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CIRCUMCISION IN THE ANCIENT WORLD The oldest documentary evidence for circumcision comes from Egypt . Tomb artwork from the Sixth Dynasty (2345 - 2181 BC) shows men with circumcised penises, and one Relief from this period shows the rite being performed on a standing adult male. The Egyptian Hieroglyph for "penis" depicts either a circumcised or an erect organ. The examination of Egyptian mummies has found both circumcised and uncircumcised men. Circumcision was common, although not universal, among ancient Semitic peoples. The Book Of Jeremiah , written in the Sixth Century BC , lists the Egyptians, Jews , Edomites , Ammonites , and Moabites as circumcising people. Herodotus , writing in the Fifth Century BC , would add the Colchians , Ethiopia ns, Phoenicians , and Syria ns to that list. Except in the portrayal of Satyr s, lechers, and Barbarian s, Ancient Greece artwork portrayed penises covered by foreskins. In the aftermath of Alexander The Great 's conquests, Greek dislike of the circumcised penis led to a decline in the incidence of circumcision among many peoples that had previously practiced it. The writer of 1 Maccabees wrote that during the Seleucid Empire , many Jewish men attempted to hide or reverse their circumcision so they could exercise in Greek Gymnasia . Cultural pressures to circumcize operated throughout the conquered the Idumea ns, he forced them to become circumcised and convert to Judaism, but their ancestors the Edomites had practiced circumcision in pre-Hellenistic times. MALE CIRCUMCISION IN THE GRECO-ROMAN WORLD According to Hodges, ancient Greek Aesthetics of the human form considered circumcision a mutilation of a previously perfectly shaped organ. Greek artwork of the period portrayed penises as covered by the foreskin (sometimes in exquisite detail), except in the portrayal of Satyr s, lechers, and Barbarian s. {Link without Title} This dislike of the appearance of the circumcised penis led to a decline in the incidence of circumcision among many peoples that had previously practiced it throughout placed on Jews and Judaizers. The first-century Alexandria n Apion denounced circumcision as a barbaric custom in his diatribe against the Jews, notwithstanding that it was still practised among the Egyptian priestly caste. Roman Satirists including Horace and Juvenal equated the exposure of the glans that results from circumcision to its exposure during Erection , and they Caricature d Jewish men as being lustful or Lecher ous, sometimes in an Incest uous or Homosexual sense, often implying that Jewish men had unusually large penises and were of great sexual potency. Techniques for restoring the appeareance of an uncircumcised penis were known by the 2nd century B.C. In one such technique, a copper weight (called the ''Judeum pondum'') was hung from the remnants of the circumcised foreskin until, in time, they became sufficiently stretched to cover the glans. The first-century writer , ca. 100, added two more steps to the Biblical rite of circumcision:
Circumcision was an important issue for first century Jews and Christians. at the advice of a Jewish merchant named Ananias. He was going to get circumcised, but his mother, Helen, who herself embraced the Jewish customs, advised against it on the grounds that the subjects wouldn't stand to be ruled by someone who followed such "strange and foreign rites". Ananias likewise advised against it, on the grounds that worship of God was superior to circumcision (Robert Eisenman in ''James the Brother of Jesus'' claims that Ananias is Paul Of Tarsus who held similar views) and that God would forgive him for fear of his subjects. So Izates decided against it. However, later, "a certain other Jew that came out of Galilee, whose name was Eleazar", who was well versed in the Law, convinced him that he should, on the grounds that it was one thing to read the Law and another thing to practice it, and so he did. Once Helen and Ananias found out, they were struck by great fear of the possible consequences, but as Josephus put it, God looked after Izates. As his reign was peaceful and blessed, Helen visited the Jerusalem Temple to thank God, and since there was a terrible famine at the time, she brought lots of food and aid to the people of Jerusalem. There was also division in Pharisaic Judaism between Hillel The Elder and Shammai on the issue of circumcision of Proselytes . See also Circumcision In The Bible#In Rabbinic Literature The . These terms (circumcised/uncircumcised) are generally interpreted to mean Jews and Greeks , who were predominate, however it is an oversimplification as 1st century Iudaea Province also had some Jews who no longer circumcised, and some Greeks (called Proselytes or Judaizers) and others such as Egyptians, Ethiopians, and Arabs who did. The Gospel Of Thomas saying 53, said to be of Jesus , states: :"His disciples said to him, "is circumcision useful or not?" He said to them, "If it were useful, their father would produce children already circumcised from their mother. Rather, the true circumcision in spirit has become profitable in every respect."" SV {Link without Title} Parallels to Thomas 53 are found in Paul's 2:11-12. In John's Gospel 7:23 Jesus is reported as giving this response to those who criticized him for healing on the Sabbath: :Now if a man can be circumcised on the sabbath so that the Law of Moses is not broken, why are you angry with me for making a man whole and complete on a sabbath? ( Jerusalem Bible) This passage has been seen as a comment on the Rabbinic belief that circumcision heals the penis (Jerusalem Bible, note to John 7:23) or as a criticism of circumcision {Link without Title} . MALE CIRCUMCISION IN THE RENAISSANCE Europeans, with the exception of the Jews, did not practice male circumcision. The Church issued a papal bull in 1442 that prohibited the practice of circumcision for all Christians {Link without Title} . MALE CIRCUMCISION IN THE 18TH CENTURY Circumcision was not practiced amongst Christians in Europe in the 18th Century. It was regarded with repulsion. :Edward Gibbon had referred to it as a "singular mutilation" practised only by Jews and Turks and as "a painful and often dangerous rite" ... (R. Darby) {Link without Title} In 1753 in London there was a proposal for Jewish emancipation. It was furiously opposed by the pamphleteers of the time, who spread the fear that Jewish emancipation meant universal circumcision. Men were urged to protect: :"the best of Your property" and guard their threatened foreskins. It was an extraordinary outpouring of popular beliefs about sex, fears about masculinity and misconceptions about Jews, but also a striking indication of how central to their sexual identity men considered their foreskins at that time. (R.Darby) {Link without Title} MALE CIRCUMCISION IN THE 19TH CENTURY AND BEYOND Until well into the Nineteenth Century, the same sentiments prevailed. : Richard Burton observed that "Christendom practically holds circumcision in horror". This attitude is reflected in the ninth edition of the Encyclopaedia Britannica (1876) which discusses the practice as a religious rite among Jews, Moslems, the ancient Egyptians and tribal peoples in various parts of the world. The author of the entry rejected sanitary explanations of the procedure in favour of a religious one: "like other body mutilations ... is of the nature of a representative sacrifice". (R. Darby) [http://www.circinfo.org/review.html] Then, a change of attitude began, something that was reflected in successive editions of the Encyclopaedia Britannica: :By 1910 the entry had been turned on its head: "This surgical operation, which is commonly prescribed for purely medical reasons, is also an initiation or religious ceremony among Jews and Muslims": now it was primarily a medical procedure and only after that a religious ritual. The entry explained that "in recent years the medical profession has been responsible for its considerable extension among other than Jewish children ... for reasons of health" (11th edition, Vol. 6). By 1929 the entry is much reduced in size and consists merely of a brief description of the operation, which is "done as a preventive measure in the infant" and "performed chiefly for purposes of cleanliness". Ironically, readers are then referred to the entries for "Mutilation" and "Deformation" for a discussion of circumcision in its religious context (14th edition, 1929, Vol. 5). (R. Darby) {Link without Title} Historically, routine neonatal circumcision was promoted during late Victorian times in the English-speaking parts of Canada , Australia , New Zealand , the United States and the United Kingdom and was widely practiced during the first part of the 20th Century in these countries. However, the practice declined sharply in the United Kingdom after the Second World War, and somewhat later in Canada, Australia and New Zealand. It has been argued (e.g., Goldman 1997) that the practice did not spread to other European countries because others considered the arguments for it fallacious. In South Korea , circumcision was largely unknown before the establishment of the United States trusteeship in 1945 . More than 90% of South Korean high school boys are now circumcised, but the average age of circumcision is 12 years, which makes South Korea a unique case {Link without Title} . Routine infant circumcision has been abandoned in New Zealand and Britain, and is now much less common in Australia and in Canada (see table 1). The decline in circumcision in the United Kingdom followed the decision by the National Health Service (NHS) in 1948 not to cover the procedure following an influential article by Douglas Gardiner which claimed that circumcision resulted in the deaths of about 16 children under 5 each year in the United Kingdom. {Link without Title} . In most of the rest of the world, circumcision is done either as a religious or cultural practice. Routine infant circumcision in the United States grew out of a widespread fear that masturbation caused various diseases, a view now universally rejected by the medical community. Circumcision was thought to reduce masturbation and other Sexual Behavior considered undesirable. Circumcision, depending on how it is practiced, can have a significant impact on masturbation; see Masturbation for a detailed discussion. MALE CIRCUMCISION TO PREVENT MASTURBATION Non-religious circumcision in English-speaking countries arose in a climate of sexual fear, especially concerning masturbation. In her 1978 article ''The Ritual of Circumcision'', {Link without Title} Karen Erickson Paige writes: "In the United States, the current medical rationale for circumcision developed ''after'' the operation was in wide practice. The original reason for the surgical removal of the foreskin, or prepuce, was to control 'masturbatory insanity' - the range of mental disorders that people believed were caused by the 'polluting' practice of 'self-abuse.'" "Self-abuse" was a term commonly used to describe masturbation in the 19th century. According to Paige, "treatments ranged from diet, moral exhortations, hydrotherapy, and marriage, to such drastic measures as surgery, physical restraints, frights, and punishment. Some doctors recommended covering the penis with plaster of Paris, leather, or rubber; cauterization; making boys wear Chastity Belt s or spiked rings; and in extreme cases, Castration ." Paige details how circumcision became popular as a masturbation remedy: :"In the 1890s, it became a popular technique to prevent, or cure, masturbatory insanity. In 1891 the president of the Royal College of Surgeons of England published ''On Circumcision as Preventive of Masturbation,'' and two years later another British doctor wrote ''Circumcision: Its Advantages and How to Perform It,'' which listed the reasons for removing the 'vestigial' prepuce. Evidently the foreskin could cause 'nocturnal incontinence,' hysteria, epilepsy, and irritation that might 'give rise to erotic stimulation and, consequently, masturbation.' Another physician, P.C. Remondino , added that 'circumcision is like a substantial and well-secured life Annuity ...it insures better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor bills.' No wonder it became a popular remedy." [http://www.noharmm.org/paige.htm] At the same time circumcisions were advocated on men, clitoridectomies (removal of the clitoris) were also performed for the same reason (to treat female masturbators). The US "Orificial Surgery Society" for female "circumcision" operated until 1925, and clitoridectomies and Infibulation s would continue to be advocated by some through the 1930s. One of the leading advocates of circumcision was John Harvey Kellogg , who is well known for his pseudoscientific views on human sexuality. He advocated the consumption of Kellogg's corn flakes to prevent masturbation, and he believed that circumcision would be an effective way to eliminate masturbation in males. :"Covering the organs with a cage has been practiced with entire success. A remedy which is almost always successful in small boys is circumcision, especially when there is any degree of phimosis. The operation should be performed by a surgeon without administering an anaesthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment, as it may well be in some cases. The soreness which continues for several weeks interrupts the practice, and if it had not previously become too firmly fixed, it may be forgotten and not resumed. If any attempt is made to watch the child, he should be so carefully surrounded by vigilance that he cannot possibly transgress without detection. If he is only partially watched, he soon learns to elude observation, and thus the effect is only to make him cunning in his vice." Robert Darby, writing in the Australian Medical Journal, noted that some 19th Century circumcision advocates—and their opponents—believed that the foreskin was sexually sensitive: :In the 19th century the role of the foreskin in erotic sensation was well understood by physicians who wanted to cut it off precisely because they considered it the major factor leading boys to masturbation. The Victorian physician and venereologist William Acton (1814–1875) damned it as "a source of serious mischief", and most of his contemporaries concurred. Both opponents and supporters of circumcision agreed that the significant role the foreskin played in sexual response was the main reason why it should be either left in place or removed. William Hammond, a Professor of Mind in New York in the late 19th century, commented that "circumcision, when performed in early life, generally lessens the voluptuous sensations of sexual intercourse", and both he and Acton considered the foreskin necessary for optimal sexual function, especially in old age. Jonathan Hutchinson, English surgeon and pathologist (1828–1913), and many others, thought this was the main reason why it should be excised. {Link without Title} MEDICAL CIRCUMCISION FROM 1870 TO 1950 IN ENGLISH-SPEAKING COUNTRIES Until , a prominent New York Orthopedic Surgeon and vice president of the newly-formed American Medical Association , examined a five-year-old boy who was unable to straighten his legs, and whose condition had so far defied treatment. Upon noting that the boy's genitals were inflamed, Sayre hypothesized that chronic irritation of the boy's foreskin had paralyzed his knees via Reflex Neurosis . Sayre circumcised the boy, and within a few weeks, he recovered from his paralysis. After several additional incidents in which circumcision also appeared effective in treating paralyzed joints, Sayre began to promote circumcision as a powerful orthopedic remedy. Sayre's prominence within the medical profession allowed him to reach a wide audience. He lectured widely in the United States and the United Kingdom, and his ideas influenced physicians throughout the English-speaking world. As more practitioners tried circumcision as a treatment for otherwise intractable medical conditions, sometimes achieving positive results, the list of ailments reputed to be treatable through circumcision grew. By the 1890s, Hernia , Bladder infections, Kidney Stone s, Insomnia , chronic indigestion, Rheumatism , Epilepsy , Asthma , Bedwetting , Bright's Disease , Erectile Dysfunction , Syphilis , Insanity , and Skin Cancer had all been linked to the foreskin, and many physicians advocated universal circumcision as a preventive health measure. Specific medical arguments aside, several hypotheses have been raised in explaining the public's acceptance of infant circumcision as preventive medicine. The success of the s in urban areas, Childbirth , at least among the upper and middle classes, was increasingly undertaken in the care of a physician in a hospital rather than that of a Midwife in the home. It has been suggested that once a critical mass of infants were being circumcised in the hospital, circumcision became a class marker of those wealthy enough to afford a hospital birth. {Link without Title} During the same time period, circumcision was becoming easier to perform. William Halstead 's 1885 discovery of hypodermic Cocaine as a local anaesthetic made it easier for doctors without expertise in the use of Chloroform and other general anaesthetics to perform minor surgeries. Also, several mechanically-aided circumcision techniques, forerunners of modern clamp-based circumcision methods, were first published in the medical literature of the 1890s, allowing surgeons to perform circumcisions more safely and successfully. By the 1920s, advances in the understanding of disease had undermined much of the original medical basis for preventive circumcision. Doctors continued to promote it, however, as good penile hygiene and as a preventive for a handful of conditions local to the penis: balanitis, phimosis, and penile cancer. Routine infant circumcision was successfully promoted in the English-speaking parts of Canada , Australia , New Zealand , the United States and the United Kingdom . Although it is difficult to determine historical circumcision rates, one estimate {Link without Title} of infant circumcision rates in the United States holds that 30% of newborn American boys were being circumcised in 1900, 55% in 1925, and 72% in 1950. CIRCUMCISION SINCE 1950 In 1949 , a lack of consensus in the medical community as to whether circumcision carried with it any notable health benefit motivated the United Kingdom's newly-formed National Health Service to remove routine infant circumcision from its list of covered services. Since then, circumcision has been an out-of-pocket cost to parents, and the fraction of newborns circumcised in the hospital has fallen to less than one percent. Similar trends have operated in Canada. Individual provincial heath services began delisting circumcision in the 1980s; at present, only Manitoba and the Northwest Territories pay for the procedure. The infant circumcision rate in Canada has fallen from roughly half in the 1970s to its present value of 11%, albeit with strong regional variations. In South Korea , circumcision was largely unknown before the establishment of the United States trusteeship in 1945 and the spread of American influence . More than 90% of South Korean high school boys are now circumcised, but the average age of circumcision is 12 years, which makes South Korea a unique case [http://www.cirp.org/library/cultural/pang1/]. In the United States, statistics collected by the National Center for Health Statistics show that the overall rate of neonatal circumcision has remained near 65% since data collection began in 1979 However, strong regional differences in the circumcision rates have developed during this time. While more than 80% of newborn boys are circumcised in the s, who usually do not circumcise [http://www.cdc.gov/nchs/products/pubs/pubd/hestats/circumcisions/circumcisions.htm . CIRCUMCISION IN THE 21ST CENTURY The major medical societies in America Britain[http://www.bma.org.uk/ap.nsf/Content/malecircumcision2003 , Canada Australia and New Zealand[http://www.racp.edu.au/hpu/paed/circumcision/summary.htm do not recommend routine non-therapeutic infant circumcision. Major medical organizations in the United States and Canada now say that parents should decide what is in their child's best interests, declining to make a recommendation one way or another. In recent years, some have voiced ethical concerns about the procedure. ''See Bioethics Of Neonatal Circumcision for more information.'' As of August 2005, sixteen US states no longer pay for the procedure under Medicaid ; the other 34 still do (see map ). Twelve Canadian provincial and territorial health insurance plans no longer pay for non-therapeutic circumcision; one still does. Neonatal circumcision nonetheless still remains the most common pediatric operation carried out in the U.S. today. For current circumcision rates, please see this table . EXTERNAL LINKS
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