Circumcision

To The Editor:

In reply to The Journal, Sept. 18, 1954, page 292, to a question about the advisability of circumcising all newborn male infants, it should be noted that the opinion is that of a urologist based on his observations of his own patients. His sample of the male population can hardly be considered representative, since the vast majority of men go through life without ever consulting a urologists. His observations may be valid, but his perspective is necessarily limited.

As a general practitioner in a rural area where less than 0.3% of the adult males are circumcised, I am impressed with the rarity of any disease that could be honestly blamed on the foreskin. Further, it would appear that the normal prepuce is of advantage to its owner, protecting the sensitivity of the glans and supplying the integument to accommodate penile growth at puberty and enlargement during erection. Its unnecessary removal seems unphysiological. The conviction that the normal foreskin is a nuisance is held exclusively by the circumcised. There have been attempts to rationalize the procedure along many lines. Prior to 1900 a great deal was published about the value of circumcision in the prophylaxis and treatment of masturbation, feeble-mindedness, epilepsy, spastic paralysis, and even diabetes and tuberculosis. More recent essays in this direction have been equally bizarre. A study by Dr. Ernest L. Wynder relates carcinoma of the cervix to uncircumcised husbands. The idea that smegma, the desquamated epithelium of the glans, could have any significant carcinogenic activity seems absurd. Penile cancer is rare in the United States. That any significant amount of this substance is deposited on the cervix during coitus also seems absurd.

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