In ancient Egypt the performance of circumcision was at one time limited to the priesthood, who, in addition to the cleanliness that this operation imparted to that class, added the shaving of the whole body as a means of further purification. The nobility, royalty, and the higher warrior class seem to have adopted circumcision 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 precaution, 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 physician class. In general conversation with physicians on this subject, it has really been surprising to see the large number who have had themselves circumcised, either through the advice of some college professor while attending lectures or as a result of their own subsequent convictions when engaged in actual practice 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 dangers 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, annoyances, 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 by 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 operation 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 supposed, as there are many Christian families where males are regularly circumcised soon after birth, who simply do so as a hygienic measure.

For the benefit of these, who may congratulate themselves upon the dangers and annoyances that they 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 especially 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 physicians, 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 sufficiency of facts, so that, unless the reader is too overexacting, he will not find much difficulty in arriving at a conclusion on the subject.

P. C. Remondino, M.D.

San Diego, California, 1891.