By CHRISTOPHER LEHMANN-HAUPT
CIRCUMCISION: A History of the World's Most Controversial Surgery
By David L. Gollaher
Illustrated. 253 pages. Basic Books/Perseus.
''Circumcision is the oldest enigma in the history of surgery,'' writes David L. Gollaher, a medical historian, in his fascinating new book, ''Circumcision: A History of the World's Most Controversial Surgery,'' in which he sets out to make ''the strange familiar,'' but also ''the familiar strange.''
Certainly the procedure has been prevalent throughout recorded human history. With the earliest evidence of the practice showing up on mummified remains in Egypt dating from about 4000 B.C., circumcision is so old that no one knows how or why it got started. Yet the notion of a tradition confined to Egyptians, Jews and Muslims was shattered by the discovery in the age of exploration that tribes in remote parts of the world – Africa, the Americas, Australia and Indonesia – performed, in Mr. Gollaher's words, ''a bewildering variety of circumcisionlike surgeries on both males and females.''
Today it is the most common surgery in the United States, with 1.2 million newborn male infants routinely circumcised every year.
Equally persistent over the millenniums have been attempts to explain just why circumcision is done. For ancient Egyptians it was thought to be an initiation ritual and a sign of high social standing. For the descendants of Abraham it was ''not merely a sign of the covenant,'' Mr. Gollaher writes, citing the views of anthropologists; ''it constituted a vital part of the promise itself,'' since it involved the instrument through which ''a multitude of nations'' would be produced, although thinkers like Moses Maimonides, the great 12th-century philosopher, reasoned that its purpose was to dull sexuality so as to promote spirituality.
Jesus was circumcised, of course, but in the tradition of Pauline theology, ''Gentiles, by accepting Christ's blood sacrifice on the cross, are through their faith in him vicariously circumcised.'' In late 16th-century England, circumcision had come to be regarded by some as part of a diabolical conspiracy fomented against Christian babies.
Still later James Frazer, in ''The Golden Bough,'' saw circumcision as an initiation rite that was essentially sacrificial. Freud called it ''the symbolical substitute of castration,'' expressing the child's submission to the father's will. Bruno Bettelheim proposed just the opposite, that, in Mr. Gollaher's words, ''it was about fertility,'' to make the male bleed and thus become more female. But ''no theory fits the myriad facts,'' the author concludes. ''No one has been able to identify a discrete biological or cultural disposition for genital cutting.''
Yet most astonishing in Mr. Gollaher's history is the medical transformation undergone by the ritual of circumcision in America in the late 19th century. This began with the supposed discovery that the procedure cured cases of paralysis, and went on to embrace the inhibition of cancer of the penis, cervical cancer in women, sexually transmitted diseases, urinary tract infection and even the spread of H.I.V.
Mr. Gollaher has striven to write a ''balanced account,'' he says. ''This book is a history, not a polemic nor a tract for the times.'' Still, one can't help being overwhelmed by his conclusions. After reviewing some of the evidence for and against the medical benefits of circumcision, he cites a study that calculates the life expectancy of the average man circumcised at birth to be 84.999 years, ''whereas his uncircumcised counterpart would live 84.71 years.'' He concludes, ''statistically, the known pros and cons of circumcision cancel each other out.''
Even more impressive, he tries to remedy the neglect over the millenniums to understand the physiological purpose of the foreskin, concluding that it is analogous to the eyelid, serving the dual purposes of protection and lubrication. The point of those functions, he concludes, is to heighten the experience of sex.
The book's final chapter is devoted to female circumcision, whose status in the civilized world is of a wholly different order, even though, he argues, it parallels male circumcision in a number of ways.
The chapter's inclusion serves to illustrate a thought experiment proposed by Mr. Gollaher in his preface, namely to imagine what would happen if the United States were innocent of circumcision, like Norway, say, and ''that a physician were to urge, in a talk at the annual meeting of the American Academy of Pediatrics, that doctors begin operating on the genitals of all baby boys shortly after birth in order to achieve marginally lower incidence of urinary tract infections and perhaps some other diseases.'' Just imagine.
He continues, ''Indeed, as the history of female circumcision suggests, if male circumcision were confined to developing nations, it would by now have emerged as an international cause celebre, stirring passionate opposition from feminists, physicians, politicians and the global human rights community.''
And why are we not innocent of circumcision, in Mr. Gollaher's view? He concludes: ''The United States became the new Promised Land. The religious core of American culture remained Protestant, but from the era of the founding fathers it also developed an important secular dimension: a common national creed and intellectual idiom that has been called America's 'civil religion.'
''Evidence of this generic religiosity is everywhere, from presidential discourse to the inscription In God We Trust on the copper penny. Ironically, circumcision, converted more than a century ago from a religious tenet to medical wisdom, has marked generations of males born in the United States not as the children of Israel but, in Lincoln's astute phrase, God's 'almost chosen people.' ''
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