CIRCUMCISION

the operation of cutting away all or part of the foreskin (prepuce) of the penis. The origin of the practice is unknown. The widespread ethnic distribution of circumcision as a ritual and the quite widely preferred use of a stone knife rather than a metal one suggest a great antiquity of the operation. Wherever the operation is performed as a traditional rite, it is done either before or at puberty and sometimes, as among some Arab peoples, immediately before marriage. Among the ancient Egyptians, boys were generally circumcised between the ages of 6 and 12 years. Among the Ethiopians, the Jews, the Muslims, and a few other peoples, the operation is performed shortly after birth (among Jews, on the eighth day after birth) or perhaps a few years after birth. Among most other peoples who practice it ritually the operation is performed at puberty. At any age the ritual operation is regarded as of the profoundest religious significance. For the Jews it represents the fulfillment of the covenant between God and Abraham (Genesis 17:10-14), the first divine command of the Pentateuch, that every male child shall be circumcised. That Christians were not obliged to be circumcised was first recorded biblically in Acts 15. The operation at puberty represents a beginning of the initiation into manhood and the leaving behind of childhood. From the medical aspect the operation consists in the cutting of the foreskin to allow its free retraction behind the glans penis (the conical head). The foreskin consists of a double layer of skin that, without circumcision, more or less completely covers the glans penis. Under the inner layer of foreskin there are situated a number of glands that secrete a cheeselike substance called smegma. Accumulation of smegma beneath the foreskin may result in great discomfort and may serve as the source of a rather penetrating odour, if cleanliness and hygiene are not observed. Studies have indicated that uncircumcised men have a higher incidence of AIDS, syphilis, and other sexually transmitted diseases than circumcised men, and it has been speculated that the foreskin might allow viruses and other microorganisms to survive longer on the skin and thus give the organisms more time to enter the body. Moreover, cancer of the penis is rare in circumcised males and in uncircumcised males with high standards of hygiene. Overall, the physiological value of circumcision may be highest in countries and regions where poverty and endemic disease make high standards of hygiene difficult or nearly impossible. In Western countries, in any event, the operation has been widely practiced as a hygienic procedure. In many hospitals it has been routinely performed upon the newborn unless there is some objection. For female circumcision, see clitoridectomy.