The Circumcision Decision
Excerpt from Child Health Guide: Natural treatment for children
Randall Neustaedter OMD, LAc, CCH
Myths and Misconceptions
Surgical circumcision involves the removal of the foreskin of the penis. Routine circumcision is an arcane surgical procedure which gained popularity in the Victorian era to reduce the incidence of masturbation in boys. Although the success of the procedure for this purpose was never proven, the sexual importance of the foreskin lends credence to the theory. The foreskin is a source of sexual stimulation. In the past, under the influence of Victorian morals, sexual pleasure was discouraged. Modern views, however, tend to encourage rather than discourage sex and masturbation as beneficial activities rather than harmful or shameful sins. Forms of female genital mutilation similar to male circumcision are prohibited by law. These have included surgical removal of the clitoris and chemical mutilation for a similar purpose, reducing women's sexual desire and pleasure.
The other common misperception is that circumcision will assist in cleanliness of the penis and reduce problems associated with poor hygiene, specifically an unpleasant odor and irritation. This may have been a problem in an era or geographical location where water was scarce, but adequate bathing will prevent these symptoms. Ironically, the foreskin serves the useful function of maintaining cleanliness of the head of the penis, not collecting secretions, an argument that is often used to continue the practice of its surgical removal.
The medical profession has sought justification for routine circumcision by attempting to associate various diseases with the non-circumcised penis. Various older studies suggested that circumcision might reduce the incidence of cancer of the penis, cancer of the cervix in women, urinary infections in infants, and sexually transmitted diseases. Modern studies have discounted or disproven the relationship of any of these disease conditions with circumcision. Penile cancer occurs in both circumcised and uncircumcised men. Cervical cancer is associated with hygiene, STDs, and a history of multiple sexual partners, not the foreskin of those sexual partners.
Urinary infections are not more common in uncircumcised babies. There is no medical justification for routine circumcision. The American Academy of Pediatrics has concluded that data regarding benefits "are not sufficient to recommend routine neonatal circumcision."
Like any other surgical procedure, circumcision is associated with a number of side effects. The most dangerous side effect is hemorrhage. The discovery by parents of a diaper full of blood is horrifying to them. This can occur if one of the blood vessels severed during the surgery continues to bleed or opens later at the site of the wound during the inflammatory response that follows surgery. Other common side effects include infection, and inadvertent cuts to the glans or shaft of the penis with subsequent scarring or permanent skin tags.
Function of the foreskin
The foreskin has two major functions: it protects the head of the penis, and it plays a considerable role in sexual stimulation and intercourse. The foreskin provides protection from urinary tract infections because it covers the glans (head) of the penis and the opening of the urethra. This prevents feces and ammonia in your baby's diaper from irritating the sensitive mucus membranes of the glans and the urethra. Removing the foreskin allows pathogens easier access to the urethra. In addition, the foreskin contains specialized glands which secrete a lubricating and moisturizing fluid that keeps the glans moist. This is important because the surface of the glans is similar to that of the gums and eyeball, both of which require protection in order to maintain a moist state. The foreskin is similar to the eyelid in its ability to slide across the glans with its innermost layer and protect the glans with its outer layer of skin. When the foreskin is removed, the glans loses its sensitivity, becoming tough and relatively insensitive.
The foreskin maintains the sexual sensitivity of the glans, but it also provides nerve endings itself, an estimated 20,000 of them, that contribute to sexual pleasure and eroticism. More importantly, the gliding motion of the foreskin over the shaft of the penis and the glans produces erotic stimulation. This rolling and gliding mechanism stimulates specialized receptors on the surface of the foreskin during both masturbation and intercourse. The gliding foreskin also contributes to sexual pleasure in the woman and protects the sensitive vaginal membranes from friction and chafing when the foreskin slides over the glans.
The surgical procedure
Removal of the foreskin requires that the baby be restrained. A special board is employed to strap the infant down so that he cannot escape or flail during the painful procedure. A general anesthetic cannot be used because it may cause respiratory arrest in infants. Instead a cream containing the analgesics lidocaine and prilocaine is applied to the penis, or a local anesthetic is injected directly into the penis. These endeavors to relieve pain seem to be partially successful. However, studies have shown that crying and elevation of heart rate, two typical reactions to pain, are only diminished by approximately 50 percent. In many ritual religious circumcisions, no anesthetic is used to numb the excruciating pain.
Circumcision is a four-step procedure. First a blunt probe is used to forcibly separate the foreskin from the underlying glans. This is necessary because at birth the foreskin adheres to the glans [illustration]. Normally the foreskin will gradually separate from the glans over the first few years of life, allowing complete retraction of the foreskin by the time a boy is about five years old. The second step involves cutting the foreskin longitudinally from its tip to the ridge of the glans with a knife or scissors. A clamp or bell structure is then placed over the glans and a tight band or string crushes the foreskin around its circumference. Finally, the foreskin is draped over the bell and cut off with a knife. During the ensuing days, the penis is red, swollen, and painful.
Parental reasons for circumcision
Parents are sometimes concerned that leaving the baby intact will require inordinate care and hygiene of the penis. This is not the case since no special care whatsoever is required for the intact penis. No forceful retraction of the foreskin, no special cleaning, no handling at all.
Other parents worry that their son's penis will not look like his father's or his peers'. If parents explain to their son that a painful and disfiguring operation was performed on the father and they have spared their son this operation, and that the foreskin is a useful part of the body, then the boy should be satisfied, and probably grateful. Since nearly 50 percent of American males are not circumcised, it is unlikely that a boy will feel abnormal if his penis is left intact. In most parts of world circumcision is discouraged.
Jewish or Muslim parents may be subject to religious laws that dictate circumcision for all males. Although some religious leaders have questioned the continuation of the ritual, many parents feel compelled by custom, tradition, and strict religious codes that demand circumcision. On the other hand, a growing number of Jewish and Muslim parents now question the validity and appropriateness of circumcision, choosing alternative and more humane forms of ritual to bring their children into the religious covenant.
Care of the circumcised penis
When a baby has been circumcised, it is important to be vigilant about bleeding and signs of infection, which include inordinate swelling and the formation of a pussy discharge. Infection can usually be prevented by liberal use of Calendula ointment applied to the diaper where it comes into contact with the penis. Calendula encourages healing of wounds and acts as a natural antiseptic. Give the baby Arnica 30c (a homeopathic medicine), two pellets twice a day orally for three days following circumcision to prevent swelling and promote a healing reaction in the injured tissues.