Abraham L. Wolbarst

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Abraham Leo Wolbarst

Abraham Leo Wolbarst, M.D., (1872 – 1952) a New York City physician, was a notorious promoter of non-therapeutic neonatal male circumcision.

Holt (1913) reported in an article published in the Journal of the American Medical Association (JAMA) that tubercular mohelim were infecting baby boys with tuberculosis by the performance of ritual circumcision .[1] Wolbarst was incensed by what he perceived as an attack on ritual circumcision, so he resolved to defend ritual circumcision by arguing that circumcision provided health benefits. Wolbarst's defense of circumcision was published in JAMA in 1914 and entitled "Universal Circumcision as a Sanitary Measure".[2]

This was before the days of evidence-based medicine, when doctors relied on medical opinion, instead of scientific evidence. Wolbarst collected the opinions of several physicians and published those opinions as evidence for his argument that circumcision prevented diseases. Wolbarst argued that non-therapeutic neonatal circumcision prevented numerous diseases including venereal disease (now known as sexually transmitted disease).

Wolbarst's article appeared on the eve of World War I. It apparently influenced American military commanders to order circumcision of military personnel under their command to prevent venereal diseases and improve military readiness.[3] No statistics exist to document how many men were circumcised because of Wolbarst's article.

The adoption of circumcision as a prophylactic amputation by American military services falsely stigmatized the foreskin as being unhealthy. Van Howe (1999) has exhaustively shown that circumcision does not protect against STDs.[4]

Myth: protection against penile cancer

Wolbarst was solely responsible for the invention of the myth that circumcision rendered males immune to penile cancer.[5] Wolbarst wrote an article that was published in The Lancet in 1932, implicating human male smegma as carcinogenic.[5] Wolbarst's myth was based entirely on unverifiable anecdotes, ethnocentric stereotypes, a faulty understanding of human anatomy and physiology, a misunderstanding of the distinction between association and cause, and an unbridled missionary zeal, and it had absolutely no basis in valid scientific and epidemiological research.[6]

Wolbarst was directly responsible for its proliferation. All subsequent repetions of this myth are directly traceable to Wolbarst's article, though Wolbarst himself advocated universal neonatal circumcision principally as a preventive for epilepsy, paralysis, and masturbation. Circumcision advocates such as Wolbarst do not seem to have promoted this myth because they have a genuine interest in reducing penile cancer; they used it instead as a scare tactic in the promotion of neonatal circumcision.[6]

Boczko & Stanley (1979) collected numerous cases of cancer in circumcised men.[7] Epidemiological studies disproved Wolbarst's myths long ago. In North America the rate of penile cancer has been estimated to be 1 in 100,000.[8] Maden et al (1993) reported penile cancer among a fifth of elderly patients from rural areas who had been circumcised neonatally and had been born at a time when the rate of neonatal circumcision was about 20% in rural populations.[9] Their study also shows that the rate of penile cancer among men circumcised neonatally has risen in the United States relative to the rise in the rate of neonatal circumcision.

Although Wolbarst's falsehoods were disproved decades ago, they had entered into the American psyche where they continue to exert influence that they do not deserve.[10]

See also

References

  1. REFjournal Holt, L. Emmet (12 July 1913): Tuberculosis acquired through ritual circumcision, in: JAMA. 61 (2): 99-102. Retrieved 30 March 2020.
  2. REFjournal Wolbarst, Abraham L. (10 January 1914): Universal Circumcision as a Sanitary Measure, in: JAMA. 62 (2): 92-97. Retrieved 30 March 2020.
  3. REFweb Hill, George (4 November 2002). The Rise and Fall of Neonatal Circumcision: The Irrational Abuse Of Helpless Children, purewatergazette. Retrieved 30 March 2020.
  4. REFjournal Van Howe, Robert S. (1999): Does circumcision influence sexually transmitted diseases?: A literature review, in: BJU Int. 83 Supple 1: 52-62, PMID, DOI. Retrieved 31 March 2020.
  5. a b REFjournal Wolbarst, A.L. (16 January 1932): Circumcision and penile cancer, in: Lancet. 1 (5655): 150-153.
  6. a b REFjournal Fleiss, P.M. / F. Hodges (1996): Neonatal circumcision does not protect against cancer, in: BMJ. 312 (7033): 779-80.
  7. REFjournal Boczko, Stanley / Selwyn Freed (November 1979): Penile carcinoma in circumcised males, in: N Y State J Med. 79 (12): 1903-04, PMID. Retrieved 2 April 2020.
  8. REFdocument Cutler S.J., Young J.L. Jr.Third national cancer survey: incidence data., US Dept of Health, Education, and Welfare, Public Health Service (Bethesda, Md.). (1975).
  9. REFjournal Maden, C. / K.J. Sherman / A.M. Beckman / T.G. Hislop / C.Z. Teh / R.L. Ashley, et al. (1993): History of circumcision, medical conditions, and sexual activity and risk of penile cancer, in: JNCI. 85: 19-24.
  10. REFjournal Hill, George (22 June 2000): The Ghosts of Abraham Wolbarst and Aaron Fink, in: BMJ, DOI. Retrieved 31 March 2020.