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Jewish ritual circumcision is carried out by a specially trained religious official called a ''[[mohel]]''. The [[Preputial mucosa| inner foreskin]] of an infant boy is fused with the underlying [[glans penis]] by a [[synechia]]. [[James Peron]] (2000) reported:
<blockquote>
Periah consists of tearing and stripping back the remaining inner mucosal lining of the foreskin from the glans and then, by use of a sharp finger nail or implement, removing all of the inner mucosal tissue, including the excising and removal of the [[frenulum]] from the underside of the [[glans]]. The objective was to insure that no part of the remaining penile skin would rest against the glans corona. If any shreds of the mucosal [[foreskin ]] tissue remained, or rejoined to the underside of the glans, the child was to be re-circumcised.<ref name="peron2000">{{REFjournal
|last=Peron
|init=JE
The periah procedure was introduced in the Second Century by the rabbinate as a result of the conflict that occurred between Jewish and Greek culture in Biblical times. The periah procedure is not mentioned in the Bible so there is no Biblical support for the procedure.
[[Frederick M. Hodges]], D. Phil., (2001) has provided a vivid description of the value that the Greeks placed on the [[foreskin| prepuce]]. The Greeks valued the [[acroposthion| longer tapered prepuce]]. Exposure of the [[glans penis]] in public was considered rude and unacceptable. Athletic events were carried out in the nude. The [[prepuce ]] was frequently tied with a cord called the ''[[kynodesme]]'' to prevent inadvertent exposure of the [[glans penis]].<ref name="hodges2001">{{REFjournal
|last=Hodges
|first=
The Jewish male, with his [[circumcised]] [[penis]] and exposed [[glans penis]], was placed in an impossible position. The answer was [[epispasm]].
At that time, Jewish males were only given the original style of [[Brit Milah| circumcision]], which only removed the tip ([[acroposthion]]) of the [[foreskin]], so they were still substantially covered by foreskin.<ref name="peron2000" /> Minimal stretching ([[tissue expansion]]) could easily recover the [[glans penis]] and make the Jewish male appear as the Greek culture demanded.
Hall (1992) reported that [[epispasm]] evidently was very popular with Jewish men and was practiced for several centuries. Hall believed that surgery was necessary, but that was not correct.<ref name="hall1992">{{REFjournal
When medical doctors started to do [[circumcision]] in the Nineteenth Century, the procedure adopted was essentially the Jewish version with periah. According to [[E. J. Spratling]] (1895) who emphasized the importance of tissue destruction:
<blockquote>
To obtain the best results one must cut away enough skin and mucous membrane to rather put it on the stretch when erections come later. There must be no play in the skin after the wound has thoroughly healed, but it must fit tightly over the [[penis]], for should there be any play the patient will be found to readily resume his practice, not begrudging the time and extra energy required to produce the orgasm. It is true, however, that the longer it takes to have an orgasm, the less frequently it will be attempted, consequently the greater the benefit gained...<ref>{{REFjournal
|last=Spratling
|init=EJ