THE PREPUCE AS AN OUTLAW, AND ITS EFFECTS ON THE GLANS.
Ricord has well termed this appendage to civilized man "a useless bit of
flesh." Times were, however, when--man living in a wild state, and when
in imitation of some of our near relatives with tails and hairy bodies;
when he still found locomotion on all-fours handier than on his two
feet; when in pursuit of either the juicy grasshopper or other small
game, or of the female of his own species to gratify his lust, or in the
frantic rush to escape the clutches, fangs, or claws of a pursuing
enemy, he was obliged to fly and leap over thorny briars and
bramble-bushes or hornets' nests, or plunge through swamps alive with
blood-sucking insects and leeches--Ricord's definition would certainly
have been inapplicable. In those days, but for the protecting double
fold of the preputial envelope that protected it from the thorns and
cutting grasses, the coarse bark of trees, or the stings and bites of
insects, the glans penis of primitive man would have often looked like
the head of the proverbially duel-disfigured German university student,
or the Bacchus-worshiping nose of a jolly British Boniface. So that in
those days, unless primitive man was intended to have an organ that
resembled a battle-scarred Roman legionary, a prepuce was an absolute
necessity.
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 aegis 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but, now that its natural office had been replaced by the perineal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 hyperaesthetic; 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. Fodere 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 Fodere 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.