|A source of serious mischief (1)|
"A source of serious mischief":
New South Wales
Aust Capital Territory
In the early 1990s it looked as though such preventive (non-religious) circumcision was set to disappear, but in recent years it has made a comeback: after falling to a low of 10.4 per cent in 1996, the national rate increased to 12.1 per cent in 2000. Most of this increase occurred in Queensland (from 16.3 to 20.6 per cent) and New South Wales (from 12.3 to 14.2 per cent), outweighing declines in Victoria (from 6 to 4.9 per cent) and the Northern Territory (9.3 to 5.9 per cent). (15) The reasons for the disparities are not known, but it has been suggested that the high and rising rate in Queensland is due, at least in part, to the evangelical fervour of a prominent GP there, Dr Terry Russell, who apparently tells parents that an early circumcision is the equivalent of immunization against venereal disease, cancer of the penis and many other problems. The continuing popularity of such forcible circumcision among old guard medicos thus suggests that nineteenth century theories about the link between the foreskin and disease have lost little of their relevance. Russell writes that, if they had been circumcised, "a vast number of neonates would have been saved from UTI and its consequences of renal failure, septicaemia, meningitis, hypertension and death". Circumcision "may reduce the risk of STDs (syphilis, gonorrhoea, herpes and candida) and carcinoma of the cervix of female partners. It also prevents balanoposthitis and phimosis", not to mention such "potentially fatal conditions" as neonatal UTI, HIV/AIDS and cancer of the penis. (16) A hundred years earlier Dr Remondino had asserted:
Circumcision is like a substantial and well-secured life annuity; every year of life you draw the benefit, and it has not any drawbacks …. Parents cannot make a better paying investment for their little boys, as it insures them better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor-bills, as well as increases their chances for an euthanasian death. (17)
Even the British Medical Journal found such an extreme advocacy "excessive and strained". (18) Any similarities between Russell’s scientific approach and late Victorian quackery are purely coincidental.
Few statistical details are available for the period when the circumcision of infants and boys first became popular. Unlike the composer Percy Grainger (19) (born 1882), the writer Frank Dalby Davison (born 1893) did not leave us a nude photograph to prove he was intact, but in his last novel he clearly assumes that boys have foreskins to play with. (20) Patrick White (born 1912) was circumcised, but he was born in England to upper class parents, among whom the practice was then common. (21) The historian Russel Ward (born 1914) was "one of the very few boys in the whole World who had been circumcised", as he puts it in his autobiography, but his boyhood playmates in north Queensland were not; the extra-curricular uses they found for their foreskins would certainly have confirmed the fears of those who advocated removal on moral grounds. Significantly, his parents were respectable Methodists from "staid, puritanical South Australia" who found Queensland "uncouth and barbarous". (22) Russell Braddon (born 1921) does not reveal his own status, but he reports that in Changi prison during World War II the army doctors (mainly British) "circumcized practically every man who was not already circumcized" in the belief that the operation would improve the men’s health prospects. (23)
Australian doctors probably started performing circumcisions on a wide scale in the 1890s, by which time the operation was well established in Britain and the US. Herbert Moran refers to circumcision in the period 1890–1914 as though it was a commonplace or even routine procedure, (24) and in 1903 A.S. Joske, a surgeon in the children’s department at the Alfred Hospital, Melbourne, reported that the number of children being operated on was "steadily increasing". (25) By 1906 a sceptical doctor in Brisbane referred sourly to circumcision as a "mania" of "twelfth-rate surgeons" who preached "a new gospel, the conversion of baby boys into Jews, not for their love of Judaism, but for the three or five guinea fee hanging on the operation". (26) Although Australia lagged behind the mother country it was more egalitarian; while in Britain the procedure was concentrated among middle, upper and professional classes, here "the poorer portion of our population is beginning to see the advantages of the operation". (27) There was very little discussion of the practice in the Australian medical press, and it seems likely that British-trained doctors brought it with them and that Australian-trained doctors read British and US textbooks which recommended it. In 1908 the Australasian Medical Gazette published a warm review of L. Emmett Holt’s The care and feeding of children. (28) Holt was an expert on paediatric medicine in the US and a professor at the College of Physicians and Surgeons in New York. He was a zealous circumciser and recommended the practice in his influential textbook, The diseases of infancy and childhood, which became a standard work and went through eleven editions between 1897 and 1940. Where many doctors advised circumcision only when the infant foreskin could not be drawn back, Holt urged it in all cases "because of the moral effect of the operation"; the effects of neglect included "priapism, masturbation, insomnia, night terrors" and "most of the functional nervous disease of childhood". (29) Mary Truby King, author of a book on mothercraft popular in the 1930s, quoted "Professor Holt" on the nature of masturbation and continued with a sentence on the need for circumcision if the fault was found to lie with the foreskin. (30) In 1910 the same journal printed an enthusiastic review of Abraham Jacobi’s textbook, Diseases of children, (31) and the author was, if possible, an even keener exponent of circumcision than Holt. Jacobi (1830–1919) was a founder of the American Pediatric Society, first Chairman of the Section on Diseases of Children of the American Medical Association and a leading figure in many other influential bodies. He strongly advocated the circumcision of all male infants as a means of preventing masturbation and cited his personal experience as a Jewish physician as evidence for the claim that circumcised boys did not masturbate (or not as much) and hence were not so susceptible to the many diseases which arose from the practice. (32) If this was typical of the material on which Australian doctors and medical students were being educated, it is not surprising that they came to hold such strong views in favour of circumcision.
With or without debate, the practice of circumcising male babies spread rapidly. In 1916 Sir Thomas Anderson Stuart, Dean of the Faculty of Medicine at Sydney University, remarked that "more and more the operation is being performed as a simple matter of hygiene". (33) By 1921 "some medical men" were advising "the circumcision of all children as a matter of routine". (34) In 1917, in a letter to the Medical Journal of Australia, J.I. Sangster of Brighton, South Australia, observed that "nowadays it has become a surgical fashion to advocate circumcision in every male infant", but he was a critic of the trend, objecting that many of the supporting arguments were based on supposition and doubting that nature was "so often at fault as to demand universal interference". (35) One other dissenting voice joined him in the wilderness, pointing out that circumcision was originally introduced as a religious ritual in which a part of the body was sacrificed. The routine removal of a normal and healthy structure, however, was "surely the last word in absurdity" and about as sensible as removing "the labia minora or the little toe". (36) These comments attracted neither support nor condemnation. The only other reference to circumcision I have located in the Medical Journal of Australia between 1914 and 1935 is a brief report that a certain Dr C.W.B. Littlejohn demonstrated four different methods of circumcision at a meeting of the Victorian branch of the British Medical Association in 1923; (37) the report did not reveal whether the demonstration was on live subjects. The steady advance of circumcision during the 1920s may be seen in the various editions of a guide for mothers prepared by Muriel Peck. The first edition (1925) makes no mention of the procedure, but by the fourth (1929) the foreskin is seen as a problem area that needs to be washed carefully yet not interfered with; if it is tight or long, medical advice should be sought, and if circumcision is considered necessary it should be done as early as possible. (38)