The History of Circumcision

The walls of Egyptian tombs depict male circumcision, so the practice is known to be at least 5,000 years old. The Jewish and Muslim traditions of circumcision have their origin in the Old Testament. Jews accept the practice as a sign of the covenant between God and Abraham. In Genesis 17:12, God instructs Abraham: "He that is eight days old shall be circumcised among you, every male throughout your generations." As a Jew, Jesus was circumcised, and the early Christian church debated the need for circumcision as a criterion for joining the Christian fellowship; it was decided that circumcision was not necessary for salvation. According to the apostle Paul, "For in Jesus Christ neither circumcision availeth nor uncircumcision; but faith which worketh by love" (Gal. 5:6). These religious traditions remain strong, although the health debate has led to a questioning of the religious practice by a few members of the Jewish community (Milos and Macris).

The practice of routine neonatal circumcision has been debated within the U.S. medical profession for over a century. Circumcision was initially advocated in the Victorian era as a measure that would reduce masturbation. Medical benefits from the procedure were first widely proposed in 1891 by P. C. Remondino, who claimed that circumcision prevented or cured a host of diseases, including alcoholism, epilepsy, asthma, and renal disease (Wallerstein). More scientific studies of the potential medical benefits of circumcision began to appear in the professional literature in the 1930s. Urologists observed an association between penile cancer and an intact foreskin (Schoen, 1992). During World War II, American troops stationed in the Pacific and in desert climates had problems with irritation and infection of the penis because of sand and the inability to maintain adequate hygiene. The military response was to circumcise many of the affected soldiers. However, the Japanese did not use circumcision despite their war experience in the same environments (Wallerstein).

Circumcision became popular, indeed almost universal, after the war. Rates remained high until the 1970s, when both the medical profession and the general public began to question the widespread use of the procedure for newborns. The American Academy of Pediatrics issued two separate statements, in 1971 and 1975, declaring that there were no valid medical indications for neonatal circumcision (Committee on Fetus and Newborn). Specific concerns were raised over the pain of the procedure and over potential complications in the face of questionable medical benefits. In 1985, the first in a series of papers was published that documented an increased risk of urinary tract infections in uncircumcised neonates (Wiswell et al., 1985). These reports came in association with an apparent increased risk of sexually transmitted disease, specifically the human immunodeficiency virus (HIV), in uncircumcised males (Schoen; Bailey). In 1989 the American Academy of Pediatrics issued a revised statement that concluded that there were both medical advantages and medical disadvantages to the procedure and that full information and informed consent were important for parents who were making this decision.

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