Chapter XXVI (2)

[86] The reader is referred to a very interesting paper detailing
conditions of adhesions in the _American Journal Med.
Sciences_ for July, 1872. It is taken from the Hungarian of M.
Bokai.

[87] _New York Med. Journal_, vol. xxvi.

[88] _American Journal Med. Sciences_, vol. lx.

[89] Dr. Vanier describes this operation of Celsus mentioned by
Vidal in his work on "Circumcision," at page 294, which
consisted in making, by a circular incision immediately back
of the glans, like in a circular amputation, a complete
detachment of the integument from back of the corona. The
penis was then made to retreat into the sheath thus made and a
short catheter introduced into the urethra, to the end of
which the free end of the new preputial fold was made fast, a
piece of oiled lint being interposed between the raw inner
surface and the glans. Another operation consisted in
forcibly drawing the integument forward and in making a number
of transverse incisions in the integument so as to assist its
extensibility. By these means it was drawn sufficiently
forward so as to fasten it to a canula or catheter made fast
in the urethra. But it can well be imagined that a person must
possess the most exalted idea of the physiological needs of a
prepuce and feel the most sensitive need of such an appendage
to submit to the first of these operations, although it is
more than probable that many Jews submitted to the operation
in the days of Celsus to avoid being exiled or plundered of
all their possessions. The resulting prepuce could not have
been a much more unsightly appendage than that which ornaments
the overburdened virile organ of many Christians, and there is
no doubt but that in many cases they passed muster.

[90] "Circumcision." Dr. A. B. Arnold.

[91] Ashhurst. "Int. Enc. Surgery," vol. vi.

[92] "Pertes Seminales."

[93] "Circoncision." Dr. Vanier, du Havre.

[94] "Dictionaire des Sciences Medicales."

[95] Erichsen's "Surgery," page 1144. Edition of 1869.

[96] _Medical News_ of Philadelphia, page 115. Vol. for 1860.

[97] "Pertes Seminales." In the fourth American edition of the
English translation of McDougall of Lallemand we find that he
fully appreciated the dangers that lurk in a prepuce. At page
216 he says: "Such is the condition which the parts present in
cases of recent balanitis, and these are the inflammations and
ulcerations that cause more or less extensive adhesions of the
prepuce to the glans. Such adhesions are generally cellular,
but sometimes fibrous or even cartilaginous, according to the
severity and frequent repetition of the inflammation. Various
degrees of induration also results according to the intensity,
the duration, and the frequency of the phlogosis. Thus, I have
often found a mucous membrane hardened, thickened, and covered
with numerous papillae, sometimes fibrous or cartilaginous,
with three times its natural thickness. I have also met with
cases in which the prepuce has become cancerous. I have
operated in several cases of cancer of the penis, too, which
certainly arose from no other cause. The patients were
generally peasants between fifty and sixty years of age, who
had never known other than their own wives, but who had
frequently suffered from balanitis attended by abundant
discharge, swelling of the prepuce, and excoriation of its
opening, which was so contracted as to prevent the passage of
the glans. I have seen one case, also, in which balanitis,
irritated by a forced march and the abuse of alcoholic
stimulants, passed into gangrene, by which the greater part of
the glans was destroyed. Such have been the accidents which I
have observed on those whose prepuce was too narrow to permit
the glans being uncovered; accidents which I can only
attribute to the long retention of the sebaceous matter in a
kind of _cul-de-sac_, into which a certain quantity of urine
passes every time the patient makes water."

[98] Claparede. "La Circoncision."

[99] Baron Boyer. "Traite des Maladies Chirurgicales," vol. x, page
370.

[100] I have practiced considerably among the Jewish people, but I
have never seen their elderly men suffer with prostatic
troubles like our own people who are uncircumcised. From
having observed the tendency to prostatic complications in
young people with troublesome prepuces, and that the great
number of the elderly people who are affected with prostatic
disease or enlargement are the unlucky possessors of long or
large prepuces, I have arrived at the conclusion that the
prepuce can be entered as a factor in the etiology of enlarged
prostate.

[101] I have now under my care a poor consumptive who has all the
appearance of having always been as virtuous as Joseph, but
who, unlike Joseph, has from infancy had as a constant
companion a long, miserable, smegmanous, and annoying prepuce.
The young man has an oedema which first affected his feet, but
one day, owing to the irritation of a slight balanitis, the
prepuce swelled at once; it proceeded through the penis
integument to the scrotum; the penis itself retracted, leaving
the integument and scrotum to assume a translucent, puffy,
cork-screw appearance and attitude; from its labyrinthic
passage the urine slowly dribbles during urination in a
scalding stream. In addition to the physical sufferings, he is
tormented by the knowledge that his friends attribute all his
disease and troubles--since the occurence of the penile
oedema--to the fact that his earlier manhood must have been
indiscreet, as well as sinful. The laity cannot connect any
penile, scrotal, or testicular disease with anything except
venereal disease; and if the physician attempts to explain
matters, they simply look upon it as the good-natured and
well-intentioned efforts of the doctor to deceive them and to
cover up the shortcomings of some frail mortal. Many a poor
fellow has to leave this world under a cloud of mistrust and a
bad odor of past deviltry to which he is not entitled, and
suffer all this in addition to all his physical ills, owing to
his having been ornamented through life with an annoying
prepuce,--the luckless heritage of having been born a
Christian. Columbus in chains moralizing on the ingratitude of
this world is nothing to the poor invalid with a swollen
prepuce, innocently acquired, silently "cussing" the ignorance
of his relatives and friends.

[102] This patient, on convalescing, suffered considerable from the
action of numerous small carbuncles, resulting from the
toxaemic condition induced by the partial suppression of urine
that he at times suffered from, and, when nearly well, brought
on a serious relapse by the mail-bag appendage at the penis
working up the organ into a state of erection. While so
situated he had intercourse, and from 99 deg. his temperature
immediately rose to 1041/2 deg., where it remained for several days,
lengthening out his illness by several weeks, into a
long-protracted convalescence. The man is not yet circumcised,
and, from the knowledge that I have of his tendency to uraemia,
I feel that, although in his prime, a fever or an accident may
take him off at any moment.

[103] In looking over the literature of reflex neuroses and more
direct injurious results, I find that George Macilwain, in a
work on "Surgical Observations on the More Important Diseases
of the Mucous Canals of the Body," published in London in
1830, calls special attention to the case of a man aged
thirty-eight, admitted to the Finsbury Dispensary, and who was
in the care of Mr. Hancock. The patient was suffering from
excruciating pain in different joints, the pain being so
great that he was confined to his bed and unable to stand on
his feet. He was unable to rest at nights, and neither
rheumatic nor any other apparently suitable treatment was of
any service. Rigors were soon added to his other troubles, and
during their continuance the pain in his joints was greatly
aggravated. He was referred to Mr. Macilwain for treatment,
who promptly relieved him by the removal of a urethral
stricture, which had quietly been the cause of all the
disturbance. It is particularly interesting that even at that
early day the reflex neuroses and complications that may arise
from the irritability of the genito-urinary organs were so
well understood. How well Dr. Macilwain appreciated the nicety
of these relations can be seen from his remarks in connection
with the above case, in which he says: "It may be observed
that the severity of the symptoms is not always commensurate
either with the duration of the disease or the degree of
stricture, and that, although the progressive development of
them varies considerably in rapidity, in different
individuals, it is, nevertheless, in the latter stages, always
more rapid." Macilwain also graphically describes the
insidious approach of these genito-urinary troubles. In
speaking of stricture he says: "Although minute inquiry
generally informs us that the stricture has been of some
standing, and in some instances has existed for years, yet it
may happen that it is only a few months or a year since the
patient's attention has been directed to the disease. This is
very intelligible; for, in conformity with what we observe in
other parts of the body, the bladder has a power of
accommodating itself to a change of circumstances. Its
strength, for a long time, may increase so correctly in
proportion to the increase of the obstacle which opposes the
ejection of its contents that a very considerable period
elapses before the difficulty in making water becomes
cognizable to the patient, or it occasions an annoyance so
trifling as scarcely to excite his attention. This increase of
strength in the bladder frequently renders the formation of
stricture so insidious that the urethra at the affected part
is very narrow before the individual is aware of the existence
of any contraction whatever; the bladder, however, at length
becomes unable to empty itself, and the abdominal muscles and
diaphragm powerfully act as coadjutors, so that each effort to
make water is accompanied by a straining which is very
distressing, and the complete evacuation of the bladder is
often not accomplished even by these combined forces. The
straining which accompanies stricture, and which seems
necessary to evacuate the bladder, although it be occasionally
exceedingly annoying to the patient at the time, is more
important with reference to the results which are its
consequence. I am firmly of opinion that there are a great
number of patients laboring under hernia which has been
produced by no other cause. I must confess that I had seen a
great number of instances of stricture in ruptured patients
before I drew any inference from the observation of their
co-existence." The foregoing observations of Macilwain, made
in 1830, are here reproduced for their clearness of expression
and explanation, as well as to show what injuries can be
produced on the young child afflicted with phimosis. We are,
as surgeons, familiar with the anatomical and pathological
changes there are undergone by the bladder and its lining
membrane, as well as in the ureters and kidneys, in many
cases of stricture, as well as of the great amount of
prostatic irritability and enlargement that is due to the same
cause. How similarly these results can be and are actually
produced by phimosis is undeniably expressed by the
post-mortem appearances in the poor infant described by
Golding Bird to the London Medical Society, and mentioned in
the London _Lancet_ of May 16, 1846. The bladder and ureter
were like those of a man who had long suffered from stricture.
From the remarks of Dr. J. Lewis Smith, that phimosis may be
productive of inguinal hernia and prolapsus of the rectum, and
the observations of Edmund Owens and Arthur Kemp, both high
authorities on children's diseases, being both connected with
children's hospitals, as well as the remarks of Mr. Bryant in
his "Surgical Diseases of Children," who all concur in looking
upon phimosis as a great factor in hernia, Bryant having
observed thirty-one in fifty consecutive cases of phimosis, we
are certainly warranted in assuming that phimosis is not only
a mere local timely inconvenience that will disappear with the
approach of puberty, but a condition which, in the more easily
affected organism of the child,--lacking, as it does, that
resistance that comes with our prime,--is productive of
serious harm; as even the first few years of life, even a few
months of infant life, with a phimosis, are sufficient to so
change the structures of parts that the poor child will grow
into a man with an impaired kidney or sacculated ureter. The
strain required to induce a prolapsus of the bowel or a
rupture into the inguinal canal is exerted as much on the
bladder, ureter, and kidney as on the other localities.
Physicians who have taken the pains to observe must have
noticed, more than once, how the child afflicted with a
phimosis has not only at times to wait for the stream of urine
to appear, there seemingly being some obstruction to its
starting, but how often such a case is afflicted with a
stammering, halting urination. A child thus started out into
life, with a defective kidney or kidneys, is sadly handicapped
in his usefulness, comfort, or in properly competing in the
race of life. No parent would for a moment think of starting
his son in life by giving him a business that is heavily
mortgaged at the start, but many a parent unconsciously
launches the unsuspecting child into a life of such ill
health--resulting from a simple narrow prepuce--beside which a
heavy mortgage or a heavy yearly tribute would be but a mere
trifle. I have seen such men, who in after life, broken-down
and perfectly physical wrecks, would gladly have given all
their wealth and been willing to have some genii set them down
in the middle of the Sahara, shirtless and pennyless, provided
they had their health. To say nothing of the trifling loss of
the prepuce, these parties would gladly have had a foot or a
leg go with the prepuce if necessary, and have their health.

[104] I have often performed dilatation where, for some reason,
either the timidity of the parents or the health of the child
seemed to contraindicate any more radical procedure. It is
customary to advise mothers or the nurses to retract the skin
daily, but even after a good dilatation I have found as sudden
a recontraction, and even in the majority of cases, where
daily drawing back the skin might have been practicable, the
cries and struggles of the child are a positive prohibition to
these instructions being carried out; it is not once in ten
times that it can be carried out. I have seen two very
annoying cases of paraphimosis resulting from this procedure,
the struggles of the child having prevented the return of the
prepuce to its proper place, and the violent crying and
sobbing of the child having assisted to congest the organ.

[105] It may well be a question, considering the well-established
fact that nervous injuries and affections are easily
transmissible and become hereditary, how much
feeble-mindedness is due to an heredity originally induced in
either parent through reflex neuroses from the genital organs.
The Jews have a very small percentage of feeble-minded; it is
true that they have not any inebriates to assist in their
manufacture, but still the absence of these well-pronounced
cases of reflex neuroses among the race must be largely
ascribed to their practice of circumcision, as that operation
cures the gentiles so afflicted.

[106] I have seen precisely similar conditions resulting from a
sphincterismus being relieved by anal dilatation. I had one
such case who had fallen into the hands of a quack, who made
him believe that he was being affected with incipient
softening of the brain; systematic dilatation or a rupture of
the sphincter _a la_ Van Buren is the appropriate remedy.

[107] In the first volume of the "American and English Encyclopedia
of Law" there is an interesting account of a young child (who
had been bound out by the parish officials) who murdered his
little bed-fellow and, on trial and conviction, was sentenced
to be hanged, but who was reprieved by royal favor on account
of his tender years, the sentence being changed to
imprisonment for life. The little fellow was only eight years
of age. On the trial the boy said he was driven to commit the
crime because the other child soiled the bed. The two children
being both paupers, it may well be imagined that their bedding
was none of the cleanest at the best, or that their bed-room
had the best of ventilation. As at the time the murder was
committed English paupers were not treated in the most humane
manner, it is not surprising that a nervous, sensitive child
would, under such a combination of circumstances, be converted
into an insane murderer.

[108] The study of prematurely acquired impotence in the male is a
most interesting one. I have frequently seen it result from
the presence of anal or rectal irritation, from haemorrhoids. I
have seen cases who could not have erections, and in whom all
sexual desire was extinct at a very early age, who have
informed me that, although unable to have sexual intercourse
because of the total absence of sexual desire, the flaccidity
of the organ, and the want of sound physiological organic
functional activity to suggest the thought, they had,
nevertheless, frequently been the victims of nocturnal
emissions before the total extinction of the function. As a
rule, much of this premature impotence--induced by either
irritation of the genital organs or rectal or anal
troubles--runs its unfortunate possessor through such a course
of physical incidents as described by Hammond, as the wild
Indians of the Southwest induce in the _mujerado_. At first
the sound organ responds in a natural manner to any stimulus
that may affect it, but soon a local satyriacal condition is
set up, which, running a more or less rapid period of intense
activity, soon leaves its victim completely, permanently, and
hopelessly impotent, even as much so as if eunuchized in the
most approved manner. Hammond's description of the manner in
which these unfortunates are manufactured is an interesting
addition to the facts contained in the natural history of man,
and is as follows: "A _mujerado_ is an essential person in the
saturnalia, or orgies, in which these Indians, like the
ancient Greeks, Egyptians, and other nations, indulge. He is
the chief passive agent in the pederastic ceremonies which
form so important a part in the performances. These take place
in the spring of every year, and are conducted with the utmost
secrecy, as regards the non-Indian part of the population. For
the making of a _mujerado_ one of the most virile men is
selected, and the act of masturbation is performed upon him
many times every day; at the same time he is made to ride
almost continuously on horseback. The genital organs are thus
brought, at first, into a state of extreme erethism, so that
the motion of the horse is sufficient to produce a discharge
of seminal fluid, while at the same time the pressure of the
body on the animal's back--for the riding is done without a
saddle--interferes with their proper nutrition. It eventually
happens that, though an orgasm may be caused, emissions can no
longer be effected, even upon the most intense degree of
excitation. Finally, the accomplishment of an orgasm becomes
impossible; in the meantime the penis and testicles begin to
shrink, and in time reach their lowest plane of degradation.
But the most decided changes are at the same time going on,
little by little, in the instincts and proclivities of the
subject. He loses his taste for those sports and occupations
in which he formerly indulged, his courage disappears, and he
becomes timid to such an extent that, if he is a man occupying
a prominent place in the council of the pueblo, he is at once
relieved of all power and responsibility, and his influence is
at an end. If he is married his wife and children pass from
under his control,--whether, however, through his wish or
theirs, or by the orders of the council, I could not
ascertain. They certainly become no more to him than other
women and children of the pueblo." Hammond examined one of
these men, who had, as he himself informed him, formerly
possessed a large penis and testicles "grande como
huevos,"--as large as eggs. The penis was in its flaccid state
and about an inch and a half in length, with the glans about
the size of a thimble, which it very much resembled in shape.
The glandular structure of the testicles had disappeared; they
were atrophied, little besides connective tissue remaining. He
examined another _mujerado_ in the pueblo of Acoma, who had
been so made when at about the age of twenty-six. The penis
was not more than an inch in length and about the diameter of
the little finger, and of the testicles there was apparently
nothing left but a little connective tissue. Both of these men
had high-pitched voices. The last one examined was then
thirty-six years of age. (Hammond: "Male Impotence.") The
foregoing detailed description shows an extreme degree of
results produced by an equally extreme degree of intense and
persistent irritation applied to the genital organs, purposely
employed to obtain certain results. In the cases cited the
irritation or excitation is directly applied, but it is safe
to assume that reflex irritability from the anus or rectum,
or from that of a stricture or of a prepuce, will in some
cases produce a certain degree of excitation in the testicles
that may result in their functional or organic derangement, in
a degree proportionate to that of the amount of excitation
from which they have suffered. That the testicles are very apt
to suffer from the existence of a stricture is a well-known
fact. I have myself worried over a case of stricture, in whom
the attempted passage of a filiform bougie was always
immediately followed by a severe attack of epididymitis, and
who had always been afflicted with a tenderness and a tendency
to inflammation of the testes. I have also noticed a much
greater tendency to orchitis in the wearer of an irritating
prepuce than where it was absent; so that the presence of a
satyriacal tendency, no matter in what proportion of a degree
it may be present, can safely be assumed to result in a
corresponding degree of apathy, due to an actual physical
degeneration of the parts. That these conditions, when present
in any degree of permanency or persistence, will in the end
induce early impotence, I have no reason to doubt. In this
regard we must not overlook the fact that persons with
phimosis, stricture, or other genital irritants and
impediments, are more liable to be afflicted with haemorrhoids,
prolapsus ani, or other anal and rectal irritation, which
retroactively assist in bringing about the condition under
question. How much this may have to do with certain prolific
peculiarities among the Jews may well be questioned; it is a
well-known fact that in London the Jewish excess of male
births has been as high as eighteen per cent., while among the
Christian or Gentile population it is only six and one-half
per cent.,--a somewhat analogous condition of proportion being
also observable in the United States. Here, it is accounted
for, in a measure, by Dr. Billings, in the following words:
"This comparatively large proportion of males among the Jews
is probably due to the fact that the death-rate of their
infants is less for males, as compared with females, than it
is among the average population." Children gotten during the
prime of life of the parents are naturally more virile and
have better stamina than those gotten before full maturity is
reached. If the father is on the verge of impotency just about
the time he is expected to beget his best offspring, that
offspring cannot be expected to present an extra amount of
vitality, virility, or physical stamina; hence, the prepuce
can be brought in as directly tending--in no matter how small
the degree it may be, but nevertheless a factor--to the
physical degeneracy of the race, as well as it demonstrates
the existence of some law for the production of the sexes
which we do not as yet fully comprehend. Aside from the above
considerations, there are those of the actual bar to the
increase of population which the prepuce induces, either by
primarily being the cause of impotence or by direct
interference, as already mentioned, and the impotence that
naturally results from the causes set forth in this note. The
results of a prepuce are certainly such as must act like a
moist, warm, and oily poultice to the irritability induced in
the most confirmed Malthusian when contemplating the--to
him--rapid and unwarranted increase of population.

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Women's and Children's Diseases. Dillnberger. Philadelphia, 1871.

Male Impotence. Hammond. New York, 1883.

Genito-Urinary Diseases. Otis. New York, 1883.

Urinary and Renal Diseases. Roberts. Philadelphia, 1885.

Urinary and Renal Disorders. Beale.

Renal and Urinary Organs. Black. Philadelphia, 1872.

Gout in its Protean Aspects. Fothergill. Detroit, 1883.

Venereal Diseases. Bumstead and Taylor. Philadelphia, 1883.

Traite sur les Maladies des Organes Genito-Urinaires. Civiale. Paris, 1850.

Pathologic Chirurgicale, tome vi. Nelaton. Paris, 1884.

Pathologie Externe, tome v. Vidal (de Cassis). Paris, 1846.

Guy's Hospital Reports, 3d series, vol. xvii. London, 1872.

Transactions of the Ninth International Medical Congress, vol iii. Washington, 1887.

American Journal of Obstetrics for January, 1882.

On the Reproductive Organs. Acton. Philadelphia, 1883.

Operative Surgery. Smith. Philadelphia, 1852.

Operative Surgery. Stephen Smith. Philadelphia, 1887.

System of Surgery. Gross. Philadelphia, 1859.

Principles and Practice of Surgery. Agnew. Philadelphia, 1881.

International Encyclopedia of Surgery. Ashhurst. Philadelphia, 1886.

Science and Art of Surgery. Erichsen. Philadelphia, 1869.

Diseases of the Kidneys. Ralfe. Philadelphia, 1885.

The Clinic. Cincinnati, 1872.

American Journal of the Medical Sciences for July, 1872; also vol. lx.

New York Medical Journal, vols. xvi, xix, xxvi.

Occidental Medical Times. Sacramento, October, 1890.

London Lancet, 1875.

Distribution Geographique de la Phthisie Pulmonaire. Lancereaux. Paris, 1877.

Annual Report of the Bureau of Ethnology. J. W. Powell. Washington, 1884.

Western Journal of Medicine and Surgery. Louisville, 1846.

Native Races of the Pacific Coast. Bancroft. San Francisco, 1875.

Encyclopedia Britannica, 9th edition.

Classical Dictionary. Lempriere. New York, 1847.

Commentary on the Bible. Clark.

Satellite for February, 1889, and January, 1891. Philadelphia.

Pedigree of Diseases. Hutchinson.

Medical Inquiries. Rush. Philadelphia.

Half-Yearly Abstract of the Medical Sciences, vols. xii and lx, Philadelphia.

Cincinnati Lancet and Observer, vol. xvi.

Statistics and Climate of Consumption. Millard.

Traite des Maladies Chirurgicales, vol. x. Baron Boyer. Paris, 1825.

Dictionary of Medicine. Quain. New York, 1884.

INDEX

Abolishment
of circumcision by Christians, 18;
by the Romans, 66
of eunuchism in Italy, 91, 96

Abraham, 32

Absence of penis, 13
of testicles, 105

Abyssinians, carry off the male members of slain enemies, 30;
circumcised bishop among the, 64

Acosta, Rev. Father, on Mexican circumcision, 47

Adams, Dr. C. Powell, of Hastings, Minn., 198

After-treatment of circumcised Hebrews, 158

Agnew, D. Hayes, on penile cancer, 230;
on eczema as a reflex neurosis from phimosis, 320

Albutt, T. Clifford, on primary cause of disease, 13

American circumcision, 47;
infibulation and muzzling, 48

Amputation of penis, 230, 233, 247

Androgynes, 118

Augleria, Pierre d', on American circumcision, 47

Apis, the white bull, sacred to the Egyptians, 29

Apollo Belvidere, as evidence of exactness of ancient sculpture, 62

Apure Indians and their circumcision, 48

Arabian circumcision, 38;
prostitutes, 323

Arias Montan, on Mexico, 46

Arnold, Dr. A. B., of Baltimore, 25, 219, 220, 223

Asthma as a reflex neurosis from genital irritation, 291

Australian circumcision, 44;
operation on the urethra, 56

Author's modification of circumcision, 307

Aztec circumcision, 46

Ballance, C. W., dressing after circumcision, 317

Bamboo stick worn in vagina as a chastity protector, 52

Baptismal ceremonies of Omaha Indians, 56

Barbarous Arabian marriage custom, 54
mutilations of Guamo and Othomaco Indians, 48

Bas-relief representing Egyptian emasculation, 31

Bassouto circumcision, 42

Battos circumcision, 45

Baumgartner's devout and chaste dervish, 49

Beale, Sir Lionel, on blood changes, 296

Bell, Dr. John, on Jewish hygiene, 181
Dr. J. Royes, 191, 223, 229, 239

Bells, jingling of, under the skirts, denotive of Judean virginity, 52

Belt of brass mail to insure female chastity, 51

Berbers, mutilations of their prisoners, 30

Bergmann, of Strasburg, 20, 27

Bergson, Dr., 160

Bernbeim, Dr., on freedom of Jews from syphilis, 195;
on preputial statistics, 220;
on circumcisial operation, 312

Bernoulli, Prof., of Bale, 168

"Beth Yosef" of Joseph Karo, 153

Biblical vouching for homoeopathy, 113

Billings, Dr. John S., U. S. Army, on Jewish vital statistics, 174;
on cancer amongst Jews, 230

Bird, Dr. Golding, on phimosis, 257

Bishop of Abyssinia accused of heresy on account of circumcision, 64

Blood of prepuce sprinkled on bride's veil, 55;
sprinkled on ears of corn, 56
changes as starting-points of disease, 293, 298

Bobovii, Alberti, on Mohammedan circumcision, 39

Bogera, or African circumcision, 44

Bokai, on preputial statistics, 220

Bornean circumcision, 45

Bowditch, Henry I., on Jewish vital statistics, 176

Boyer, Baron, on cancer of the penis, 232;
on gangrene of the penis, 237

Brett, Dr. F. H., case of hypertrophy of prepuce, 251

Bryant, Thomas, on skin-grafting, 328

Bumstead, on circumcision, 310

Burial of Algerine prepuces in the sands of the deserts, 39

Cahen, Dr., on diminished sensibility of glans after circumcision, 224

Calculus, liability of the Chinese to preputial, 248;
Dr. J. G. Kerr, on preputial, 248;
C. H. Martin, of Mobile, on climatic influence on, 248;
Prof. Enoch, of Berlin, on preputial and vesical calculi, 249;
Claparede's case, 249;
composition of preputial, 249;
Civiale's case, 249;
induced by phimosis, 287

Canary Islands, remains of an antediluvian world, 25

Cancer of the penis, 232;
views of Jonathan Hutchinson as to its origin, 226;
pre-cancerous stage of, 226;
views of Lallemand, 228, 329;
statistics of, 231;
Cullerier on, 231;
fifty cases reported by Dr. Zielewicz, 233;
early mention of, 234;
views of Prof. John C. Warren, 235;
views of Walshe, 235

Canon of St. John Lateran and his profane doubts, 74

Carter, Dr. Wm., on toxic urines, 298

Casalis, M., on Bassouto circumcision, 42

Cases of spontaneous circumcision, 58

Castration, etymology of the term, 80;
as a self-sacrifice to deities, 89

Celsus, on Roman infibulation, 50;
on operations on the prepuce, 302, 313, 328;
originator of Cloquet's operation, 313

Chabas, M., description of Egyptian _bas-relief_, 23

Charlemagne endows an abbey with a holy prepuce, 72

Charles V sacks Rome, and robbery of the holy prepuce, 73

Chastity among Egyptian dervishes, 49;
belt of brass mail of the Ethiopians, 51;
plug of bamboo of Soudan, 51;
rings to insure chastity in the male mentioned by Nelaton, 54;
enforced among the Hindoo bonzes by infibulation, 54;
among the Cybelian priesthood, 89;
Greek monks, ideas of, 89;
comparative, among the different religious creeds of Prussia, 195

Chinese, peculiar liability of, to calculous disease, 248;
considered a delicate diet by Australian cannibals, 327

Chippeway Indians and circumcision, 23

Chivalry of the male Hottentot, 60

Christian abolishment of circumcision, 18;
circumcision in Abyssinia, 63

Circumcised phallus as a religious and civic symbol, 35;
races peculiarly exempt from syphilis, 192

Circumcising knife (see Knife).

Circumcision, abolished by Christians, 18;
among Chippeway Indians, 23;
among the Atlanteans of Plato, 23;
among the Phoenicians, 34;
among the Egyptians, 34;
Arabian, 35, 54;
during the reign of Psammetich, 34;
civil and religious symbol of ancient Egypt, 35;
Aztec, 46;
among the Mijes, 46;
Mexican, 46;
Totonac, 46;
among the Orinoco Indians, 47
the climatic limits of, as a general rite, 47;
in the Island of Cosumel, 47;
in Yucatan, 47;
in old Florida, 47;
Apure Indians, 48;
among the Amazons, 56;
accidental case of, mentioned by Cullerier, 57;
spontaneous, 58;
abolished by the Romans, 66;
destroying marks of, 68;
of Abraham, 143;
Hebraic, 143;
not practiced in the wilderness, 143;
physical conditions that exempt Jewish children from, 144, 145;
description of Hebraic, by Montaigne, 146;
as a cure for epilepsy, 261;
as a preventive of hernia or rupture, 263;
as a preventive to prolapsus of the bowel, 263;
as a preventive of idiocy, 266;
as a cure for dyspepsia, 270, 271

Civiale, on moral effects of penis amputation, 247;
case of phimosis and preputial calculi, 249

Claparede, on evils resulting from the prepuce, 229;
on preputial calculi, 249

Clarke, Sir Andrew, on renal inadequacy, 300

Clavigero, on Mexican circumcision, 46

Climatic limits of circumcision, 65

Cloquet operation, 306, 316

Colchis, colony of, 33

Constantine punished circumcisers with death, 66

Constipation as a divine attribute, 288;
as a result of phimosis and its results, 292

Consumption, relation of, to Jewish race, 178, 179

Controversy about the holy prepuce, 73

Convent of St. Corneille and the holy knife, 78

Convulsions induced by phimosis, 260, 261

Cullerier, accidental circumcision, 57;
on penile cancer, 231

Cybelian priesthood and castration, 89

Dakotas, the white bull sacred among the, 26

David and the Philistine prepuces, 31

Debreyne, trappist, monk, and physician, 224

Delange, on Arabian circumcision, 37

Delpech, on female circumcision, 36

Demarquay, on penile gangrene, 236

Dervishes, holy and chaste, 49

Difference between Turkish and Buddhist heaven, 116

Dilatation of prepuce, 308, 312, 332

Donnelly, Hon. Ignatius, on Atlantean circumcision, 23

Dressing in cases of retraction of penile skin, 304;
C. W. Ballance's, after circumcision, 317;
A. G. Miller's, 318

Du Bisson, on Soudanese harems, 52

Dyspepsia induced by preputial irritation, 270, 271

Ebers, Dr., on Karnac _bas-relief_, 23

Eczema induced by phimosis, 320

Effect of the holy prepuce on the hands of a lady, 74

Effects of age on the prepuce, 285

Egypt, uncircumcised persons not allowed to study in ancient, 34

Egyptians emasculated their prisoners, 30

Emasculation, its early practices and evolutions, 29;
of Uranos, 83

Emperor Adrian forbids circumcision, 66

Endurance and fortitude of Arabs, 55

Enforced continence and its effects on the penis, 61

Ennery, M., Grand Rabbi of Paris, 158

Enoch, Prof., of Berlin, on preputial calculi, 249;
on results of phimosis, 266;
on enuresis, 277

Enuresis, 275

Epilepsy, induced by the prepuce, 258, 261, 301

Epstein, Dr., of Cincinnati, 156

Erichsen, Prof., on cancer of the penis, 228

Ethics at the battle of Fontenoy, 76

Ethiopian infibulation of infant females, 51

Eunuchism, beneficial to guardians of public funds, 84;
as excluding from the priesthood, 90;
in Italy, 91;
in China, 91, 93;
in India, 92;
in the Soudan, 99;
and music, 94;
as a punishment, 97;
mortality attending its manufacture, 91, 92, 93, 99, 100, 107;
does not prevent copulation at all times, 92, 100, 101, 102, 103;
manner of procedure among the Pagan priesthood, 106;
prices of eunuchs, 99;
numbers annually made, 91, 98;
fecundating eunuch of Mecca, 100;
Velutti, the opera-singer, 102;
eunuchs as possessors of harems, 90;
eunuch warriors and statesmen, 90

Evidence of circumcision on Egyptian monuments, 23

Extraordinary results of phimosis, 282

Female circumcisers in Arabia, 36

Females subject to preputial reflex neuroses, 267, 268

Flaccourt, M. Martin, account of the Madecasses, 54

Fothergill and the unlicensed practitioner on renal pathology, 77

French war-office records, on Jewish vital statistics, 175

Frenum, statistics relating to abnormalities of, 221

Frerichs' ammoniaemia, 300

Fresnel, M., on marriage circumcision, 54

Full-moon rites among the Bassouto maidens, 44

Galen, on the flaccid virile member, 60, 61

Gangrene of the penis, 236

Golden padlocks worn on prepuce for five years, 54

Greek and Roman statuary and the penis, 60

Greek monks' object in infibulations, 54;
extreme ideas of chastity, 89

Gregg, Dr. Robert J., operative procedure, 320

Griffith, Dr. J. D., cases of reflex irritation, 261

Gross, Prof. S. D., on penile cancer, 230;
operations, 320

Grotius and the origin of the Peruvians, 46

Guimara, the, 153

Guinzburg, Dr., on Jewish vital statistics, 176

Gumilla and his South American voyages, 47

Haemostatic powders, 160

Hare, Prof. Hobart A., on circumcision, 301

Haskins, Dr. A., on Jewish vital statistics, 176

Heaven, Turkish, 115;
Buddhist, 116

Hebraic idea of parental origin of constitution of the child, 144

Hebrew Consistory of Paris, 157

Hebrew words in Central American languages, 24

Hebrews, attempts to efface signs of circumcision, 69;
secretly circumcise their dead, 68;
Hebrew vital statistics, 169 to 179;
as proverbial good livers, 171;
escape epidemics, 173;
peculiarly free from syphilitic taint, 191;
their circumcision suitable to young children, 306

Heliogabalus, Emperor, was circumcised, 66

Henry III of France as a Moslem godfather, 64

Henry V of England and the holy prepuce, 71

Heraclius, Emperor, persecuted the Jews, 67

Hermaphrodites, earliest mention of, 117;
pederasty causes belief in their existence, 118, 119, 120;
Debierre on, 123;
notable cases of, 124, 125, 127, 128

Hernia induced by phimosis, 263

Herodotus, his views adopted by Voltaire, 22;
visits Egypt, 34

Herrera, on Mexican circumcision, 47

Hey, Dr. William, on preputial cancer, 227

Hindoo devotee wears a six-inch ring in prepuce, 54

Hitouch, 156

Holgate, Dr., of New York, on preputial adhesions, 220;
on preputial dilatation, 308

Holy circumcision, 70, 78
prepuces, 70, 72
vinegar and its miraculous effects, 79

Homer, Surgeon U. S. Navy, on the worship of Venus Porclna, 193

Horrible marriage performance, 54

Hottentot restriction on making twins, 60

Hough, Dr., on Jewish longevity, 173

Humphry, Geo. Murray, on "Old Age," 14

Hutchinson, Dr. Jonathan, on the pre-cancerous stage of cancer, 226;
on urethral child, 300

Hypospadias, as a heredity, 129;
artificially made, 56;
formerly led to belief in hermaphrodism, 129;
fecundation in, 129;
difficulty in determining sex owing to, 131

Idiocy induced by phimosis and preputial adhesions, 265, 269

Impious wretch steals the holy prepuce, 74

Impotence, holy vinegar and shrinal observances in, 71 to 81

Indians and circumcision, 46 to 48

Induration of prepuce, 250

Inflbulation practices, 48 to 52

Isis inaugurates Osirian rites, 29

Isserth, Rabbi Israel, 153

Jansen, Surgeon of the Belgian Armies, on frenum deformities, 221

Jews' letters to Voltaire, 22;
Jews (see Hebrews).

Judaism unfavorable to religious insanity, 166

Justinia, Emperor, persecuted the Jews, 67

Karo, Joseph, and the "Beth Yosef," 153

Kemp, Dr. Arthur, on phimosis as a cause of hernia, 264

Kerr, Dr. J. G., on Chinese preputial calculi, 248

Keyes, Dr. E. L., on composition of preputial calculi, 249, 264

King David, the first homoeopathic patient, 113;
secures two hundred Philistine prepuces, 31

Knife, circumcising, used in ancient Egyptian rite, 23;
of shell used by Tonga Islanders, 45;
of stone used by Australians, 45;
of the holy circumcision, 78;
made of rattan among the Fiji Islanders, 327

Lafargue, on Australian circumcision, 44

Lallemand, on masturbation, 223;
on tendency to preputial cancer, 228, 329;
on circumcision, 317

Las Casas, on Aztec circumcision, 46

Leech, Dr. T. F., on preputial irritation, 260

Letenneur, Prof., on the knife of the holy circumcision, 78

Life-insurance and the circumcised, 290

Lisfrane, rules for operations on the penis, 232;
on recession of the body of the penis, 306

Livingstone, on Bassouto circumcision, 44

Longevity of Hebrews, 162, 169, 179

Lonyer-Villermay, M., on female circumcision, 36

Louis XVI as a candidate for the rite, 201

Love, Dr. I. N, on the Mosaic law, 262

Lumholtz, on Australian hypospadias, 56

Macilwain, on reflex neuroses, 330

Magruder, Dr. G. L., on reflex irritation, 261

Maids as heat radiators, 114

Maimonides, Jewish rabbi and physician, 32, 144, 153

Malay circumcision, 45

Malgaigne, operative views, 313, 316

Mapato, or mystery hut, 42

Marriage preceded by circumcision, 54

Martius and Spix, on circumcision on the Amazon, 56

Mastin, Dr. C. H., on calculous disease, 248

Masturbation, 224

Maury, Dr. Frank, on preputial statistics, 219

McLeod, Dr. Neil, circumcision operation, 318

McMahon, Dr. W. R., on reflex epilepsy, 261

Mendelssohn, Rabbi Moses, 164, 168

Mexican circumcision, 46

Mezizah, or act of suction, 150

Milah, 156

Miracles performed by the holy prepuce, 70 to 74

Mishna, the, 153

Mohammed, 65

Mohel, 157, 158

Moses, Dr., of New York, preputial statistics, 220

Moses circumcises his son, 150

Mott, Jr., Dr. A. R., cases of reflex irritation, 258

Music, first schools of, 94

Music at Algerine circumcision, 39;
at Mohammedan, in Asia, 39;
at Turkish feast, 41

Nelaton, case of infibulation, 54;
on penile cancer, 231;
on penile hypertrophy, 252

Nelson, Lord, disregard for red tape, 77

New Caledonian circumcision, 45

Newton, Sir Isaac, and the storm-predicting cow, 77

Nicaraguan baptism of blood, 56

Oath of mohel, 158

Oath, Egyptian manner of making oath, 35

Obod, Battle of, 36

Operations on the prepuce, 302;
Cloquet's, 306;
Bumstead's, 310;
Hue's, 312;
Bernheim's, Sedillat's, 313;
Chauvin's, 313;
Cullerier's, 313;
Vanier's, 316;
Vidal de Cassis', 316;
Lallemand's, 317;
A. G. Miller's, Neil McLeod's, 318;
Erichsen's, 319;
Gross's, 320;
Van Buren and Keyes', 320;
D. Hayes Agnew's, 320;
Overall's procedure, 321

Origin of phallic worship, 29
of human slavery, 29

Orinoco, circumcision on the, 47

Orloth, penis or prepuce? 31

Osiris vanquished by Typhon, 28

Othomacos Indians and their bloody rite, 48

Owen, Dr. Edmund, on phimosis, 263

Packard, Dr., on preputial statistics, 219

Papal indulgences to worshipers of holy prepuce, 72

Paralysis induced by phimosis, 259

Penis, absence of, 132;
diminutive specimens, 213;
amputation of, 230, 233, 234, 247;
cancer of, 232;
gangrene of, 236;
hypertrophy of, 248, 251, 252

Periah, 156

Persecutions on account of circumcision, 66

Phoenician origin of circumcision, 22

Phimosed penis on ancient statues, 60

Phimosis, 218, 221;
as a cause of hernia, 263

Physicians as practical Christians, 141

Pooley, Prof. J. H., case of preputial irritation, 260

Pope, Rabbi Rav, and the _Guimara_, 153

Portuguese sailors as Mohammedan proselytes, 40

Potentia generandi, 103
coeundi, 104

Prepuce, infibulated, 54;
swallowed by mother, 54;
fired off in gun, 54;
holy, 71;
useful for skin grafts, 207;
absence of, 209;
influence on man at different ages, 225;
induration of, 250;
warts of, 250;
reflex neuroses from, 256

Preputial miracles, 72;
statistics, 219;
adhesions, 219, 220;
calculi, 248

Price, Dr. M. F., on reflex neuroses, 265;
on female preputial irritation, 267, 268

Primitive phallic rites, 28
homoeopaths, 113

Procedure in retraction of skin of penis after circumcision, 304

Proselytes, Mohammedan, how circumcised, 40, 41

Public women between decks in U. S. Navy, 193

Puzey, Dr., of Liverpool, on preputial skin grafts, 207

Pythagoras 32;
visits Egypt, 34

Ralfe, on causes of interstitial nephritis, 300

Rameses II, circumcision of his sons, 23

Ranney, Prof. A. L., on enuresis, 282

Reconstruction of a prepuce, 68, 69, 328

Rectum, prolapsus of, induced by phimosis, 263

Reflex neuroses from preputial irritation, 254, 330, 331

Regulations of French Hebrew consistories of 1854, 157

Religion, its connection to insanity, 166

Resectricis nympharum, profession of, 36

Restriction on impregnation, 57;
on twins, 60

Retraction of skin of penis after circumcision, 303

Richardson, Dr. B. W., on relation of race to disease, 169, 170, 171, 177

Ricord's definition of the prepuce, 206;
operations on the prepuce, 313

Roman infibulation, 58

Royal decree of 1845 in France, 157

Roux, on cancer of the prepuce, 227

Rush, Benjamin, and the cancer quack, 77

Saint-Germain, Dr., on preputial abnormalities, 264

Saint Foutin and his shrine, 78

Saint Guerluchon at Bourg-Dieu, 79

Saint Guignole and the miraculous phallus, 80

Saint Coulombs and the miraculous prepuce, 70

Saturnus the first eunuchiser, 83

Sayer, Prof. Lewis A., contributions to medical science, 255

Scythians carry off heads of the slain, 30

Self-circumcision, attempt at, 203

Semiramis first employs eunuchs, 85

Severus Sulpicius, on effects of climate, 50

Sham battles at circumcision feasts, 37, 41, 42, 44

She-circumcisers, 36

Shrine for the recovery of impotent males, 79

Smith, Dr. J. Lewis, on preputial irritation, 263

Solomon, Dr., of Brunswick, on suction, 158

Soudanese chastity protector, 52

Sphincterismus due to phimosis, 292

Spiked chastity belt in Naples museum, 52

Stallard, Dr., on Jewish vital statistics, 173

Sterility cured at sacred shrines, 71 to 81

Stricture of urethra and phimosis, 289, 290

Styptics used by mohels, 158, 159

Syphilis, statistics relating to, 187 to 199

Syphilis and scrofula, 190

Taylor, Dr. C. F., on masturbation, 269

Totonac circumcision, 46

Tonga Islanders' rite, 45

Toxaemia, resulting from phimosis, 293;
of von Jaksch, 294

Tube, penis carried in, 56

Tunca Indian circumcision, 56

Turkish circumcision, 39 to 41

Tylor, on the Stone Age and circumcision, 336

Van Buren and Keyes, on circumcision, 320

Vanier du Havre, Dr., 54, 224;
on operations, 316

Venus, birth of, 84

Vidal de Cassis, on preputial operations, 316

Virey, account of Hindoo bonze, 54

Virgins' chain of bells in ancient Judea, 52

Vital statistics of Jews, 169 to 179

Voltaire, on origins of circumcision, 22

Von Jaksch's definition of Toxaemia, 294

Wadd, Dr., on preputial cancer, 227;
on hypertrophy of penis, 252

Walshe, on preputial cancer, 235

Warren, on preputial cancer, 235

Warts of penis and prepuce, 250

Waterman, Dr., on Jewish vital statistics, 177

Wax images of penis deposited on shrines, 79

Welsh words in Mandan language, 24

Wet dressing objectionable after circumcision, 304, 311

White Bull, sacred among Sioux and Egyptians, 26;
origin of sacredness, 29

Willard, Dr. De Forest, observations on the prepuce, 262

Wine at circumcision feasts, 151

Wirthington, Dr. F. J., on preputial irritation, 259

Wise, Dr. I. M., on St. Paul the apostle, 19

Warman, Prof., of Brooklyn, on circumcision, 26

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HOW TO REDUCE SIZE WITHOUT LOSING STRENGTH. 1109

voice. A thorough-bred person may belong to the artistic, mechanical, or scientific classes, either appreciatively or executively; he must exhibit both gentleness and spirit, as occasion requires; he must be governed by the law of justice; he must make the comfort of his associates his concern, and do what is _right_ in order to enhance their happiness.

The facial indications of those who are not thorough-bred, speaking physiologically, are as follow: A coarse, thick skin; a "muddy" complexion, or one permanently blotched, pimpled, or discolored; dull eyes, very small or very large and bulging; coarse hair, or that which is very light or colorless,--that is to say, of no _decided_ hue. I regard very light colored, pallid people as morbid varieties; also those with irregular teeth, a very small or ill-shapen nose, small nostrils, perpendicular jaws, exposed gums, open mouth, receding chin, or one that projects greatly forward, ending in a point; thin, pallid, dry lips; hollow cheeks, flat upper cheeks. ugly or ill-shapen ears, a voice weak, thin, hoarse, shrill or nasal; a long, cylindrical neck; a high, narrow forehead.

The undue development of certain organs and systems of the body induces abnormal conditions, as, for example, an excessive disposition of fatty tissue. When the appetite is voracious, or the nutritive system uncommonly active, too much of the carbonaceous elements of the food are eliminated, or, as it often occurs, too much carbonaceous food, such as white bread, potatoes, etc., is consumed for the needs of the body; the consequence is an excess of fat, which, in many subjects, impedes respiration, prevents activity, and gives a generally uncomfortable feeling. For this condition a spare diet is often prescribed, but as this is felt to be a hardship, and as few who attempt it succeed in continuing it long enough to produce satisfactory results, it is pronounced a failure.

For this class of people there is a very agreeable and sure method of reducing the bulk without reducing strength and without compelling too great a sacrifice of the appetite.

HOW TO REDUCE THE SIZE WITHOUT LOSING STRENGTH.

A diet which will attain this result is easily obtained, and of it the subject can use a quantity sufficient to allay the craving for food.

This diet consists of absolutely _raw_ foods, nothing cooked being allowed. This diet, of course, must consist mainly of fruits, nuts, grains, milk, and, when flesh-meat is desired, a Hamburg beefsteak may be partaken of; this steak is raw beef chopped fine and seasoned with onion, salt, pepper, or other condiments; to this may be added raw oysters and clams. Every kind of fruit

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SYSTEMS AND FACULTIES REQUIRED FOR A SURGEON. 1143

is a dangerous being); he should develop his friendliness, love of children, and of the opposite sex; in short, he should be a _lover_ of _humanity_.

THE SYSTEMS AND FACULTIES REQUIRED FOR A SURGEON.