Circumcision. - The fold of integument called the prepuce, which has been previously described, has upon its inner surface a large number of glands [This is false.] which produce a peculiar secretion. Under certain circumstances, and from inattention to personal cleanliness, this secretion may accumulate, and then often becomes the cause of irritation and serious disease. To prevent such disorders, and to insure cleanliness, the Jewish law required the removal of the prepuce, which constituted the rite of circumcision. [There is no evidence that this is the reason for it.] The same practice is followed by several modern nations dwelling in tropical climates; and it can scarcely be doubted that it is a very salutary one, and has contributed very materially to the maintenance of that proverbial national health for which the Jews are celebrated. Eminent physicians have expressed the opinion that the practice would be a salutary one for all men.



It is doubtful, however, whether as much harm as good does not result from circumcision , since it has been shown by extensive observation among the Jews that very great contraction of the meatus, or external orifice of the urethra, is exceedingly common among them, being undoubtedly the result of the prolonged irritation and subsequent cicatricial contraction resulting from circumcision in infancy. (pp106-7)



[This is meatal stenosis, still recognised as a complication of circumcision.]





Treatments for Self-Abuse and its Effects:



Spinal Irritation. -- Irritation of the spinal cord, with its resultant evils, is one of the most common of the nervous affections originating in this cause. Tenderness of the spine, numerous pains in the limbs, and spasmodic twitching of the muscles, are some of its results. Paralysis , partial or complete, of the lower limbs, and even of the whole body, is not a rare occurrence. We have seen a number of cases in which this was well marked. Two of the patients were small boys who began to excite the genital organs at a very early age. In one, the paralytic condition was complete when he was held erect. The head fell forward, the arms and limbs hung down helpless, the eyes rolled upward, and the saliva dribbled from his mouth. When lying flat upon his back, he had considerable control of his limbs. In this case, a condition of priapism seems to have existed almost from birth, owing to congenital phimosis. His condition was somewhat improved by circumcision.



In another case, in which phimosis also existed, there was paralysis of a few of the muscles of the leg, which produced club-foot . Circumcision was also performed in this case, and the child returned in a few weeks completely cured, without any other application, though it had previously been treated in a great variety of ways without success, all the usual remedies for club-foot proving ineffectual. Both of these cases appeared in the clinic of Dr. Sayre at Bellevue Hospital, and were operated upon by him. (p 282)





Here is the most famous quote from him:



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 anæsthetic, 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. (p 295)



In females, the author has found the application of pure carbolic acid to the clitoris an excellent means of allaying the abnormal excitement, and preventing the recurrence of the practice in those whose will-power has become so weakened that the patient is unable to exercise entire self-control. (p 297)



On the other hand,



Phimosis. -- This is a condition in which the foreskin is so tight that it cannot readily be drawn back over the glans penis. In some cases, the orifice is so small that there is barely room for the passage of the stream of urine in the evacuation of the bladder. A person may be born with this condition, or it may be the result of long-continued inflammation or irritation. This matter is one which should receive attention, as the irritation arising from phimosis may occasion various sexual disorders, particularly nocturnal emissions, a disease which is always aggravated by it, though originally induced by other causes.



As soon as discovered, this condition should be removed by the proper operation. It is rarely necessary to resort to the old method of circumcision , as the same results may be obtained by a less formidable and painful operation. (p 585)



- and he did not actually advocate routine infant circumcision.

