Changes

| Text=… neither of these [figures >10,000 and >20,000] is anywhere near the truth, because they are an order of magnitude too high. | Author=[[Ken McGrath]] | ref=<ref name="footnote2">see footnotes 27 and 31</ref>

| Text=In orders of magnitude, the number has to be >1,000 and <10,000. | Author=[[Ken McGrath]] | ref=<ref name="footnote2" />

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">Taylor JR, Lockwood AP, Taylor AJ. [http://www.cirp.org/library/anatomy/taylor/The prepuce: specialized mucosa of the [[penis]] and its loss to circumcision]. ''Br J Urol'' {{TaylorJR LockwoodAP TaylorAJ 1996;77:291-295.}}</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 traceable story of the legend of "20,000 nerve endings" began in October '''1997''', when the article "The Case Against Circumcision"<ref name="Fleiss">{{REFjournal |last=Fleiss, |init=P |author-link=Paul M. [Fleiss |url=http://www.cirp.org/news/Mothering1997/ |title=The case against circumcision]. '' |journal=Mothering Magazine'' ( |location=Santa Fe). |season?Winter |date=1997.}}</ref> by Paul Fleiss appeared in the popular mothers’ magazine “''Mothering''”. This is the first documentation of the ‘fact’, that the [[foreskin]] contains "more than 20,000 nerve endings". Fleiss referred to an article from 1932 by the English physiologist H. C. Bazett (1885-1950) together with other authors within a medical scientific journal.<ref name="bazett1932">{{REFjournal |last=Bazett |init=HC, |last2=McGlone |init2=B, |last3=Willams |init3=RG, |last4=Lufkin |init4=HM. [ |url=http://www.cirp.org/library/anatomy/bazett/ |title=I. Depth, distribution and probable identification in the prepuce of sensory end-organs concerned in sensations of temperature and touch thermo-metric conductivity]. '' |journal=Arch Neurol Psychiatry'' |date=1932; |volume=27( |issue=3): |pages=489-517.}}</ref>

The popular American pediatrician [[Paul Fleiss]] (1933-2014), in empathy with the children, was very active against the genital mutilation of newborns by [[RIC]](non-therapeeutic) (Routine Infant Circumcision) in USA. Fleiss, [[Marilyn Milos|Marilyn F. Milos]], and alongside them many other [intactivist]] pioneers, have contributed enormously to explaining its negative consequences. Fleiss knew of the article by Bazett et al. (1932) through the medical historian F. Hodges. Fleiss and Hodges were well known to each other. They appeared both in the 1995 film “[[Whose Body, Whose Rights?]]”<ref name="WhoseBody">[{{REFweb |url=https://www.youtube.com/watch?v=W0kr6BiVZMM |title=film "Whose Body, Whose Rights?"] |publisher=YouTube}}</ref>, and together they co-authored several articles<ref>Letter; Neonatal circumcision does not protect against penile cancer; [[foreskin]] IS NECESSARY; [[AIDS ]] and circumcision; Circumcision in infancy; Authors’ reply; Immunological functions of the human prepuce</ref> and two books<ref name="SweetDreams">a) Sweet Dreams 2000; b) www.amazon.com/What-Your-Doctor-About-Circumcision/dp/0446678805 2002</ref>. In “The Case Against Circumcision” Fleiss referred to Hodges’ article: “A short history of circumcision in the United States” from Jan. 1997, wherein Hodges writes about Bazett’s “detailed anatomical description of the innervation of the [[foreskin]].”<ref>http://www.historyofcircumcision.net/index.php?option=com_content&task=view&id=90&Itemid=0: Fn 50</ref>

The dissemination of Fleiss’ article took place through the Intactivist movement through [[NOCIRC]], [[Doctors Opposing Circumcision|DOC(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.

==== The number of nerve endings in normal [[skin ]] ====

As early as 1971, the anthropologist [[Ashley Montagu]] (1905-1999) had written in a study on the importance of [[skin ]] as a tactile organ for the social development of man: “A piece of [[skin ]] the size of a quarter [25-US-cent piece] contains more than […] 50 nerve endings, […]”<ref>A. Montagu, Touching: The Human Significance of the Skin, 1971, ²1978, p. 4; https://archive.org/stream/youchingthehuman000780mbp/youchingthehuman000780mbp_djvu.txt and 1979: http://www.foreskin.org/quarter.htm</ref>

1992 (²1996) appeared in the small book "Say No to Circumcision" of [[Thomas J. Ritter|T.J. Ritter]] and [[George C. Denniston|G.C. Denniston]] ([[DOC|D.O.C.]]): "Circumcision removes a piece of [[skin ]] (that in the adult is) almost equivalent to a 3 × 5 index card.”<ref name="galleryIntact">quoted in {{REFweb |url=http://www.circumcisionharm.org/gallery%20intact.htm |title=Global Survey of Circumcision Harm |last= |first= |accessdate=2021-09-01}}quoted in </ref> Thus, the [[foreskin]] size of an adult was given as 3×5 = 15 sq.inch = 96.8cm²<ref>{{REFweb

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" />^b 

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.

| Text=The following method has been used to estimate the number of corpuscular nerve endings in the [[foreskin]]. The frenular delta and frenular band are more sensitive than a fingertip; one square centimetre of fingertip has about 30-40 ridges with approximately three [[Meissner's corpuscles]] in every millimetre of ridge. For each centimetre of ridge there would be thirty [[Meissner's corpuscles]] and thus 900-1200 per cm2 of tip. The area of the frenular delta is equivalent to or greater than three fingertip areas, i.e. about 3-4 cm2. Therefore, at a minimum, the most sensitive area of the prepuce would have at least 3000 corpuscular endings. In orders of magnitude, the number has to be more than 1000 and less than 10,000. Some writers have erroneously inflated this estimate to 20,000 or more. More research is needed to clarify the actual number and distribution. | Author=[[Ken McGrath]]

| Text=[…] it is impossible for the [[foreskin]] to support such a huge number: there is not enough surface area to mount so many receptors (they would nearly outnumber the epithelial cells!) and the known number of axons ranging into the prepuce could not connect to that number. Furthermore, such a vast number is totally unnecessary to achieve the known high sensitivity of the prepuce. | Author=[[Ken McGrath]] | <ref>a.) quoted after [[Ken McGrath|McGrath]], Fn 27a; b.)</ref>

| Text=I made my estimate at the Symposium held in Oxford UK, Summer 1998. … I made my informal ‘back of the envelope’ estimation in response to a question during discussion outside the meeting. … Paul Fleiss did not differentiate between the types [of nerve endings] either and simply took Bazett's total number for his estimate. <br><br>In my estimation, I extrapolated the numbers of [[[[Meissner's corpuscles|Meissner corpuscular endings]] from the finger tip to the prepuce as these are the principal mediators of fine touch (and, therefore, of sexual sensation). All [[skin ]] appears to have many free nerve endings evenly distributed over their surfaces regardless of the local function; two epithelia, however, have virtually no fine touch—the cornea of the eye and the [[Glans penis|glans penis]]—having almost nothing but free nerve endings. The prepuce is no exception to this general pattern of having FNE over its entire surface, but like most other [[skin ]] (except the two exceptions above) it has varying numbers and distribution of corpuscular endings which are in lower numbers than the FNE. From teaching [[skin ]] enervation to medical students using sections of an index finger, I knew the numbers of [[Meissner's corpuscles]] in that [[skin]]. Observation and personal experience told me that the prepuce was more sensitive than the finger tips which suggested there are more of those fine touch endings in the prepuce. But I could not be definite about the numbers in the prepuce having only looked at some general sections. So I made an estimate in orders of magnitude: not less than 1000 nor more than 10,000 with the view that the numbers were probably at the lower end; i.e. between 1000 and 2000. Some recent work seems to confirm a figure around 1500. | Author=[[Ken McGrath]]

The genital tissue by male and woman is probably not so far different. The difference is mainly in the form and the nerve endings are differently distributed in detail, but on the whole their number maybe nearly equal. The [[Glans penis|glans]] of the [[penis]] may have 4k and the [[clitoris ]] 8k. If the [[foreskin]] for instance has 10k, then the number of nerve endings in the whole would be 14k, so that the non-clitoridal genital has 6k, with the same total number in men and women. If the [[foreskin]] has 12k, then there is 16k together with the [[Glans penis|glans]], and the non-clitoridal genital has the same as the [[clitoris]]: each 8k. If the female non-clitoidal genital has less than the [[clitoris]], for example max. 6k, ie together max. 14k, then stays for the [[foreskin]] max. 10k. – Gender equality seems possible: for the whole 12k, [[clitoris ]] or [[foreskin]] 8k, non-clitoridal genital or [[Glans penis|glans]] 4k.

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.

| Text=If you make a mistake and do not correct it, this is called a mistake. | Author=KonfuziusConfucius

}}</ref> - In the link to Bazett ''et al'' . there is not no such a number.

# " … a circumcised man actually loses many more than 1000 nerve endings. (About 20000 20,000 nerveendings)."<ref>{{REFweb

# "Infos for Parents: What is the [[foreskin]]":<ref>http://webcache.googleusercontent.com/search?q=cache:iiQtHltjyG8J:thecircumcisiondecision.com/20000-nerve-endings/+&cd=1&hl=de&ct=clnk&gl=de</ref> "What is the [[foreskin]]? Anatomical and physiological facts of Dr. med. Paul M. Fleiss and Dr. philPhil. Frederick Hodges [...] In fact, the [[foreskin]] contains more than 70 meters of nerve fibers and tens of thousands of specialized erotogenic [...] nerve endings ... "<ref>https://www.beschneidung-von-jungen.de/home/infos-fuereltern/was-ist-die-vorhaut/was-ist-die-vorhaut-anatomische-and-physiological-fakten.html</ref> (graphic like above) "Citation of the English original text: Fleiss, Paul M; Hodges, Frederick. What Your Doctor May Not Tell You About Circumcision. New York: Warner Books; C2002. Chapter 1, What is the [[foreskin]]. Anatomical facts, that your doctor may not know; p. 1-17." <br />'''This text<ref>{{REFweb |url=https://www.amazon.com/What-Your-Doctor-About-Circumcision/dp/0446678805#reader_0446678805 |title=What your doctor may not tell you about circumcision |last= |first= |accessdate=2021-09-01}} p. 2f.</ref> by Fleiss and Hodges and an earlier article by Fleiss<ref name="Fleiss /> in 1997 seem to be the source of the greatly exaggerated misleading vacant figure of 20,000.'''

# https://www.beschneidungsforum.de/index.php/Thread/1660-Erkl%C3%A4rung-von-Volker-Beck-et-al/?postID=10717&highlight=20000%2BNervenenden#post10717 : "The clipping of a clitoral [[foreskin]] is not comparable with amputating the entire [[penis]] [[foreskin]]. Clear: The entire [[clitoris ]] including [[foreskin]] has only 8000 nerve endings, the male [[foreskin]] alone but 20000. Therefore, this is not comparable. Already confusing." Such a confusing misfortune then comes out as a result of the phantased "20,000".

* '''FB page of the circumcision forum''': <ref>https://www.facebook.com/beschneidungsforum.de/posts/1785501095046354</ref> It accepts here the page with the empty claim of the "20,000 nerve endings" from the "DocCheck Flexikon"<ref>{{REFweb |url=http://flexikon.doccheck.com/de/Sexuelle_Auswirkungen_der_Zirkumzision |archived= |title=Sexuelle Auswirkungen der Zirkumzision |trans-title= |language=German |last=Fink |first=Bijan |author-link= |publisher=Einfach Eintauchen |website=DocCheck |date= |accessdate=2021-09-03 |format= |quote=}} (only German version)</ref>: “On average, the [[foreskin]] has about 73m of nerve fibers around 20000 mostly specialized nerve endings ..."

* '''[[Ken McGrath]]''' (Email 5.7.2013 to Stephen Moreton {{PhD}}): “No one since about 1923 has published a count of neural receptors in the human [[penis]]. At a conference (1998 in Oxford I think) a group asked me to make an estimate of the number of nerve endings in the prepuce. I did a quick back-of-the-envelope guesstimate based on a fingertip and arrived at an orders of magnitude figure of >1000<10000. … this figure quickly inflated, first to >10,000 and then to >20,000; neither of these is anywhere near the truth, because they are an order of magnitude too high.” (emphasis from the author) http://circfacts.org/sensitivity/

* '''Fleiss on [[Mothers Against Circumcision|MothersAgainstCirc.org]]'''<ref>{{REFweb |url=http://www.mothersagainstcirc.org/fleiss.html |title=The case against circumcision |last=Fleiss |first=Paul |date=1997 |accessdate=2021-09-02}}</ref>: The Case Against Circumcision, Paul M. Fleiss, 1997: “Circumcision denudes: … circumcision cuts off … 240 feet of nerves, and more than 20,000 nerve endings. [H. C. Bazett et al., "Depth, Distribution and Probable Identification in the Prepuce of Sensory End-Organs Concerned in Sensations of Temperature and Touch; Thermometric Conductivity," ''Archives of Neurology and Psychiatry '' 27 (1932): 489-517]” - There is no proof for "20,000"!

* [[Morten Frisch]] (Sexologist, main author of the AAP replica, Copenhagen)<ref>On 12.10.2017 the German and English first version of the article were posted with an accompanying text on Facebook: https://www.facebook.com/groups/248240545511361/534302533571862/. Morten Frisch shared and linked the article on Facebook on 28.10.2017 and wrote a post in which he called to mention no exaggerated numbers, thanked the author and recommended reading the article. He then received 93 likes, including 89 from [[Denmark]], Marilyn F. Milos, Lloyd Schofield (president of Bay Area Intactivists), Brian D. Earp and Georg Zimmermann ({{UNI|University of Osnabrück|UOS}}, formerly [[human rights ]] activist at intactivism); please refer: https://www.facebook.com/morten.frisch/posts/10214297927219433?pnref=story .</ref>