A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain (review)

Robert Darby has added a fascinating chapter to the history of sexuality by detailing the attitudes toward the foreskin and the rise of circumcision in Britain throughout the eighteenth, nineteenth, and twentieth centuries. The book is impressive in its scholarly erudition and depth of observation, and it builds on various studies of sexuality, especially masturbation, by Thomas Laqueur and others. In addition to its careful attention to detail and its impressive range of observations, the book is largely a pleasure to read. Clear and carefully argued, it builds a case that is as fascinating as it is penetrating. At times there are repetitions and restatements of facts stated earlier, but in every case the new context seems to warrant these repetitions, and I could not imagine the study any shorter. Because Darby writes so clearly about such complex and at times contradictory material, I would be pleased to have the study continue even further into the twentieth century and into cultures beyond the British. He does have a good deal to say about the United States and Australia, to be sure, but we have to wait for a more complete study of the latter, which we are assured in the conclusion is his next book-length project.

The thesis of this book is a simple one. In the eighteenth century circumcision was considered an act of deformation, relegated to Jewish and Muslim cultures, but by the early twentieth century had become a fairly common medical procedure, at least among the elite classes. Darby sets out to explain that change in attitudes. In doing so he talks in detail about masturbation phobia in families, in schools, and in the British culture at large. He also talks about the ways in which various nervous complaints were connected to the foreskin. As Darby tells us in his introduction:

Frederick Hodges locates the origin of circumcision in Europe and Britain specifically in the masturbation phobia of the eighteenth century and in theories of reflex neurosis, which held that disturbances of the nervous equilibrium could cause disease and which thus targeted sensitive parts of the body as the guilty parties. In this scenario, particularly according to the work of Claude-François Lallemand on spermatorrhea, erotic sensation was redefined as irritation, prepubertal orgasms misinterpreted as epilepsy, and erections viewed as pathological; as the dynamic and most sensitive part of the penis, the foreskin was particularly suspect. (7)

The implications of this illogical connection make chilling reading, and at times this book is impossible to put down. "The conviction that circumcision would alter sexual behavior was thus not a side effect of a procedure adopted as a health precaution," Darby tells us, "but its original purpose" (15). This is the story that Darby tells, and the general shape of his argument is what I will explain here. I want to say at the outset, though, that I think this is a wonderful study that I would recommend without qualification to historians of sexuality and medicine.

Darby begins his study by looking at various eighteenth-century accounts of the foreskin. There, "in striking contrast to the nineteenth century," he points out, "there was no concern that a man's well-being was somehow threatened by his foreskin, and no sign of the 'congenital phimosis' that suddenly become so common in boys after the 1860s" (25). (Phimosis is a condition in which the foreskin is too tight for the glans to emerge. It was prevalent in cases of syphilis, "since the disease often produced scabs that fused foreskin to glans" [26].) Eighteenth-century medicine and medical practice were backward by later nineteenth-century standards. Robert James, the author of a famous medical dictionary (A Medicinal Dictionary, 1743–45), referred to circumcision as a therapeutic procedure, and he also, "more ominously," according to Darby (41), discussed the operation in terms of its hygienic importance...