This book is the amplification of a paper, the subject of which was, “A Plea for Circumcision; or, the Dangers that Arise from the 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 suggested 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 enlarge the scope of our observation and comparison; this naturally led to a study of the physical characteristics of the only race that could practically be used for the purpose. This race is the Jewish race. On carefully studying into the subject, I plainly saw that much of their 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 family is also more calculated to promote long life, as, strangely as it may seem, family veneration and family love and attachment are far more strong and practical among this people than among Christians, this sentiment not being even as strong in the Christian races as it is in the 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 There is also a less tendency to criminality, debauchery, and intemperance in the race; this, again, can in a measure be ascribed to their family influence, which even in our day has not lost that patriarchal influence which tinges the home or family life in the Old Testament. 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 inmates of our poor-houses, but, what is also singular, they are never accused of many silly crimes, such as indecent exposures, assaults on young girls; nor do they figure in any such exposures as the one recently made by the Pall Mall Gazette. After allowing all that, which we can, in its fullest limit, to religion, family, or social habit, there is still a wide margin to be accounted for. This has naturally let the inquiry, followed in the course of this book, into a careful review of the Jewish people; into their 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 Ecclesiastical writers and moralists, as well as writers of fiction or dramatizers, can write on anything they please, and it is eagerly taken up and read by the people generally, either of high or low degree, alike; and somehow these people seem never to require an apology on the part of the author, for having attempted rapes, seductions, or even unavoidable fornication committed through the leaves of the story, or having it imaginably take place between acts on the stage. But if the physician writes a book touching anything 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 who all of a sudden have become intensely moral and extremely sensitive in their modesty. Why 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 seventeenth century,—who felt compelled by the extreme modesty of the people in this particular—but who, outside 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 modesty 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 For my part, I think that people who can go to the theatre and enjoy “As in a Looking-Glass,” and witness some of the satyrical or billy-goat traits of humanity so graphically exhibited in “La Tosca,” with evident satisfaction; or attend the more robust plays of “Virginius” or of “Galba, the Gladiator,” with all its suggestions of the CÆsarian 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 but few general readers who could honestly plead an ignorance of the “Decameron,” Balzac, La Fontaine, “Heptameron,” CrÉbillon 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 Some fault may, perhaps, be found with some of the occasional style of the book, or with some of the subjects used to illustrate a principle. To the extremely wise, good, and scientific, these illustrations were unnecessary; 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 read by the Solon, Socrates, Plato, or Seneca 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 that it exists. So, for the sake of boring and driving a few solid facts into the otherwise undigesting and unthinking, as well as primarily obdurate understanding of the untutored plebeian, I ask the indulgence of the intelligent and broad-minded as well as the easily inducted reader. Cleopatra was smuggled into CÆsar’s presence in a roll of tapestry; the Greeks introduced 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 recesses of which was a magic table whereon would pass in grim procession the different events of the 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 study, 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 thousands of years through which the human species has evolved from its earliest appearance on earth, gradually working up through the different evolutionary processes to what 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 many of the carnivorous animals with whom he was contemporary, or, as the shades Man has now no use for any of these necessaries of a long-past age,—an age so remote that the speculations of Ernest Renan regarding the differences between the Semitic race of Shem and the idolatrous descendants of Ham, away off in the far mountains and valleys of Asia lying between the Mediterranean Sea and the Euphrates, seem more as if he were discussing an event of yesterday than something which is considered contemporary with our earlier history,—and we find them disappearing, disuse gradually 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 legacy that has descended from our long-haired and muscular ancestry, is the best example of disappearance caused by disuse, while the effectual disappearance of the prepuce in many cases shows that in that regard there exists a marked difference in the evolutionary march 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. Firstly, 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 disappearance. 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, 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 very organ it was intended to protect, when that organ, through its iniquitous tastes, has got itself into trouble, and, Job-like, is lying repentant and sick in its many wrappings of lint, with perhaps its companions in crime imprisoned in a suspensory 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 annoyance. In the far-off land of Ur, among the mountainous regions of Kurdistan, something over six thousand years ago, the fathers of the Hebrew race, inspired by a wisdom that could be nothing less than of divine origin, forestalled the process of evolution 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 brothers with some embodied facts that they may use in 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 faulty 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, Then, there is our statistical friend, who cannot discriminate between the exception and the rule by any common-sense deductions. He must have all the authentic, carefully-compiled statistics before he can allow himself to form any opinion. As long as there is the smallest fraction of a decimal unaccounted for in a mathematical way, this individual is inconvincible. These men pride themselves upon being methodically exact; they express their willingness to be convinced if you can present acceptable proofs; but, trying to present simple rational proofs to these individuals is considerably like presenting a meal of boiled pork and cabbage to a confirmed and hypochondriacal dyspeptic,—it only increases their mental dyspepsia. Had Columbus waited to discover America, or had Galileo waited to proclaim the motion of the earth, until authorized to a serious consideration of the matter by properly-tabled statistics, they would have waited a long, long time; and, it may be added, the inconveniences that attend the proving of a negative will so The ideas of the etiology and pathological processes through which we journey,—from a condition of health and good feeling to one of disease, miserable feeling, and death,—as described in, or rather as they control the sentiment and policy of, this work, are such as have been followed by Hutchinson, Fothergill, Beale, Black, Albutt, and Richardson, so that if I have totally ignored the old conventional systems, with their hide-bound classification of diseases to control the etiology, I have not done so without some reliable authority. 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 disease. As truthfully observed by T. Clifford Albutt: “The philosophic inquirer is not satisfied to know that a person is suffering, for example, from a cancer. He desires to know why he is so suffering,—that is, what are the processes which necessarily precede or follow it. He wishes to include this phenomena, now isolated, in “The first requisite for longevity must clearly be an inherent or inborn quality of endurance, of steady, persistent nutritive force, which includes reparative force and resistance to disturbing agencies, and a good proportion or balance between the several organs. Each organ In following out our study of diseases, we have been too closely narrowed down by the old symptomatic story of disease; we have too much treated surface symptoms, and neglected to study the man and his surroundings as a whole; we have overlooked the fact that there exists a geographical fatalism in a physical sense as well as the existence of the influence of that climatic fatalism so well described by Alfred Haviland, and the presence of a fatalism of individual constitution as well, which is either inherited or acquired. The idea that Charcot elaborates, that, as the year passes successively through the hot and the cold, through the dry and the wet season, with advancing age the human body undergoes like changes, and diseases assume certain characteristics, 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 fully 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 “ThÈorie From the above outline it will be easier for the reader to follow out the reasons, or the whys or wherefores, of the views expressed on medicine in the course of the book; and, although 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 eternal bliss and glory of the 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 will be plainly presented in the following pages. I simply have given the facts and my impressions: the reader is at liberty to draw his own conclusions. If I 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 preponderance 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 circumcision before the bar of public opinion, as well as that of my professional brother, I would but illy do justice to the subject at the bar, or to myself, not to properly present the case; as it was remarked by Napoleon, “God is on the side of the heaviest artillery,” and The reasons for the existence of the book will become 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 specialty, singularly and unpardonably silent and deficient on the subject of either the prepuce and the diseases to which it leads, or circumcision; and even our surgical works are not sufficiently 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 prepuce 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 appendage 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 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 Christianity but very imperfectly explains why 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, seeing 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 why came the authority that abolished this rite?” There is one probable explanation, this being that Paul, who was the real promulgator of Gentile 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 Gentiles, This, in short, with the exception of the sayings of Paul on the subject, which are all secondary considerations, 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 they who were with the Master should always have insisted on the From these premises, I have seen fit to inquire into the relative merits of the three religions practiced by what we call the civilized nations, as they affect man morally, physically, and mentally. I have given the facts, 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 operations, 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 mutilations practiced on the genitals while discussing the subject of circumcision, they being, in the originality of performance, somewhat intimately connected; this also tends to make the subject more interesting as a contribution to the natural history of man,—something in which all intelligent persons are more or less interested. P. C. Remondino, M.D. San Diego, California. |