Along with Columbus’ ‘discovery’ of North America he noted that many of the natives there were circumcised [192]. In fact, as mentioned earlier, circumcision is seen in diverse people all over the world, ranging from African, Middle Eastern, groupings within Asians, Australian aboriginals, Pacific Islanders and native Americans, both North and South. Whether this indicates a very ancient origin that was part of human practice as our species colonized the globe, or whether it arose independently in different regions of the world will probably never be known.
There is evidence to suggest that hygiene may be one reason, as appears to be the case for elite classes in ancient Egypt and the Aztec peoples [462]. Its practise by indigenous populations in the hot, dry, sandy environments of the deserts of Egypt, Saudi Arabia, Mexico, the Kalahari and central Australia may have been a practical solution to the fact that sand would readily get under the foreskin and set up balanitis, which could lead to urethritis, cystitis, nephritis and death [529].
Ritualistic circumcision has been practiced in West Africa for more than 5000 years and in the Middle East for over 4000 years [380, 601]. It is virtually universal in the Jewish and Muslim religions, having started with Abraham (Genesis 17: 11) who lived around 2000 BC. A 15th century Ottoman textbook describes the procedure in detail [295]. In the non-Muslim African countries of Cameroon and the Congo most men are circumcised. Similarly, in Kenya (mostly non-Muslim) all tribes except the Luo practice male circumcision.
In the late 19th century circumcision became routine in the United States of America and elsewhere as a result of pronouncements in publications by various physicians, most notably Peter Remondino [12, 206, 462]. He recognized the various health benefits at the time, although he overemphasized the clinical significance of the foreskin in masturbation, a practice thought at the time to have adverse consequences [514]. Most other authorities at the time did not agree with him on this point, as is discussed in the next paragraph. The procedure rapidly gained popularity and became routine.
Some of the purported benefits have stood the test of time, namely that circumcision prevents penile cancer, syphilis, balanoposthitis and phimosis. Although it is often claimed (by anti-circ activists) that circumcision was popular in the Victorian era as a cure for masturbation, the truth is quite different. This hypothesis appeared in an 1891 commentary [260] by an author who, decades earlier, was the first to observe that circumcision protects against syphilis [259]. But the idea that circumcision prevented masturbation had no common currency in Victorian times. For example, the purported ‘evil’ of masturbation occupies much of the 1913 book ‘Youth and Sex’, yet circumcision is not mentioned [492]. A well-known book on circumcision by Felix Bryke completely rubbishes the idea [84] and Whitla’s ‘Dictionary of Treatment’ does not list ‘circumcision’, whereas, under ‘masturbation', only suggests performing circumcision if irritation from a tight prepuce is responsible [619].
By the mid-1930s about half of male newborns in the USA were circumcised, and increased to about 90% in the 1950s and 1960s (after World War II when the Armed Forces demonstrated the health advantages [134, 431, 432, 548, 591]). In the early 1970s promotion of infant bonding became popular, and ways of reducing discomfort in newborns were advocated, leading some middle-class families on the East and West coast of the USA to not get their boys circumcised. The folly of this became evident as research unfolded over the years, as will be discussed in this internet review, and the rate of circumcision then rose between 1988 and 2000 [392, 506].
In the United Kingdom, a trend not to circumcise started in 1948 when Britain adopted a nationalized healthcare system and removed procedures in which it considered cost exceeded benefit. Circumcision also dropped rapidly across Europe after a (misguided) paper by Gairdner in 1949 [192].
It was not until the early 1970s that a similar fall happened in Australia and Canada, in response to statements by the pediatric bodies in each country [36, 125].
