Changes

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. The prepuce: specialized mucosa of the [[penis]] and its loss to circumcision. Br J Urol 1996;77:291-295. http://www.cirp.org/library/anatomy/taylor/</ref>, and is very sensitive to fine touch, even more sensitive than the [[Glans penis|glans]]<ref>Sorrells ML, Snyder JL, Reiss MD, ''et al''. Fine-touch pressure thresholds in the adult [[penis]]. ''BJU Int '' 2007;99:864-9. https://www.ncbi.nlm.nih.gov/pubmed/17378847</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">Fleiss, P. The case against circumcision. Mothering Magazine (Santa Fe). Winter 1997. http://www.cirp.org/news/Mothering1997/</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="Bazettbazett1932">Bazett HC, McGlone B, Willams RG, Lufkin HM. [http://www.cirp.org/library/anatomy/bazett/ I. Depth, distribution and probable identification in the prepuce of sensory end-organs concerned in sensations of temperature and touch thermo-metric conductivity]. ''Arch Neurol Psychiatry '' 1932;27(3):489-517. http://www.cirp.org/library/anatomy/bazett/</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">film "Whose Body, Whose Rights?" https://www.youtube.com/watch?v=W0kr6BiVZMM</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>

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." Pretense? – the entire article is available in the archive of "The JAMA Network"<ref name="JAMA">http://jamanetwork.com/journals/archneurpsyc/article-abstract/645191</ref>.

1992 (²1996) appeared in the small book "Say No to Circumcision" of T.J. Ritter and G.C. Denniston [DOC]: "Circumcision removes a piece of skin (that in the adult is) almost equivalent to a 3 × 5 index card.”<ref name="galleryIntact">quoted in http://www.circumcisionharm.org/gallery%20intact.htm</ref> Thus, the [[foreskin]] size of an adult was given as 3×5 = 15 sq.inch = 96.8cm²<ref>https://www.15square.org.uk/ ("15 Square" = trade name of NORM-UK)</ref>, going out of about 1.5 inches = 3.81cm in length for inner and outer [[foreskin]] sheet and 5 inches = 12.7cm circumference. This too is found in Fleiss and Hodges, 2002<ref name="Fn11b">see Fn 9b, p. 4. Mistranslation in “Beschneidung-von-Jungen.de“: „ungefähr die Größe einer 4[!]x5 Zoll (also: 10x12,5cm) Karteikarte“ [but in the picture animation: “100cm²”]. → 125×212 = 26,500 nerve endings. http://archive.is/20130903162537/www.beschneidung-von-jungen.de/home/infos-fuer-eltern/was-ist-dievorhaut/ was-ist-die-vorhaut-anatomische-und-physiologische-fakten.html#selection-603.105-603.168</ref>. The length also is indicated to be about 4cm and the circumference 13cm, which leads to an area of 8×13=104 cm².<ref name="circumcisionharm">a) http://www.circumcisionharm.org/gallery%20intact.htm and b) http://noharmm.org/snip.htm</ref> Size-measuring studies give a maximum (not average!) area of 99.8 cm².<ref name="ForeskinSize">see: Werker ''et al''., 1998 and Kigozi ''et al''., 2009</ref>

In 1997 Fleiss knew from Bazett ''et al''.<ref name="Bazettbazett1932" />,<ref name="JAMA" /> that they had counted 212 nerve endings within a 1cm²-piece of a single [[foreskin]] tissue (Table 1, p. 492). Now it is obvious that Fleiss reckoned similarly therewith and with the [[foreskin]] size of 15 sq.inch = 96.8 cm² (or with 8×13 = 104 cm²): 96.8 cm²×212 nerve endings / cm² = 20,522 nerve endings (or 104×212 = 22,048; short: 100×>200= >20,000). So he obviously came to "more than 20,000 nerve endings".

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 enervated 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.

A claim from [[Stephen Moreton]] PhD , Ph.D. that [[Ken McGrath]] has given a previous higher estimate in a 2008 e-mail<ref>in www.circfacts.org/sensitivity</ref> is refused by [[Ken McGrath]] as not being by him.<ref>a.) according to McGrath’s e-mail from 18.09.2017 to the author: “… the message to which he refers was from another of the colleagues who inflated the figure.” b.) In an e-mail from 27.09.2017 to the author [[Ken McGrath|McGrath]] writes: “I have no idea where the ’70,000’ number comes from. It is even more impossible, absurd even, than the 20,000 estimate. It is probably representative of the inflation of the number brought on by wishfull thinking and should be ignored.”</ref>

The genitale 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 nonclitoridal 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 nonclitoridal non-clitoridal genital has the same as the clitoris: each 8k. If the female nonclitoidal 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, nonclitoridal non-clitoridal genital or [[Glans penis|glans]] 4k.

The assertion that the male [[foreskin]] containes contains "20,000 nerve endings" is often encountered in the case of circumcision opponents. I also used this figure in texts of mine. When I was asked for a proof, I searched for hours without success. Instead of a proof, one only comes across a widespread legend as documented in the following. – Concerning hearsayings about extrapolation using the density in a small cross-section: there are no scientific publications thereabout.<ref>See also: http://webcache.googleusercontent.com/search?q=cache:iiQtHltjyG8J:thecircumcisiondecision.com/20000-nerve-endings/+&cd=1&hl=de&ct=clnk&gl=en</ref> See also:

# "Physical effects of circumcision. [[John Warren]], Royal College of Physicians, London, UK; NORM-UK, Staffordshire, UK; Excerpt ... loss of at least 10000 to 20000 specialized erotogenic nerve endings, .... [...] It was calculated that at least 10000 -20000 specialized erotegenic nerve endings are removed during circumcision. (Winkelmann, 1959, 1956)."<ref>https://www.beschneidung-von-jungen.de/home/argumente-gegen-beschneidung/nachteile-der-beschneidung.html</ref> And: "Graphics added later [!]. ... Citations of the English original article: Warren J. PhysicalEffects Physical Effects of Circumcision. In: Denniston GC, Milos MF, Hodges FM (eds.). Genital Autonomy: Protecting Personal Choice. Heidelberg, New York: Springer; 2010. p. 75-79." – But there is no calculation. “20,000” in the graphic is without proof.# "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. phil. 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 Circum-cisionCircumcision. 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>https://www.amazon.com/What-Your-Doctor-About-Circumcision/dp/0446678805#reader_0446678805 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/4649-England-Why-the-UK-has-no-moral-right-to-tell-Africans-to-stop-genital-mutilatio/?postID=32474&highlight=20000#post32474 : "The [up to 20000 20,000 nerve endings] is by the way an urban legend. There are about 10,000 cells. No one knows where the 20,000 come from. I think this is only a quotation and nowhere with source." (G.) "10,000 to 20,000" noharmm.org/advantage.htm The "urban legend" probably originates from Fleiss, P.M. (1997) The case against circumcision. ''Mothering'', Winter, 36-45 (see below)