page_title: History of circumcision
section_title: Medical concerns
hierarchical_section_title: History of circumcision / Revival in the English-speaking world / Medical concerns
caption_attribution_description: J. Hutchinson
context_page_description: Circumcision has ancient roots among several ethnic groups in sub-equatorial Africa, and is still performed on adolescent boys to symbolize their transition to warrior status or adulthood. Circumcision and/or subincision, often as part of an intricate coming of age ritual, was a common practice among Australian Aborigines and Pacific islanders at first contact with Western travellers. It is still practiced in the traditional way by a proportion of the population.
  In Judaism, circumcision has traditionally been practised among males on the eighth day after birth. The Book of Genesis records circumcision as part of the Abrahamic covenant with Yahweh. Circumcision was common, although not universal, among ancient Semitic people. Herodotus, writing in the 5th century BCE, lists the Colchians, Ethiopians, Phoenicians, and Syrians as circumcising cultures. In the aftermath of the conquests of Alexander the Great, however, Greek dislike of circumcision led to a decline in its incidence among many peoples that had previously practiced it.
context_section_description: The first medical doctor to advocate for the adoption of circumcision was the eminent English physician, Jonathan Hutchinson. In 1855, he published a study in which he compared the rate of contraction of venereal disease amongst the gentile and Jewish population of London. Although his manipulation and usage of the data has since been shown to have been flawed (the protection that Jews appear to have are more likely due to cultural factors), his study appeared to demonstrate that circumcised men were significantly less vulnerable to such disease. (A 2006 systematic review concluded that the evidence "strongly indicates that circumcised men are at lower risk of chancroid and syphilis.")
  Hutchinson was a notable leader in the campaign for medical circumcision for the next fifty years, publishing A plea for circumcison in the British Medical Journal (1890), where he contended that the foreskin "... constitutes a harbour for filth, and is a constant source of irritation. It conduces to masturbation, and adds to the difficulties of sexual continence. It increases the risk of syphilis in early life, and of cancer in the aged." As can be seen, he was also a convert to the idea that circumcision would prevent masturbation, a great Victorian concern. In an 1893 article, On circumcision as a preventive of masturbation he wrote: "I am inclined to believe that [circumcision] may often accomplish much, both in breaking the habit [of masturbation] as an immediate result, and in diminishing the temptation to it subsequently."
  Nathaniel Heckford, a paediatrician at the East London Hospital for Children, wrote Circumcision as a Remedial Measure in Certain Cases of Epilepsy, Chorea, etc. (1865), in which he argued that circumcision acted as an effective remedial measure in the prevention of certain cases of epilepsy and chorea.
  These increasingly common medical beliefs were even applied to females. The controversial  obstetrical surgeon Isaac Baker Brown founded the London Surgical Home for Women in 1858, where he worked on advancing surgical procedures. In 1866, Baker Brown described the use of clitoridectomy, the removal of the clitoris, as a cure for several conditions, including epilepsy, catalepsy and mania, which he attributed to masturbation. In On the Curability of Certain Forms of Insanity, Epilepsy, Catalepsy, and Hysteria in Females, he gave a 70 per cent success rate using this treatment.
  However, during 1866, Baker Brown began to receive negative feedback from within the medical profession from doctors who opposed the use of clitoridectomies and questioned the validity of Baker Brown's claims of success. An article appeared in The Times in December, which was favourable towards Baker Brown's work but suggested that Baker Brown had treated women of unsound mind. He was also accused of performing clitoridectomies without the consent or knowledge of his patients or their families. In 1867 he was expelled from the Obstetrical Society of London for carrying out the operations without consent. Baker Brown's ideas were more accepted in the United States, where, from the 1860s, the operation was being used to cure hysteria, nymphomania, and in young girls what was called "rebellion" or "unfeminine aggression".
  Lewis Sayre, New York orthopedic surgeon, became a prominent advocate for circumcision in America. In 1870, he 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.
  As more practitioners tried circumcision as a treatment for otherwise intractable medical condition
caption: Jonathan Hutchinson was the first prominent medical advocate for circumcision.
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