Robert Darby, aged five, about to set off on the long journey that would demonstrate the truth of Ecclesiastes 1.18: "For in much wisdom is much grief; and he that increaseth knowledge increaseth sorrow." With feminine intuition, his sister looks doubtful.

Robert Darby BA, B Litt, PhD

I am an independent historian and freelance writer with degrees from La Trobe University (BA 1975), the Australian National University (B Litt 1985) and the University of New South Wales (PhD 1989). I live in Canberra, Australia, and do most of my research at the National Library and the Australian National University - where I was a Visiting Fellow in the School of Social Sciences in 2004. I am also a frequent visitor to the wonderful History of Medicine Library maintained by the Royal Australasian College of Physicians in Sydney.

I first became interested in male circumcision in the late 1990s as part of a wider interest in the history of male sexuality, and of the various ways in which it has been viewed and managed by different societies. I began to study circumcision because it seemed a useful guide to how a society perceived and valued masculinity and how it judged or categorised sexual behaviour; it provided a particularly sharp focus on the point where culture and biology, society and nature, steel and flesh, came together so fatefully. As I read more deeply into the literature on this topic I quickly realised that there was a serious imbalance in sex and gender studies - all too often seen as the history of women, and all too often focused on the mind rather than the body. I have thus been particularly concerned to redress what I saw as the imbalance in sex and gender studies - too often seen as the history of women - by bringing men into the picture; and to correct the tendency in studies of masculinity to concentrate on the mind and downplay the importance of the body.

Many studies of masculinity, and even of the penis - particularly those written by Americans - seemed completely unaware of the fact that most penises all over the world and throughout history have included the foreskin with which it came into the world. Ignoring the fact that the biologically - and on a world scale, numerically - normal penis was not circumcised seemed a dangerous example of cultural blindness that ought to be countered. It soon became apparent from my study of circumcision in Britain that many of the early beneficiaries/victims of the operation were not happy with the result; I therefore wanted to tell something of their story and to arouse some sympathy for the indignities and cruelties inflicted on men and boys in the name of controlling disease and curbing sexual desire, especially in the nineteenth century, when masturbation was seen as such a crime that forcible surgery seemed an acceptable response. The historical literature on the masturbation scare offered plenty of information, often written in a tone of justified indignation, about surgery on women, such as clitoridectomy; but such texts were usually silent about the fact that similar surgery on men's genitals had been introduced first and was always far more common.

When I began my research I was of course aware that routine male circumcision was still common in the USA, and that Australia had a past history of the practice, but I thought that it was pretty much a thing of the past. Since Australian paediatric bodies had been discouraging the procedure since the early 1970s, and I had observed that the boys of all my same-age relations and friends were growing up (very happily) with normal and unaltered penises, I assumed that the fad was dead as a doornail. Nobody with any medical knowledge or scientific understanding would ever try to revive the old Victorian stories about the "health benefits" of pre-emptive amputation - or so I thought.

Imagine my astonishment when I found that a few vocal evangelists from the fringes of the medical world were trying to do just this, and, what was more, that they were getting a lot of coverage in the popular media. It seems that whenever a new and incurable disease involving the genitals appears, some people always jump to the conclusion that the solution is to cut part of them off. The reason for this is to be found in the fact circumcision emerged as a valid medical treatment at a time when the causes of most diseases were poorly understood, children were not regarded as having any independent human rights, no meaningful standards of medical evidence had been established, and medical ethics were rudimentary or non-existent. History is thus needed to explain the persistence of the practice into an age which should know better.

Although this site does not intend to take issue with contemporary claims for the "advantages of circumcision", I hope that the historical perspective it provides will encourage people to take a sceptical view of reports that it should be enforced on children as a preventive of AIDS, cervical cancer, urinary tract infections etc, and show them to be not so far removed from nineteenth century assertions that circumcision should be enforced to prevent or cure masturbation, syphilis, epilepsy, bed-wetting, hip-joint disease, hernia, pimples and other disorders too numerous to mention. And also to wonder whether it was ethically acceptable to inflict such a mutilation on helpless children even if such therapeutic claims were true.

My publications

"A source of serious mischief: The demonisation of the foreskin and the rise of preventive circumcision in Australia", in George Denniston, Frederick Hodges and Marilyn Milos (eds) Understanding circumcision: A multi-disciplinary approach to a multi-dimensional problem, London and New York, Kluwer Academic Publishers and Plenum Press, 2001

Full text available on this site

"Been there, done that: Thoughts on the proposition that yet more circumcision can save the world from AIDS", Australian Quarterly, Vol. 74. No. 5, Sept-Oct 2002

"Medical history and medical practice: Persistent myths about the foreskin", Medical Journal of Australia, Vol. 178, 17 February 2003

"Treating phimosis", Medical Journal of Australia, Vol. 178, 2 June 2003

"Circumcision as a preventive of masturbation: A review of the historiography", Journal of Social History, Vol. 36, Spring 2003.

Full text available from findarticles.com
 

"‘An oblique and slovenly initiation': The circumcision episode in Tristram Shandy", Eighteenth Century Life, Vol. 27, Spring 2003.

"Where doctors differ: The debate on circumcision as a preventive of syphilis, 1855-1914", Social History of Medicine, Vol. 16, Spring 2003

Full text: Download PDF here.

"Captivity and captivation: Gullivers in Brobdingnag", Eighteenth Century Life, Vol. 27, Fall 2003. Full text available on this site.

"A post-modernist theory of wanking", review article of Thomas Laqueur, Solitary sex: A cultural history of masturbation, in Journal of Social History, Vol. 38, September 2004.

Full text available from findarticles.com
 

"William Acton's antipodean disciples: A colonial perspective on his theories of male sexual (dys)function", Journal of the History of Sexuality, Vol 13, April 2004

"Male circumcision and risk of HIV-1 infection", The Lancet, Vol. 363, June 12, 2004, p. 1997

"Pathologising male sexuality: Lallemand, spermatorrhoea and the rise of circumcision", Journal of the History of Medicine and Allied Sciences, Vol. 60, July 2005, pp. 283-319

"The sorcerer's apprentice: Why can't we stop circumcising boys", Contexts magazine (USA), Vol. 4, No. 2, Spring 2005. Expanded version available on this site.

"The riddle of the sands: Circumcision, history and myth", New Zealand Medical Journal, Vol. 118, 15 July 2005

Abstract

Although many nineteenth century misconceptions about the foreskin have been dispelled since Douglas Gairdner showed that infantile phimosis was not a congenital defect, other old ideas have proved more persistent. Among the most ubiquitous are the proposition that ritual or religious circumcision arose as a hygiene or sanitary measure; and the related idea that allied troops serving in the Middle East during the Second World War were subject to such severe epidemics of balanitis that mass circumcision was necessary. Both these claims are medical urban myths which should be firmly laid to rest.

New book

A surgical temptation: The demonization of the foreskin and the rise of circumcision in Britain (Chicago and London: University of Chicago Press, 2005)

What the critics say:

"an extremely worthwhile topic that adds considerably to our knowledge of sexual attitudes and medical practices". -- Dr Lesley Hall, Wellcome Library for the History and Understanding of Medicine

"exceptional detail and sound judgment. ... A very interesting study." -- Professor Peter Stearns, George Mason University.

"Left to its own devices, the male foreskin goes on its merry way, but Victorian England would have none of that. The uncircumcised penis was blamed for the "moral and physical decay of syphilis and masturbation", while doctors characterised the emission of sperm as "a life-threatening illness that demanded drastic treatment if there was to be any hope of a cure". Medical historian Robert Darby, a visiting fellow at ANU, brilliantly records the rise of circumcision as "a miracle working cure-all for many ills", including hysteria."

-- Tony Maniaty, Weekend Australian, 10 September 2005, p. R14

"... this book should be required reading for American physicians in particular, especially those who continue to perform an operation seldom practiced in the rest of the world and who might not know why it was originally begun."

-- Journal of the American Medical Asociation, 7 December 2005

"AIDS and society in Tanzania", review article of Philip Setel, A plague of paradoxes: AIDS, culture and demography in northern Tanzania, in Archives of Sexual Behaviour, December 2005. Full text available on this site.

"Surgical temptation: A chance to cut is a chance to cure?", American Sexuality Magazine, November 2005

Review articles

"Fortifying medical ethics with human rights and conscience", Review of Thomas Alured Faunce, Pilgrims in Medicine: An Allegory of Medical Humanities, Foundational Virtues, Ethical Principles, Law and Human Rights in Medical Personal and Professional Development. Leiden: Martinus Nijhoff, 2005.

H-Net Reviews, June 2006.

In his stress on the importance of incorporating "international human rights" into medical ethics, Faunce takes the familiar list of grounds on which people should not be subject to unequal treatment (sex, race, color, religion, disability, perhaps age and sexual preference) very seriously, but these are social rights, exercised as members of a community, not rights relating to a person as a biological or corporeal entity. Does or should the body itself have rights? The constant emphasis on the right to autonomy and physical integrity suggests that it does, but the book does not delve deeply enough into the problem of possible collisions among the various rights. Faunce is aware that the right to physical integrity may conflict with other principles (such as the right of parents to follow practices authorized by their culture or religion), but the awareness is expressed in disappointingly partial (not to say discriminatory) terms. There are several references to female genital mutilation as a harmful cultural practice, and thus one that ethical doctors should not perform, but what about boys? Do they not also have rights to physical integrity and to construct their personal life narrative that might protect them from genital mutilation? Or which might at least discourage doctors from performing such procedures? The author's apparent blind spot here is surprising given the flood of literature on the question of "routine" (that is, medically unnecessary) circumcision of minors over the past decade, and all the more remarkable considering that he cites one of the texts that contains a seminal essay on this very issue--Margaret Somerville's "Altering Baby Boys' Bodies: The Ethics of Infant Male Circumcision," in her collection The Ethical Canary (2003)

It is all very well to appeal to the authority of international instruments requiring observation of named rights, the promotion of non-discriminatory policies in medical care and the supply of health services, but what does a doctor do when confronted by Somali or Sudanese parents who bring their little girl and boy along, and request that their genitals be altered in accordance with the traditions of their original home culture? Or Australian or American parents wanting their baby boy done because they had seen a newspaper article or TV program in which it was suggested that, if he was not circumcised, he would be sure to get phimosis and urinary tract infections as an infant, STDs and probably AIDS as an adult, and (in the unlikely event that he lived that long) would die an agonizing death from cancer of the penis in middle age? (The medical excuses for circumcision of minors make many of the cultural reasons seem rational by comparison.)

Full text available at H-Net Reviews

"American Psycho: Another Surgical Temptation", Review of Andrew Scull. Madhouse: A Tragic Tale of Megalomania and Modern Medicine.  New Haven: Yale University Press, 2005. xiii + 360 pp. Illustrations, notes, bibliography, index. $30.00 (cloth), ISBN 978-0-300-10729-6.

H-Net Reviews, July 2006

In a long and distinguished career, few historians of medicine have done more to expose the fads and fallacies ruling the treatment of mental disorder than Andrew Scull, especially when they have involved therapies, such as confinement or surgery, that we would now regard as barbaric. Like a medieval priest or tribal sorcerer casting out demons, an astounding number of modern physicians, all boasting of their scientific credentials, seem to have worked on the assumption that the human body is its own worst enemy, and thus to have concluded that the road to health lay through the extraction or amputation of whatever body part could be held responsible for the dysfunction. In Madhouse, Scull excels with a detailed account of the appalling career of Dr. Henry Cotton, superintendent of the Trenton, New Jersey hospital for the insane from 1907 until his death in 1933. The story is, as he comments, a Gothic nightmare in which masked and white-gowned jailers drag terrified and often screaming patients from their cells to a well-appointed operating theater where various bits of their anatomy are surgically removed. The only features which distinguish Trenton from a torture chamber or a horror movie, such as Flesh for Frankenstein (1973), is that it all really happened, anaesthetics were usually administered, and the operations were performed solely for the benefit of the patients. And if these procedures were carried out with a benevolent and therapeutic intent, there was as little need for informed consent as there could be reason to regard the result as mutilation.

Not that there was much evidence of benefit. Walking the wards of Trenton in 1928, a newly appointed Swiss staff member "felt sad, seeing hundreds of people without teeth.... While in hospital they suffer from indigestion ... not being able to masticate their food. At home, recovered, these poor people have the same troubles, not being in a position to choose food which they would be able to eat without teeth. In addition, they are ashamed of being without teeth, since in their communities it is known to be a token of a previous sojourn at the State Hospital. They abstain from mixing with other people, refuse to go out and look for a job.... Thus, many of those recovered develop a reactive depression" (p. 255). To describe how this tragic situation came about, and explain why all attempts to curb Cotton's exuberance failed, are the twin objectives of Scull's study. An impressive feat of archival research stretching over two decades, including interviews with surviving players in the drama, Madhouse is at once a gripping narrative, a muckraking expose of medical fraud and professional vanity, and a sobering cautionary tale for our own times.

Full text at H-Net Reviews


Male and female circumcision compared:

"A Rose by any other Name: Rethinking the Similarities and Differences between Male and Female Genital Cutting" (with J. Steven Svoboda)

Medical Anthropology Quarterly, Vol. 21, September 2007, pp. 301-323.

ABSTRACT

This paper offers a critical examination of the tendency to segregate discussion of surgical alterations to the male and female genitals into separate compartments - the first known as circumcision, the second as genital mutilation. It is argued that this fundamental problem of definition underlies the considerable controversy surrounding these procedures when carried out on minors, and that it hinders objective discussion of the alleged benefits, harms and risks. The variable effects of male and female genital surgeries are explored, and a scale of damage for male circumcision to complement the World Health Organization´s categorisation of female genital mutilation is proposed. The origins of the double standard identified are placed in historical perspective, and a brief conclusion makes a plea for greater gender neutrality in the approach to this contentious issue.

MAQ Homepage

Full text: Download PDF here..

NEW BOOK

Round the Red Lamp and Other Medical Writings by Arthur Conan Doyle

Valancourt Books, 2007

When Round the Red Lamp appeared in 1895, reviewers were appalled. Expecting tales in the style of Conan Doyle's popular Sherlock Holmes stories, readers were shocked to find instead harrowing medical stories involving childbirth, venereal disease and botched amputations.

Before he became famous as a prolific writer, Arthur Conan Doyle (1859-1930) had trained as a medical doctor, practised as a GP in Portsmouth, tried his luck as an eye specialist in London and written a number of non-fiction articles and other contributions on medical subjects. For this edition, Robert Darby has collected not only the original stories compiled for Round the Red Lamp and three other stories with a medical theme, but also the full range of Conan Doyle's medical non-ficton. As he argues in a comprehensive introduction, these writings provide a rare glimpse into the world of a provincial GP at the moment when old style medicine was dying and the modern medical profession was emerging.

The stories are further illuminated by detailed explanatory notes and references.

Order from Amazon, via link in left margin

More on Isaac Baker Brown and Victorian genital surgeries:

"The benefits of psychological surgery: John Scoffern's satire on Isaac Baker Brown", Medical History, Vol. 51, October 2007

Full text and pdf avalable from PubMed

Two papers in new book on male and female genital cutting

"A rose by any other name: Symmetry and asymmetry in male and female genital cutting"
(with J. Steven Svoboda)

ABSTRACT

The human body, and the genitals specifically, are characterized by bilateral symmetry; both male and female sets develop from the same embryonic tissue, and the male genitals are anatomically homologous with the female: glans penis, foreskin, scrotum and testicles correspond to clitoris, clitoral hood, labia and ovaries. This biological symmetry is not, however, reflected in Western cultural discourses on the genitals, which tend to be extremely asymmetrical, regarding and evaluating the male genitals (and especially the part of the penis known as the foreskin) very differently from the female genitals. The asymmetry is most strikingly expressed in the contrasting discourses on surgical alterations to these organs that have evolved since the mid-nineteenth century.

In this article we make a critical examination of the tendency to segregate discussion of such genital modifications into separate compartments—the first known as male circumcision, the second as female genital mutilation. It is argued that this fundamental problem of definition underlies the considerable controversy surrounding these procedures, especially when carried out on minors, and that it hinders objective discussion of the alleged benefits, harms, and risks. The variable effects of male genital cutting (MGC) and female genital cutting (FGC) are explored, and a scale of damage for MGC to complement the World Health Organization's categorization of FGC is proposed. The origins of the double standard identified are placed in historical perspective, and there is a discussion of the respective roles of science and culture in promoting or discouraging these practices. We conclude by urging greater gender neutrality in the approach to this contentious issue.

"Objections of a sentimental character: The subjective dimension of foreskin loss"
(with Lawrence Cox)

ABSTRACT

Proponents of routine circumcision of male minors tend to downplay or ignore the adverse effects of circumcision on male sexual experience and to assert that only an insignificant minority of circumcised men are unhappy about their condition. We present evidence dating back to the nineteenth century that significant numbers of men have been sufficiently concerned to complain, and we particularly consider three attitude surveys carried out in Britain, the United States and Australia in the 1990s. We argue for the relevance of ethical, biological and subjective factors in decision-making about routine circumcision of minors, and conclude with a discussion of the implications of these considerations for medical policy.

both published in Chantal Zabus (ed.), Fearful Symmetries: Essays and Testimonies around Excision and Circumcision (Amsterdam and New York: Rodopi, 2009)