|Dr Peter Charles Remondino|
Posthephobia reaches new heights of eloquenceOne of the most ardent crusaders for universal male circumcision in the late nineteenth century was Dr Peter Charles Remondino (1846-1926), an Italian-born Protestant who had immigrated to the United States at the age of eight. There he studied medicine and rose to fame as a widely-published author, the first president of the San Diego Board of Health and a vice-president of the California State Medical Society. He was no quack, but a respected and powerful mainstream physician. His first blast at the foreskin was contained in a paper he gave to meeting of the Southern Californian Medical Society in 1889, with the revealing title, “A plea for circumcision; or, the dangers that arise from the prepuce”, but that was merely an overture to the tub-thumping diatribe on the moral and physical evils of the foreskin published two years later. Remondino’s History of circumcision from the earliest times to the present: Moral and physical reasons for its performance (1891) was, as Leonard Glick remarks,  “rambling in style, laden with polemics, replete with hyperbole and undocumented claims” – and highly influential.
MasturbationThe content and style of his intervention may be gauged from some of the chapter headings: “The prepuce as an outlaw, and its effects on the glans”, “Is the prepuce a natural physiological appendage?”, “Reflex neuroses and the prepuce”, “General systemic diseases induced by the prepuce”. As you might expect, one of the most serious of these was the great Victorian bogey, masturbation. Remondino was very much a man of his time in claiming that the prepuce was the most frequent cause of onanism, much as an advocate of circumcision today is likely to assert that it is the major risk factor for the bogey of our own time, HIV-AIDS. He quoted the opinion of Dr Bernheim, surgeon to the Jewish community in Paris, that the irritation “it produces through the sebaceous secretion is a frequent cause of masturbation which nothing short of circumcision will remedy”.  He also quoted a Dr Vanier as stating that “If the prepuce is lax, its mobility produces an irritation to the … nervous system of the child by the titillation in its movements on the glans; if too tight … it compresses the glans and by its irritation it leads the child to seize the organ”. It seems you couldn’t win, but just to make sure you got the message Remondino drove the point home:
In either case he looks upon the prepuce … as the principal cause of masturbation. … In children who have not yet the suggestions of sexual desire imparted by the presence of the spermatic fluid, the presence of the prepuce seems to anticipate those promptings. Circumcised boys may … be found to practice onanism, but in general the practice can be asserted as being very rare among the children of circumcised races, showing the less irritability of the organs in the class; neither in infancy are they as liable to priapism during sleep as those that are uncircumcised”. 
— that is, fewer wet dreams, an idea he derived from one of his major sources, Claude-Francois Lallemand.  Remondino agreed that the origins of ritual circumcision lay in the desire of ancient Judaic lawgivers first to discourage the idolatrous debaucheries practised among their free-spirited neighbours in the Middle East, and masturbation specifically; and secondly to encourage procreation. Referring to the story of the circumcision of Abraham and the impregnation of Sarah, he writes: “Here we have suggestions of a preventive to onanism, and a cure to male impotence when due to preputial interference”  – a suggestion repeated in modern times by both G.N. Weiss  and (copying from him) Brian Morris. 
SyphilisThe other great advantage of circumcision was the protection it guaranteed against the AIDS of the Victorian era, syphilis. Here Remondino relied heavily on Jonathan Hutchinson’s observational studies of Jewish and Christian venereal patients in London, asserting “the well-known greater exemption of the Jew to syphilitic infection, owing to the protecting influence of circumcision” and citing Hutchinson’s paper of 1855  as “proof” of “less syphilization among circumcised men” even before considering the evidence in favour of these propositions.  That was in fact the only evidence there was, but if Remondino was short on data he was long on explanation, and followed his mentor’s reasoning in accounting for the phenomenon: “the absence of the prepuce and the non-absorbing character of the skin of the glans penis made so by constant exposure”. But he departed from Hutchinson’s original article by suggesting that it was not only via the glans that the disease entered the body, but through the tissue of the foreskin itself; primary sores, he claimed, were usually found on the inside of the prepuce and especially around the frenum, “the retention of the virus seemingly being assisted by the topographical condition … of the parts, and its absorption facilitated by the thinness of the mucous membrane, as well as by the active circulation and moisture and heat”.
Accordingly, “any protecting mechanical aid that interferes with the favouring conditions grants an immunity to the individual, even when he is freely exposed”.  Remondino had no experimental evidence for any of this and made no mention of reliable mechanical aids such as condoms. He weakened his argument further by attempting to strengthen it with the claim that circumcision was not the only reason for Jews’ immunity to syphilis: the “well known chastity of their females” was another factor  – a direct contradiction of Hutchinson’s original point that morality had nothing to do with it. By suggesting that behavioural factors like promiscuity were relevant, Remondino undermined the argument that it was all to do with the presence or absence of the foreskin.
TuberculosisRemondino actually had stronger evidence that circumcision conferred protection against tuberculosis. On this association he was able to cite French statistics from Algeria, showing that its incidence was highest among European and lowest among Jews, with Arabs in between; and letters from two physicians in Boston who both recorded their “impression” that TB was less prevalent among their Jewish patients than among the Christians, though they had no statistics to offer.  To fill this gap Remondino turned to figures collected by B.W. Richardson which did indeed show that “the Hebrew race” seemed to suffer relatively little from this affliction. Of all tuberculosis patients at one hospital, 44 per cent were “Saxon”, 39 per cent mixed race, 10 percent Celtic and only 6 per cent Jews.  These figures hardly seem telling to a sophisticated modern reader, and it comes as no surprise to find that Remondino has not been entirely honest with them: as Richardson himself went on to explain, the statistics probably represented no more than “the relative proportions of the respective populations”,  or, as we might put it, the demographic profile of the hospital catchment. A true believer should not be afraid to offer bold hypotheses in support of his cause, and Remondino went on to assert that it was the uncircumcised condition of British sailors which brought TB to the South Pacific and that the disease could be spread by sexual intercourse:
Had it been the ancient mariners of old Phoenecia in the days of its circumcision, or the circumcised mariners of the ancient Atlantean fleets … instead of the uncircumcised sailors of modern England … it is safe to say that consumption would not now exist there. 
He commended the opinion of Dr Bernheim that sexual intercourse was a frequent means of tubercular infection because “the sensitive and absorbing covering of the uncircumcised glans” was “a ready medium for the transmission of the virus”.  There could be only one conclusion: on the evidence above
as well as the personal but unrecorded observations of many practitioners all … bear testimony to the remarkable difference … between circumcised and uncircumcised races in regard to the ravages of consumption. Is circumcision a factor in this difference, or is it not? 
Remondino had every confidence that it was the factor. 
Misuse of evolutionary ideasRemondino tried to give an evolutionary gloss to his attack on the foreskin, asserting that it was in the process of atrophy and disappearance along with the “climbing muscle” that our ancestors once used to shimmy up trees. In this modern, civilised age the penis did not need the protection it had required in the far-off days when men were naked savages leaping over thornbushes: “always careful that nothing should interfere with the procreative functions”, nature had provided primitive man
with a sheath or prepuce wherein he carried his procreative organ safely out of harm’s way, in wild steeple-chases through thorny briars and bramble-brakes or … when not able to climb a tree of his own choice, he was … forced up the sides of some rough-barked or thorny tree. This leathery pouch also protected him from the many leeches, small aquatic lizards or other animals that infested the marshes or rivers … or served as a protection from the bites of ants or other vermin. 
That was in the days before underpants, but civilized man no longer required such “necessaries of a long past age”. The problem he could not solve intellectually was why the foreskin was taking so long to disappear, despite the fact that, unlike other “vestiges” (most of which were harmless), it was “from the time of birth a source of annoyance, danger, suffering and death” and seemed “in bulk out of all proportion to the organ it is intended to cover”. Evolution could evidently not be relied on to do its manifest duty, and it thus required some assistance from culture: turning from pseudo-science to outright ideology, Remondino went on to praise “the fathers of the Hebrew race, inspired by a wisdom that could be nothing less than of divine origin [who] forestalled the process of evolution by establishing the rite of circumcision” (p. 9-10).
Anxious to appear in touch with the march of science, Remondino returned repeatedly to his evolutionary analogy (pp. 206-7, 244-6), but there is irony in the fact that his attempt to associate even a crude and non-Darwinian version of evolution (involving progress towards a desired goal rather than undirected descent by modification) undermined the argument of the sanitarians. The very conditions in which he declared the prepuce necessary as a protection against burrs and beasties were those in which they said ancient tribes were adopting circumcision to improve hygiene in hot climates: to guard the penis against irritation by desert sand or from invasion by water-borne parasites. Many tribes which practised circumcision, such as the Aboriginals of central Australia, lived in precisely the primordial conditions described by Remondino as necessitating retention of the foreskin. Despite his rhetorical references to Darwinism, he had so little faith in the power of evolution to abolish the appendage he hated that he relied on the intervention of priests and surgeons and the attractiveness of the excised tissue to those seeking to establish a lucrative market in skin grafts (pp. 206-7).
An extremistRemondino was an extremist even by the standards of the 1890s. His book is largely a hymn to the beauties of ritual circumcision, and the medical element is full of the wildest claims about the connection between the foreskin and disease, expressed in the most colourful Victorian rhetoric:
The prepuce seems to exercise a malign influence in the most distant and apparently unconnected manner; where, like some of the evil genii or sprites in the Arabian tales, it can reach from afar the object of its malignity … making him a victim to all manner of ills, sufferings and tribulations; unfitting him for marriage or the cares of business; making him miserable and an object of continual scolding and punishment in childhood, through its worriments and nocturnal enuresis; later on, beginning to affect him with all kinds of physical distortions and ailments, nocturnal pollutions, and other conditions calculated to weaken him physically, mentally, and morally; to land him, perchance, in jail or even in a lunatic asylum (pp. 254-5).
Those who retained their foreskins ought to pay higher insurance premiums, since “a circumcised labourer in a powder-mill or a circumcised brakeman or locomotive engineer runs actually less risk than an uncircumcised tailor or watchmaker” (pp. 290). Circumcision was touted as the cure- and prevent-all of the century, a “liberation” of the penis “from its fetters of preputial bonds”, allowing the glans to “assume its true shape”:
In this unyielding tube the glans is imprisoned and compressed, often suffering the tortures that the “maiden” of the … Inquisition inflicted on the unhappy heretics. It becomes elongated, cyanosed and hyperaesthetic: the meatus of the urethra is congested and hypertrophied; the corona is undeveloped and often absent, the glans having … the long-nosed, conical appearance of the head of a field-mouse. There are hardly five per cent of the uncircumcised but who suffer … from this constricting result of the prepuce (pp. 210-11)
Thank goodness surgical relief is at hand:
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. (p. 186)
Going one better than Isaac Baker Brown, who had been forced to back down from his claim that he had cured cases of insanity in women by means of clitoridectomy, Remondino asserted without a blush that he had restored a lunatic to sanity by circumcising him, and that soon after the operation he left the asylum as a normal man (pp. 272-3). Nobody has sung the praises of circumcision with quite the barnstorming fervour which he brought to his mission, but his uncertain status in Britain is suggested by a reviewer in the British Medical Journal who commented that some of his loftier flights seemed “excessive and strained”; yet even he conceded that his views were “worth putting on record as the opinion of a man who has given a great deal of time and trouble to his subject”.  In the USA, however, he enjoyed continuing esteem, and his influence is visible in later circumcision advocates, such as G. Frank Lydston and Abraham Wolbarst.
Remondino had no time for physicians who defended the foreskin. He particularly attacked surgeons who looked upon circumcision as “an unwarrantable operation, a procedure not only barbarous, painful and dangerous, but one that interferes directly with the intentions of nature”, and he complained that many people viewed the foreskin “as a physiological necessity to health and the enjoyment of life.” (p. 217) Responding some years later to a critic who “professed to see no benefit whatever in circumcision”, he reported (with great relish) the gory details of a man who had recently died from penile cancer, simply because “he had not been fortunate enough to have been born either a Jew or a Turk”. He went on (by means of a quotation ascribed to an “irascible Scotch gentleman” in whom circumcision had cured a bad case of neurasthenia) to attack St Paul for his role in banning circumcision among Christians:
I have been brought up and educated to look upon Saint Paul, the founder of Christianity, with awe and admiration, but, by God, Sir, if I had Saint Paul here now, Sir, I would shoot him, yes, Sir, I would shoot him. He had no biblical warrant nor no business to summarily abolish circumcision as he did. … Saint Paul was more of an evangelist and not as scientific a man as Moses, and I may be wrong in wanting to shoot him. He probably did not know the harm he was entailing on gentile humanity by abolishing circumcision. Still, when I think of the agonies I have been made to suffer through his carelessness, I feel he ought to be shot, Sir. 
The sentiments here are so close to Remondino’s own that there is little reason to think that the “Scotch gentleman” is any less fictitious than many of his other “cases”. Whether it is or not, the outburst offers a disturbing glimpse into the fanaticism of the circumcising mind.
Circumcision and the "Negro rape problem"Just how authoritarian this can get is shown by Remondino’s most creative application of his belief that the foreskin was the root of all evil: his serious proposal that all African Americans should be compulsorily circumcised in order to solve the “Negro rape problem” and protect white women from assault. There had been suggestions in the 1880s that Negroes should be forcibly circumcised as part of a campaign against venereal disease (since it was asserted that they were irredeemably promiscuous and impossible to educate in the laws of hygiene), but in the 1890s white doctors went further. Some, such as G. Frank Lydston and F.E. Daniel argued that Negroes committing sexual assaults should be summarily castrated,  but Remondino thought it would be both more effective and more humane to circumcise all Negro boys routinely, since the surgery was guaranteed to keep their innate lust within reasonable bounds. As he put it with his usual flair:
An irritating and ulster-proportioned and over-generously sebaceoused and generally too robust prepuce, will often cause the simulation of the evidences of an over-exuberant and impatient virility, something which should have for its only prompters over-filled or distended seminal vesicles. From our observations and experience in such cases, we feel fully warranted in suggesting the wholesale circumcision of the Negro race as an efficient remedy in preventing the predisposition to discriminate raping so inherent in that race. We have seen this act as a valuable preventive measure in cases where an inordinate and unreasoning as well as morbid carnal desire threatened physical shipwreck; if in such cases the morbid appetite has been removed or at least brought within manageable and natural bounds, we cannot see why it should not – at least in a certain beneficial degree – also affect the moral stamina of a race proverbial for the leathery consistency, inordinate redundancy, generous sebaceousness and general mental suggestiveness and hypnotizing influence of an unnecessary and rape, murder and lynching breeding prepuce. 
Remondino’s proposal was published in a mainstream public affairs magazine (the National Popular Review), and supported by several medical journals, including the Maryland Medical Journal and the Boston Medical and Surgical Journal (now the New England Journal of Medicine).
Full details of this extraordinary episode available on this site.
NOTES and REFERENCES1. Leonard Glick, Marked in your flesh: Circumcision from Ancient Judea to modern America (New York: Oxford University Press, 2005), p. 174
2. Peter Charles Remondino, History of circumcision from the earliest times to the present: Moral and physical reasons for its performance (Philadelphia and London: F.A. Davis, 1891), pp. 225-6
3. Remondino, p. 224
4. See Robert Darby, “Pathologising male sexuality: Lallemand, spermatorrhoea and the rise of circumcision”, Journal of the History of Medicine and Allied Sciences, Vol. 60, 2005, pp. 283-319
5. Remondino, p. 201
6. G.N. Weiss, “Prophylactic neonatal surgery and infectious diseases”, Pediatric Infectious Diseases Journal, Vol. 16, p. 727-34. See also the devastating critique by Robert Van Howe, “Circumcision and infectious diseases revisited”, Pediatric Infectious Diseases Journal, Vol. 17, 1998, pp. 1-6
7. Brian Morris, In favour of circumcision (Sydney: NSW University Press, 1999), p. 60
8. Jonathan Hutchinson, “On the influence of circumcision in preventing syphilis”, Medical Times and Gazette, NS Vol. II, 1 December 1855, pp. 542-3
9. Remondino, pp. 179, 191-2
10. Remondino, p. 192
11. Remondino, pp. 194-5
12. Remondino, pp. 175-7
13. Remondino 1891, 177-8
14. Benjamin Ward Richardson, Diseases of modern life, 5th edn (London: Macmillan, 1878), pp. 23-4. Richardson also considered the various explanations for the supposed superior health the “Jewish race”. He made no reference to circumcision at all, but explained it in terms of “soberness of life”: Jewish people drank less, ate better food, married earlier and took better care of their children.
15. Remondino, p. 180
16. Remondino, p. 195
17. Remondino, p. 199
18. The proposition that tuberculosis could be caused by masturbation was common in the eighteenth and nineteenth centuries, so it could seem logical that anything thought to discourage masturbation would reduce the danger of contracting it. Although Remondino’s conviction that circumcision could provide protection against TB was not as widely held as the idea that it reduced the risk of syphilis, his was far from being a lone voice. S.G.A. Brown wrote: “The prepuce is an important factor in the production of phthisis. This can be proven by the immunity of the Jewish race from tubercular affections”, Medical World, Vol. 15, 1897, pp. 124-5. Joseph Howe was another believer: see his Excessive venery, masturbation and continence (New York, 1887), esp. pp. 19, 92 and 121.
19. Remondino 1891, pp. 8-9
20. British Medical Journal, 20 February 1892, pp. 391-2
21. P.C. Remondino, “Circumcision and its opponents”, American Journal of Dermatology and Genito-Urinary Diseases, Vol 6, March 1902, p. 73
22. Philip Reilly, The surgical solution: A history of involuntary sterilization in the United States (Johns Hopkins University Press, 1991), pp. 37-8
23. P.C. Remondino MD, “Questions of the day: Negro rapes and their social problems”, National Popular Review, Vol. 4, January 1894, pp. 3-6