“These statements from Dr. Guinzburg are confirmed by the following letter from Dr. A. Haskins, of this city. Dr. Haskins is connected with one of the Jewish benevolent associations for the benefit of the sick. I sent to him similar questions and make the following extracts from his reply:—

“‘I am generally employed in about sixty families (Jewish). I have had these families under my care for two and a half years. During this time I have seen but one case of consumption. I have averaged among these sixty families about two visits daily. In my other Jewish practice, which is not inconsiderable, I have in this time (two and a half years) seen two cases of consumption.... I am sorry I have no statistics whereby I could compare the two peoples, viz., Jews and Christians. I can, therefore, give you only my impressions. I should say that I find consumption less frequent among the Jews than among Christians. This would be my own impression without any data to fortify it.’

“Dr. Waterman also sustains the same idea. The following extract will give some idea of his opportunities for observation and the sources of his deductions:—

“‘Boston, November 2, 1872. Dear Sir,— ... First, I have attended four charitable associations; number about forty, fifty, sixty, and one hundred families. At present I only attend one, containing one hundred families, and on which I average a fraction over one visit a day. I have, besides, many private families among the Jews. I have attended but few cases of consumption, and I think the disease is not so prevalent as among Christians.’”

The same report of Dr. Bowditch quotes from Stallard’s “London Pauperism Amongst Jews and Christians,” as saying that there is no hereditary syphilis, and scarcely any scrofula to augment the mortality in the Jewish families.

In relation to the liability of the Hebrew race to phthisis, Richardson has the following at page 22 of his “Diseases of Modern Life”: “The special inroads on vitality made on other races by disease are not easily determined, because of the difficulties arising from temporary admixture of race. I tried once to elicit some facts from a large experience of a particular disease, phthisis pulmonalis, and, as the results of this attempt may be useful, I put them briefly on record.

“At a public institution at which large numbers of persons afflicted with chest diseases applied for medical assistance, and at which I was for many years one of the physicians, I made notes during a short portion of the time of the connection that existed between race and the particular disease I have instanced—phthisis pulmonalis, or pulmonary consumption. The number of persons observed under the disease was three hundred, and no person was put on the record who was not suffering from a malady pure and simple; I mean without complication with any other malady. They who were thus studied were of four classes: (a) those who were by race distinctly Saxon; (b) those who were of mixed race, or whose race could not be determined; (c) those who were distinctly Celtic; (d) those who were distinctly Jewish.

“The results were, that of the three hundred patients, one hundred and thirty-three, 44.33 per cent., were Saxon; one hundred and eighteen, 39.33 per cent., were of mixed or undetermined race; thirty-one, 10.33 per cent., were Celtic; and eighteen, 6 per cent., were Jewish.”

Although Dr. Richardson admits it would be unfair to accept the above figures as a basis for general application, he argues that they are, on the average, sufficiently suggestive, as among the Saxons it was noticed that there were more cases in whom the disease was hereditary, while among the others it was generally acquired.

In going over the subject of this question in regard to phthisis, we must admit that, although the Jew in his own home, synagogue, or in his social reunions, is not exposed to tubercular emanations, and that he has less chance of contracting the disease from tuberculous meats, he is, after all, a theatre-goer; a pretty constant inhabitant of the sleeping-car and hotel, as a commercial traveler and general merchant; and that, on the whole, he eats the same food, breathes the air and dust of the same streets, and drinks the same milk and water as the Christian, and, as observed by Dr. Billings, cooking destroys the bacillus in meats. So that the comparative exposure in this country—where the practice is not as prevalent as in Germany of eating raw minced-meat sandwiches—existing between the Jew and the Christian to tubercular infection from meat are about equal. The records of the Jewish Hospital of New York gives, out of 28,750 persons admitted, only 44.17 per 1000 of its admissions as being due to consumption; while those of the Roosevelt Hospital, out of 25,583 admissions, gives a per 1000 of 67.93.

From what is known of the relation of syphilis to consumption, not only as affecting the primary individual, but the subsequent generations of the same, and the known greater exemption of the Jew to syphilitic infection, owing to the protecting influence of circumcision, it is safe to assert that therein is to be found one of the main reasons of the exemption of that race to consumption. If we but look at the geographical distribution of phthisis and the history of its progress, we shall find that it has had syphilis as its avant courrier on more than one occasion. Lancereaux, in his “Distribution of Pulmonary Phthisis,” points to the fact that where consumption has made its greatest ravages, and where it has nearly depopulated one of the great divisions of the globe,—namely, the groups of islands in the Pacific Ocean,—the disease had no existence at the beginning of the present century. Syphilis, scrofula, and a quick, galloping consumption have, since the last ninety years, taken off the greater part of the population. The same course of transition from the best of physical conditions to racial deterioration and extinction from the same relative condition of causes—syphilis, scrofula, and phthisis—has been observed among the open-air dwellers of the New Mexican Plains, in the mountains of Arizona, and on the arid wastes of the Colorado Desert, where the appearance of consumption cannot be attributed to housing or incipient civilization, as it is attributed to housing among the Chippeways, Sioux, or Mandans in the regions that formerly formed the Northwest Territory. The question is very plainly answered as to how consumption was introduced or whence it sprung that has so ravaged the Oceanic Islands. The sailors who first visited those islands were not, as a rule, a batch of consumptive tourists on a voyage in search of health or recreation; but we can well understand that the proverbially improvident mariner has not always had his health looked after by an Anson or a Cook, and that many a festive tar who induced the unsophisticated Indian maid to join him in worship at the shrine of Venus Porcina carried in the innermost recesses of the folds of his pendulous and sea-beaten prepuce the remnants of former Bacchanalian festivities performed in the questionable temples of Venus and Bacchus in Portsmouth or London. Consumption, as such, was neither imported nor propagated by Europeans into those islands, its original entry being in the shape of syphilis. Had it been the ancient mariners of old Phœnicia in the days of its circumcision, or the circumcised marines of the ancient Atlantean fleets from the sunken continent of Plato, instead of the uncircumcised sailors of modern England, that first and since visited those islands, it is safe to say that consumption would not now exist there. From this, it may be well to inquire what would be the relation between the Jewish race and consumption; were circumcision among them to be done away with, would it not be greatly on the increase?

The weight of testimony is evidently convincing that the Jew has a greater longevity and stronger resistance to disease, as well as a less liability to physical ills, than other races; that all these exemptions or benefits are not altogether due to social customs is evident; how much circumcision may have to do in inducing these favorable conditions can be better appreciated by a consideration of how circumcision affects those of other races, and more particularly how its performance works changes in the individual in his general health and condition, and in doing away with many physical ailments that the individual was previously subjected to. So that the Jew cannot be said to be a loser by his observance of this rite, and he and his race have been well repaid for all the sufferings and persecutions that its observance has subjected them to. As observed by John Bell, “The preservation of health and the attainment of long life are objects of desire to every man, no matter in what age or country his lot is cast, nor by what arbitrary tenure he holds his life. They are the wish of the master and the slave, of the illiterate and the learned, of the timid Hindoo and the warlike Arab, of the natives of New Zealand not less than of the inhabitants of New England,—an indispensable condition for the greatest and longest enjoyment of the senses and propensities; for the widest range and exercise of intellect and gratification of the sentiments, whether these be lofty or ignoble, health, in any special degree, has ever been a fit subject of contemplation and instruction by the philosopher and legislator. Their advice and edicts on the means of preserving it have frequently been enforced as a part of religious duty, and, at all times, civilization, even in its elementary forms, has been marked by laws on this head. With the numerous and minute hygienic enactments of the great Jewish lawgiver for the guidance of the people of Israel we are all familiar. Prompted, we may suppose, in part by the example of Moses, and also by considerations growing out of the nature of the climate in which he lived, Mohammed incorporated with the mingled reveries, ethics, and blasphemies, which composed his Koran, dietetic rules and observances of regimen that are to this day implicitly obeyed by his zealous followers.”[71]

If circumcision is not a factor in the difference that exists between the Jewish race and other races, if it goes for nothing as an exemptor of disease and the promoter of longevity, then there must exist some other factor or cause that induces these conditions. What this factor is, the legislator, the sociologist, and the physician should make it their business to find out.

CHAPTER XV.
Predisposition to and Exemption and Immunity from Disease.

The peculiar differences that exist between different animals in regard to their susceptibility to the action of drugs is even more remarkable than the differences that exist in their susceptibility to certain forms of disease. We can understand and appreciate what Koch tells us in regard to the different susceptibilities exhibited by the house-mice and the field-mice to the anthrax bacillus, or why a nursing child should offer different results, when exposed to the diphtheria bacillus or the contagious poison of any of the exanthemata, from those witnessed in the meat or promiscuously dieted child. We can also appreciate that different individuals have different susceptibilities to disease, as well as we understand that the same degree is not always in an unvarying point of resistance or susceptibility in the same individual. The investigation and study of these conditions teach us, however, that there is a cause, or that there are causes that induce and modify this susceptibility. But there are conditions that are as yet beyond our comprehension. Take, for instance, two animals, both vertebrates, mammals, and dwelling together, eating the same food, and even having a mutual understanding or sympathy of mind and affections, having a like circulation, a like brain and nervous system, it would naturally be supposed that these two would exhibit a like susceptibility to the actions of narcotic poisons; but when we are told that one dog has taken 21 grains of atropia with impunity we are staggered. Atropia may not affect rabbits (as it does not), but the rabbit does not approach man in the same close relationship as the dog. Richardson administered to a healthy young cat 7 drachms of Battley’s solution of opium, then 10 grains of morphia, and a little later 20 grains more of morphia without rendering the cat unconscious. The same experimenter gave to a pigeon 21, 30, and 40, then 50 grains of powdered opium on succeeding days with no bad effect. S. Weir Mitchell gave to three pigeons, respectively, 272 drops of black drop, 21 grains of powdered opium, and 3 grains of morphia without any effect.[72] On the other hand, horses show a like susceptibility to man to the action of drugs. In the island of Ceylon, a sloth can take 10 grains of strychnia with safety,—chickens presenting a like immunity to the poisonous effects of this alkaloid. While the dog offers such a contrast to the action of drugs as compared to man, he is as subject to goitre, and they have been seen in a true state of cretinism.[73]

An Apache, or Colorado Indian, will prefer a dessert of decomposed gophers to one composed of the best canned peaches or Bartlett pears; he will devour the mass without any resulting evil, while a German—after many generations of training on all forms of sausages in every degree of age and ripeness, and on every form of cheese, from the refreshing cottage cheese from curdled milk and the delicious cream cheese, down through to all and every grade as far as Limburgher, or maggoty, common cheese—has not, in every case overcome the tendency of the civilized intestine and constitution to the action of sausage poison, something that has no effect on the ordinary Indian, or on the uncivilized dweller north of the arctic circle. Even the house-dog, that faithful companion of man, in many cases living on exactly the same fare as his master, is insensible to the action of this poison. An Indian will gorge and gormandize, after a prolonged fast, on such quantities and qualities of food that, if the ordinary white man were to indulge in a like feast, he would be in imminent danger of literal rupture or explosion, or liable to end in sudden apoplectic seizures, or, in case of a too healthy and active digestion, liable, owing to a lack of a correspondingly active condition of the excretory organs, to go off in uræmic coma. This sporadic and fitful feasting has no perceptible effect on the Indian, who either simply works it off in exercise, or sleeps it off in a long and prolonged period of sleep, during which his lungs work with the deep and steady pull and persistence that a tug-boat exhibits when towing in a large ship against the tide and a head wind,—working in and out more air in one respiration than the ordinary white man will in a dozen. All these different conditions are more or less plain to us and as easy of explanation,—just as plain as to how and why some birds eat gravel to improve their digestion. In the cases of different susceptibility to the action of strychnia or of narcotics, the explanation must of necessity, for the present, be more or less speculative. But how are we to account, even in the way of speculation, for the peculiar immunity, lack of predisposition and hereditary tendencies to disease exhibited by the Hebrew, who, since the history of the world, has been a civilized and rational being,—even for decades of centuries before the civilization of Europe? Living under the same forms of government, climate, and shelter, practically using the same varieties of food and drink, he exhibits an entirely different vitality and resistance to disease, decay, and death,—being, in fact, a puzzle to the demographic student. The only really marked difference that exists between this race and the others lies in the fact that the Hebrew is circumcised, other differences not being sufficiently constant to be accounted as factors. Circumcision is, in the opinion of the writer, the real cause of the differences in longevity and faculty for the enjoyment of life that the Hebrew enjoys in contrast to his Christian brother. Christian and uncircumcised races may individually, or in classes, develop some peculiar immunity or exemption, as, for instance, the tolerance to arsenic exhibited by some German mountaineers, or the peculiar safety enjoyed by the butcher class from attacks of continued fever;[74] but these exemptions are purchased at the expense of the future, the effects of arsenic, long continued, finally having its morbid effects, and the very plethora which is the bulwark of resistance in the butcher, this plethora being in the end a treacherous foe, diseases result from it which make a sudden ending to this class when it is least expected.

For an all around long-liver the Hebrew holds a pre-eminence, and, as the factor in this pre-eminence, circumcision has no counter-claimant. Circumcision is like a substantial and well-secured life-annuity; every year of life you draw the benefit, and it has not any drawbacks or after-claps. Parents cannot make a better paying investment for their little boys, as it insures them better health, greater capacity for labor, longer life, less nervousness, sickness, loss of time, and less doctor-bills, as well as it increases their chances for an euthanasian death.

CHAPTER XVI.
The Prepuce, Syphilis, and Phthisis.

Syphilis is not restricted to classes by any means; it is not those of the lower class alone who are its victims. Dr. Fr. J. Behrend, in his work, “Die Prostitution in Berlin,” observes that abolition of the brothels in that city in 1845, ’46, ’47 and ’48, trebled the number of cases of syphilis treated at the Der Charité; in the year 1848 the cases of syphilis treated at that hospital numbered over 1800. It was also remarked during this period of legally-enforced virtue, that, as inconsistently as it might appear, the disease invaded the best of families. From Dr. Neumann, in his brochure entitled “Die Berliner Syphilisfrage,” published in 1852, we learn that, in the Trades and Mechanics’ Benevolent Union of Berlin, in 1849, 13.51 per cent. of the sick were so from syphilis.

In the thirteenth volume of the British and Foreign Medico-Chirurgical Review, we find, in a review of the control of prostitution, an estimate in regard to the syphilization of a nation. The estimates are made on the most conservative figures, as, in the desire of the reviewer not to overestimate, he starts by figuring out the actual number of prostitutes in England, Wales, and Scotland to be only 50,000, when they were estimated, by those who had carefully studied the subject, as being more than double that number; the conservative estimate is, however, suitable for our purpose; so that we cannot be accused of overestimating the results. The portion of the review to which we wish to call attention is as follows:—

“Though the result of the evidence contained in the first report of the commissioners on the constabulary force of England and Wales was that at that time about 2 per cent. of the prostitutes of London were suffering under some form of venereal disease, yet we will descend even lower, and presume that of one hundred healthy prostitutes, taken promiscuously from England and Scotland, if each submits to one indiscriminate sexual act in twenty-four hours, not more than one would become infected with syphilis, an estimate which is without doubt far too low; yet, if admitted to be correct, the necessary consequence will be, that of the fifty thousand prostitutes five hundred are diseased within the aforesaid twenty-four hours.

“If we next admit that a fifth of these five hundred diseased women are admitted to hospital on the day on which the disease appears, it follows that there are every day on the streets four hundred diseased women. Let it be supposed that the power of these four hundred to infect be limited to twelve days, and that of every six persons who, at the rate of one each night, have connection with these women, five become infected, it will follow that there will be four thousand men infected every night, and consequently one million four hundred and sixty thousand in the year. Further, as there are every night four hundred women diseased by these men, one hundred and eighty-two thousand five hundred public prostitutes will be syphilized during the year; hence, one million six hundred and fifty-two thousand five hundred cases of syphilis in both sexes occur every twelve months.

“If, then, the entire population had intercourse with prostitutes in an equal ratio, the gross population of Great Britain, of all ages and sexes, would, during eighteen years, have been affected with primary syphilis. Be it remembered, we do not assert that more than a million and a half of persons are attacked every year, but that that number of cases occurs annually in England, Wales, and Scotland, though the same individual may be attacked more than once. Although it is evident that all the estimates used for these calculations are (we know no other word that expresses it) ridiculously low, yet we find that more than a million and a half of cases of syphilis occur every year,—an amount which is probably not half the actual number. How enormous, then, must be the number of children born with secondary disease! How immense the mortality among them! How vast an amount of public and private money expended on the cure of this disease!”

The same reviewer (P. S. Holland), in another article on the “Control of Prostitution,” observes that among the British troops syphilis is one of the most frequent of diseases, about one hundred and eighty cases occurring annually among every one thousand soldiers.

The effect of syphilis in depopulating the islands of the Pacific has been pointed out in a former chapter; the nature and origin of the disease that takes them off is unmistakable. Scrofula and rapid phthisis are taking off the inhabitants at a rate that, in those islands most affected, the native population will soon become extinct. According to Lancereaux, in the Marquesas group the women do not live beyond the age of thirty to thirty-five years, three or four months being the duration of the disease. Ellis, in his “Polynesian Researches,” published in 1836, remarks that at that date the disease, as above described, had but recently appeared. In the nineteenth volume of the “Archives de Médecine Navale,” Rey mentions that at the Easter Island pulmonary phthisis is the dominant affection with the adults, and that scrofula is very prevalent with the children.[75]

The effect of syphilization in inducing a scrofulous taint and the appearance of a rapidly-marching consumption among savage races has been well observed among the Indians in the southwestern parts of the United States, where the appearance of these fatal diseases can easily be traced to that as a cause. There is something peculiar about the Anglo-Saxon race that is fatal to the Indian; wherever they come in contact, the savage race begins physically and morally to crumble; the habits of the Anglo-Saxon in the matter of intemperance and his lust soon end the poor Indian; while, on the other hand, the Latin races mix with them without any physical detriment to the Indian. In what was formerly the Northwest Territory the French and Indian intermarried, and syphilis did not begin to tell on the Indian until the Americans settled the country. From these observations it is very evident that in the Polynesian Archipelago syphilis must have been the precursor of the phthisis and scrofula, as we know it to have been that which induced those diseases among the Indians of the Mississippi or Missouri Valleys, or of the Colorado and Mojave Deserts, or in the mountains and valleys of Arizona.

On the other hand, circumcised races, whose women have not carried a syphilitic taint into the race, are as a class free from any syphilitic taint. Neither their teeth, physiognomy, skin, nor general condition denote any syphilitic inheritance. This is true of the Jewish descendants of Abraham, who have more strictly adhered to the non-intercourse or marriage with other races, and whose women have abstained from vice; the Arabian descendants of Ishmael have, in a great measure, also retained their marked family individuality, except it be a few tribes, who, by contact with the soldiery of European nations, have had their women corrupted and syphilis introduced into the tribe through this channel.

Richardson, in his “Preventive Medicine,” observing on the effects of syphilis in inducing deterioration of the organs of circulation and their degenerative changes, says that, in his opinion, syphilis is the progenitor of various diseases, and that those who give this opinion the greatest range are, unfortunately, nearest the truth. The breathing organs, he remarks, are distinctly susceptible to injury from this hereditary cause.

In 1854, at the Metropolitan Free Hospital, situated in the Jews’ quarter in London, Hutchinson observed that the proportion of Jews to Christians among the out-patients was as one to three; at the same time the proportion of cases of syphilis in the former to the latter was one to fifteen. Now, this result was not due to any extra morality on the part of the Jews, as fully one-half of the gonorrhœa cases occurred among those of that faith. J. Royes Bell also observes the less syphilization among circumcised races.[76]

The absence of the prepuce and the non-absorbing character of the skin of the glans penis, made so by constant exposure, with the necessary and unavoidably less tendency that these conditions give to favor syphilitic inoculation, are not evidently without their resulting good effects. Now and then syphilitic primary sores are found on the glans, or even in the urethra or on the outside skin of the penis, or outer parts of the prepuce; but the majority are, as a rule, situated either back of the corona or on the reflected inner fold of the prepuce immediately adjoining the corona, or they may be in the loose folds in the neighborhood of the frenum, the retention of the virus seemingly being assisted by the topographical condition and relation of the parts, and its absorption facilitated by the thinness of the mucous membrane, as well as by the active circulation and moisture and heat of the parts. It must be evident that but for these favoring conditions the inoculation or infection would and could not be either as sure or as frequent. Any protecting mechanical aid that interferes with these favoring conditions grants an immunity to the individual, even when he is freely exposed; this protection has often been obtained by applying to the glans and penis a substantial coat of some tenacious oil like castor-oil, which was afterward gently washed off, first in a shower of tepid water and afterward in a tepid bath of warm water and borax.

Horner, formerly of the navy, in his interesting little work on “Naval Practice,”[77] relates that it was customary, in the older navy of the United States, to allow public women to come on board at some of the ports and to go down to the men between decks, the Department of the Navy being probably actuated by the same humane principle that used to induce some of the West Indian cannibals to lend their wives to their prisoners of war who were intended, in the shape of roast or fricandeau, to grace the festive board, as it was deemed inhuman by these philanthropists to deprive a man of his necessary sexual intercourse, even if they were soon to roast him and pick his bones. They may, however, have been selfish in the matter, as by some authorities it is represented that this was done to improve the flavor of the prisoner, who was said to offer a more savory dish through this considerate treatment, the strong flavor that the semen gives to flesh being well eradicated by free fornication. Whether it was through these motives of humanitarianism, or the feeling that an American tar was the equal of the British tar, whose praises and equality Sir Joseph Porter, K.C.B., writes a song about in “Pinafore,” who had as much right to contract a left-handed marriage as any Prince of Wales or any other prince or crowned head of Europe, the women were, nevertheless, allowed to go down between decks in preference to giving the men indiscriminate liberty on shore, the government further providing for their welfare by causing the assistant surgeon to examine the women at the gangway or hatchway, to see that they were not diseased. Horner relates the ludicrous appearance presented by a near-sighted assistant at one of the hatchways while making this professional examination, surrounded by the sailors and marines, who were greatly-interested spectators. Had the government provided a pot of castor-oil wherein the tar could dip his penile organ, as bridge piles are dipped into a creasoting mixture, these humiliations to our professional brother could have been avoided.

In the conclusion to be reached, circumcision is not put forward as the only exempting element or preventive measure that deserves all the credit for the immunity that the Jews enjoy from syphilis, or to the absence of hereditary diseases that are secondary or due to the presence of that disease in the parents, as considerable credit is to be given to the well-known chastity of their females. This chastity is, in a great measure, due to the inseparable conditions of their religion,—moral and social fabrics which are welded into one. Their charity assumes the most practical form, so that it is not possible for one of their females to have to resort to a life of prostitution to save herself or her children from starvation, as, unfortunately, is too often the case in Christian communities, where religion is put on and off with Sunday clothes. The temperance and sobriety, as well as the economy and industry of the father, are not without a good moral as well as a hereditary effect on the daughters, who are neither rendered brutal nor demoralized through the example and instigation of drunken fathers. They have, therefore, a better average homelife, to which they cling and which protects them. The aid and benevolent associations of the Jews are among the most efficacious of charitable institutions, and no class gives more freely or generously for this purpose. The Home for Aged Hebrews in New York is an example of the character with which they dispense charity. We need not, therefore, be surprised to find, in statistics of illegitimacy by religious denominations taken in Prussia, that the Jewish women are three times as chaste as the Catholics and more than four times as chaste as the Evangelists.[78] The Jew has, therefore, two avenues of infection from syphilis cut off,—the lesser liability due to his circumcision and the chastity of the women.

Richardson mentions the immunity of the Jewish race from tubercular disease, and notices the well-known relation existing between a syphilitic taint and a phthisical tendency. The comparative statistics offered by the Mohammedans, Jews, and Christians in regard to deaths from consumption have already been mentioned in a former chapter, they being as four Christians to one Jew, while the Mohammedan, from his greater abstemiousness and temperance to assist him, shows a still lower percentage than the Jew. There can be but little doubt that to this particular and well-marked less syphilization the Hebrew race owes much of its exemption from many other diseases and its greater resistance to ordinary ailments and epidemic diseases.

The relative less frequency of syphilis among all circumcised people is noticed by Dr. Bernheim, in his brochure “De la Circoncision,” he being the surgeon of the Israelitish Consistory of Paris. His utterances on this subject are worthy of attention, he having not only paid particular attention to this, but having had unusual opportunities for the basis of his opinions. Dr. Bernheim looks upon coition as a frequent source of tubercular infection, and the sensitive and absorbing covering of the uncircumcised glans as a ready medium of transmission of the virus from one system to the other. He calls attention to the frequent granular condition of the uterine os, in confirmed cases of tuberculosis, as something that is too much overlooked. This view of the case, from Dr. Bernheim’s stand-point, is worthy of greater consideration than it has generally received at the hands of the profession.

The great number of examples that have recently come to light in connection with the direct inoculability of tubercular consumption, both in the later works on phthisis and in the medical press, are not without interest or without a lesson. The case recorded within the past year of a healthy chambermaid, who was immediately inoculated with tubercular matter with rapidly-following constitutional effects through a scratch on the hand, received from the sharp edge of a broken china cuspidor that a consumptive was using, is one of these cases that are to the point; so it is evident that the uncircumcised need not always wait for the degeneration of syphilis into syphilitic phthisis or syphilitic scrofula to become a consumptive, but it is within the greatest range of possibility and probability that he may become at once a consumptive through an excoriation or abrasion received during coition with a tubercular woman. So many tubercular prostitutes ply their trade, or, to be more definite, so many prostitutes become tubercular, and in its different stages follow their occupation as the only means of keeping out of the poor-house, that man runs as much if not more risk, in consorting with the class, of contracting tuberculosis than that of contracting syphilis.

There is something about syphilis that is not generally noticed; we are all well acquainted with the dire results that usually follow syphilitic infection, its course through every stage of suffering and misery, its transmission and effects in tubercular meningitis or in syphilitic affections of the mesentery through heredity in children, and of the many horrible cases of destruction of tissue, in skin, mucous membrane, cartilage, or bone, with their attending mutilations and disfigurations; but there is no record of the great number of cases, and very few physicians of any extended practice but who can recall some such cases, where, after undoubted syphilitic infection, with the usual course of primary sores and secondary eruption, the patient has suddenly blossomed out into a state of robust health that his system was an entire stranger to before the infection. The writer has, in the course of a long practice, seen a number of such results follow both the infection attended with a miliary eruption and that followed by the large small-pox-appearing eruption, both kinds being preceded by the primary sore; and these results have been observed in cases of both what are called the soft and multiple and the hard or Hunterial initial sore. Some of these cases rapidly gained in flesh, with an evident increase in the redness of their blood, increasing in vigor and strength with a very perceptibly less tendency to attacks from accidental or previously subject-to diseases.

The same result has been observed to follow an attack of small-pox with some individuals, and the writer well remembers a similar result following a very extraordinary event. The subject was a man well known among his old comrades of the First Minnesota Infantry as “Duke,” and to many of the older practitioners of Wabashaw County, of that State, as “Old Duke.” In early life he was sickly and weakly, never having fully recovered from a malarial fever contracted in the Mexican war. Coming to Minnesota, he adopted the life of a raftsman, with all the irregularities that accompanied such a life. On one occasion, after a protracted spree, feeling the need of stimulation and not having the wherewith to procure it, he secured a jar in which a snake and several other reptiles were preserved in spirits, and drank the fluid contents. He was, some days afterward, taken violently ill with a high fever and racking pains, ending in an eruption of boils that covered him from head to foot; he made a slow and tedious recovery; but when recovered he seemed to have become imbued with a constitution resembling lignum-vitæ, for a more stubborn-twisted constitution never existed than that of “Old Duke.” The power of resistance that this man developed was something wonderful. Dr. C. P. Adams, of Hastings, Minnesota, and the St. Paul physicians who were connected with the regiment well remember, though, wiry, precise, and soldierly “Duke,” who, even in the old Army of the Potomac, immersed up to his ears like the rest of the army in the mud and dirt of the encampment of Falmouth, above Fredericksburg, came out on general inspection as prim as if he had just stepped out of a bandbox, for which he received a medal for soldierly conduct and bearing.

These apparent digressions are not made either to be tedious or to weary the reader, nor without an object. They are made to show that, whereas syphilis is looked upon as such a deadly disease, and it may be said to be the sole cause of fear to the assiduous worshiper at the shrine of Venus Porcina, there is another still more fatal danger awaiting him, ambushed in the folds of the vaginal mucous membrane, or coming along silently out of the cervical canal,—like the legions of Cyrus stealing along the dry bed of the Euphrates into ancient Babylon, to fall unawares on the feasting Nebuchadnezzar on that fatal night. So, in like manner, the virus of tuberculosis, either extruding from a granular os or from its neighborhood, gradually moves down on the unsuspecting, uncircumcised, and easily inoculable-surfaced glans penis, to infect the system with a tubercular poison that has no such exceptions as those above noted, as at times are the followers of syphilis. It is not alone the individual himself that may be the sufferer from this poison, but his progeny for several generations may have to suffer for the infection thus received, just as much as they would were that infection to have been syphilitic. As before remarked, this has heretofore not sufficiently occupied the consideration of the profession, and, as it cannot certainly be denied that such a source of tubercular infection is both possible and probable, the subject is entitled to more serious and deliberate consideration than that which has heretofore been paid to it.

Tuberculosis certainly has these two channels of entrance: either through direct infection or through an evolutionary process resulting from syphilis. The appearance and vital statistics offered by the French War Office in regard to the Algierine provinces, the report of the United States Census, the opinion of Dr. Billings deduced from the census reports, the opinions of Hutchinson, Richardson, Bernheim, and many other observers, as well as the personal but unrecorded observations of many practitioners, all tend to bear testimony to the remarkable difference that exists between circumcised and uncircumcised races in regard to the ravages of consumption. Is circumcision a factor in this difference, or is it not? If it is, then circumcision should receive more attention than it has; if it is not, then we should not be idle in hunting up the cause of difference, for an ounce of prevention is certainly worth in this regard a whole pound of Koch’s lymph as a curative agent.

CHAPTER XVII.
Some Reasons for Being Circumcised.

Jahn, in speaking of the people by whom the early Hebrews were surrounded, mentions their idolatrous practices, and that their peculiar forms of Pagan worship were accompanied by indulgence in fornication, lascivious songs, and unnatural lust. Others of their neighbors worshiped the “hairy he-goat,” with which they also practiced all manner of abominations. Sodomy, or pederasty, seemed a sort of religious ceremony with some of these heathen nations; from a religion it necessarily became a social practice; this, in connection with the phallic practices and worship, necessitated frequent exposure of the male member. The evil results, to say nothing of the disgusting and demoralizing tendency of these practices of the Pagan, were evidently well known to the Jews. The contrast between the physique and health of the pastoral habits, out-of-door life and simple diet of the Jews, and the necessary opposite condition of health and physique due to luxury and to these practices among their neighbors, could not have escaped their attention. How much onanism had to do with the establishment of circumcision may well be conjectured. Again, the other hint is in reference to procreation, as some stress is laid to the connection between the conception of Sarah and the circumcision of Abraham. Here we have suggestions of a preventive to onanism, and a cure to male impotence when due to preputial interference.[79]

Strange as it may seem, these two important results, due to circumcision, seem to have been lost sight of for some thousands of years, as even the able works of the physicians of the latter part of the last century have nothing to say connecting onanism and circumcision. Neither the works of Tissot on male onanism nor the pioneer work of Bienville on nymphomania speak of the presence of the prepuce in the male, or of the nymphar or clitorian prepuce in the female, as being causative of, or their removal curative of, either masturbation, satyriasis, or nymphomania; moral, hygienic, and internal medication being by both these authors considered to be all that our science could offer or do to alleviate or cure this unfortunate class. It is only of late years that circumcision, in its true relations to onanism, has received full consideration. In regard to its being a cure of impotence, its recognition has been of longer duration.

It is related by Leonard, in his “Memoires,”—who, in his capacity of hair-dresser in ordinary to her Majesty, the unfortunate Marie-Antoinette, had ample opportunity for picking up all the domestic small talk of the royal family and their affairs,—that Louis XVI, in addition to all his troubles and the indignities which he suffered, besides finally being beheaded, was afflicted with a congenital phimosis which prevented the flow of semen from properly discharging itself. It appears that his Majesty was no little annoyed at not being able to procure an heir to his throne. His royal sister-in-law, the Countess d’Artois, had given birth to a prince, the Duke of Angouleme, who was the heir presumptive to the throne in case of the non-issue from Louis; another sister-in-law had been brought to bed with a royal princess, and here was the king himself without any prospective possibility of any heir. Like all kings, he was more or less unreasonable; so he blamed his first surgeon in ordinary for all these short-comings,—as if it were the duty of these court surgeons, among their many other tribulations, to furnish heirs to thrones. The surgeon finally informed his Majesty that if he wished to become a father it would be necessary for him to submit to the slight operation that was the subject of the church festival of the first day of January, namely, the Feast of the Circumcision. His most Christian Majesty entered a protest to this acknowledgment that there was anything in Judaism worth imitating. The surgeon insisted that the operation celebrated on the first of January would put him in a way to have the much-desired heir. The king finally waived all objections from any religious scruples, but could not be brought to look at the prospective operation with any sentiments of agreeable expectation.

The king finally became good-natured, and a touch of that plebeian jollity which at times made him quite agreeable spread over his features as he imagined the ludicrousness of the spectacle that would be presented by a king of France in the hands of these handlers of the scalpel, treating him like an African savage. He took some days to consider the matter. On the next day he informed M. Louis, his first surgeon in ordinary, that he had decided on submitting to the operation, and the day and hour were fixed. The royal circumcision, however, never took place, as it is most likely that in the privacy of his chamber his Majesty worked, like many a plebeian or man of low degree had done before him and has done since, to bring a refractory prepuce to terms. The king was somewhat of a mechanic, as his skill as a locksmith has passed into history; so that it is not unlikely that, with what little information he had on the subject, he managed to sufficiently dilate, by scarification and stretching, the preputial opening, as from the year 1778 the queen had three children.

Cases of attempted self-circumcision are not rarities, as people have some inexplicable idea that a self-inflicted cut is not as painful as one that is done by others. The writer well remembers being called to assist one of these domestic surgeons who had undertaken to circumcise himself with his wife’s great scissors. The man had a very long but thin and narrow prepuce that had always been an annoyance to him. The writer had circumcised two of his children for the same malformation, and the father, seeing the benefit to these two, determined to share in the general benefit; but at the same time he arranged to do it all by himself, and give the family and the surgeon a sample of his courage and a simultaneous surprise party. Securing the scissors, he wended his way unperceived into the recesses of his wood-shed. The mental and physical anguish the poor man underwent, and what soliloquies he must have addressed to the rafters of the wood-shed while making up his mind and screwing up his physical courage for the last fell act with the scissors, can hardly be described, as, in all probability, they were of the most rambling and inconsistent order. At any rate, he must have reached a climax in time and grasped the fated prepuce with a revengeful glee, and, with all his powers concentrated in his good right hand, he must have closed the remorseless blades of the scissors on the unlucky prepuce. When the surgeon arrived at the scene of carnage, he was directed to the wood-shed, on the outskirts of which hovered the family, frantic with fear and apprehension; within, in the darkest corner, with wildly dilated eyes, and performing a fantastic pas seul, was a man with a huge pair of scissors dangling between his legs, warning all hands as they valued his life not to approach or lay a hand on him. He had shut the scissors down so that it clinched the thin prepuce, and there his courage and determination had forsaken him; he lost his presence of mind, and was not even able to take off the scissors; he had simply given one wild, blood-curdling yell—like the last winding notes from Roland’s horn at Roncevalles—that had brought his family to the wood-shed-door, and they had then sent for a surgeon. New terrors here awaited the unlucky victim for self-circumcision. He dreaded lest the surgeon should accidentally have it enter his mind to finish the operation with the scissors, and in that case he would be helpless, as the surgeon would, undoubtedly, have a sure and tender hold of it. After executing a number of pas à deux on the Magilton step, while the surgeon endeavored to reassure him and gain his confidence, promising to remove the scissors without inflicting any further harm, he was finally allowed to approach, and, while the patient assumed a Taglioni attitude on one foot, the other leg being extended at right angles with the body and his hands clawing the air, the scissors was removed. The patient, through the aid of lead lotions and a week’s rest, made a good recovery with a whole prepuce, chagrined at his failure, but happy to have escaped immediate pain.[80]

There is not much doubt but that the operation could have been suggested by its, at times, spontaneous performance, a case of which, by Cullerier, and some other additional cases have been mentioned in a former chapter. Cases occur at times, also, wherein the person having a previously normal and uninterfering prepuce has, through either herpetic inflammations or through impure connection, spurious gonorrhœa, or the use of some venereal-disease preventing-wash after connection, produced some irritation resulting in the abnormal thickening of the inner fold, or an interstitial deposit at the junction of the skin and mucous membrane, with consequent constriction, this deposit finally forming a hard, inelastic ring, which prevented a free exposure of the glans and interfered in sexual connection. In such cases,—like in stricture of the meatus,—any mechanical interference short of cutting with a knife only aggravates the existing difficulty, and it is not uncommon to have such cases apply for assistance after they have in vain tried to dilate the constricting preputial orifice. In the early writings of the Greeks, it is mentioned that among the Egyptians circumcision exempted them from a certain form of disease that affected the penis. Philon mentions particularly the immunity that the operation conferred against a species of affection which Michel Levy asserts to have been a gangrenous disease. So that, outside of any religious significance, there is no doubt that, in individual cases, circumcision has more than once been suggested, although it cannot be said that such individual cases would ever, or could, lead to its becoming a national or racial, much less a sectarian, rite.

CHAPTER XVIII.
The Prepuce as an Outlaw, and its Effects on the Glans.

With improvement in man’s condition and his gradual evolution into a higher sphere, the assumption of the erect posture, and the great stride in civilization that originated the invention of the manufacture of the perineal band, which not only protected the glans in its thorny passage through life, but also acted like a protecting ægis to the scrotum and its contents, the prepuce became a superfluity; not only a superfluity, but, now that its natural office had been replaced by the perineal cloth, it actually began to be a nuisance, as its former free contact with the air had retained it in a state of vigorous and disease-resisting health which was now fast departing. As Montesquieu observes, in the causes that led to the decline and fall of the Roman Empire, those seasons of trials, tribulations, and struggle for existence are those of health and progress and healthy life, and the periods of luxury and idleness are those of degeneracy and decay. So with the prepuce, the luxury and idleness, voluptuousness and consequent feasting incident to its being supplanted in its original functions by the perineal cloth, which left it thenceforth unemployed, led it in the pathway of disease and death. This first innovation in civilization was to the prepuce the beginning of its decay and fall. Like Belshazzar in his great banquet-hall in ancient Babylon, the prepuce might have read the hand-writing on the wall, “Mene, Mene, Tekel, Upharsin,” and foreseen the gory end that awaited it. Like to other human affairs, however, even in his fallen estate a kind word can be said for the prepuce. Puzey, of Liverpool, has found it of extreme value, and even unequaled by any other part of the body, for furnishing skin-grafts,[81] these grafts showing a vitality that is simply phenomenal, considering the laxity of its tissues and its seemingly adipose character. There is no doubt, however, that for skin-transplanting there is nothing superior to the plants offered by the prepuce of a boy, and where any large surface is to be covered this should undoubtedly be chosen, as offering the greatest and quickest success and the least chances of failure. This is really the only disadvantage that can be charged against circumcision, as in a strictly circumcised community they would be debarred from this great advantage. An uncircumcised individual could be procured, however, to supply the deficiency. It is related that in the latter part of 1890, a Knight Templar, in Cincinnati, required a great supply of grafts or skin-plants to cover a largely-denuded surface, and that the whole of his Commandery chivalrously and generously supplied the needed skin-plants in a body. A few healthy prepuces would have been more efficacious. In advising the use of the prepuce for these purposes it must not be overlooked that in case of a white man it would not do to use skin of any other color besides his own. We have no data to base any assertion as to the relative action of skin-grafts taken from Mongolians or Indians, but we have very reliable data in relation to the proliferating action of those of the negro,[82] which induces a growth of epidermis of its own kind; so that preputial grafts from the negro, combining the extra vitality and proliferation of the preputial tissue with the strong animal vitality of the negro, if applied to a white man, might not produce the most desirable cosmetic effects, especially if on one side of the countenance.

But, taken as a whole, when considered in its relation to onanism, nocturnal enuresis, preputial calculus, syphilis, cancer, and a lot of nervous and other ailments, or induced abnormal physical conditions, we can really conclude that the days of the prepuce are past and gone, that it has outlived its usefulness, and that those whom a religious or civil ordinance or custom happily makes them rid of it are people to be greatly envied. As Sancho Panza remarked, “God bless the man who invented sleep,” so we may well join in blessing the inventor of circumcision, as an event that has saved some parts of the human family from much ill and suffering.

Phimosis is an ancient attendant on our inheritance of the prepuce, we being, in fact, born with it; this is the rule. There are, however, exceptions to this rule, which, singularly enough, are found to be hereditary. The writer has met with a number of such instances, and they have always been found to have been family traits. Within the past year, after attending a confinement, his attention was called to the child by the nurse, who thought that the child was deformed; the nurse, singularly enough, never having seen a natural-looking glans penis in all her life, was astonished at the size and appearance of the member. On examination, the organ showed a complete absence of prepuce. On inquiry, the father and another son, born more than twenty years previously,—this comprising every male member of the family,—were found to have been thus born, with the glans fully exposed. The family is now residing in San Diego, and is naturally one of more than superior physical health and intelligence. I saw another family similarly affected in the north of France, and of individual cases, without knowing the history of the rest of the family, I have seen a large number. As the prepuce can be observed in every stage of disappearance among mixed races, it would seem that in time it would disappear altogether. Its effectual absence in so many cases evidently belongs to some evolutionary process, and shows beyond question that nature does not insist on its presence either as a necessity or as an ornament.

The word or term “phimosis” is derived from two Greek roots, signifying “string” and “to tighten,” or “to tie with a string.” Galen, from its signification, accepted the word, and from him it has been transmitted through the different epochs of medicine down to our own times. In virtue of its etymological significance, it was formerly applied to any stenosis or closure of duct or aperture, but at present the term is used simply to denote that constriction that affects the prepuce, and which prevents the glans from being passed through the preputial orifice. Phimosis is said to be congenital or natural and acquired. The first of these is the common lot of all, as a rule, and with some it remains so throughout life. As babyhood advances in boyhood and boyhood into youth, the prepuce gradually becomes lax and distensible, and in proportion to the existence of these conditions it also loses in its length. Where, however, the distal end persists in its constricted condition it is drawn forward as the penis increases in bulk.

In many cases its tightness prevents the escape of the sebaceous matter that collects in the sulcus back of the corona, and the resulting irritation on the surface of the glans and the inner mucous fold of the prepuce ends in an inflammatory thickening of the latter, its inner surface becoming thick, undilatable, hard, and unyielding, all the natural elasticity that should be present having departed, with more or less inflammatory thickening and adhesions between the two layers of skin that form the prepuce. In this unyielding tube the glans is imprisoned and compressed, often suffering the tortures that the “maiden” of the dungeons of the Inquisition inflicted on the unhappy heretics. It becomes elongated, cyanosed, and hyperæsthetic; the meatus of the urethra is congested and hypertrophied, the corona is undeveloped and often absent, the glans having, on the whole, the long-nosed, conical appearance of the head of a field-mouse. There are hardly five per cent. of the uncircumcised but who suffer in some degree from this constricting result of the prepuce, to a greater or less extent.

On the other hand, the unconstricted glans penis assumes the shape and appearance that is seen in the circumcised. The head is shorter, the face flat and abrupt, and the meatus, instead of being at the end of a conical point, is situated on the smooth, rounded front of the glans, and does not differ in color from the covering of the glans itself. From the superior commissure of the meatus to the sulcus in the rear of the corona its topographical outline may be said to describe two opposite segments of a circle, as seen in the cuts representing the glans in its natural shape. The corona is prominent and well developed.

The opponents of circumcision base much of their opposition to the fact that circumcision interferes with the natural condition of the parts. The question may well be asked, which of these two shaped glans is the natural product as nature intended it should be? It is a well-known fact that the most forlorn and mouse-headed, long-nosed glans penis will, within a week or two after its liberation from its fetters of preputial bands, assume its true shape. We may naturally inquire if nature made the glans of a certain shape, which seems to be the proper shape for copulative purposes, only to have the condition most effectually abolished by a constricting, unnatural band? How much the shape of this glans, from meatus to corona, may have to do with retaining the urethra to a healthy and normal calibre and condition has not been inquired into, but, as far as the writer has observed, a normal glans seems to have less abnormalities of the urethra, and in treating such cases he has always found that when the urethra of one of these normal-glans subjects was affected it was far easier to manage; on the other hand, secondary and even a tertiary recurrence to an operation is often the fate of a long, narrow, conical-pointed penis.

Phimosis is known to have been a cause of male impotence by its direct interference with the outward flow of the seminal fluid; but, although we have cases where impregnation has taken place by the aid of a warm spoon and a warm syringe, as in the case related in a former chapter, it must be admitted that the corona is not without some functional office in the act of procreation. Its shape indicates a valve action like that of the valve in a syringe-piston, and if we examine the two extremes of these conditions of glans—one devoid of corona, as many are, and the other with the corona in its most pronounced form, when in a state of erection—the difference, either in the appearance of the two organs or in the different philosophical action and results that must necessarily follow the use of these two differently shaped glans, will at once be apparent. Unfortunately—or, as many may consider it, most fortunate—the female organs are not always so shaped as to be in themselves wholly favorable to impregnation. The wearing of corsets, the habitual constipation of females, the relaxed and unnatural condition of the uterine ligaments and vagina in civilized women, all favor uterine displacement, with any or all forms of uterine ailments. To this we may add the effect of repeated miscarriages, application of astringent washes, irregular menstruation, etc., all of which conditions often result in an elongation of the neck, constriction of the cervical canal, with the external os placed on the depended point of the sharply pointed cervix, which is liable to point in any direction. Just imagine one of these conditioned females and one of the mouse-headed, corona-deficient, long-pointed glans males in the act of copulation! The conical penis finds its way in the reflected fold of the vagina, while the point of the uterus may be two or three inches in some other direction, making impregnation wholly impossible; besides, in the normal-shaped penis, the corona acting as a valve, behind which the circular muscular fibres of the vagina close themselves, tends to retain the seminal fluid in front, while the very shape of the organ assists in straightening out the vaginal canal and to bring the uterus in proper position. In the long, thin, narrow and pointed glans, devoid of corona, there is no mechanical means to retain the seminal discharge. Some years ago some one introduced the idea of postural copulation, to be tried in cases of sterility, and it has been found that impregnation would take place in some cases where it had formerly appeared impossible, this position having the effect of righting malpositions during the act, which were the cause of the sterility; but it stands to reason that, where the shape of the organ is such that it further favors malpositions, as well as where it offers no obstacle to the vagina immediately expressing or dropping out all the seminal fluid, impregnation is more difficult, and that, where the uterine deformity is coincident with this condition of penis to assist, it becomes well nigh impossible. Foderè mentions a penis about the size of a porcupine-quill on an adult male, and Hammond mentions one of the size of a lead-pencil in diameter and two inches in length. From total absence of the penis, either through disease or accident, to the diminutive organs mentioned by Foderè and Hammond, and on up to the full-sized and normal-shaped organ, we have every degree of sizes and shapes, and with these go every conceivable degree of ability or faculty for impregnation.

Aside from the foregoing considerations, there are others equally important. Although Greece was involved for years in war and ancient Troy was destroyed and all its inhabitants slaughtered because of the seduction of one woman; and Semiramis, through her beauty, got all her successive husbands in chancery; and poor, susceptible Samson, from firing Philistine vineyards and killing lions bare-handed, and the Philistines by the thousands with the jaw-bone of an ass, was reduced through Delilah to bitter repentance and turning Philistine mill-stones; and we know that the familiar infatuation of Antony for Cleopatra ruined Antony; and we are familiar with the well-known maxim of the French police-minister, that to catch a criminal it was but necessary to first locate the woman and the man would soon be found,—society has determined to ignore the influence of the animal passions as factors in our every-day life, or factors in the estrangements, coldness, and the bickerings that end in divorces. Not to shock the reader with detailed accounts as to what an important factor the shape of the penis may be in the domestic economy, I will refer the reader to Brantome’s works.

Although the councils of the older church were not above giving these conditions their calm and deliberate consideration, which resulted in the foundation of the present physical considerations in relation to divorce laws, such studies or considerations are at present only touched upon gingerly and with apologies for doing so, as if the “study of man” was of any less importance to-day from what it was in the days of Moses, the elder church, or when Pope formulated his oft-quoted but little-followed maxim, that “the proper study of mankind is man.” The present miscalled “delicacy of sentiment” is about as misplaced a condition of disastrous and misleading morality as was the out-of-place and untimely bravery of poor old Braddock when refusing Washington’s advice at the Monongahela. The success and beauty of the Mosaic law is its squarely facing the conditions of actual life, and its absence from nonsense or nauseating sentimentality. Were our present churches to observe more of this plain talk, for which the good old Anglo-Saxon is as fully expressive and convincing as the old Hebrew, and deal less in rhetorical flourishes and figurative mean-nothings to tickle the ears of our modern Pharisees, mankind as well as womankind would be infinitely so much the better off, mentally, morally, and physically, and there would be less of the conflict between science and religion. Luther’s dream of restoring religion to its primitive purity has come to but as poor realization at the hands of his so-called followers, which leads one to think that if the martyrs of the Reformation could come back and see the fruits of their martyrdom—suffered that pure religion might live—they would conclude that, for all the resulting good accomplished, they might as well have kept a whole skin and a whole set of bones.

In cases of pronounced phimosis the aperture in the prepuce may not be in a line with the meatus, and the resulting discharge of urine or the ejaculations of seminal fluid may from this cause be unable to find an egress. The fluid escaping from the urethra will, in case the opening is at the side or upper part of the prepuce, cause it to balloon out until a sufficient quantity is thrown out so as to distend, the opening as well as the prepuce, before it can find its way out; in such cases impotency is liable to be as complete as in those cases of stricture wherein the seminal fluid is forced backward into the bladder. Having given this general view of the effects of phimosis as it may affect man in the shape of his organ, which may have a serious result in his domestic relations or in becoming a father, we will proceed to the consideration of diseases and conditions that phimosis encourages and to which it renders man more liable. In the consideration of these cases it must not be forgotten that the sexual relations are much more to man or woman than is generally acknowledged. The days for the establishment of the Utopian republic of Plato are not yet with us. That Platonic love does exist is true, as it has in the past and will in the future. Scipio, refusing to accept the beautiful betrothed bride of an enemy as a present, or Joseph leaving his coat-tail in the hands of the amorous bride of the eunuch Potiphar, with the suicide of Lucretia, in the past, are events which virtue and modern continence probably duplicate every day; but these are exceptions to the rule. Physicians daily see evidences of the most devoted Platonic affection in either sex, but they also see enough of the opposite side of the question to convince them that in the majority of cases the sexual relations are the bond of union, as well as the mainspring of love. As observed by Montesquieu, the bride of a first-class Turkish eunuch has but a sorry time, and a woman of the same calibre of mind as that possessed by the ordinary Circassian or Armenian bride cannot be in a much happier condition with a husband partly eunuchised by a constricted prepuce.