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A frequent argument against the non-therapeutic [[foreskin]] [[amputation]] is the concept that the [[foreskin]] not only contains numerous nerve endings and is more sensitive for touch than the [[Glans penis|glans]], but also that the number of nerve endings is “more than 10,000”, "(more than) 20,000" or even "up to 70,000" or “100,000”. There appears to be no reliable evidence for these figures.<ref name="Appendix">see Appendix: Documentary Part, p. 5f. – Ditto on facebook: [https://www.facebook.com/notes/hannes-mueller/the-legend-of-20000-nerve-endings/2034618236765662/ The legend of the “20,000 nerve endings]”:</ref> Nevertheless, this article identifies the origin and the calculation of these figures, explains how credible they are, and what magnitude range is the most realistic.
The [[Intactivists]] movement, which promotes the idea that the possession of [[intact ]] genitals is a [[human rights|human right]], is active against the genital mutilation of all children. [[Intactivists]] clarify many widespread myths about [[circumcision]], especially those concerned with male genital cutting. Advocates of [[circumcision ]] often allege there are advantages. But the results of evidence-based scientific studies disprove these. They provide convincing arguments that the [[foreskin]] is not a superfluous piece of [[skin]], but a part of the body with many positive functions and its lack leads to many disadvantages. To explain this, it is important to provide reliable, i.e. also verifiable, information about the anatomy of the [[foreskin]].
Medical studies of the past 25 years have provided much good evidence for [[intactivists]]. Evidence can be found, for example, that the [[foreskin]], especially at the end, is very densely supplied with nerve endings<ref name="Taylor">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref>, and is very sensitive to fine touch, even more sensitive than the [[Glans penis|glans]]<ref>{{Sorrells etal 2007}}</ref>. Basically this is enough to emphasize the special sensitivity of the [[foreskin]]. However, it is in this connection that the above figures are often quoted.
The dissemination of Fleiss’ article took place through the Intactivist movement through [[NOCIRC]], [[Doctors Opposing Circumcision (D.O.C.)]]], [[NOHARMM]], NRC and “[[Mothers Against Circumcision]]”, amongst others.<ref>http://www.nocirc.org/; http://www.doctorsopposingcircumcision.org/; http://www.noharmm.org/; http://childrightsnurses.org/; “For More Information”: http://www.mothersagainstcirc.org/fleiss.html</ref>
However, in the article by Bazett et al. (1932),<ref name ="bazett1932" /> no number is given for the nerve endings in the [[foreskin]] as a whole. Only a count of 212 nerve endings in a 1 cm² piece of a single prepuce tissue is given (see Table 1, p. 492). The 29-page Bazett article of 1932<ref name="bazett1932"/> to which Fleiss refers as a source for his "20,000", without mentioning the page, is only provided with "Conclusions" at CIRP: "For both technical reasons and perceived lack of general interest, CIRP will not present these parts and will only transcribe the conclusions." – — the entire article is available in the archive of "The JAMA Network"<ref name="JAMA">http://jamanetwork.com/journals/archneurpsyc/article-abstract/645191</ref>. The article may be available in 2019 but it was not available in the spring of 1997.
=== How did Fleiss come to this number, which is nowhere documented? ===
==== Nerve endings in the [[foreskin]] / Quarter (25-US-Ct.) ====
1995, in the film "[[Whose Body, Whose Rights?]]"<ref name="WhoseBody" /> starting from Montagu's description of the number of nerve endings in normal [[skin]], the number of nerve endings in the [[foreskin]] was calculated as follows: “15 square inches comfortably fits 15 quarters. This analogy helps us to understand that the adult [[foreskin]] contains … over 1000 nerve endings …" (15 × more than 50 = more than 750), which NOHARMM supplements to "Since Dr. Taylor's research suggests that the [[foreskin]] is '''more densely enervated innervated than "normal" [[skin]]''', a [[circumcised ]] man likely loses many times more than 1,000 nerve endings.”<ref name="circumcisionharm" /><sup>b</sup>
==== The “ridged band" ====
In 1996 the article by the Canadian pathologist [[John R. Taylor]] et al.<ref name="Taylor" /> about the “ridged band” of the [[foreskin]] had appeared. Taylor reported, that the encapsulated nerve endings<ref>Nerve endings can be divided into types with or without end corpuscles (corpuscular/encapsulated or free nerve endings). “… the free nerve endings (FNE) … do not seem to have any part in fine touch sensation (they are innervated by unmyelinated axons which conduct too slowly, don’t have specialised end corpuscles to transduce vibration, etc. and have a high threshold, all of which prevent the conduction of fine touch).” [[Ken McGrath|McGrath]], Fn 29b</ref> of the [[foreskin]] are concentrated in the “ridged band” and thus are distributed very differently. In his article, Fleiss also mentions the "ridged [[mucosa]]" and calls Taylor as a source. He therefore knew of Taylor’s work.
=== Conclusion ===
It is time to take leave of the exaggerated number of 20,000 nerve endings in the [[foreskin]].<ref>If you want to name a number, you should only specify the order of magnitude >3,000 <10,000. The number of nerve endings in the [[foreskin]] is probably at least 4,000, since the [[Glans penis|glans]] already has 4,000 and the [[foreskin]] is more sensitive – — but this is not qualitatively differentiated, for instance between sensitivity to [[pain ]] or touch.</ref> This legend is very wide spread by the opponents of [[circumcision]]. As long as the number cannot be scientifically proven, it is sufficient to say that the prepuce is very densely innervated and for fine touch is more sensitive than the [[Glans penis|glans]]<ref name="Approvals" />,<ref name="Appendix" />. Otherwise, the credibility and persuasive power of the [[Intactivist ]] movement suffers and makes itself unnecessarily vulnerable. Unfortunately, this can also be seen on the Internet.
Statements on [[foreskin]] anatomy should be evidence-based on studies published in scientific journals, to keep them verifiable and comprehensible. This should be taken seriously. Publications containing the 20,000 (or 10,000 and more) legend should no longer be disseminated. We should make sure our articles are accurate and add correcting notes to published articles where possible.
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[[Paul M. Fleiss| Dr. Fleiss]], however, is no longer with us, so no explanation or correction may be expected from him. It is likely that when he prepared the article for publication in the popular press in 1997, he simply meant to informally express the concept of a [[Ridged band| very substantial innervation of the foreskin]] as had been previously reported by [[John R. Taylor| Taylor]] et al.<ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref>
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: {{NOTE}} IntactiWiki has updated the relevant text to "The [[foreskin]] contains '''very many''' nerve endings ..." since then.
* '''[[PflegeWiki]]''': "And more than 20,000 nerve endings are irreversibly removed."<ref>{{REFweb