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→Sayre and circumcision
Gollaher reports:
<blockquote>
The medical history of circumcision in the United States properly begins in New York on 9 February 1870. That morning Dr. Lewis A. Sayre was summoned by a colleague, the eminent New York gynecologist James Marion Sims, to consult on a perplexing case. "Please let me know at what hour you can come to my house to see the son of Mr. M_____, of Milwaukee," Sims wrote. "The little fellow has a pair of legs that you would walk miles to see." Sayre was at the time America's leading orthopedic surgeon, a renowned teacher and scholar, an authority on the anatomy of bones, joints, and muscles. Intrigued by the prospect of seeing some rare musculoskeletal pathology, he dropped what he was doing and went at once. When he arrived, Sayre encountered "a most beautiful little boy of five years of age, but exceedingly white and delicate in his appearance, unable to walk without assistance or stand erect, his knees being flexed at about an angle of 45 degrees." Sims, it turned out, had called him in to perform a tenotomy, the desperate remedy of severing the child's hamstring tendons. [4]
After he examined the patient though, Sayre concluded that "the deformity was due to paralysis and not contraction, and it was therefore necessary to restore vitality to the partially paralyzed extensor muscles, rather than to cut the apparently contracted flexors." But the cause of this paralysis was a mystery. There was no history of injury and seemed to be no other symptoms of disease. Puzzled and determined to trace the problem to its source, he finally decided to test the boy's reflexes by applying electric current to his legs. While he was doing this, the child's nurse exclaimed, "Oh, doctor! be very careful - don't touch his pee-pee - it's very sore." An examination of the patient's genitals showed that the penis was normal, except that "the glans was very small and pointed, tightly imprisoned in the contracted foreskin, and in its efforts to escape, the meatus urinarius had become as puffed out and red as in a case of severe granular urethritis." This was, according to the nurse, a chronic condition. Often the pain awaked him at night, the child's genitals having become so sensitive that even the slight friction of bedclothes caused painful erections. Pondering this information, Sayre suddenly imagined that he knew the source of the boy's problem. "As excessive venery is a fruitful source of physical prostration and nervous exhaustion, sometimes producing paralysis," he explained afterward, "I was disposed to look upon this case in the same light, and recommended circumcision as a means of relieving the irritated and imprisoned penis."