Surgical Operation Vs Traditional Practice

Medicalisation of the circumcision procedure can often obscure the origins and practices of modern traditional techniques.

This rebrand covers up an important distinction in the methods of modern medicine and the ritual methods that are still used today.

This article shows this distinction and covers what is a surgical operation.

This article is part of the 15 Square archives.

Is circumcision a surgical operation?

Up until the 1860s, there was no doubt that circumcision was not a surgical operation. Len Glick and John Efron documented how circumcision came to be rebranded as a part of Jewish Medicine which brought health benefits and was delivered as a surgical operation. In the modern world, circumcision continues to be practiced as a surgical operation in mainstream medical practice for a variety of indications including phimosis and even balanitis.

Whilst many medical referrals for circumcision are inappropriate, it remains the case that circumcision may be the only treatment for some conditions such as severe lichen sclerosis (aka “BXO”) or might be the preferred treatment for some adult men.

Despite 150 years of rebranding, we would argue that circumcision practised as a religious practice does not have the features of a surgical operation:-

It is done to someone with no disease
It is done to someone who gives no consent
It is not done by a surgeon
It is not done in a surgical facility
There is no aseptic environment
There are no anaesthetic facilities
There are no resuscitation facilities

TRADITIONAL PRACTICE

The late Rabbi Snowman published a book “The Surgery of Ritual Circumcision“. Despite his branding of the practice as “surgery”, he described steps that do not feature in surgical operations:-

When the penis of an infant is in a state of erection the operation is more easily performed and the dressing more efficiently applied. The manipulation of the organ necessary to grasp the prepuce is generally sufficient to stimulate the increased blood supply requisite for an erection.

The Mohel will now, at a glance, observe the exact disposition of the mucous membrane covering the glans. He insinuates the nail of the right thumb under its edge, and seizes it between the nail and the index finger.

The performance of Metzitzah throughout the ages was by direct suction by the mouth. The original sources of the practice of Metzitzah indicate that it was considered to be an essential part of the operation in the same way as the dressing of the wound. Failure to carry out this measure was regarded as constituting a serious risk to the infant. The possible dangers of infection from direct suction of the wound have become obvious
during recent years.

– Traditional practices

Traditional Practice vs medically unnecessary circumcision.

There is a precedent for surgeons being struck off by the GMC for, among other things, inducing erections in patients before performing circumcisions.

We favour the term Traditional Practice to describe medically unnecessary circumcision.

Despite claims that it brings benefits to health, we would say that the practice is prejudicial to health in view of the potential complications.

References

Leaonard B. Glick (2005). Marked in Your Flesh: Circumcision from Ancient Judea to Modern America. 5: Oxford University Press.
John M. Efron. (2002). Medicine and the German Jews. A History . Social History. 27 (3), 389-391.
Jacob Snowman (2018). The Surgery of Ritual Circumcision. Hansebooks.