History of circumcision

1. Circumcision,
Medical ,Cultural , and Ethical Aspects
Sameh Shehata
Alexandria , Egypt
EPSA PRESIDENT
WOFAPS VICE PRESIDENT
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2. Circumcision
• Cercum: around
• Caedere: cut
• Oldest
• Most commonly performed
• Most controversial
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3. Circumcision
• Brit Milah - Hebrews
• Circoncision - French
• Katsurei - Japanese
• Hallae - Korean
• Tuli - Filipino
• Cua paw phe - Chinese
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4. Circumcision
• Where did it begin .
• Religion and faith.
• Medical indications .
• Opponents /proponents .
• Medical societies .
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5. Where and when ?
• 10,000 (?) BC: Aboriginal tribes introduce
circumcision of boys as puberty rite
• 6000 (?) BC: Circumcision was practiced as
puberty rite by tribes in north-eastern African
and Arabian peninsula
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6. History of Circumcision
• Egypt
– Depicted in tombs (2300
B.C.)
– Mummies were
circumcised
– First depicted operation
• Captured warriors were
often mutilated AAPS Fukuoka 2016

7. Sakkara 2400 BC
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8. What is common?
• Egypt,
• Saudi Arabia,
• Mexico,
• Kalahari
• central Australia
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9. Desert
Hot
Humid
Sand
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10. US Army report
General John Patton
• World War II 150,000 soldiers were
hospitalized for foreskin problems due to
inadequate hygiene
• “Time and money could have been saved had
prophylactic circumcision been performed before
the men were shipped overseas”
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11. On the other side
Foreskin was beneficial in
savannah-wandering or
cave-dwelling ancestors
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12. RELIGIOUS CIRCUMCISION
The Covenant
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13. The covenant : Torah
the old testament
A covenant is made between God and Abraham
that God would make Abraham a rich and
powerful man and the father of a great
nation, and in return, Abraham's people
would adhere to a certain way of life
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Judaism

14. Religious Circumcision: Jewish View
– A Mitzvah
(commandment)
– In the Talmud: whole
glans uncovered when
penis is flaccid
– Performed by a Mohel
• Metzitzah performed
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15. Greco-Roman
311 AC
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16. Reversal of circumcision
•Epispasm :
• Different techniques.
– Stretching
– Weights
– Surgery
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17. Christianity
• The Early Church ( the Council of Jerusalem) decided that
circumcision is not required for Gentile Christians.
• The Council of Florence in the 15th century] prohibited
it.
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18. Luther and Calvin.
• the spiritual circumcision of the heart
• the physical circumcision of the foreskin.
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Christian philosophy

19. Jesus Christ
born as a Jew,
circumcised
on the 8th day
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Jesus David

21. Religious Circumcision: Muslim
View
• Word for circumcision is
an ancient Arabic word
• “Sunnah” : Prophet’s
tradition
• “Tahara” : Procedure for
cleanliness
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22. Circumcision =Tahara
•to cleanse and/or purify
•circumcised males more pure or clean
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23. possible philosophy behind
religious circumcision
•covenant between god and man .
•human sacrifice .
•reduce excessive desire .
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24. INDICATIONS
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25. • cure of “impotence, sterility, priapism,
masturbation, venereal disease, epilepsy,
bed-wetting, night terrors, paralysis and
homosexuality
• Immunity against tuberculosis, cancer,
syphilis, polio, idiocy, forgetfulness
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19th century

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27. MEDICAL INDICATIONS
Evidence Based
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29. 20th Century
• In 1932, Wolbarst
• penile cancer virtually never
occurred in circumcised men
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30. Medical indications
• The Lancet 1999 editorial
• mass circumcision in Africa to prevent
spread of HIV-AIDS
• WHO 2002 Male foreskin increases risk
of cervical cancer in women which lead to
demand for universal male circumcision
• UTI is significantly lower in circumcised
boys (2008)
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31. MEDICAL SOCIETIES
Changing attitudes
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33. USA Rates of Circumcision
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34. Circumcision map
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35. Reasons for Circumcision
•Necessity (hygiene)
•Religious (sacrifice/reduce desire)
•Indicator of status(elite/slaves)
•Medical (false/true)
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36. Enigma
•Devine /human
•Pain /pleasure
•Fact /fiction
•Proponents /opponents
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37. More evidence
• Function of prepuce .
• Benefits .
• Disadvantages .
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