Circumcision : History , Philosophy and Facts

Introduction: Circumcision (from Latin “circumcidere” meaning to cut around) is one of the most ancient and common surgical procedures worldwide. Every male who undergoes this procedure has to experience severe pain and vulnerable to serious complications including, but not limited to, infection, hemorrhage, accidental injury, ethical concerns, as well as death. Methods: A retrospective review of the factual, therapeutic, and rational aspects of circumcision from its believed conception to the present. Conclusion: Though the origins of this procedure are still sketchy, it is an age-old belief that, dating to the early civilizations, circumcision could be synonymous as a penance in context to humanity’s sexual awakening.


Introduction
The concept of well health and sexual prowess, being on the same social scale, and adhering to religious rituals are a few of the key indicators for male circumcision.The age group mostly varies from neonates to the late teens or twenties.Data estimates that roughly 30% of males are circumcised globally, of whom two-thirds are Muslims.The practice is interspersed in many countries due to cross-cultural exchange and theories of plausible sexual and therapeutic benefits.
Circumcision consists of removing the foreskin, a retractable double-sided fold of skin and mucosal tissue that covers the head of the penis.This is the natural covering of the head of the penis.

The Foreskin
Evolution of the foreskin developed around 100 million years BC in proto-mammalian species.Through eons of time, evolution of the foreskin progressed and provided protection from the hostile environment that existed then.History saw the emergence of Homo sapiens about 400,000 BC, with a complete foreskin.Adam, the first man, was created with a complete foreskin.Uncorroborated speculation exists that aboriginal tribes favored circumcision as a puberty rite around 10,000 BC.Practice of circumcision as a puberty rite by nomadic tribes of the north-eastern African and Arabian peninsula existed around 6000 BC [1] [2].To ancient Egypt goes the honor of having a sound corroborated history of circumcision, around 2400 BC.The act, however, was limited to those intertwined in priesthood.In addition to cleanliness, depilation (shaving) of the entire body was an added element towards purgation.This practice was embraced by royalty, followed swiftly by nobility and elite warriors, either for sanitary reasons or as a blue-blooded prerogative.Entry to the inner sanctum of ancient Egyptian temples required sanctification, as imposed on visiting Greek philosophers [2] [3].
The practice was taken up by the Phoenicians around 400 BC, from either the Egyptians or Israelites, and propagated to other nations.In 170 BC, ritual circumcision was banned by Greeks.Renowned Greek philosophers construed circumcision as a flaw of the human body, hence only Jews and slaves were subjected to this practice.

Ritual Circumcision
Per the sign of the covenant between Yahweh and Abraham, as quoted in the Hebrew Bible (Torah), Abraham was to circumcise himself, his sons, and his slaves and servants.For Abraham, this resulted in the removal of the very tip of skin that extended beyond the glans penis.The circumcision theory was enforced by Jewish priests.According to Exodus 4:25, Moses and his progeny were uncircumcised.Per Jewish tradition, at the age of 8 days, Jesus was circumcised.It is Jewish belief that the male who undergoes circumcision adds a dimension of spirituality to the body.Circumcision was declared by St. Paul as not a prerequisite for Christian converts 43 years later, but he strongly advocated that circumcision of the heart and spirit was needed and not of the flesh.Based on these teachings, ritual circumcision was shunned by Christians [4].Christianity in its two oldest existing forms, Egyptian Coptic and Ethiopian Orthodox, however, still practiced the rites and rituals of early Christianity, including that of circumcision (97% of orthodox Christian men in Ethiopia are circumcised) [5] [6].
Abraham circumcised Ishmael, the father of Arabs, at the age of 13.The process of purification is called tahera.In all likelihood, Prophet Mohammed was circumcised at the age of 13.The given age for a Muslim to be circumcised is anywhere from birth to puberty.In order to take the Hajj, the holy pilgrimage to Mecca, one of the seats of the five pillars of Islamic belief, a man has to be lawfully circumcised [7].

Ethnicity and Cultural Factors
The key indicators for which certain societies practice circumcision, aside from religious criterion, are masculinity, peer relationship, and most importantly as a fundamental component in the passage to manhood and a trial of courage and endurance [8].Bonding with peers of the same age group circumcised at the same time, selfidentity, and spirituality [9] [10] also contributory factors.

Circumcision: From the Medical Point of View
Historically, during the 18th and 19th centuries, circumcision was propagated as the remedy of almost all known ailments such as impotence, sterility, priapism, masturbation, venereal disease, epilepsy, bed-wetting, night terrors, paralysis, and homosexuality.It was also employed as a prophylactic measure against tuberculosis, cancer, syphilis, polio, idiocy, and forgetfulness [11]- [16].
Penile cancer was literally nonexistent in circumcised men based on a survey conducted in USA of 1250 large general hospitals in 1932 by Wolbarst [17] [18].
Contradictory views were expressed by The American Academy of Pediatrics.In 1975, the conclusion was that there was no valid medical indication for this procedure [19], and in 1989 they conceded that there might be certain advantages to neonatal circumcision, although their recommendations did stop short of advising routine operation [18].In 1999, a new policy on routine male circumcision states that the potential medical benefits of circumcision does not warrant performing it routinely.The 2012 policy statement says that not only should newborn circumcision be available to any parent who might wish, but it should be paid for by third-party payers.
The Australian Pediatric Association in 1996 stated, "It is considered to be inappropriate and unnecessary as a routine to remove the prepuce."This was shared by the Canadian Pediatric Society [20].

Prevalence of Circumcision Worldwide (WHO 2006) [21]
As of 2006, World Health Organization estimates that 30% of males aged 15 years or older (approximately 665 million men or boys) are circumcised worldwide.

Contradictions and Controversies of Circumcision
The below facts clearly outline that circumcision carries the title of being the surgical procedure that can be termed with striking extremes and diverse nature of the highest degree known to mankind.
• Purification and sanitation of the body through circumcision versus mutilation, condemnation, and slavery.
• Propagated as the universal treatment of all medical issues versus genital mutilation.• A ritualistic ceremony followed by Jews and Muslims versus being shunned by the Christian Church.
• The aesthetic and natural viewpoint (uncircumcised versus circumcised).

Philosophy of Circumcision
The thought revolves mainly on the extremely puzzling fact if the sole existence of humanity rests on the organ of manhood.Adam and Eve committed the original sin by consuming fruit from the forbidden tree in the Garden of Eden, thus exposing hidden sexual facts and an end to their celibacy (The Holey Qura'an).Through the course of time, based on the original sin, mankind modified itself to embrace this sinful organ as the most sacred part of the human body.
As the male genitalia represents reproduction and empowered to bring forth new life, Abraham asked his servant to swear an oath by placing his hand under his thighs, opposing the customary way of touching the heart.This presumably led to the origin of the word testimony, stemming from the word testis.
While the opinion about circumcision is deeply split, that it can cause unequivocal health issues and extreme pain, the answer is obscure.Perhaps it could be repentance to the true revelation of one's sexual organs by enduring the painful process.