Words of up-to-the-minute wisdom from Morris Fishbein MD, editor of JAMA from 1924 to 1949
The quotes are from Morris Fishbein (ed), Modern Home Medical Adviser (New York: Doubleday, 1969)
The speed of medical progress continues to be one of the marvels of our scientific century .... Many new and brilliant young authors have kindly associated themselves with me in this work. I express appreciation to them.
Sex Hygiene: The Teaching of Sex to The Young Child
Within the first few days of life the genital organs of the baby should be carefully examined for evidence of defects or abnormalities. In case such defects are found they should be corrected when possible, as such peculiarities are often responsible for irritations or abnormal stimulations which may greatly complicate the sexual life of the child when he or she is older. The tissues of the infant are still highly plastic, and it frequently happens that corrections made early are surprisingly successful for this reason.
The boy baby should be carefully examined to see if he needs circumcision. If the foreskin can be completely and easily retracted most authorities think that circumcision should not be done, but when there is the least doubt about the matter, decision should be made in favor of the operation, which is a trivial one when done within the first week or two of life. Later it is somewhat more serious, but never dangerous when performed by a competent surgeon. When the foreskin is tight or adherent there will accumulate under it secretions which will produce bad odors and cause pain and itching.
The girl baby also should be carefully examined for abnormalities. In the washing of the female infant, care must be taken. Sometimes the hymen may be ruptured by rough handling. While it is true that the presence of an intact hymen is by no means proof of virginity, or the absence of it proof of sexual experience, a large percentage of people still believe that such is the case, and so care must be taken to prevent an accident which might later put the baby, grown to womanhood, in an embarrassing position. Washing the parts should be done in such a way that the friction will not cause erotic stimulation and in this way lead the child to the habit of playing with herself.
Crying babies, male and female, will nearly invariably hush when the genital organs are manipulated. This old, old trick of careless nurses and ignorant mothers, should never be practiced, as it may lead to masturbation. Masturbation is probably far less harmful than has been supposed. The routine care of a child should never be delegated to someone else when it is physically possible for the mother to see to it herself.
Sex Hygiene: The School Child
Frequently children will get into the habit of playing with or pulling at the genitals. Such children - both boys and girls - may be in need of a thorough examination by a competent physician. Not unlikely circumcision or other special corrective measure is needed. If there is no pathologic basis for the habit, the child should be taught that it is bad manners to behave in such a way and that an ugly habit may be formed. With help, rather than scolding, he may soon correct the ugly practice .... Little boys and girls are occasionally found to have developed the practice of masturbation. Normal children of this age will rarely go into excess unless they are being stimulated by some older person.
Sex Hygiene: Abnormalities of Sexual Function: Masturbation
When children are kept busy with wholesome play, work and planning, and when they are loved and understood in matters such as these, a little masturbation may occur but will be speedily forgotten. Be sure the children are healthily tired when they go to bed. Be sure that there is no need of circumcision, or if there is that it is corrected. Be sure the organs are clean so that they will not be irritated by foul secretions. Be sure that tight underwear does not demand constant pulling at the clothing.
Sex Hygiene: The Hygiene of the Reproductive System: Cleanliness
The first principle in the hygiene of the reproductive system is cleanliness. By this we do not mean to imply that lack of cleanliness will often jeopardize the physical health of the individual. Actually there is more danger that meddlesome methods of attaining cleanliness will cause disease than that lack of cleanliness will cause it. This is particularly true in the case of the woman. The reproductive organs must be clean if they are to be held in high regard; they must be free of odor; they must be wholesome; they must not offend. They are exceedingly important to the welfare of the race, the self-respect of the individual, and the happiness of the family.
Washing of the external genitalia is extremely important. The external organs need washing and not the internal. Much harm has been done by the excessive use of antiseptic or even cleansing douches. The normal vagina nearly always contains germs. These germs are not only harmless, but actually beneficial, because they prevent the growth of other germs which can cause trouble. If they are frequently washed away with cleansing douches or inhibited with antiseptics, abnormal conditions may develop in the vagina, and trouble may ensure. Further more, strong antiseptics frequently irritate the mucous membrane and make it more susceptible to invasion by other bacteria.
Sometimes, particularly in the male, it is impossible to hold down odors merely by washing the external genitalia. In some men the foreskin is so tight about the end of the penis that it cannot be retracted and the groove beneath it cleaned of the white secretion - known as smegma - which accumulates there. This secretion is of an oily nature and easily becomes rancid, producing exceedingly bad odors and also irritation of the mucous membrane. At the time of birth every male child should be carefully examined to determine whether or not he is in need of circumcision which consists of removing the foreskin. When done in the early days of life the operation is a trivial one. Later it is somewhat more serious, but never dangerous when performed by a competent surgeon. Even those who are not in need of circumcision should retract the foreskin and clean the groove beneath it carefully at least once a day. A child in need of circumcision is often made nervous by the irritation of the rancid secretions and will be constantly twisting, squirming, and pulling at himself. He may also develop the habit of masturbation as a result of the irritation which induces him to handle his penis.
Care and Feeding of the Child: Development of the Infant
If the baby is a male and has not been circumcised, the foreskin should be gently retracted and cleansed beneath. Several months may pass before this retraction can be completely accomplished and force should never be used. It is easier to care for the penis of a newborn who has been circumcised, but even then, the small amount of foreskin left should also be retracted and the edge of the glans, or head of the penis, cleaned daily.
Morris Fishbein (1889-1976) was the editor of the Journal of the American Medical Association from 1924 to 1949, the key years in which routine circumcision established itself in American medical culture. He published many popular books on health (unfortunately), and his autobiography (505 pages of it!) in 1969. The continuity of his views on the supposed irritation and smell provoked by preputial moisture with Victorian agonising over secretions and masturbation will be noted. Also striking is the difference in his attitude to the female genitals, which (unlike the penis) must not be washed too much lest the soap cause irritation. This seems rather more plausible than the strange proposition that the body's own natural moisturisers could irritate the skin.
There are dozens of web articles along the lines of this one, all more or less claiming (inter alia) that a certain Harry Hoxsey invented a cure for cancer, but that Fishbein, as President of the American Medical Association, tried to buy the formula in order to suppress it. This appears to be a favourite myth of the alternative therapists, as Dr Peter Bowditch notes.
One can well believe their claim that Fishbein had failed anatomy, however, as his Victorian views on sex and sexuality make all too sadly clear. Interestingly enough, Fishbein was the author of a book called Fads and Quackery in Healing, published in 1932; some sceptics might wonder whether routine circumcision was yet another example of the same.