In the "Biblical, Theological, and Ecclesiastical Cyclopaedia" of Drs. McClintock and Strong the following description of the rite, as taking place in our modern synagogues, is given:—

"The ceremony of circumcision, as practiced by the Jews in our own times, is thus: If the eighth day happens to be on the Sabbath, the ceremony must be performed on that day, notwithstanding its sanctity. When a male child is born the godfather is chosen from amongst his relatives or near friends; and if the party is not in circumstances to bear the expenses, which are considerable (for after the ceremony is performed a breakfast is provided, even amongst the poor, in a luxurious manner), it is usual for the poor to get one amongst the richer, who accepts the office, and becomes a godfather. There are also societies formed amongst them for the purpose of defraying the expenses, and every Jew receives the benefit if his child is born in wedlock.

"The ceremony is performed in the following manner, in general: The circumciser being provided with a very sharp instrument called the circumcising-knife, plasters, cummin-seeds to dress the wound, proper bandages, etc., the child is brought to the door of the synagogue by the godmother, when the godfather receives it from her and carries it into the synagogue, where a large chair with two seats is placed; the one is for the godfather to sit upon, the other is called the seat of Elijah the Prophet, who is called the angel or messenger of the covenant. As soon as the godfather enters with the child, the congregation say, 'Blessed is he that cometh to be circumcised, and enter into the covenant on the eighth day.' The godfather being seated, and the child placed on a cushion in his lap, the circumciser performs the operation, and, holding the child in his arms, takes a glass of wine into his right hand, and says as follows: 'Blessed be Thou, O Lord our God, King of the Universe, Creator of the fruit of the vine! Blessed art Thou, O Lord our God! who hath sanctified His beloved from the womb, and ordained an ordinance for His kindred, and sealed His descendants with the mark of His holy covenant; therefore, for the merits of this, O living God! our rock and inheritance, command the deliverance of the beloved of our kindred from the pit, for the sake of the covenant which He hath put in our flesh. Blessed art Thou, O Lord, the Maker of the Covenant! our God, and the God of our fathers! Preserve this child to his father and mother, and his name shall be called in Israel, A, the son of B. Let the father rejoice in those that go forth from his loins, and let his mother be glad in the fruit of her womb, as it is written: "Thy father and mother shall rejoice, and they that begat thee shall be glad."' The father of the child then says the following grace: 'Blessed art Thou, O Lord our God, King of the Universe! who hath sanctified us with His commandments, and commanded us to enter into the covenant of our holy father, Abraham.' The congregation answer: 'As he hath entered into the law, the canopy, and the good and virtuous deeds.'"[59]



CHAPTER XIII.

MEZIZAH, THE FOURTH OR OBJECTIONABLE ACT OF SUCTION.

Biblical and rabbinical traditions throw no light on the origin of the details of the operation as now performed. That it was anciently performed with a knife of stone is certain; an event common in its general observance, and which seems to have pervaded all nations or races, howsoever remote or scattered, that it has induced Tylor[60] to ascribe the origin of the rite to the stone age. We are told that when Moses was returning to the land of Egypt he had neglected circumcising his son, and that because of that neglect he nearly lost his son's life; his wife, Zipporah, the daughter of the Midian king and priest, Jethro, seeing the danger and knowing its cause, took her little son Gershom and circumcised him with a stone knife, and offered the foreskin to God as a peace-offering. Just where the wine was first used we are not told. Wine, however, was an emblem of thanksgiving, and, being one of the fruits of the earth, was considered an acceptable offering to God. It has since, in some form or other, either as wine or as the representative of either divine or human blood, been used in both the Catholic and Protestant Churches in their ceremonials or vicarious sacrifices, or imitations of old customs. Circumcision was by many connected with a blood sacrifice; it was so suggested by the words of Zipporah at the circumcision of Gershom: "And Zipporah, his Midianitish wife, took up a sharp stone and cut off the foreskin of her son, and cast it at his feet and said, 'Surely a Khathan of blood art thou to me.'" Much speculation has followed the use of this word Khathan, which, in the ordinary Arabian, may mean either husband or son-in-law; it also means a newly-admitted member of a family; a similar word means "to provide a wedding feast," and one other word from the same root and branch means "to give or receive a daughter in marriage." In our own day, the mohel, or ministerial circumciser, makes it a practice to draw a little blood from the skin of such as are presented for the rite, but whom nature has not furnished with sufficient foreskin for the operation. The application, thrice repeated, of the blood and wine to the lips of the child, is probably used as a sign of the sealing of the compact. Wine is mentioned in connection with the High-Priest Melchisedeck as the wine of thanksgiving at his meeting with Abraham; wine was presented to Aaron by the angel, who, giving him a crystal glassful of good wine, said to him: "Aaron, drink of this wine which the Lord sends you as a pledge of good news." Originally, circumcision must have consisted of the simple removal of the foreskin, and the elaboration of the ceremonial details must have been a subsequent occurrence; persons wounding their fingers will instinctively carry them to their mouth, and it may be that the suction practiced by the Hebrews had its origin in this natural haemostatic suggestion. Wine as a haemostatic and as an emblem of thanksgiving and an acceptable offering naturally came in as an accessory.

This practice—which, in the old, patriarchal days of the simple shepherds, when men only lived on the flesh of their own flocks, their diet, however, consisting mostly of cakes of flour, milk, honey, a few herbs, or the flesh of the goat or sheep—could not have been as objectionable as it is at the present day, with blood and secretions in a continued ferment through diet and habits. Man, living in the open air of Armenia, Palestine, or Arabia, sleeping in the open tents of our Biblical forefathers, living on the simple diet of a shepherd's camp, with the abstemiousness that those climates naturally induce in man, could not help but be healthy. In those early days, when neither passion, anxiety, nor worry disturbed either digestion or sleep, man had no vitiated secretions, wine was then a rarity, and water was the drink. One of the early patriarchs on such diet would have furnished a dainty and savory dish to the most fastidious cannibal, who is now tormented by the komerborg kawan, this being a term used by the Australian cannibals to designate the peculiar nausea that is induced in them when they recklessly eat of white man,[61]—something which they do not experience from feasting on the savages who live on the simple diet of a pastoral tribe. This primitive gastronomic science in regard to cannibalism even reached such a pitch of refinement that, as has been previously mentioned, some tribes even resorted to emasculation to improve the flavor of the animal juices, which by this procedure became less acrid. The Arabian and Oriental traditions bring us down tales of how, on the same principles, human beings intended to grace the festive platter were fed exclusively on rice. The salivary and buccal secretions, under such a simple diet as that indulged in by our Biblical forefathers, become bland and harmless; not only harmless, but even antiseptic and positively beneficial, acting on the same principle as local applications of pepsin. So that the practice, at the time of the patriarchs and in their own family, of this part of the rite could not have offered the same objection that it does at the present day. The modern house-dweller, living on a mixed diet and in a climate that induces him to eat grossly, both as to quality and quantity, partaking more or less of vinous, spirituous, or fermented liquors, as well as indulging in tobacco, is quite another being from the Arabian or Armenian shepherd of former days. Business anxieties and worry also have a very pronounced effect; so that, with the change in the conditions of man and the inception and multiplication of diseased conditions, as well as the creation of constitutional and transmissible diseases, this practice of suction should have been stopped.

Intelligent rabbis, devoted to their religion, are necessarily prone to defend any of the details in its ceremonials that age and practice have sanctioned, and even some of the later writings of Israelism seem to make the mezizah, or suction, a necessary and ceremonial detail. In the "Guimara," composed in the fifth century, Rabbi Rav Pope uses these words: "All operators who fail to use suction, and thereby cause the infant to run any risk, should be destituted of the right to perform the ceremony." In the "Mishna" it says, "It is permitted on the Sabbath to do all that is necessary to perform circumcision, excision, denudation, and suction." The "Mishna" was composed during the second century. The celebrated Maimonides lent it his sanction, as in his work on circumcision he advises suction, to avoid any subsequent danger. Our modern Israelites are supposed, as a rule, to have taken their authority, aside from previous usage and custom, from the "Beth Yosef," which was written by Joseph Karo, and subsequently annotated by the Rabbi Israel Isserth. In all of these sanctions, however, there is no reason expressed why it should be performed.[62] Maimonides undoubtedly looked upon this act as having a decided tendency or action in depleting the immediate vessels in the vicinity of the cut surface, and that the consequent constriction in their calibre would prevent any future haemorrhage. That this is the natural result of suction is a fact readily understood by any modern physician. The depletion of the vessel for some distance in its length, with the contraction in the coat that follows, is certainly a better preventive to consequent haemorrhage than the simple application of any styptic preparation that can only be placed at the mouth of the vessel, but which leaves its calibre intact. Hot water, or an extreme degree of cold, will answer to produce this contraction and depletion, but there is here a local physical reaction that is more liable to occur than when the contraction has taken place naturally, as when induced by depletion, instead of by the stimulus of either heat or cold. So that if, in the light of modern civilization and changed conditions of mankind, and the existence of diseases which formerly did not exist, we are now convinced that suction is dangerous, we should not judge the ancients too hastily or rashly for having adopted the custom, as it is certainly not without some scientific merit; although, authorities are not wanting who hold that suction or depletion increases the danger of haemorrhage.

It can be understood that the results of suction would be in some measure analogous to those left by the application of an Esmarch bandage on a limb. The ancients, performing the operation with rude implements and having no haemostatic remedies or appliances, naturally followed the best means at their command; they evidently feared haemorrhage, and their rule in regard to exemption shows us that they recognized the existence of haemorrhagic diathesis or other transmissible peculiarities of constitution. This same fear of haemorrhage probably suggested the second step of the operation being performed, as it is by laceration instead of by cutting instruments, showing in this an evident desire to limit the cutting part of the operation to as small a limit as possible. Against an infant who has decided haemorrhagic tendency, we are about as helpless as were the ancient Hebrews, and, while the Turkish or some of the Arabian methods of performing the operation may be said in ordinary cases—by the application of cord and the consequent constriction—to limit the danger from subsequent haemorrhage, still, in the haemorrhagic diathesis this would not be of any avail; so, as already observed, we must not too rashly judge those old shepherds of the Armenian plains for adopting a practice which to them was calculated to avert subsequent dangers, or their descendants following in their footsteps, until having learned better, even if that practice is to us disgusting, primitive, and useless.

Cases occur,—happily not frequently,—of alarming and uncontrollable haemorrhage. The following case is suggestive of the alarming extent and persistence that may attend one of those haemorrhagic cases, even when recovery eventually takes place. It is reported by Dr. Sannanel in the Gazetta Toscana delle science medicale e fisiche of 1844. The case was that of a Jewish infant circumcised on the eighth day. Some hours after the operation the child was observed to be bleeding; the haemmorrhage would only cease for a few moments, and then come on with increased force, and which proved rebellious to ordinary remedies. Dr. Sannanel was called during the night of the third day after the operation. A number of physicians had been in attendance, and neither ice, astringents, pressure, nor any usual haemostatic means had had the least effect; cautery with nitrate of silver, sulphuric acid, and the actual cautery by means of heated iron were tried in succession, without any good results. Ten days passed in this manner, the haemmorrhage only ceasing for a few moments at a time, and the child was nearly exsanguinated from the continued serous seepage and the paroxysmal haemorrhages, when a lucky application of caustic potassa almost immediately stopped the haemorrhage. This case was seen by nearly all the leading medical men of Leghorn, who lent their aid and counsel to save the little life. The case is interesting from the length of time it persisted, and that even after all the loss of blood and suffering that the little fellow endured he survived.[63]

Dr. Epstein, of Cincinnati, in a letter of March 29, 1872, to the Israelite of that city, mentions a nearly fatal case from haemorrage after the rite of "Milah," and gives the result of his experience in such cases. He argues that Hitouch or Hitooch alone, or the first step or cutting off of the prepuce, performed with ordinary care, could hardly be followed up with any more serious results than can be controlled with the application of a little acidulated water. The second act, or Periah, the act of laceration, he looks upon as one that calls for coolness, judgment, and skill, as the membrane should only be torn so far and no farther, the thin, inner fold of the prepuce being vascular only in the sulcus back of the corona and at its lower attachment, where it forms the frenum, or bridle; any carelessness or over-anxiety on the part of the operator in tearing this membrane too far back results in danger of haemorrhage; especially is this part of the operation liable to be badly done if the inner preputial fold is thick and resisting, as in that case undue force may carry the laceration back into the vascular tissue. The means suggested by Dr. Epstein to arrest haemorrhage are those ordinarily used in haemorrhagic cases, such as will be given presently. The doctor regrets that the operators are not as they should be, physicians, and that, when mohels are employed, persons are not sufficiently exacting as to their qualifications.[64]

In France the government has managed to secure more safety in the operation. By a royal decree of date of May 25, 1845, in compliance with a desire expressed by the Hebrew Consistory, it was ordered that no one should exercise the functions of a mohel or of schohet, without being duly authorized to perform said functions by the Consistory of the Circonscription; and that all mohels and schohets shall be governed in the exercise of their functions by the Departmental Consistory and the General Consistory. By virtue of this decree a regulation was passed by the Consistories on the 12th of July, 1854, ordering that thereafter circumcision should only be performed in a rational manner, and by a properly qualified person. Suction was likewise abolished, and the wound directed to be sponged with wine and water. This decree and the resulting regulations have been of the greatest benefit to the French Israelites, and some attention to the matter would not be amiss in the United States.

This reformation has met with the approval of the leading French Jews, whose General Consistory decided that suction was not necessarily a part of the religious rite, and that, as it was undoubtedly introduced into the rite on the days of primitive surgery, it was perfectly rational to suppress this operative accessory, now that that same science, in its enlightenment, pronounced it unsafe. The whole body of the Congregation did not tamely submit to what they considered an innovation, and from some of the mohels all possible resistance was opposed to prevent the abolishment of this part of the operation from becoming a law. So determined was this opposition in some instances that the Consistory of Paris found it necessary to impose on all the mohels an obligation, bound by an oath, that they would respect the law. Those who refused to take the obligation gave up their vocation.

The Grand Rabbi of Paris, at the time of this reformation, M. Ennery, was one of the most zealous supporters of the new departure. The influence of the French pervaded northward, and the mezizah was abolished in Brunswick, Dr. Solomon, a learned Hebrew of that State, being instrumental in having it done legally. The discussion of this subject, in 1845, had one very happy effect,—the supporters of the reformed idea of the rite issued a circular letter to all the leading continental surgeons and medical men asking for their opinion on several points in relation thereto, especially, however, on this part of the rite. The opinions of many of these will be referred to in the medical part of this work.

The after-treatment of the circumcised infant is governed more or less by local habits and the individual intelligence of the mohel and his experience. After turning back the inner fold of the prepuce, the parts are covered with a small, square bandage, with an aperture to admit the passage of the glans. This, and the subsequent small bandage of old linen, which is calculated to hold it in place, are slightly coated with a powder composed of lycopodium, with the slight addition, at times, of Monsel's salts, alum-powder, or some vegetable astringent. Over these another compress is placed, to prevent the friction of the clothes of the infant or of the bedding. The infant then receives a final benediction, and the godmother then receives the child in her arms and carries it to its cot or crib. The operator generally visits the infant in the afternoon of the operation, and carefully inspects the dressings, to see that no haemorrhage has supervened.

It is customary to place the child in a bath, either the same evening or on the following morning, the object of this being to remove and to facilitate the removal of the dressings, which are more or less saturated and clotted with blood. After the removal of these, the wound is redressed, as previously, except that some cerate—ointment of roses or some other mild ointment—is used. Some prefer the simple water dressing from beginning to end. Since the introduction of creasote, acid phenique, and carbolic acid, many mohels are in the practice of washing the parts with water impregnated with one of these before performing the operation, and using subsequently the same form of lotion at every dressing. In case of haemorrhage there is an haemostatic water or lotion, which has been long used by the German and Polish mohels with considerable success, and which, in ordinary cases, has been found to be all that was required. This water, called by the French "Mixture d'arguesbusade," "Eau vulneraire spiriteuse de Theden," and by the Germans as "Spritzwasser" and "Schusswasser," is composed as follows:—

Acetic acid, 10 grammes. Rectified spirits of wine, 5 " Diluted sulphuric acid, 21/2 " Clarified honey, 8 "

This mixture is well mixed and filtered, and is then kept in a tightly-stoppered vial.

Dr. Bergson uses a mixture composed of diluted sulphuric acid, 1 part; alcohol, 3 parts; honey, 2 parts; and 6 parts of wine vinegar.

Haemostatic powders are also used by the Hebrews, being more conveniently kept or carried than the haemostatic waters. In Russia and in Poland they are composed of decomposed or decayed hawthorn-wood powder and lycopodium. That of Berlin is composed of Armenian bole, red clay, dragons' blood, powdered rose-leaves, powdered galls, and powdered subcarbonate of lead. In France a haemostatic fluid, composed of dragons' blood digested in turpentine, is in vogue. The Eau de Pagliari is also used; it is composed of a mixture of tincture of benzoin, 8 ounces; powdered alum, 1 pound; and 10 pounds of water, boiled together for six hours, and is considered a powerful styptic. In addition to these, burnt linen, spiders' webs, starch-powder, powdered alum, and plaster-of-Paris powder are used by different mohels. Touching the bleeding points with a pointed pencil of nitrate of silver is also a practice understood by the Jewish circumcisers.



CHAPTER XIV.

WHAT ARE THE BENEFITS OF CIRCUMCISION?

There are those, even among the Hebrews, who are so imbued with the purely theological idea of the origin, performance, and causes of circumcision, that they cannot see any moral nor hygienic value in the operation. Among many Christians the idea still prevails that circumcision is the relic of some barbarous rite, practiced in some epoch away in the remote ages of the world, grafted on to the Jewish religion by some accident or other; but that beyond the clinging of the Jews to this custom, as being a remnant of their old religion, they neither see in the rite any other significance, moral results, nor hygienic precaution; and the fact of a Jew being circumcised is too often made a subject of merriment among the unthinking portion of the Christian world. Neither are physicians all of one accord on the subject as to whether circumcision is a benefit, or, being useless, a dangerous and an unnecessary operation. The writer is most emphatically in favor of circumcision, and has the fullest faith in the positive moral and physical benefits that mankind gains from the operation.

It may well be asked: What does the Jew receive in return for all the suffering that he inflicts through circumcision on himself and his little children? What is there to repay him or his for all the risks and annoyances, besides branding himself and his with an indestructible mark, which has been more than once the sign by which they have suffered persecution, spoliation, expatriation, and death? Are there any benefits enjoyed by the Jew that the uncircumcised does not enjoy in equal proportion?

The relative longevity between the Hebrew race and the Christian nations that dwell together under like climatic and political conditions indicates a stronger tenacity on the part of the Jewish part of the nations to life, a greatly less liability to disease, and a stronger resistance to epidemic, endemic, and accidental diseases. By some authorities it has been held that the occupations followed by the Jew are such as do not compel him to risk his life, as he neither follows any labor requiring any great and continued exertion, nor any that subjects him to any great exposure; that, as a rule, when in business, by some intuition he follows some branch that has neither anxiety, care, nor great chance of loss connected with it; that he does not follow any occupation that is attended with any risk of accident for either life or limb. Besides all these, it is also urged that in cities the careful inspection of their meat, and the peculiar social fabric of the family, the love and veneration for their aged, as well as their proverbial charity to their own poor and sick, and their provident habits and hygienic regulations imposed upon them by the Mosaic law, are all conditions that conspire to induce longevity.

That the Hebrew is generally found in such conditions as above described is undisputed; but it is questionable if all these conditions are necessarily such as are favorable to health and long life, and that, therefore, the longevity of the Jewish race cannot altogether be ascribed to the above conditions. Looking at the subject of occupation, if we consult Lombard, Thackrah, and the later works on the effects of occupation on life, we must admit that the Jew has no visible advantage in that regard, as he follows hardly any out-of-door occupation, being often in-doors in a confined and foul atmosphere. To those who have closely observed the race in this country,—coming as they do from the cold-wintered climates of Germany, Austria, or Poland, bringing with them the habit of living in small, close rooms, for the sake of economy and comfort,—it must be admitted that among the lower classes and the poorer of the race, their shops being connected, as they usually are, with their living-rooms, the toute ensemble is anything but conducive to a long life. Their anaemic and undeveloped physical condition and weak muscular organization are sufficient evidence that their surroundings are not calculated to improve health. In England, statistics sufficiently prove that the fisherman on the coast, exposed to all kinds of weather, is not as prone to disease as is his brother Englishman who deals out the groceries in his snug shop. Exercise has been held an important element in the factory of the long-lived. From the time of Hippocrates down to Cheyne, Rush, Hufeland, Tissot, Charcot, Humphry, and all authorities on the factors of old age, exercise has been looked upon as favoring long life. Exercise cannot be said to enter in any way as a factor in the longevity of the Jew; but, on the contrary, his in-door life is known to be very productive of phthisis in other races. His recreations are, as a rule, of the home social order. They visit and spend the time allotted to recreation in social intercourse, which their hospitality always insists on accompanying with a generous lunch, which, to say the least, is not an element that is conducive to either health or long life; for no people excel the Jew in home hospitality, and even among the poorer classes a stranger is never allowed to depart without some refreshment being offered him. Among the class better able to extend hospitality, social reunions and card parties, with lunches of fruits, cakes, cold meats and coffee, or wines, are among their regular occurrences. Their great affection for the family and for their youth and aged suggests these means of recreation, as then they are enjoyed by all alike; but, as observed, the hygiene of all this is very doubtful; it produces too much irregularity.

It is related that after the Roman conquest of Palestine many of the Jews, becoming more or less accustomed to Roman manners and customs, often joined in the games which the Romans held in imitation of the old Olympic games of the Grecians. Not to be ridiculed, many resorted to the practices described in a previous chapter, to efface all the marks of their circumcision, that they might enter the games with as much freedom as the Romans or other uncircumcised nations; so that the present aversion to out-of-door sports evinced by the Jew is not necessarily a racial trait; the persecutions and political inequality that until lately he has been made to suffer have driven him into retirement and seclusion. Although seeking neither converts nor political power and influence, he has been hunted down, massacred, and chased about as a dangerous beast. As the children of the great Rabbi Moses Mendelssohn asked of their father: "Is it a disgrace to be a Jew? Why do people throw stones at us and call us names?" It may well be asked, why? These actions have forced them into the social and retired habits for which they are noted; although it cannot be said that it is from a lack of spirit, as one of the Rothschilds is well known to have been present at the battle of Waterloo, where from a spot in the vicinity of the British right-centre he observed the events of the battle; and when, with the failure of Ney's last desperate charge with the formidable battalions of the Old Guard, he saw the advance of the Prussians closing in on the French right, he galloped to the sea-shore, and, crossing the Channel in a frail boat, reached London twenty-four hours in advance of the news of the battle,[65] but long enough for him to clear several millions from off the panicky state of the money market. Marshal Massena, one of Napoleon's bravest generals, the defender of Genoa and the hero of Wagram, was of Jewish origin.

Athletic sports are not of necessity conducive to long life, even if they are to temporary robust health; but there is no mistaking the fact that the sedentary and in-door life of the average Jew is a deteriorator to health and life, and especially among that class of families who are poor and keep no servant; from heredity and home education having adopted unhygienic customs, in which they have grown up,—in these a total disregard for all ventilation forms a part. Were an uncircumcised race so to live, scrofula and phthisis would be the inevitable result. This difference of results I have witnessed more than once as existing among the two races coming from the same European nationality, where their disregard to ordinary rules of hygiene, induced by climatic causes, especially ventilation, were alike in both the Semitic and European descendants of the one nation, the purely European being more prone to consumption and scrofula. It is interesting to note the difference in the moral, mental, and physical conditions induced by creeds; it would seem as if it should not make any difference. The generally accepted idea of religion is that it should raise the moral standard of all those nations who practice religion; but the results are very peculiar, as we are forced to admit that reformation in religion has not always been a reformation in morals. Take Great Britain for example; if illegitimacy is any criterion of the moral state of those professing creeds, we find the least among the Jew; next among the Catholic; next comes the Episcopalian; then last the Presbyterian,—the oldest creed showing the greatest moral tendency, and that of poor Knox, which is the youngest, showing the least. This has certainly its physical effects, that are not without its influence in producing a greater or lesser length of life. The evolution of religion has here induced a lower moral tone and a resulting physical degeneracy.

As observed by alienists, religions of different creeds have different tendencies in inducing insanity, both as to ratio of population and as to manifestations;[66] the Protestant, when unbalanced by religious cause, is generally controlled with some idea that shows itself in wild and erratic attempts at scriptural interpretation, caused by want of fixed dogmas and the unending splittings that are forever taking place in the new faith, and the persistent, intrusive, and belligerent spirit of proselytism that controls each new branch as it buds into existence. The Catholic has a fixed dogma, which the church attends to, and he neither feels called upon to make his neighbors miserable or himself insane in hunting up new interpretations. When he does go insane on the subject of religion, the cause, as a rule, can be traced to some real or imagined moral delinquency, which has brought all the terrors of the punishment of the damned forcibly and persistently to his disordered imagination. In the insane-asylums of Cork, in Ireland, with its overwhelming Catholic population, the ratio of inmates in regard to creeds is as that of one Catholic to ten of the Reformed religion, showing in the most conclusive manner the influence exerted by religion in this direction. On the other hand, the Jew has the simplest of religious creeds; he neither wastes useful time, robs himself of sleep, nor becomes dyspeptic in hunting for hidden meanings in some ambiguous scriptural phrase; he is satisfied with his creed, his dogmas are firmly anchored, and the nature of his religion being a sort of family congregation, he is not called upon to go out in search of proselytes, any more than the father of an already large family feels called upon to go out and hunt up the homeless, that he may convert his home into a promiscuous orphan-asylum. As before remarked, his creed is of the simplest, and there exists a complete and explicit understanding between his God and himself. There are no mystical, hidden meanings in Scripture for the Jew; nor does he dread any eternal, unheard-of, and inexplicable torments. His laws are very clear, and the punishments for their infraction very explicit. To the Jew it is a straight and well-lighted road, as far as religion is concerned. The writer has always felt that it took a mind that was incapable of appreciating simple truths, but that loved to hover on that mystical border-land on the confines of gloomy insanity that would allow its owner to seriously wander through and behold any theological beauties in Bunyan. To the Jew there is none of the gloomy, weird, mystical, mind-racking, ungodly theology that some of our creeds torture the poor brains of their professors with. As the wild Indian of the plains runs sticks through his anatomy and capers wildly about to torture his body, so some of the creeds delight in torturing their devotees. The Jewish religion is the one best suited to tranquilize the mind; it is very philosophical and rational. Were he to acknowledge Christ, he would not have to change his course of life to become a most exemplary Christian. The celebrated letter of Moses Mendelssohn to the Swiss clergyman, Lavater, in answer to a dedication of the latter to Mendelssohn, is probably the best exposition of the essence of the Jewish faith that can be found. Therein he says: "We believe that all other nations of the earth have been commanded by God to adhere to the laws of nature. Those who regulate their conduct according to this religion of nature and of reason are called virtuous men of other nations, and are the children of eternal salvation." Such a religion does not unsettle man's mind.

These apparent digressions are made to show what additional factors exist, besides circumcision, to induce longevity in the Jewish race, and that the subject may be better understood; for these reasons the above comparisons have been made. Students of demographic science are well aware that form of government, religion, climate, diet, habit, and custom,—all have an important bearing on the mental and physical as well as on the moral nature of man. To the true student of his art all these conditions are but factors in the physical scale, and should so be considered without fear or favor; to him the whole world is but a unit, and the people upon its surface are but as one people, alike subject to the leveling laws of nature, which recognize neither royalty nor vagrant, nationality nor creed, color, condition, nor station in life or society.

Professor Bernoulli, of Bale, found the Israelite less prolific than the Christian;[67] subject to less mortality, greater longevity, less still-born, less illegitimacy, less crime against the person, and less insanity and suicide, when compared with his Christian brother—all of which he attributes not to a superior physique or organism, but solely to the observance of the laws of their religion and to the nature of the same, which exercises a beneficial influence on the mind.

B. W. Richardson, in his "Diseases of Modern Life," in speaking of the relation of race to disease, says: "Through the valuable labors of MM. Legoyt, Hoffmann, Neufville, and Mayer, we have obtained, however, some curious facts relative to the most widely disseminated of all races on the earth, the Jewish. These facts show that, from some cause or causes, this race presents an endurance against disease that does not belong to other portions of the civilized communities amongst which its members dwell. The distinctness of the Jews in the midst of other and mixed races singles them out specially for observation, and the history they present of vitality, or, in other words, of the resistance to those influences which tend to shorten the natural cycle of life, is singularly instructive.

"The resistance dates from the first to the last periods of life. Hoffmann finds that in Germany, from 1823 to 1840, the number of still-born among the Jews was as 1 in 39, while with other races it was 1 in 40. Mayer finds that in Furth children from one to five years of age die in the proportion of 10 per cent. among the Jewish, and 14 per cent. among the Christian population. M. Neufville, dealing with the same subject, from the statistics of Frankfurt, gives even a more favorable proportion of vitality to the Jewish child population. Continuing his estimates from the ages named into riper years, the value of life is still in favor of the Jews, the average duration of the life of the Jew being forty years and nine months and that of the Christian being thirty-six years and eleven months. In the total of all ages, the half of the Jews born reach the age of fifty-three years and one month, whilst half of the Christians born only reach the age of thirty-six years. A quarter of the Jewish population born is found living beyond seventy-one years, but a quarter of the Christian population is found living beyond fifty-nine years and ten months only. The Civil State extracts of Prussia give to the Jews a mortality of 1.61 per cent.; to the whole kingdom, 2.62 per cent. To the Jews they give an annual increase of 1.73 per cent.; to the Christian, 1.36 per cent. The effective of the Jews require a period of forty-one years and a half to double themselves; those of other races, fifty-one years. In 1849, Prussia returned one death for every forty-one of the Jews and one for every thirty-two of the remaining population.

"The Jews escaped the great epidemics more readily than the other races with whom they lived. Thus, the mortality from cholera amongst them is so small that the very fact of its occurrence has been disputed. Lastly, that element of mortality, suicide, which we may look upon philosophically as a phenomenon of disease, is computed by Glatter, from a proportion of one million of inhabitants of Prussia, Bavaria, Wuertemburg, Austria, Hungary, and Transylvania, to have been committed by rather less than one of the Jewish race to four of the members of the mixed races of the Christian population. Different causes have been assigned for this higher vitality of the Jewish race, and it were indeed wise to seek for the causes, since that race which presents the strongest vitality, the greatest increase of life, and the longest resistance to death must in course of time become, under the influences of civilization, dominant. We see this truth, indeed, actually exemplified in the Jews; for no other known race has ever endured so much or resisted so much. Persecuted, oppressed by every imaginable form of tyranny, they have held together and lived, carrying on intact their customs, their beliefs, their faith, for centuries, until, set free at last, they flourish as if endowed with new force. They rule more potently than ever, far more potently than when Solomon in all his glory reigned in Jerusalem. They rule, and neither fight nor waste."[68]

Richardson attributes the great benefits enjoyed in this regard by the Jewish race to the soberness of their lives. This position is, however, not altogether tenable, if by that we mean abstemiousness; they are extremely temperate, but not abstemious. Tissot, Cornaro, Lessius, Hufeland, Humphry, Sir Henry Thompson, as well as the older Greek and Roman authorities, all are agreed that an abstemious life is the one that is most conducive to long life. There is no race that is more proverbial for their good cheer and indulgence in the good things of the table than the Jewish; no race enjoys feasting any more than they, and from childhood they are accustomed to a generous and nutritious diet, as well as to their share of the wines with which their tables are supplied. Their greater thrift and application to business, their habits of economy and carefulness in business affairs enable them to better supply their tables. In California there is no class that lives better or whose tables are supplied so well either as to quality or quantity as those of the Jews, and yet no class is more exempt than they from the class of diseases that originate in too good living. As before remarked, in relation to the poor of that faith, who are unable to keep a servant, and who live in a combination of shop and home in the most unhygienic condition, disregarding ventilation and every other sanitary needs, but who, nevertheless, escape the evil results that would and do attend such social conditions among those of other races, so in this instance of good living: the better class of Jews do not suffer in anything near a like proportion to the better class Christians from diseases incident to too full habits and an inactive life. Richardson observes that he drinks less and that he eats better food than his Christian brother. In regard to the drinking habit, overindulgence is not a Jewish failing; they do not drink to excess, but total abstinence is not in their vocabulary. It is inconsistent with their idea of wine as being a gift of God, and something that is symbolical of good faith and thanksgiving. Nor is total abstinence consistent with their idea of generous hospitality. On the eighth day after birth the Jew tastes wine, and from the time he is able to sit at table he becomes familiar with its use. To him wine is not symbolical of either moral depravity, mental or physical deterioration, or of death. Their females are all accustomed to its use from childhood, but it does not cause them to become either immoral or unchaste; so that in neither sex does wine produce that moral and mental wreckage which abbreviates the length of human existence among those of other creeds. Radical fanaticism, that drives a tack with a maul and a twenty-penny spike with a tack-hammer, cannot be expected to study this or any other question in any rational manner; but to the sociologist, the question as to what produces this remarkable soberness, in the midst of the habitual and continued use of wine in the race from the time of its earliest history, is something worthy of calm and careful consideration. How much circumcision may have to do with this will be discussed in the medical part of the volume.

In London, according to Dr. Stallard, the mortality among Jewish children from one to five years is only ten per cent., while among the children of the Christians it is fourteen per cent., the rate being analogous to that observed by Mayer among those of these ages in Furth. Among the London adults the average duration of life among the Jews is forty-seven years, while among the Christians it is only thirty-seven.

Dr. Hough[69] has gathered some interesting historical and statistical matter bearing on the subject of Jewish resistance to disease and the benefit possessed by the race in relation to the immunity enjoyed by them in prevailing epidemics. The plague of 1346 did not affect them; according to Fracastor they escaped the typhus of 1505; Rau remarks their immunity to the typhus of 1824; Ramazzini noticed their exemption to the fatal intermittents of Rome, in 1691; and Degner says that they escaped the epidemic dysentery at Nimegue, in 1736. Richardson truly observes that "from epidemics the Jews have often escaped, as if they possessed a charmed life." This racial difference and benefit, when compared to other races, has more than once cost them dear. In the dark and ignorant ages, when men reasoned nothing from a physical basis, but attributed all and every phenomena to some supernatural agency, either heavenly or diabolical, it was but natural for such minds to associate this exemption with some purchased compact made with the devil, who was often also held accountable for the existence of the epidemics. The rational and law-of-nature observing Jew supposed to be in league with his satanic majesty could neither be seen nor heard in his own defense; consequently, massacres, pillaging, and such other barbarities that an insane popular fury could suggest, were the humane manifestations with which a Christian people visited their Jewish brothers, whose only sin consisted in worshiping the God of their fathers, and in strictly observing His laws and commandments.

In France, Dr. Neufville found that, of one hundred children in the first five years of life, among the Jewish population, 12.9 die; while from the same number of the same aged class of Christians 24.1 die. One-half of all the Christians die at thirty-six years, and one-half of all the Jews at fifty-three years and one month.

Dr. John S. Billings has gathered statistics relating to 10,618 Jewish families, consisting of 60,630 persons,[70] living in the United States in December, 1889, mostly descendants of Jews from the northern or middle nations of Europe. For our purpose only the deductions as to death-rate and tendency to longevity will be given. In this valuable paper Dr. Billings says: "When we come to examine the reports of deaths for five years furnished by these Jewish families, we find that they give an average annual death-rate of only 7.1 per 1000, which would be about one-half of the annual death-rate among other persons of the same average social class and condition living in this country." To this he adds that, provided the deaths at different ages among the Jews have been correctly reported, this race will, on comparison with those of other races, show a greater tendency to longevity, as the Jewish expectation of life is at each age markedly greater than that of the class of people who insure their lives, the average excess being a little over twenty per cent.

In speaking of the death-rate among children, Dr. Billings makes the following comparisons: "The low death-rate among the Jews is especially marked among the children, and this corresponds to European experience. Thus in Prussia, in 1887, the death-rate of the Jews under fifteen years of age was 5.63 for 1000, while among the remainder of the people it was 10.46 per 1000." This result he accounts for partly to the fact that among the Jews illegitimacy is comparatively rare and to the high rate of mortality among the illegitimate born, which raises the average of the other classes.

In regard to the immunity of the race from consumption or tubercular disease, the statistics of the above Jewish families gives to the Jews less than one-third of the number of deaths from these diseases than what occurs among the others as to the male population, and less than one-fourth as to the female population. These statistics coincide with the observations of the writer on this part of the subject, and are even more than corroborated by the French War-Office Reports from Algeria, where the deaths from consumption among the Christians amount to 1 for each 9.3 deaths, and among the Jews to 1 in 36.9, while among the Mohammedans it is only 1 in 40.7 deaths. In Algeria the relative mortality from all causes is only about three-fifths of that of the Christian, and the Turk, although seeming to enjoy a greater exemption from phthisical or tubercular diseases than the Jew, falls below the Jew in exemption from deaths due to general causes, as his mortality is one-eighth greater than that of the Jew. Dr. Billings gives us some interesting food for thought in the course of his article and some more particularly bearing on the subject of immunity from consumption. He asks: "Are these differences due to race characteristics, properly so-called, to original and inherited differences in bodily organization, or are they, rather, to be attributed to the customs, habits, and modes of life of the two classes of people?"

Some years ago, Henry I. Bowditch, of Boston, put on foot an extended system of inquiry in regard to ascertaining the causes or antecedents of consumption in the State of Massachusetts. In answer to some of the questions of the circular, Rabbi Dr. Guinzburg, of Boston, answered as follows, under date of October 29, 1872:—

1st. The number of Jews living in Boston is about 5000.

2d. There certainly have not died of consumption, during the last five years, more than eight or ten Jews in the various congregations.

To this Dr. Bowditch adds, as follows:—

"If Dr. Guinzburg's data be correct, they show a very great immunity from consumption on the part of the Jews, compared with the citizens generally, as will be seen by the following comparison between these numbers and those procured from the Registration Reports, published by the State. In the report published in 1869, page 64, we find that for the five years preceding 1869 the annual average of deaths by consumption was 338 for every 100,000 living. These data from Dr. Guinzburg and the State Report give the following table:—

Proportion of Deaths to 100,000 of Living. All religions, 338 Jews, 40

"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 Phoenicia 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 uraemic 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.

It is not alone the tight-constricted, glans-deforming, onanism-producing, cancer-generating prepuce that is the particular variety of prepuce that is at the bottom of the ills and ailments, local or constitutional, that may affect man through its presence. The loose, pendulous prepuce, or even the prepuce in the evolutionary stage of disappearance, that only loosely covers one-half of the glans, is as dangerous as his long and constricted counterpart. If we look over the world's history, since in the latter years of the fifteenth century syphilis came down like a plague, walking with democratic tread through all walks and stations in life, laying out alike royalty or the vagrant, the curled-haired and slashed-doubleted knight, or the tonsured monk, we must conclude that syphilis has caused more families to become extinct than any ordinary plague, black death, or cholera epidemic. Without wishing to enter into a history of syphilis, it is not outside of the province of this book to allude to its frequency and spread.

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 Charite; 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 Medecine 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 gonorrhoea 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-vitae, 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.