By John M. Ephron.
This is an extract of a small section of Chapter 6: In Praise of Jewish Ritual: Modern Medicine and the Defense of Ancient Traditions. This section describes the way in which German Jewish medical doctors used medical science to develop arguments to defend and justify the practice of brit milah (ritual circumcision) and to promote the practice amongst Christians and other gentiles in the 19th and early 20th centuries.
As was the case with the dietary laws and shehitiah, ritual circumcision was the subject of a wide-ranging debate in nineteenth-century Germany.117 Circumcision had long been regarded as the most distintive and separartist of all Jewish rituals, and the discourse surrounding it went to the heart of the "willingness" of the Jews to fully participate in the "act" of being German. The ritual was interpreted as a signal of the Jews' refusal to rid themselves of their differences, imprinting on their own male bodies, as an aborginal would his tribal markings, an ineradicable expression of national identity. For some, it was circumcision itself that made the Jew. In the seventeenth century, the Jewish philosopher Baruch Spinoza declared that "the sign of circumcision is, as I think, so important, that I could persuade myself that it alone would preserve the nation forever."118 For figures of the German enlightenment such as Wilhelm and Alexander von Humboldt, circumcision was one of those Jewish practices that "unnecessarily" separated Jews from the rest of society. The brothers were of the opinion that circumcision should be either significantly reformed or abandoned altogether. Expressed at the time of the debates over Jewish emancipation in the eighteenth century, the von Humbolts' suggestion was designed to help foster the assimilation of the Jews, and thus promote the cause of their emancipation.119 In 1831, Heinrich Paulus, professor of Oriental languages and theology at the the University of Heidelburg, declared that for Jews to merge fully with Christians they had to abrogate circumcision, for unlike the universal act of baptism, it served only to ensure their isolaton and distinct national identity.120 At the fin-de-siècle, the opinion that circumcision was the key to Jewish separatism and national identity was highlighted in one of the most important anthropological surveys of the Jewish people to appear in the nineteeth century, Richard Andree's Ethnography of the Jews. According to the author, "Circumcision was the pride of the Hebrews and a sign of their covenant and their separateness from other, non-circumcised peoples, and that upon which their nationality was conditioned."121 Further, Andree remarked that the consequence of circumcision is that it breeds in the circumcised an "arrogant and haughty" attitude toward the uncircumcised.
Given that circumcision among German gentiles was (and still is) extremely rare, Andree's remark went beyond the mere historical or anthropological to constitute a negative commentary on what he imagined were the hostile Jewish perceptions of Germans. In response to such claims, Jewish physicians downplayed the religious and nationalistic aspect of the ceremony and instead emphasized its medically beneficial and thus universalistic qualities, for there was nothing particularistic about the desire for good health. By stressing the hygienic advantages of circumcision, German Jews could offer Germans the benefit of millennial medical wisdom.122
The offer to share with large numbers of Germans the alleged pathological advantages of circumcision (and other Jewish rituals) first took place in 1911, at the International Hygiene Exhibition in Dresden. Attracting well over a quarter of a million visitors, the exhibit, and all that followed until the rise of the Nazis, was akin to a modern world's fair, but specifically focused on those positive health and social habits that served to promote good health among the world's different nations and races. The Jews manned their own pavilion, and in explaining their customs and life cyle events, the exhibitors considered their expository performance an act of generosity rather than a display of haughtiness.123
In addition to having been the subject of historical, anthropological, and theological speculation, circumcision came under legal scrutiny and became highly regulated over the course of the nineteenth century. While this was reflective of the general trend of the German state to enforce ever more control over public health, the desire to assert authority over the Jewish body had, as we saw with the burial controversy, an established precedent. Various state governments and local authorities, often in conjunction with interested Jewish parties such as physicians and advocates of local reform, passed legislation and decrees in their attempts to control Jews, seeking to sanitize in both surgical and aesthetic terms the procedure and make it conform as best as possible to German sensibilities. For example in 1799, the Prussian Oberkollegium sponsored the preparation of an expert report on the dangers of circumcision and how they could be avoided. The result was that in 1819, Prussia promoted the practice of having a physician attend all circumcisions. This was expanded upon in 1824 when it was decreed that the mohel had to pass an examination to prove his medical proficiency in treating the wound. By 1830, the Jews of the Rhineland had reached an agreement with the state's health officers that only their officially recognized mohelim would be allowed to practice. Nevertheless, a physician still had to be in attendance, and by 1843, noncompliance resulted in a monetary fine of between 5 and 20 taler for the boy's father and from 10 to 50 taler for the mohel. In 1852 the Jewish community of Hamburg decreed officially sanctioned rules and instructions for mohelim, which were later supplemented at a general session of the mohelim commission of 1900. In 1885, the government of the district of Wiesbaden offered instruction for mohelim, and finally by 1887 in Vienna, only physicians were permitted to perform circumcisions.124
During the 1840s, when Reform Jews held conferences to discuss issues of religious modification, debates about the nature and practice of circumcision also emerged.125 For a minority, circumcision was a blood ritual, more fitting for what were deemed savage tribes than for middle-class German Jews. Still others questioned whether circumcision was itself an absolute requirement as a sign and marker of Jewish identity. In 1843, the radical reformer Samuel Holdheim maintained that the ritual was no longer binding on Jews and that the sign of the covenant was to be symbolic rather than real. This view was soundly rejected by the overwhelming majority of German Jews. But all these were theological, not scientific arguments, and the majority of Jews were simply not prepared to argue over the religious nature of brit milah. As a Jewish ceremony it was a sanctified rite of initiation to be practiced in perpetuity.
Still, brit milah was under assault and needed defending. To this end, Jewish communities early on acted in consultation with state authorities and Jewish physicians to transform and modernize circumcision by focusing on the medical aspects of the ceremony. As early as the decree of 1819, wherein the Jews agreed to permit a physician to attend every brit milah, a creeping concession to modernity was countenanced. The ceremony became more of a public performance and was conducted under the "impartial" and "scientific" eye of the modern physician. To satisfy the demands of German society, Jews ought to accommodate the ancient ceremony to the rigors of modern science. They set out to prove that the operation, with out abandoning its basic elements, still met the surgical requirements of modern medicine.
In 1844, a Jewish physician and staunch advocate of ritual circumcision from Berlin, Joseph Bergson, responded to the circumcision abolitionists by promoting medical reforms to make the procedure safer. For Bergson, circumcision served a religious, symbolic, medical, political, mythological, and, even quite possibly, a military purpose.126 In his view, the sheer antiquity of brit milah, plus its centrality in the cultural life of the nation, justified its eternal practice. But to defend brit milah from attack, Bergson proposed the introduction of modifications in the ceremony.
Because in matters of public health it was "the duty of the state to protect all its subjects, irrespective of religion and class," Bergson recommended that circumcision come under tighter regulation. Precisely because of its "bloody character," he wanted to see it more closely observed by both physicians and state medical authorities. Concerned about the possible abuses that could come from state intervention in religious affairs, Bergson suggested that the state tread lightly, embarking with the "greatest possible forbearance" on a "suitable program of education and "enlightenment" in order to promote the "physical well-being" of the child-an advantage to be later served by the state itself.127
Among the technical changes Bergson advocated were the abolition of periah by the traditional method, that is the peeling back of the entire foreskin and splitting it with a razor sharp fingernail. In order to expose the glans, and metsitsah, the sucking of the wound by the mohel to draw out the blood. Claiming that neither had biblical sanction, Bergson noted that the former procedure had long been rejected by "rational and ...modern surgery, a barbaric remnant from medieval field-surgery." In its stead, he recommended the use of recently invented scissors and other surgical implements, specifically designed for the task, and the application of the latest salves, balms, and elasticized bandages.128 Another Jewish physician who likewise sought to reform brit milah, D. Salomon, also recommended a postoperative surgical procedure that involved stitching the wound, a procedure that was never accepted in the Jewish world but nevertheless was endorsed by Bergson.129 According to Bergson, metsitsah played no prophylactic role whatsoever, and only increased the chances of transmitting a host of infectious diseases, including syphilis. It had to go entirely.130
In addition to changes in surgical procedure, Bergson wanted mohelim to receive fundamental instruction in anatomy and surgery, claiming that it was "little wonder that in recent times the opinion had been expressed that the operation should be taken out of the hands of mohelim and entrusted to qualified doctors." He lamented the fact that in antiquity, circumcision among Israelites had been performed by physicians, whereas it was now performed by the unqualified!131 This is reminscent of the call by maskilic physicians in the eighteen century to remove the control over what Jews did with their own bodies and hand it over to duly certified professionals It also recalls a common Haskalah refrain, echoed by nineteeth-century Jewish social critics, that idealized and glorified the health care culture of biblical Israel while at the same time emphasizing the extent to which modern Jews seemed to have deviated from that ideal.
With advances in medical knowledge, criticism and advocacy of circumcision took on a more scientific tone by the late nineteenth century. The medical profession at this time expressed two diametrically opposed views of circumcision: one for and one against. As for the negative assessment, Jews had long been accused of hypersexuality and of being chronic practitioners of what a liberal French cleric, the AbbÉ GrÉgoire, called, the libertinage solitaire.132 Similarly, Jews had long been linked to the spread of syphilis. Indeed as early as the fifteenth century, the Genovese ambassador to Charles VIII called it the "Peste of the Marranos." At the close of the nineteenth century, because of the association with skin diseases, antisemitic claims of their immorality, and the fact that Jews predominated in the nascent medical speciality of dermatology, Jews played an important role in the medical literature on venereal disease, and medical opponents of circumcision rarely failed to draw a causative link between alleged Jewish concupiscence and sexually transmitted diseases and the rite of circumcision. One German opponent of circumcision, a physician from Halle, even claimed that the majority of patients he treated for gonorrhea were Jewish.133
The opposite medical assessment was that Jews were to a large extent protected from a variety of diseases precisely because they were circumcised.134 Stressing the prophylactic quality of circumcision, physician-advocates of the procedure regarded it as a mode of prevention against sexual malfunction and deviance, sexually transmitted diseases, and what some physicians called "sexual neuroasthenia."135 Proponents also saw it as a means to prevent childhood bed-wetting, and prolapse of the rectum, hernia, and hydrocele, caused by overexertion of the abdominal muscles in order to overcome impediments to urination caused by inflammation of the prepuce.136 One Zionist physician, Felix Theilhaber, held circumcision responsible for the lower incidence of uterine cancer among Jewish women.137
Much like people today who display a seemingly insatiable appetite for medical news, the Jewish public at the turn of the century likewise sought out the latest information about medical breakthroughs, especially when they pertained to Jewish pathologies. In a lecture to a Breslau synagogue in 1902, Jewish physician Carl Alexander told his audience that there were several diseases that could be prevented by circumcision, for example, phimosis, a constriction of the penis opening, which was congenital in 12 percent of boys, and elephantiasis, a chronic enlargement of cutaneous and subcutaneous tissue, especially of the legs and scrotum. Alexander also believed circumcision helped stem the tide of diabetes.138 He and other Jewish advocates also stressed the humanitarian aspect of performing circumcision on newborn males because at that tender age, there would be no memory of either the event or the discomfort.139
Another physician noted that just as the dietary laws had a "hygienic basis" in addition to a religious one, circumcision was to be interpreted similarly. Circumcision and the attendant prescription of God to "be fruitful and multiply," he argued, was a holy prescription that for the Jewish people "led to a curative function." Fulfilling both requirements was "sure protection against the inclination to onanism."140 Many Jewish physicians concurred that circumcision lessened if not eliminated entirely the instinct to mastubate-an act, they suggested, that was the end result of a buildup of irritating secretions under the foreskin.141 The subtext of this observation was they because they were uncircumcised, it was Christians rather than Jews who challenged nineteenth-century bourgeois morality, which condemned masturbation as a vice that in addition to constituting a complete "loss of control" was "opposed to all that was manly and virile."142 Here could Jewish doctors turn the tables on those who had accused the Jews of unbridled passion and predatory,deviant sexual behavior.
Critics of ritual circumcision were particularly hostile to the act of metsisah, sucking the wound. For many Jews, primarily those who had joined the German middle class and had come to share the culture and aesthetic sensibilities of that group, metsitsah appeared to be an atavistic, sexually deviant act.143 Part of the traditional circumcision ceremony, the practice of metsitsah was widely condemned throughout the nineteenth century by medical and lay authorities, Jews and Gentiles alike. Charging that the practice promoted the spread of a host of sexual and infectious diseases, the arguments made against the practice were not confined to Western Europe but made their way east as well. A commission established in St. Petersburg in 1891 composed of physicians and "specialists in Jewish ritual" recommended that in the name of hygiene, metsitsah and the "tearing off of the lamina interna by hand" (periah) be abolished.144 A German Jewish physician named Bamberger also shared some of the more common misgivings about the procedure, such as the fear that syphilis or tuberculosis could be spread from child to mohel or vice versa. In a comprehensive study of brit milah Bamberger published in 1912, he advocated the use of a glass apparatus to suck the wound, citing in particular the device designed by a Professor Pettenkofer of Munich, at the urging of Rabbi Michael Cahn of Fulda.145 What Bamberger sought to impress upon his readers was that science and religion were not only compatible in theoretical terms, but the religion could be the mother to science's invention. Working together, they were capable of tackling the problems confronting the modern Jew, arriving at creative solutions that permitted ancient tradition to be adhered to.
Technical innovation was not only used to modify tradition and reconstruct ancient rites in order to harmonize them with modernity; scientific evidence could even be deployed creatively to defend all aspects of brit milah, including the most derided. In 1913, Emanuel Rosenbaum, a German Jewish physician practicing in Paris, published a thorough scientific defense of metsitsah. Drawing copiously on classical Jewish sources, he supplemented these with evidence from contemporary medical science to endorse the prophylactic nature of the act.
In defending metsitsah Rosenbaum made two principal points. The first was the hypocrisy inherent in the campaign against the practice, in that double standards of hygiene were employed to make unrealistic demands on Jews. The goal in the "rational treatment" of a wound, according to Rosenbaum, is to stave off infection by creating an "aseptic" environment. But even in a hospital setting the attainment of asepsis "in the surgical sense is an absolute impossibility."146 Why he demanded to know, were Jews required to observe standards of hygiene in domestic environment that were unobtainable even in a hospital? Rosenbaum's other method of supporting metsitsah was to use expert testimony on the treatment of snakebites. International authorities were quoted, all of whom testified that standard medical procedure in the case of such injury entailed sucking poison from the wound. From this Rosenbaum extrapolated that metsitsah was not only harmless, but efficacious.147
Rosenbaum directly tackled the issue of transmissibility of syphilis and tuberculosis through metsitsah, claiming that not one case had been reported in the medical literature of contagion having been spread in this way. At any rate, the mohel's use of alcohol-"one of the most outstanding disinfectants"-prior to performing metsitsah ensured an antiseptic oral environment. And again highlighting double standards, Rosenbaum asked rhetorically why restauranteurs and hoteliers were not compelled to disinfect cutlery, crockery, and glassware in carbolic acid or Lysol after use by their customers if the threat of orally transmitted infection was so great and so roundly acknowledged.148 The fact that they were not required to do only confirmed his sense that the attack on metsitsah was biased.
Not only did the ceremony of brit milah require defending, but the mohel had long been an object of scorn. The mohel, who had no medical training, was clearly seen as inappropriate. Berlin Jewry had required a physician to attend each brit milah since the early part of the nineteenth century, and various reforms had been instituted throughout the course of the century in order to "medicalize" the procedure.149 Although Bamberger defended the mohel, who was attacked most often because of his inadequate surgical training and because of the perception that his personal hygiene constituted a threat to the infant, he did note that rabbis were concerned about the surgical qualification and dexterity of the mohel, disqualifying anyone who suffered from "shortsightness, nervous disorders, shaking of the hands, and internal diseases." Indicating that change had taken place in the sensibilities of German Jews, Bamberger observed that "today, here and there, the religious character [of circumcision] has been stripped away and it is regarded as a medical operation."150 To this end, and in response to various accusations concerning the hygiene of the mohel himself, Bamberger offered the following inventory:
Before the [mohel] performs the act, he must thoroughly disinfect his hands. Today's mohelim wash their hands in this same warm water they soap themselves up with carbolic acid or Lysol and use a brush, especially around the nails. The same happens to the instruments which are boiled just before their use. These are: 1. A double-bladed knife, 8-10 cm long; 2. A metal clamp and forceps; 3. A common pair of tweezers to fasten the area around the wound; 4. 2-3 bolted tweezers to squeeze the bleeding; 5. different bandages, plasters, and swabs-all sterilized; 6. Scissors and a surgical sewing needle; 7. A glass tube for the metsitsah. In Hamburg the doctors have put together a 'sterile first-aid kit for circumcision.' Also the instruments, which are afixed inside a utensil for boiling, are sterilized at the scene of every circumcision.151
Here there is no God, no Abraham, no Covenant. This stark and clinical description of the mohel's instruments was designed to construct a clean counterimage of the Jews. Here in Judaism's most elemental rite of passage, one long derided for its supposed savagery and uncleanliness, Bamberger sought to demonstrate the antiseptic nature of brit milah as it was performed in contemporary Germany. Although the mohel was not a physician, let alone a trained surgeon, every precaution had been taken to ensure that he upheld the most stringent rules of modern hygiene. As much as it could be, the ceremony had been "de-orientalized," indeed Germanized, tailored to conform to German, not traditional Jewish notions of cleanliness.152
One of the most important claims made about circumcision by its opponents in the medical world was that it was an unnecessary procedure, one that "deformed" a perfect organ, a view expressed for example by Paul Ascherson, professor of medicine at the University of Berlin.153 In stark contrast, a Jewish physician, S. N. Kutna, declared circumcision to be an act of bringing about "bodily perfection," the foreskin being, "in a biblical sense, a defect."154 Jewish countercharges not withstanding, the accusation of their bodily deformity goes to the issue of how Jews fit into the ethic of human physicality is Wilhelmine Germany. Antisemites interpreted circumcision in political and nationalistic terms. For them, a deliberately mis-shapen body, such as one that had been circumcised, was an imperfect body, and an imperfect body was, by definition, inadmissable into the body politic of the nation. For example, the 1894 statutes of the fiercely antisemitic organization, the Deutschbund, claimed that "the Jew cannot belong to the Deutschbund, nor become eligible by baptism, because his circumcision harbours his nature."155 In this radical assessment, circumcision constituted a permanent taint that preventedthe integration of Jews into German society.
For many, the separatist rite of brit milah distinguished Jews from Germans in the most tangible way, permanently impressing upon Jews a mark of national otherness. Thus circumcision was to the notion of race, in that for antisemites it too was indelible. The Jew, because he was circumcised, would remain forever "physically" Jewish, even if he had converted to Christianity.
It was not only brit milah but the entire array of Jewish customs and ritualistic behavior that contributed in a sense that the Jews were fundamentally different from the Germans. Even those Germans who were well disposed to the integration of Jews into German society were quite convinced that the social product of the performance of Judaism's most important rites was Jewish separatism.
In response Jewish physicians in modern Germany enlisted the help of medicine to answer crises in and challenges to Judaism and Jewish culture itself. Sometimes, for example, in the case of the methods of animal slaughter, the challenge was driven by blatant anti-semitism. On other occasions, such as with the discussions of the ritual bath or the dietary laws, the agitation for reform could come from within as well as from without. Whatever the case, the challenges were generally the product of the Jewish encounter with the modern secular world. And, in what is a wonderfully intricate paradox, German Jews were able to use one of the defining characteristics of the modern age—science—to reinforce their Jewish identities, justify their ancient traditions, and help them navigate their way through the turbulent waters of modernity.
Copyright © 2001 Yale University.
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