex; in short, he shoidd be a Icmer 
 of It/amcmiiy, 
 
 THE SYSTEMS AND FACULTIES REQUIRED FOB A SURGEON. 
 
 The best form, for a snrgcon who attempts the most severe 
 
 No scientific physiocnunii^t could mistake this face for other than that of a physi- 
 cian, and an earnest and attentive one aa well, as evidenced by the signs of "natural 
 Fhvsician" in the cheek-bone^, in thenttitudeof the head and neck, and by the thought- 
 ul, observant expression of the eye. Tlie combination of systems in this subject is such 
 as is most frequeiill> observed among physicians, viz.. the supremacy of the osseous and 
 brain systems. The muscular, thoracic, and vegetative powers all assist in this com- 
 binatioii by their development. The signs for (Conscience and Firmness are apparent. 
 I^ve of Home and Patriotism rank hign. Benevolence, Amaliveness, Love oi Young, 
 Mirth, Approbation, Self-eslet*ni, Modesty, Friendship. Alinientiveness, Sanativenesa, 
 Pneumativenefls. and Color combine to form a lovely domestic and social nature. The 
 form, size, and peculiaritie.-* of the nose claim attention. It is a nose denoting Con- 
 fltmctiveness. Originality, and logical power. The signs for Hope. Analysis, Mental 
 Imitation, Human Nature. Ideality, Sublimity, Construction, and Acquisition are 
 Htrongly delineated. Self-will is normallv developed, while Size. Form. Observation, 
 Weight. Localitv, Calculation, and Memory of various sorts are manifest. The signs 
 of Language in theeveund mouth Ueuute tiuencv, while the practical faculties, bemg 
 dominant, would give clearness, perspicacity, ami directness to his styleof expression, 
 either oral or written. Time. Oider. Reason, and Intuition are well developed. The 
 long-continued observation and experiments of this noble physician in his endeavor 
 to protect huroanitv from the ravages of small-pox by his discovery of vaccination, 
 met at last with a suitable recognition, for he received by a vote of Parliament the 
 sum of £30,000, and special honors wercawarded him, Tt is a singular fact that all of 
 t he beVef actors of the human race— those whg havebenettted it by discoveries of any 
 kind Tvhatever— have met with the most vioIeiU wpposition, treachery, and often 
 di-sgrace. before thev could make the world see the value of their discoveries. Such 
 was the case with Dr. Jenner, but his firmness and truth at last gained the victory. 
 
 operations is the round build of body and head, and many of them 
 are of this shape. The muscular system should be supreme, with 
 the brain system a close second, the bony and thoracic systems 
 about equal and next in development 
 
 The muscular tissue is comparatively unfeeling — msensitive; 
 
FACSIMILE PAGE FROM "STANTON'S PHYSIOGNOMY"— Reduced. 
 
 OTHEE CLASSES OF SUEGEONS. 1145 
 
 in the body. Form and Size are also requisite to aid the memorj of 
 the shape and relative position of each pait, and to assist Locality. 
 Human Nature is essential in order that he may be en rapport 
 with his patients, and also to enable him to diobie instinctively all 
 bodily and mental states. He should be a good physiognomist, and 
 be well versed in the pathologi/ of ])hysiognomy. He must have 
 large Observation, in order to take cognizance of the most minute 
 changes and appearances. Calculation is a useful trait also, as it 
 is required in many ways in the medication and treatment of the 
 wounded, as in chemistry and in making suigical implements, etc. 
 He should have large Friendship, in order to attach his patients to 
 him and to command their esteem; enough Benevolence to sympa- 
 thize, but not enough to weaken the feelings when severity is 
 required. The faculty of Amativeness is necessary to cornprehend 
 the nature of the opposite sex; Love of Young also, that he may 
 inspire children with love and confidence. 
 
 The sense of Weight should be a strong one, for the muscular 
 sense is dependent upon its poucr in order to garige the amount 
 of force to be used in handling instruments and in bandaging 
 wounds, limbs, etc. Exccutivene.ss is required to assist authority 
 and give resistance. Self-will is another ally most necessary, as 
 well as Analysis, Time, Order, and Reason. A fair share of 
 musical ability is required to assist the ear in making examinations 
 of the heart and lungs, and in auscultation for various other pur- 
 poses. If to these laculties one adds large Intuition, he has a fine 
 bodily and mental equipment for the jiractice of surgery. 
 
 OTHER CLASSES OF SURGEONS 
 
 Many army surgeons are characterized by a round and broad 
 form, with broad, rather low, and round heads; short, round arms, 
 and round and tapering fingers. This build is the most suitable 
 for those severe operations which require the greatest exhibition of 
 force, endurance, and coolness; another class of surgeons — those 
 who undertake the more delicate and less forceful operations — are 
 characterized by about an equal de\elopment of the brain and 
 muscular systems. This class of surgeons tend naturally to the 
 treatment of those finer, less difficult, and more delicate cases of 
 operative surgery, such, for example, as treatment of the ear, the 
 eye. etc. This class of surgeons require a fine endowment of the 
 brain and nervous system. In short, the muscles as well as ner^•es 
 of this class must be sensitive to a great degree, and this combi- 
 nation calls for a fine and high organization. 
 
 The surgeon should be something of an actor in order to 
 tnow when to be sympathetic and when to be severe. Yet he 
 
NOVEMBEB, 1893. 
 
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 ULTZMANN— The Neuroses of the Genito- Urinary Sys- 
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 Synopsis of Contents. — First Part — I. Chemical Changes in 
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 WITHERSTINE— International Pocket Medical Formu- 
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