CIN (Circumcision Information Network) 3:13

Introduction
This weekly bulletin is a project of CIN, the Circumcision Information Network (formerly CIN CompuBulletin). The purpose of this weekly bulletin is to educate the public about and to protect children and other non-consenting persons from genital mutilation. Readers are encouraged to copy and redistribute it, and to contribute written material.
--Rich Angell, Editor.

"THE FORESKIN IS NECESSARY"
An article by Paul M. Fleiss. MD, MPH, and Frederick Hodges
Townsend Letter for Doctors and Patients, April 1996.
Contributed by typist DYKS96A@prodigy.com ( GEORGE HILL)
First of a multi-part series.

INTRODUCTION
Every part of the human body has a function and a purpose.  Millions of years
of evolution have fashioned the human body into a model of refinement,
efficiency, and elegance.

The foreskin is an integral and essential part of the penis.  Every reason
ever offered to justify the infliction of prophylactic surgical amputation
has been proven false.  As a result the rate of neonatal circumcision has
dramatically fallen from over 90% in the 1970s to the present rate of 35.5%
in the Western United States.  Unfortunately the rate still remains high in
the Midwest and South.  The legacy of the mass circumcision campaigns of the
recent past has resulted in widespread ignorance about the foreskin and the
anatomy and functions of the penis.  Ignorance and error is rampant in
American medical practice and education.  Most American produced textbooks
present the human penis without explanation as being circumcised!  This would
be analogous to the African medical textbooks presenting female reproductive
anatomy minus the labia minora, labia majora, and clitoris.

The foreskin, like all other body parts has a unique function and a complex
anatomical structure.  Since an increasing number of American male newborns
are now allowed to remain genitally intact -- as their European counterparts
have always been -- physicians should acquaint themselves with the basic
anatomy of the foreskin in order to better care for and protect the interests
of their patients.

ANATOMY OF THE FORESKIN
The foreskin is an integral part of the penis.  Depending on the length of
the penile shaft the foreskin represents from 60% to 80% of the penile skin
covering.  The foreskin also represents 25% to 50% of the overall length of
the flaccid penis.

At birth and throughout childhood the foreskin is fused to the glans.  This
desirable situation protects the meatus from contaminants.  By puberty, the
glans and meatus will have separated and developed independent mucosal
surfaces.

The foreskin is a complex and unique structure.  It is analogous to the
eyelids or lips.  As a modified extension of the penile shaft skin, the
foreskin covers the glans penis and extends beyond it before folding in upon
itself and finding its circumferential point of attachment just behind the
glans.  The skin of the glans is lined by the peripenic muscle sheet, a
muscle layer with longitudinal fibers.  At the preputial orifice the muscle
fibers are arranged in a whorled manner and form a sphincter.

On the underside of the glans, the point of attachment is advanced toward the
meatus and forms the frenulum, which is analogous in form and function to the
labial and glottal frena.  The frenulum holds the foreskin in place, and in
conjunction with the smooth muscle fibers of the foreskin automatically
returns the everted foreskin to its forward position.  The frenulum rises
from its point of attachment behind the meatus and encircles the inner
foreskin forming the frenar band.

The internal surface of the foreskin is divided into two distinct zones:  the
soft mucosa and the frenar band.  The soft mucosa lies against the glans
penis and contains ectopic sebaceous glands which continuously excrete a
natural sebaceous emollient and lubricant, commonly referred to as smegma.
 The frenar band is continuous with the frenulum and consists of tightly
pleated bands which encircle the tubular distal portion of the inner foreskin
just in front of the urinary meatus.

DOCTORS OPPOSING CIRCUMCISION
Contributed by gburlin@eskimo.com (Gary Burlingame)

Most physicians do not routinely circumcise the newborn American boy.  But
those few who have wanted to perpetuate this practice, for non-religious
reasons, have been effective with their misinformation -- until now. 

With the founding of a new non-profit organization, Doctors Opposing
Circumcision (D.O.C.), the misinformation will be met with the facts about
this practice from the same profession that has been perpetuating it. 

Already, a small Army of committed individuals and health professionals has
been instrumental in reducing the rate of routine neonatal circumcision in
America from a high of 90% to under 60%.  This means that tens of millions of
American parents have had the courage to leave their little sons' penises
intact. 

Now the official backing of physicians will support the committed pioneers,
and parents, in their efforts to halt this bizarre behavior.  D.O.C. is
committed to telling the whole truth about this tragic practice, until it is
eradicated from the American scene. 

Doctors may continue to remove part of the penis of future American men, but
they will now have to do so with full knowledge of the great pain, the harm
and the potentially lifelong adverse consequences they are unnecessarily
giving these American men.  DOCTORS OPPOSING CIRCUMCISION -D.O.C.- MEMBERSHIP

2442 NW Market St., S-42, Seattle WA 98107 I am opposed to this practice, and
wish to join D.O.C. (Send dues for 1996 to the above address.  Please make
check payable to D.O.C.) __$40 (Member) __$100 (Sustaining) __$200 (Patron)
 My e-mail address is gcd@u.washington.edu. George C Denniston, MD, MPH
President.

SCREAM OF THE WEEK 
(Statements Documenting Infant Circumcision Pain)
Submitted by Johnny4444@aol.com

"I have never heard such screams."  ("Zachary's Circumcision," by his mother,
Lauren Friederich, Circumcision:  The Rest of the Story) 

FOR ADDITIONAL INFORMATION call NOCIRC, the National Organization of
Circumcision Information Resource Centers at (415) 488-9883, fax (415)
488-9660.  Ask about the resource provider nearest you.  For written
information, write NOCIRC, PO Box 2512, San Anselmo, CA 94979, with SASE
and/or donation if possible.

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