John M. Foley, M.D.
FACT Magazine, July-August 1966
One answer, of course, is that if circumcision were made compulsory, the circumciser would be protected whenever he happens to cripple or kill the little boy he operates on -- "complication" that is not so very uncommon. Another answer, I think, must be sought in the darker regions of the human mind, because circumcision is simply an unmitigated fraud. It is nothing but wanton and unnecessary mutilation. The annual 2 million assembly-line circumcisions in this country are a monument to the gullibility and stupidity of the American public.
For 60 years, a powerful and articulate minority in our profession has tried to enforce a tabu against any objective discussion of the merits or demerits of circumcision. Over in Great Britain the climate of opinion is decidedly against routine circumcision, but here the operation has become a sacrament: To question its value has become all but unthinkable. The medical literature is virtually closed except to those who drool over the operation's alleged advantages.
Efforts to justify circumcision have been made since the very beginnings of history. The desire to mutilate came first; the "reasons" came later, and run the gamut from spiritual through cultural, esthetic, and finally medical.
Since circumcision has practically nothing to recommend it, an important question is: Why has it become a routine operation? A few physicians go so far as to suggest that money may have something to do it. Dr. Van Zante asks rhetorically: "Don't you think that the doctor delivering the baby thinks more about the $10 or $15 surgical fee he'll get than the possible after-effects?"
My own view is: Circumcision provides a convenient and socially acceptable outlet for the perverted component of the circumciser's libido. I have had person experience with the psychopathology that underlies the wish to circumcise. The pitiful wails of the suffering infant are all too often the background for lewd and obscene commentary by the obstetrician to his audience of nurses. Several years ago I saw an infant born with multiple deformities. He could not live more than a few months at most, but to add to his miseries, this unfortunate bit of humanity had to undergo a thorough circumcision.
I have seen two medical students fight over the privilege of doing circumcision on the newborn, although these same students showed neither interest nor aptitude for opening boils or doing other surgical tasks.
In 1951, I witnessed an autopsy on an infant who had died from an infected circumcision -- a death rendered even more tragic because the mother had tried to persuade the obstetrician to spare her infant this ordeal.
Because the motivations of the foreskin-phobes are so irrational, these people are hard to combat. The introduction of routine circumcision as a "medical" measure at the turn of the century aroused vigorous opposition within the profession. Dr. Warren Stone Bickham, an eminent surgeon, declared that circumcision was a disgrace and a discredit to the surgeon responsible. Nonetheless by 1930 the opposition had dwindled, and the fanatical circumcisers were in possession of the field. The opponents of circumcision failed because they did not understand the motives of the circumcisers and therefore could not grapple with them.
The circumcision of a newborn boy is a spectacle so appalling and revolting in its cruelty that, on their first encounter with the ordeal, many robust medical students faint. The infant is tied down securely to a circumcision board, with his genitals exposed. Next, the entire foreskin and much of the penile skin is pulled through a clamp, and as the clamp's screw is tightened, the skin is crushed off. As much as 80% of the total penile skin is removed. In this country anesthetics are rarely used. The infant struggles and screams, and often vomits and defecates, before lapsing into unconsciousness.
As a result of circumcision, some infants die. Countless others are doomed to become sexual cripples. In 1958 a 4-year- old boy underwent surgery for an undescended testicle. The surgeon, noticing that the child still had his foreskin, just couldn't pass up this tidbit. The circumcision failed to heal, and 5 days later the penis sloughed off. The parents sued for $150,000 and settled for $80,000. In a similar case last year, the parents asked for $4,500,000. These are two cases that have come to public attention because of lawsuits. In England and Wales, however, it is known that an average of 16 children died annually from 1942 to 1947 as a direct result of circumcision.
Dr. Van Zante has this to say: "Proponents of circumcision do not mention any of the ill-effects of circumcision. Duf and Ware state, 'Major losses of penile skin are fairly common as a complication of circumcision.' The child may get a meatal ulcer. The sensitive, exposed glans [the head of the penis] sometimes becomes infected with diaper rash.... Occasionally a babe, especially of hemophiliac parents, bleeds to death."
Dr. Weiss mentions these other possible complications: sepsis, eczema of the glans and meatus, meatal stenosis, surgical adhesions, interference with nutrition, edema of local tissue, seepage of blood with resulting anemia, and injuries of the glans or scrotal skin.
Dr. John Van Duyn of Georgia, a plastic surgeon, has complained that often circumcisions are performed by young interns, and after they perform a few circumcisions, they are left unsupervised. "Unless the operator is competent and care is exercised," he writes, "there is always the possibility of damage from poor technique."
Dr. Can Duyn goes on: "A short time ago, I was called upon to split-graft the penis of a newborn where too much skin had been inadvertently removed, and in reporting this case found that this error had occurred in a number of other instances.
"In another case, involving incorrect use of a circumcision clamp in an infant, the glans was found gangrenous on removal of the clamp and was subsequently lost."
"There is also the danger from hemorrhage, especially if the baby is placed in a prone position and supervision is minimal, In a near fatality from this cause, of which I have firsthand knowledge ... a growing puddle of blood beneath the baby was not discovered for a considerable time.
For the mature man, the foreskin provides a covering during erection, and the organ increases in bulk from six to eight times. In coitus, it rolls back to expose the sensitive glans. And especially when the vagina is snug, this elastic covering promotes sexual satisfaction: It enables the penis to penetrate smoothly and without friction.
A number of students have confirmed that the uncircumcised man has a sexual advantage over the circumcised. For instance, Martin L. Edwards Sr., M.D., a Texas physician, writes: "I have counseled with many married men who are circumcised, and this alone has been a great drawback between man and wife."
Circumcision, in the unconscious, is confused with castration. Thus, in Man Against Himself, Dr. Menninger writes: "I could cite many illustrations from psychiatric practice to show how, in the unconscious, circumcision and castration are equated. Because the fear of cutting in connection with the genitals is so widespread, and apparently so basic in the formation of character, any surgery in connection with the genitals is apt to be associated with strong emotional feeling which psychoanalysts, on the basis of their daily experiences with the language of the unconscious, ascribe to the 'castration threat,' i.e., the fear that the genitals are to be irremediably injured."
Still, at the present time I think that it is parents who are our best hope. It is they who can campaign for a more open discussion of the problem. It is they who can prevent their sons from being circumcised. And it is, therefore, to parents that I appeal:
Let us be honest and fair enough to let our sons grow up to decide for themselves if they want to exchange their foreskins for the very dubious advantages of circumcision.
And I would like to remind parents of that perceptive remark of the great historian Henry Thomas Buckle: "Every great reform which has been effected has consisted, not in doing something new, but in undoing something old."