Traveling within the World
2024-03-29T07:01:21Z
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There’s a 1,200-year-old Phone in the Smithsonian Collections By Neil Baldwin
tag:travelingwithintheworld.ning.com,2014-02-05:2185477:Topic:197365
2014-02-05T22:01:56.052Z
Dept of PMM Artists & things
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<h2 class="subtitle">One of the earliest examples of ingenuity in the Western Hemisphere is composed of gourds and twine<span><span><img alt="None" src="http://thumbs.media.smithsonianmag.com//filer/DEC13-A01-NationalTreasure631.jpg__800x600_q85_crop.jpg"></img></span></span> From the Smithsonian National Museum of the American Indian <span class="credits">(Travis Rathbone)…</span></h2>
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<h2 class="subtitle">One of the earliest examples of ingenuity in the Western Hemisphere is composed of gourds and twine<span><span><img src="http://thumbs.media.smithsonianmag.com//filer/DEC13-A01-NationalTreasure631.jpg__800x600_q85_crop.jpg" alt="None"/></span></span>From the Smithsonian National Museum of the American Indian <span class="credits">(Travis Rathbone)</span></h2>
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<div class="sharing addthis_toolbox addthis_default_style addthis_32x32_style"><a href="http://www.smithsonianmag.com/innovation/theres-a-1200-year-old-phone-in-the-smithsonian-collections-180947641/?all#" title="Facebook" class="addthis_button_facebook at300b"></a><a href="http://www.smithsonianmag.com/innovation/theres-a-1200-year-old-phone-in-the-smithsonian-collections-180947641/?all#" class="addthis_button_compact at300m"><span class=" at300bs at15nc at15t_compact"><span class="at_a11y"><br/></span></span></a></div>
<div class="article-body pagination-first"><p>As a nomadic cultural historian, my subjects have led me in wildly different directions. I spent every Friday for five years in a dim, dusty reading room in West Orange, New Jersey, formerly a laboratory on the second floor of Thomas Edison’s headquarters, deciphering the blunt-penciled scrawls of the celebrated inventor. Two years after my biography of Edison appeared, I found myself laboring up vertiginous stairs at daybreak in Mexico, photographing the faded ocher outlines of winged snakes etched into stone temples at the vast ruins of Teotihuacán. The daunting treks led to a book on Mesoamerican myth, <em>Legends of the Plumed Serpent</em>.</p>
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<p>Those two disparate worlds somehow collided unexpectedly on a recent afternoon in the hushed, temperature-controlled precincts of the National Museum of the American Indian storage facility in Suitland, Maryland. There, staffers pushing a rolling cart ushered one of the museum’s greatest treasures into the high-ceilinged room. Nestled in an acid-free corrugated cardboard container was the earliest known example of telephone technology in the Western Hemisphere, evoking a lost civilization—and the anonymous ancient techie who dreamed it up.</p>
<p>The gourd-and-twine device, created 1,200 to 1,400 years ago, remains tantalizingly functional—and too fragile to test out. “This is unique,” NMAI curator Ramiro Matos, an anthropologist and archaeologist who specializes in the study of the central Andes, tells me. “Only one was ever discovered. It comes from the consciousness of an indigenous society with no written language.”</p>
<p>We’ll never know the trial and error that went into its creation. The marvel of acoustic engineering—cunningly constructed of two resin-coated gourd receivers, each three-and-one-half inches long; stretched-hide membranes stitched around the bases of the receivers; and cotton-twine cord extending 75 feet when pulled taut—arose out of the Chimu empire at its height. The dazzlingly innovative culture was centered in the Río Moche Valley in northern Peru, wedged between the Pacific Ocean and the western Andes. “The Chimu were a skillful, inventive people,” Matos tells me as we don sterile gloves and peer into the hollowed interiors of the gourds. The Chimu, Matos explains, were the first true engineering society in the New World, known as much for their artisanry and metalwork as for the hydraulic canal-irrigation system they introduced, transforming desert into agricultural lands.</p>
<p>The artifact’s recent past is equally mysterious. Somehow—no one knows under what circumstances—it came into the hands of a Prussian aristocrat, Baron Walram V. Von Schoeler. A shadowy Indiana Jones-type adventurer, Von Schoeler began excavating in Peru during the 1930s. He developed the “digging bug,” as he told the <em>New York Times</em> in 1937, at the age of 6, when he stumbled across evidence of a prehistoric village on the grounds of his father’s castle in Germany. Von Schoeler himself may have unearthed the gourd telephone. By the 1940s, he had settled in New York City and amassed extensive holdings of South American ethnographic objects, eventually dispersing his collections to museums around the United States.</p>
<p>The sophisticated culture was eclipsed when the Inca emperor Tupac Yupanqui conquered the Chimu king Minchancaman around 1470. During its heyday, the urban center of Chan Chan was the largest adobe metropolis in pre-Columbian America. The central nucleus covered 2.3 square miles.</p>
<p>Today, the angular contours of ten immense compounds, once surrounded by thick, 30-foot-high walls, are visible. The compounds, or <em>ciudadelas</em>, erected successively by ten Chimu kings, were subdivided into labyrinths of corridors, kitchens, courtyard gardens, wells, burial sites, supply rooms and residential and administrative chambers, or <em>audiencias</em>.</p>
<p>Like the Inca, Matos says, the Chimu were organized as “a top-down society; this instrument would have been made only for, and used by, a member of the elite, perhaps a priest.”</p>
<p>Walls within walls and secluded apartments in the ciudadelas preserved stratification between the ruling elite and the middle and working classes. The NMAI telephone, Matos says, was “a tool designed for an executive level of communication”—perhaps for a courtier-like assistant required to speak into a gourd mouthpiece from an anteroom, forbidden face-to-face contact with a superior conscious of status and of security concerns.</p>
<p>Contemplating the brainstorm that led to the Chimu telephone—a eureka moment undocumented for posterity—summons up its 21st-century equivalent. On January 9, 2007, Steve Jobs strode onto a stage at the Moscone Center in San Francisco and announced, “This is the day I have been looking forward to for two and a half years.” As he swiped the touchscreen of the iPhone, it was clear that the paradigm in communications technology had shifted. The unsung Edison of the Chimu must have experienced an equivalent, incandescent exhilaration when his (or her) device first trasnsmitted sound from chamber to chamber.</p>
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Medieval & Renaissance Inventions by Poppy Whiteheart
tag:travelingwithintheworld.ning.com,2012-10-13:2185477:Topic:183995
2012-10-13T13:17:07.101Z
Dept of PMM Artists & things
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<div class="discussion"><div class="description"><div class="xg_user_generated"><p><a href="http://storage.ning.com/topology/rest/1.0/file/get/829676950?profile=original" target="_self"><img class="align-center" src="http://storage.ning.com/topology/rest/1.0/file/get/829676950?profile=original" width="530"></img></a></p>
<p><span class="font-size-3">A lot of Inventions and knowledge was suppressed in the early part of the Medieval age by the Christians as work of the devil or later as Witchcraft, most Inventions came out of China and other non-Christian countries. though a few did get past the Church laws,…</span></p>
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<div class="discussion"><div class="description"><div class="xg_user_generated"><p><a href="http://storage.ning.com/topology/rest/1.0/file/get/829676950?profile=original" target="_self"><img src="http://storage.ning.com/topology/rest/1.0/file/get/829676950?profile=original" class="align-center" width="530"/></a></p>
<p><span class="font-size-3">A lot of Inventions and knowledge was suppressed in the early part of the Medieval age by the Christians as work of the devil or later as Witchcraft, most Inventions came out of China and other non-Christian countries. though a few did get past the Church laws, some by monks others by a good standing with the relationship with Royalty</span></p>
<p><span class="font-size-3">Historians differ in their opinions of when the Middle Ages began and ended, most sources define the Middle Ages as an historical period from 500 AD to 1450 AD. While there was a suppression of knowledge and learning, the Middle Ages was a period full of discovery and inventing.</span></p>
<p><span class="font-size-3">One of the greatest inventions of the medieval world was the mechanical clock. The difficulty in inventing a mechanical clock was to figure out a way in which a wheel no bigger than a room could turn at the same speed as the Earth, but still be turning more or less continuously. If this could be accomplished, then the wheel became a mini Earth and could tell the time.</span> <br/><span class="font-size-3">It was Yi Xing, a Buddhist monk and mathematician, who made the first model of a mechanical clock in 725 AD. It was an astronomical clock, the clock operated by dripping water that powered a wheel which made one full revolution in 24 hours. An iron and bronze system of wheels and gears made the clock turn. This system caused the chiming of a bell on the hour. </span></p>
<p><span class="font-size-3"><a href="http://storage.ning.com/topology/rest/1.0/file/get/829676991?profile=original" target="_self"><img width="223" src="http://storage.ning.com/topology/rest/1.0/file/get/829676991?profile=RESIZE_320x320" class="align-left" width="223"/></a>Su Sung's great 'Cosmic Engine' of 1092 was 35 feet high. At the top was a power driven sphere for observing the positions of the stars. The power for turning it was transmitted from the dripping water by a chain drive.</span></p>
<p><span class="font-size-3">A celestial globe inside the tower turned in synchronization with the sphere above. It was two more centuries before the first mechanical clock was developed in Europe.</span></p>
<p><span class="font-size-3">Some scholars believe the first record of a mechanical escapement (the part of the clock that stops and releases the gear movement at regular intervals) is illustrated in an album of sketches from c. 1250, but this was not used in a timepiece as such. Several references to iron clocks appear during the first half of the 14th century.</span></p>
<p><span class="font-size-3"><a href="http://storage.ning.com/topology/rest/1.0/file/get/829676999?profile=original" target="_self"><img src="http://storage.ning.com/topology/rest/1.0/file/get/829676999?profile=original" class="align-left" width="192"/></a>The first detailed description of a mechanical clock movement comes from an Italian, Giovani da Dondi, in 1364 The oldest extant mechanical clock is from 1389 and can be found in Rouen, France</span></p>
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<p><span class="font-size-3">The origin of the all-mechanical escapement clock is unknown; the first such devices may have been invented and used in monasteries to toll a bell that called the monks to prayers. The first mechanical clocks to which clear references exist were large, weight-driven machines fitted into towers and known today as turret clocks. These early devices struck only the hours and did not have hands or a dial. The oldest surviving clock in England is that at Salisbury Cathedral, which dates from 1386. A clock erected at Rouen, France, in 1389 is still extant and one built for Wells Cathedral in England is preserved in the Science Museum in London</span></p>
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<p><strong>Gunpowder was first invented by Chinese alchemists around 9th century. It was an accidental discovery and it wasn’t long before gunpowder found its place in the Chinese army. </strong></p>
<p><strong>A Chinese text named Zhenyuan Miaodao Yaolue, which dates back to the mid-8th century, gives a reference to gunpowder, indirectly suggesting that gun powder had already been invented when that text was being written </strong></p>
<p><strong>Gunpowder was used as an incendiary substance in the beginning but soon other uses were found. By the 14th century, gunpowder was providing fuel for early military rockets; it was being used in the artillery. From China it found its way to Arabia and from there it spread to the whole world.</strong></p>
<p><strong>1023 First paper money printed in China.</strong></p>
<p><strong><a href="http://storage.ning.com/topology/rest/1.0/file/get/2060055012?profile=original" target="_self"><img src="http://storage.ning.com/topology/rest/1.0/file/get/2060055012?profile=original" class="align-left" width="220"/></a></strong></p>
<p>1045</p>
<p><strong>Movable type printing by Bi Sheng in China</strong></p>
<p><strong><a href="http://storage.ning.com/topology/rest/1.0/file/get/2060055023?profile=original" target="_self"><img src="http://storage.ning.com/topology/rest/1.0/file/get/2060055023?profile=original" class="align-left" width="340"/></a></strong></p>
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<p><strong>Circa 1050</strong></p>
<p><strong>Crossbow invented in France.</strong></p>
<p><a href="http://storage.ning.com/topology/rest/1.0/file/get/2060055205?profile=original" target="_self"><img width="400" src="http://storage.ning.com/topology/rest/1.0/file/get/2060055205?profile=RESIZE_480x480" class="align-full" width="400"/></a><br/><strong>1202</strong></p>
<p><strong>The Hindu-Arabic numbering system introduced to the west by Italian mathematician, Fibonacci.</strong><br/><strong>1249</strong></p>
<p><strong>Rodger Bacon invented his gunpowder formula.</strong><br/><strong>Circa 1250</strong></p>
<p><strong>Gun invented in China.</strong><br/><strong>Circa 1268 - 1289</strong></p>
<p><strong>Invention of eyeglasses.</strong><br/><strong>Circa 1280</strong></p>
<p><strong>Mechanical clocks invented.</strong><br/><strong>Circa 1285 - 1290</strong></p>
<p><strong>Windmills invented.</strong><br/><strong>1295</strong></p>
<p><strong>Modern glassmaking begins in Italy.</strong><br/><strong>1328</strong></p>
<p><strong>First sawmill.</strong><br/><strong>1326</strong></p>
<p><strong>First mention of a handgun.</strong><br/><strong>1366</strong></p>
<p><strong>Scales for weighing invented.</strong></p>
<p><strong>The 15th century gave birth to three major events: the beginning of the Renaissance Era (circa 1453)</strong> <br/><strong>with a return to research and learning after the Dark Ages; the birth of the Age of Discovery with</strong> <br/><strong>increased exploration and improved naval ships and navigation methods that created new trade routes</strong> <br/><strong>and trade partners; and the birth of modern printing marked by 15th century master printer Johann</strong> <br/><strong>Gutenberg's invention of movable type presses (1440) that made the inexpensive mass-printing of</strong> <br/><strong>books possible.</strong></p>
<p><strong>1400</strong></p>
<p><strong>First golf balls invented.</strong><br/><strong>The first piano called the Spinet invented.</strong><br/><strong>1411</strong></p>
<p><strong>Trigger invented.</strong><br/><strong>1420</strong></p>
<p><strong>Oil painting invented.</strong><br/><strong>1421</strong></p>
<p><strong>In Florence, hoisting gear invented.</strong><br/><strong>1450</strong></p>
<p><strong>Nicholas of Cusa creates spectacles of polished lenses for nearsighted persons.</strong><br/><strong>1455</strong></p>
<p><strong><a href="http://storage.ning.com/topology/rest/1.0/file/get/2060055194?profile=original" target="_self"><img src="http://storage.ning.com/topology/rest/1.0/file/get/2060055194?profile=original" class="align-left" width="150"/></a>Johannes Gutenberg invents printing press with metal movable type.</strong><br/><strong>1465</strong><br/><strong>The earliest dated printed book known is the "Diamond Sutra", printed in China in 868 CE. However, it</strong> <strong>is suspected that book printing may have occurred long before this date.</strong><br/><strong>In 1041, movable clay type was first invented in China. Johannes Gutenberg, a goldsmith and</strong> <br/><strong>businessman from the mining town of Mainz in southern Germany, borrowed money to invent a</strong> <br/><strong>technology that changed the world of printing. Johannes Gutenberg invented the printing press with</strong> <strong>replaceable/moveable wooden or metal letters in 1436 (completed by 1440). This method of printing</strong> <strong>can be credited not only for a revolution in the production of books, but also for fostering rapid</strong> <strong>development in the sciences, arts and religion through the transmission of texts.</strong></p>
<p><strong>Gutenberg Press</strong></p>
<p><strong>The Gutenberg press with its wooden and later metal movable type printing brought down the price of</strong> <strong>printed materials and made such materials available for the masses. It remained the standard until the</strong> <strong>20th century. The Gutenberg printing press developed from the technology of the screw-type wine</strong> <strong>presses of the Rhine Valley. It was there in 1440 that Johannes Gutenberg created his printing press,</strong> <strong>a hand press, in which ink was rolled over the raised surfaces of moveable hand-set block letters held</strong> <strong>within a wooden form and the form was then pressed against a sheet of paper.</strong></p>
<p><strong>In Germany, drypoint engravings invented.</strong><br/><strong>1475</strong></p>
<p><strong>Muzzle-loaded rifles invented in Italy and Germany.</strong><br/><strong>1486</strong></p>
<p><strong>In Venice, the first known copyright granted.</strong><br/><strong>1485</strong></p>
<p><strong>Leonardo DaVinci designed the first parachute.</strong><br/><strong>1487</strong></p>
<p><strong>Bell chimes invented.</strong><br/><strong>1492</strong></p>
<p><strong><a href="http://storage.ning.com/topology/rest/1.0/file/get/2060055314?profile=original" target="_self"><img src="http://storage.ning.com/topology/rest/1.0/file/get/2060055314?profile=original" class="align-left" width="239"/></a>Leonardo da Vinci first to seriously theorize about flying machines.</strong></p>
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<p><strong>Martin Behaim invented the first map globe.</strong><br/><strong>1494</strong></p>
<p><strong>Whiskey invented in Scotland.</strong></p>
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Anvils and Anvil Types
tag:travelingwithintheworld.ning.com,2011-01-31:2185477:Topic:97380
2011-01-31T15:51:55.333Z
Dept of PMM Artists & things
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<font face="book antiqua, century schoolbook, times new roman, times"><br></br><img alt="The American Blacksmith" height="26" src="http://www.blackiron.us/graphics/black-logo.gif" width="375"></img> <br></br><br></br><img alt="Anvils and Anvil Types" height="35" src="http://www.blackiron.us/graphics/anvil-logo.gif" width="314"></img> <br></br><br></br><br></br><img alt="Anvil Parts" height="324" src="http://www.blackiron.us/graphics/anvil-parts-txt-1.gif" width="434"></img> <br></br><br></br><br></br>
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<tbody><tr><td><center><br></br><img alt="Anvil Types" height="38" src="http://www.blackiron.us/graphics/types.gif" width="182"></img> <br></br><br></br><img alt="Medieval Anvils" height="30" src="http://www.blackiron.us/graphics/medieval.gif" width="184"></img> <br></br><br></br><table bgcolor="#FFFFFF" width="96%">
<tbody><tr><td><font face="book antiqua, century schoolbook, times new roman, times"><a href="http://www.blackiron.us/graphics/seusenhofer-fullw.gif"><font size="-2">(See Full…</font></a></font></td>
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<font face="book antiqua, century schoolbook, times new roman, times"><br/><img height="26" width="375" src="http://www.blackiron.us/graphics/black-logo.gif" alt="The American Blacksmith"/> <br/><br/><img height="35" width="314" src="http://www.blackiron.us/graphics/anvil-logo.gif" alt="Anvils and Anvil Types"/> <br/><br/><br/><img height="324" width="434" src="http://www.blackiron.us/graphics/anvil-parts-txt-1.gif" alt="Anvil Parts"/> <br/><br/><br/>
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<tbody><tr><td><center><br/><img height="38" width="182" src="http://www.blackiron.us/graphics/types.gif" alt="Anvil Types"/> <br/><br/><img height="30" width="184" src="http://www.blackiron.us/graphics/medieval.gif" alt="Medieval Anvils"/> <br/><br/><table bgcolor="#FFFFFF" width="96%">
<tbody><tr><td><font face="book antiqua, century schoolbook, times new roman, times"><a href="http://www.blackiron.us/graphics/seusenhofer-fullw.gif"><font size="-2">(See Full Image.)</font></a> <br/><img src="http://www.blackiron.us/graphics/seusenhofer.gif" align="left" alt="Seusenhofer engraving" border="0"/> <img src="http://www.blackiron.us/graphics/anvils-3a.gif" align="left" alt="Three Medieval Anvils" border="0"/></font>
<div align="justify"><font face="book antiqua, century schoolbook, times new roman, times"> <b>The</b> anvil is the primary tool of blacksmiths and one of the few tools that most blacksmiths will purchase. The first metalsmiths probably used flat rocks but as the world entered the iron age, iron anvils came into being. These were probably simple blocks of iron with a flat working surface. Still, there is evidence that the early Viking smiths used flat rocks for their work. The anvil went through a long period of development and there was no common or standard type through the western world. <br/> Since most of early iron work was directed to the making of arms and armor, the armourers developed anvils that suited their work. It was the Germans who improved steel and therefore they produced the finest armor. Their knowledge of metal led to excellent anvils. Through the centuries, there evolved a European or continental type of anvil that is represented by the double horn anvil but without a table. <br/> The English also developed an anvil, but with a style all their own. The English controlled the market to the American colonies and in the mid-1700s, the <i>London</i> style came into being. Even after the Revolutionary War, the <i>London</i> style continued to be imported in such numbers, that in time it has also been called, the <i>London/American</i> style. It is today an American favorite. <br/><br/><br/></font></div>
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<img height="28" width="379" src="http://www.blackiron.us/graphics/colonial.gif" alt="Colonial American Anvils"/> <br/><br/>
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<tbody><tr><td align="left" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/colonial-2.gif" alt="Colonial Anvil, ca 1650"/></td>
<td align="center" width="32%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/colonial-3.gif" alt="Colonial Anvil, ca 1740"/><br/><br/></td>
<td align="right" width="34%" valign="top"><img height="180" width="200" src="http://www.blackiron.us/graphics/colonial-1.gif" alt="Stake Anvil"/></td>
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<tr><td align="left" width="34%" valign="top"><img height="233" width="200" src="http://www.blackiron.us/graphics/stake-anvil.gif" alt="Stake Anvil"/></td>
<td align="center" width="32%" valign="top"><img height="252" width="200" src="http://www.blackiron.us/graphics/nailers-anvil.gif" alt="Nailer's Anvil "/></td>
<td align="right" width="34%" valign="top"><img height="252" width="200" src="http://www.blackiron.us/graphics/nailers-bench.gif" alt="Nailer's Anvil Bench"/></td>
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<br/><br/><img height="38" width="375" src="http://www.blackiron.us/graphics/london-am.gif" alt="London American Anvils"/> <br/><br/>
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<tbody><tr><td align="left" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/peter-wright-100.gif" alt="Peter Wright Anvil"/></td>
<td align="center" width="32%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/vulcan-sm.gif" alt="Vulcan Brand Anvil"/></td>
<td align="right" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/hay-budden-ny-300.gif" alt="Hay Buden Anvil"/></td>
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<br/><br/><img height="32" width="266" src="http://www.blackiron.us/graphics/continental.gif" alt="Continental Style Anvils"/> <br/><br/>
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<tbody><tr><td align="left" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/peddinghaus.gif" alt="Peddinghaus Anvil"/><br/><br/><br/></td>
<td align="center" width="32%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/gladiator.gif" alt="Nimba Anvil"/></td>
<td align="right" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/windows-1.gif" alt="Austrian Type Anvil"/></td>
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<tr><td align="left" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/habermann.gif" alt="Habermann Style Anvil"/></td>
<td align="center" width="32%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/soding-halbach.gif" alt="Soding and Halbach Anvil"/></td>
<td align="right" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/german-czech.gif" alt="German Type Anvil"/></td>
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<br/><br/><img height="32" width="333" src="http://www.blackiron.us/graphics/horseshoers.gif" alt="Horseshores Anvils"/> <br/><br/>
<table bgcolor="#FFFFFF" width="96%">
<tbody><tr><td align="left" width="34%" valign="top"><img height="188" width="200" src="http://www.blackiron.us/graphics/nccavalry.gif" alt="NC Cavalry Anvil"/></td>
<td align="center" width="32%" valign="top"><img height="188" width="200" src="http://www.blackiron.us/graphics/jhm-competitor.gif" alt="JHM Competitor"/></td>
<td align="right" width="34%" valign="top"><img height="188" width="200" src="http://www.blackiron.us/graphics/lye-pattern.gif" alt="Lye Pattern Mini Anvil"/></td>
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<br/><br/><center><img src="http://www.blackiron.us/graphics/cottam-84.gif"/></center>
<br/><img height="32" width="179" src="http://www.blackiron.us/graphics/specialty-anvils.gif" alt="Specialty Anvils"/> <br/><br/><table bgcolor="#FFFFFF" width="96%">
<tbody><tr><td align="left" width="34%" valign="top"><img src="http://www.blackiron.us/graphics/bench.gif" alt="Workbench Anvil"/></td>
<td align="center" width="32%" valign="top"><img src="http://www.blackiron.us/graphics/bridge-300.gif" alt="Bridge Anvil"/></td>
<td align="right" width="34%" valign="top"><img height="162" width="200" src="http://www.blackiron.us/graphics/peddinghaus-silver.gif" alt="Peddinghaus Silversmiths' Anvil"/></td>
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<br/>
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<tbody><tr><td><font face="book antiqua, century schoolbook, times new roman, times"><img src="http://www.blackiron.us/graphics/steel-anvils-1.gif" align="left" alt="vaughn/Brooks anvils" border="0"/></font><div align="justify"><font face="book antiqua, century schoolbook, times new roman, times"> <font size="+1">Anvils</font> have been made for many special uses ranging from the smallest jewelers anvils to the heaviest industrial anvils. Of course, silversmiths don’t use heated metal on their anvils and swages. Rather, they anneal their metal and work it cold. It is the blacksmith who works the metal hot, and not all blacksmiths preformed the same tasks. <br/> The old Mousehole Forge in Sheffield England made five types of anvils:* <br/> 1. The London shape anvil<br/> 2. The double pike anvil<br/> 3. Coachsmiths’ anvil<br/> 4. Farriers’ anvil<br/> 5. Sawmakers’ anvil <br/> Additionally, there is the bench anvil - made to ge used on a workbench, the bridge anvil, and the coopers’ anvil. <br/> The image to the left shows traditional single and double bick (horn) anvils, a cast iron anvil stand, and two <i>Saw Makers</i> anvils, (<i>from Vaughn/Brooks</i> Lye, England). <i>Western Saw Inc.</i> (Oxnard, California) also makes Saw Makers anvils. <br/><br/><br/></font><center><font face="book antiqua, century schoolbook, times new roman, times"><font size="+1"><font face="book antiqua, century schoolbook, times new roman, times"><img height="38" width="99" src="http://www.blackiron.us/graphics/vise-logo.gif" alt="The Vise"/> <br/><br/></font></font></font><table bgcolor="#FFFFFF" width="96%">
<tbody><tr><td align="left" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/vise-anvil.gif" alt="Anvil Vise"/><br/><br/><img height="170" width="200" src="http://www.blackiron.us/graphics/vise-star-pat18881022.gif" alt="Anvil Vise"/></td>
<td align="center" width="32%" valign="top"><img height="281" width="200" src="http://www.blackiron.us/graphics/vise-box-leg.gif" alt="Anvil Vise"/></td>
<td align="right" width="34%" valign="top"><img height="170" width="200" src="http://www.blackiron.us/graphics/vise-anvil-1.gif" alt="Anvil Vise"/></td>
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<font face="book antiqua, century schoolbook, times new roman, times"><br/></font></div>
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<tbody><tr><td><div align="justify"><font face="book antiqua, century schoolbook, times new roman, times"><font size="+1" color="#B22222">Credits:</font> <br/><font size="-1"> <i>Two Medieval Armourers and the Anvil Bench</i> graphic, detail from an engraving of the anvil bench of sixteenth century armourer, Conrad (Konrad) Seusenhofer. <br/> <i>Medieval Square Anvil</i> and <i>Medieval Double Horn Anvil</i> graphics redrawn from <i>The Art of Blacksmithing</i> by Alex W. Bealer, p. 65. <br/> All <i>Colonial</i> graphics except the black and white <i>Stake Anvil</i> redrawn from <i>Museum of Early American Tools</i> by Eric Sloan, pp.90, 92. <br/> <i>JHM Anvils, NC Tool Co., Nimba, Peddinghaus, Sterling,</i> and <i>Vaughn/Brooks</i> graphics from the makers’ advertisements, and are copyrighted by them. <br/> * The listing of the five Mousehole Forge anvils was complied by David Poppke and presented online by David W. Wilson and the <a href="http://www.flash.net/~dwwilson/ntba/anvnm.html">North Texas Blacksmiths Association</a>. <br/> The primary display font use on this page is “Webster Roman” which was the typeface use by Noah Webster in his famous 1828 dictionary. The font is available from <a href="http://www.waldenfont.com/">Walden Font Co.</a> <br/></font></font></div>
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A Chronology of the Furniture Influencing
tag:travelingwithintheworld.ning.com,2011-01-30:2185477:Topic:97083
2011-01-30T21:36:04.074Z
Dept of PMM Artists & things
https://travelingwithintheworld.ning.com/profile/Artistsandthings
<h3 class="clear">The Pre-Christian Era</h3>
<ul class="list">
<li>The Egyptian is the earliest mode, and is divided into Early Egyptian (4000 B.C. to 1525 B.C.) and the Theban (1557 B.C. to 525 B.C.).</li>
<li>The Assyrian is dated 1270 B.C. to 625 B.C.</li>
<li>The Indian includes Brahman, 1400 B.C. to 500 B.C., when the Buddhist era commences.</li>
<li>The Etruscan (1000 B.C. to 500 B.C.).</li>
<li>The Persian mode (625 B.C. to 330 B.C.).</li>
<li>The Chinese may be dated from the time of…</li>
</ul>
<h3 class="clear">The Pre-Christian Era</h3>
<ul class="list">
<li>The Egyptian is the earliest mode, and is divided into Early Egyptian (4000 B.C. to 1525 B.C.) and the Theban (1557 B.C. to 525 B.C.).</li>
<li>The Assyrian is dated 1270 B.C. to 625 B.C.</li>
<li>The Indian includes Brahman, 1400 B.C. to 500 B.C., when the Buddhist era commences.</li>
<li>The Etruscan (1000 B.C. to 500 B.C.).</li>
<li>The Persian mode (625 B.C. to 330 B.C.).</li>
<li>The Chinese may be dated from the time of Confucius (500 B.C.).</li>
<li>The Greek periods are as follows: -Graeco-Pelasgic or Prehistoric (1900 B.C. to 1384 B.C.) Doric (700 B.C.); Ionic (600 B.C.); Corinthian; Hellenistic (290 B.C. to 168 B.C.).</li>
<li>The Roman may be dated from about 750 B.C. and the Pompeiian (pure Greek), 100 B.C.</li>
</ul>
<h3>First Century (1-100 A.D.)</h3>
<ul class="list">
<li>Rome was the dominating force. Western Europe was practically barbarian, including England, France and Germany, except so far as Roman influence had penetrated.</li>
<li>In Egypt Roman art flourished.</li>
<li>The Persian Empire had given place to the Parthian, and its art was debased Persian.</li>
<li>Greece was a province of Rome.</li>
<li>China was a great but little known nation. Much in Chinese records must be regarded as merely legendary.</li>
<li>In Britain the Celtic gave place to the Roman from the date of the Roman Invasion (54 B.C.).</li>
</ul>
<h3>Second Century (101-200 A.D.)</h3>
<ul class="list">
<li>Rome's sway continued over the Western nations.</li>
<li>The Parthians remained independent, but of little weight in matters artistic.</li>
<li>The European nations made gradual progress, consequent upon increasing familiarity with the Romans' manners and customs.</li>
</ul>
<h3>Third Century (201-300 A.D.)</h3>
<ul class="list">
<li>Rome's art became luxurious. The conflict between pagan and Christian became more intense, and increasing dangers were experienced from the Barbarians of the North, who constantly threatened invasion, and obtained local successes. The Barbarians had no art.</li>
<li>The Parthian Empire had given way to the Sassanian, whose art was Persian.</li>
<li>The Europeans steadily progressed along Roman lines.</li>
</ul>
<h3>Fourth Century (301-400 A.D.)</h3>
<ul class="list">
<li>Rome became Christian (nominally) in the reign of Constantine, and<br/>Byzantium (Constantinople) became the capital of the Roman Empire (330 A.D.). The Byzantine dates from this period.</li>
<li>Europe progressed considerably, its development being hastened by missionary zeal on the part of Roman Christians, who dispatched preachers.</li>
</ul>
<h3>Fifth Century (401-500 A.D.)</h3>
<ul class="list">
<li>The Roman Empire fell (476 A.D.) under attacks by the Northern Barbarians. Great destruction of works of art took place. The Roman style became the Romanesque, a Byzantine corruption of pure Roman.</li>
<li>Europe adopted the Romanesque toward the end of this century. Ireland was still Celtic.</li>
<li>The dominating influence of the century was the Byzantine.</li>
</ul>
<h3>Sixth Century (501-600 A.D.)</h3>
<ul class="list">
<li>The Romanesque style was still the dominant one.</li>
<li>Europe developed the Romanesque.</li>
<li>The Byzantine was now in its prime. The birth of Mohammed (571 A.D.) marks the commencement of the Mohammedan and Saracenic nations.</li>
</ul>
<h3>Seventh Century (601-700 A.D.)</h3>
<ul class="list">
<li>The Byzantine continued to flourish, though in frequent danger from the Saracens, whose strongholds were in Arabia. Before the death of Mohammed (632 A.D.), the Saracenic, or Moorish, style was commenced.</li>
<li>Europe was still Romanesque.</li>
</ul>
<h3>Eight Century (701-800 A.D.)</h3>
<ul class="list">
<li>The Romanesque flourished in France and Italy.</li>
<li>The Moors conquered Spain, and Moorish style rapidly developed.</li>
<li>The Saxon flourished in England.</li>
<li>The Byzantine flourished in the East and spread to Russia.</li>
</ul>
<h3>Ninth Century (801-900 A.D.)</h3>
<ul class="list">
<li>The Moors continued to hold Spain. The Moresque style developed.</li>
<li>England continued Saxon.</li>
<li>The Romanesque continued to flourish in France and Italy.</li>
<li>The Byzantine continued to flourish in the East and in Russia.</li>
<li>Germany and Flanders became independent Powers. In both the-art was Romanesque.</li>
</ul>
<h3>Tenth Century (901-1000 A.D.)</h3>
<ul class="list">
<li>The Moors continued supreme in Spain.</li>
<li>The Saxons continued supreme in England.</li>
<li>The Romanesque held sway in France.</li>
<li>The Russian Byzantine gave way to a new style formed by a conlbination of Byzantine and Celtic, the latter being introduced into the country by Irish Christian missionaries.</li>
<li>The pure Byzantine developed into the late or Italian style.</li>
</ul>
<h3>Eleventh Century (1001-1100 A.D.)</h3>
<ul class="list">
<li>The Romanesque style continued to flourish in France and Italy, though Spanish influence extended to France, leading to the adoption of Moorish details.</li>
<li>The Byzantine continued to flourish in the East.</li>
<li>The Moorish in Spain entered its best period in this century, and the style remained the dominant one, though the entrance of Christianity into the northern part of the kingdom led to the introduction of the Romanesque.</li>
<li>The Norman Conquest (1066) led to the introduction of the Romanesque into England. Bayeux tapestry, wrought by Matilda of Flanders, wife of William the Conqueror.</li>
</ul>
<h3>Twelfth Century (1101-1200 A.D.)</h3>
<ul class="list">
<li>Byzantine in the East.</li>
<li>The Moresque flourished in Spain.</li>
<li>The Early English style-a crude Gothic (1189).</li>
<li>French Gothic commenced in the latter half f this century. </li>
</ul>
<h3>Thirteenth Century (1201-1300 A.D.)</h3>
<ul class="list">
<li>Byzantine in the East.</li>
<li>Moorish still flourished in Spain. Alham"braic during this century.</li>
<li>French Gothic developed.</li>
</ul>
<h3>Fourteenth Century (1301-1400 A.D.)</h3>
<ul class="list">
<li>Byzantine in the East, but weakening.</li>
<li>The Moorish still flourished in Spain, though in the North the Gothic gained increasing influence. Dutch (1383-1750).</li>
<li>Decorated Gothic or Ornamental English style (1307). Perpendicular or Florid Gothic (1399).<br/>In France the style was Gothic. Tapestry weaving introduced toward the end of this century. The Gothic style flourished in Italy.</li>
</ul>
<h3>Fifteenth Century (1401-1500 A.D.)</h3>
<ul class="list">
<li>Byzantine (to 1453). The Turkish followed the Byzantine. Moorish (to 1492).</li>
<li>Italian Renaissance (a variation of the Byzantine).</li>
<li>Venetian Renaissance (1490).</li>
<li>Roman Renaissance (1444). Originated with Donato Lazzari, followed by Giacomo Barozzio (1507).<br/>Supreme period reached in Michael Angelo Buonarotti (1474).</li>
</ul>
<h3>Sixteenth Century (1501-1600 A.D.)</h3>
<ul class="list">
<li>The Arabian (1500-1699).</li>
<li>German Renaissance (1550).</li>
<li>Spanish Renaissance (1500), Hispano-Moresque.</li>
<li>Flemish (1507-1750).</li>
<li>Venetian Renaissance (Palladio, 1518).</li>
<li>The Tudor or English Renaissance (1509). Introduced by John of Padua, architect to Henry VIII. Tapestry making introduced into England.</li>
<li>The Elizabethan Style (1558). Dutch influence became apparent. (Henry VIII., 1509-1547; Edward VI., 1547-1553; Mary, 1553-1558; Elizabeth, 1558-1603.)</li>
<li>French Renaissance (1515). - A freely ornamented Gothic, introduced by Fra Giacondo, about 1502, in the reign of Louis XII. (Louis XII., 1498-1515; Francois I., 1515-1547; Henri II., 1547-1559; Francois II., 15591560; Charles IX., 1560-1574; Henri III., 15741589; Henri IV., 1589-1610.)</li>
</ul>
<h3> Seventeenth Century (1601-1700 A.D.)</h3>
<ul class="list">
<li>Arabian ends (1699).</li>
<li>The Jacobean style (1603). Italian influence appeared. Mortlake tapestry manufactory established (1619). (James I., 1603-1625; Charles I., 1625-1649.)</li>
<li>The Cromwellian style (1653). (The Commonwealth, 1663-1659; Charles II., 1660-1685; James II., 16851689.)</li>
<li>The William and Mary style (1689). Dutch furniture largely imported. (William and Mary, 1689-1702.)</li>
<li>Italian Renaissance, followed by rococo styles.</li>
<li>Louis XIV. Style (1643). The Gobelins and Beauvais factories established. Rococo style appeared (1690). The era of Charles Le Brun, Andre Charles Boulle, Jean Berain, Jean Le Pautre, Daniel Marot. (Louis XIII., 1610-1643; Louis XIV., 1643-1715.)</li>
</ul>
The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme by FREDERICK M. HODGES
tag:travelingwithintheworld.ning.com,2011-01-30:2185477:Topic:96889
2011-01-30T19:40:45.291Z
Dept of PMM Artists & things
https://travelingwithintheworld.ning.com/profile/Artistsandthings
<div class="corpus"><p class="summary"><span class="smallcaps">SUMMARY</span>: This study examines the evolution of Greek and Roman medical conceptualizations of preputial aesthetics, utilizing evidence found in classical medical texts as well as clues from literature, legal sources, and art. A conclusive picture emerges that the Greeks valued the longer prepuce and pathologized the penis characterized by a deficient prepuce—especially one that had been surgically ablated—under the disease…</p>
</div>
<div class="corpus"><p class="summary"><span class="smallcaps">SUMMARY</span>: This study examines the evolution of Greek and Roman medical conceptualizations of preputial aesthetics, utilizing evidence found in classical medical texts as well as clues from literature, legal sources, and art. A conclusive picture emerges that the Greeks valued the longer prepuce and pathologized the penis characterized by a deficient prepuce—especially one that had been surgically ablated—under the disease concept of <cite>lipodermos</cite>. The medical conceptualization of <cite>lipodermos</cite> is also placed in the historical context of the legal efforts to abolish ritual circumcision throughout the Seleucid and Roman empires.</p>
<p class="summary"><span class="smallcaps">KEYWORDS</span>: <cite>lipodermos</cite>, penis, prepuce, aesthetics, classics, Greek art, Roman art, circumcision</p>
<p class="heading1">Introduction</p>
<p>It is a biological norm in <cite>Homo sapiens</cite> that, in youth, that part of the penis known as the prepuce often runs to impressive lengths, frequently representing more than three-quarters of the length of the penis.<sup><a href="http://www.cirp.org/library/history/hodges2/#n1">1</a></sup> This anatomical fact is not without its cultural or artistic consequences. In his survey of images of the phallus in Greek vase painting, K. J. Dover <span class="page">[Page 376]</span> comments that depictions of attractive, virtuous, heroic, or divine subjects feature <a href="http://www.cirp.org/library/history/hodges2/hodges01.jpg">a prepuce that can comprise up to three-quarters the entire length of the penis</a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n2">2</a></sup> This may be an accurate representation of an ethnic norm; a broad-based, culturally significant idealization of the penis; or, in some cases, the representation of a prepuce that has been deliberately lengthened. Whatever the case, the well-proportioned prepuce was the longer prepuce, with its distinctive taper.</p>
<p class="2">An iconographic representation of this feature of male excellence can be seen in the well-known masterpiece of Attic red-figure vase painting, attributed by J. D. Beazley to the Sosias painter, in which <a href="http://www.cirp.org/library/history/hodges2/hodges02.jpg">Achilles binds the wounded arm of Patroklus</a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n3">3</a></sup> The frontality of Patroklus and the linear arrangement of his legs and upper body directs the gaze to his penis, the most prominent feature of which is the prepuce, <a href="http://www.cirp.org/library/history/hodges2/hodges02a.jpg">which decorously drapes itself across his right foot</a>. It is also a convention of vase painting that, even when in a state of erection, the prepuce of paragons of male beauty should retain its proportionality to the rest of the penis; despite erection, therefore, <a href="http://www.cirp.org/library/history/hodges2/hodges03.jpg">it is almost invariably represented as unretracted, long, and finely tapered</a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n4">4</a></sup></p>
<p class="2">The special value accorded to the prepuce in Greek culture is mirrored in the medical literature, where Galen (ca. 129–210 <span class="bce">C</span>.<span class="bce">E</span>.) singles it out as being among the most brilliantly useful adornments of the body:</p>
<p class="quote">Nature out of her abundance ornaments all the members, especially in man. In many parts there is manifest ornamentation, though at times this is obscured by the brilliance of their usefulness.The ears show obvious ornamentation, and so, I suppose, does the skin called the prepuce [ποσθη] at the end of the penis and the flesh of the buttocks.<sup><a href="http://www.cirp.org/library/history/hodges2/#n5">5</a></sup></p>
<span class="page">[page 377]</span><br />
<p>Galen is content here to leave his admiration for the prepuce unqualified by allusions to its length, but he nonetheless provides us with powerful corroboration of the fact that the Greeks prized the prepuce on its own merits while simultaneously associating it with other aspects of male beauty.<sup><a href="http://www.cirp.org/library/history/hodges2/#n6">6</a></sup></p>
<p class="2">As I will demonstrate, the aesthetic preference for the longer, tapered prepuce is a reflection of a deeper ethos involving cultural identity, morality, propriety, virtue, beauty, and health. Accordingly, the violation of this ethos by the specter of a deficient prepuce was addressed through individual, political, legal, and medical remedies. Here as elsewhere, medicine reinforced cultural values and their political application.</p>
<p class="heading1"><cite>Posthe</cite> and <cite>Akroposthion</cite></p>
<p>As would be expected in a culture that valued the prepuce, the Greek language reflected this esteem through precise terminology. The Greeks understood the prepuce to be composed of two distinct structures: the <cite>posthe</cite> (ποσθη) and the <cite>akroposthion</cite> (ακροπσθτου). <cite>Posthe</cite> designates that part of the prepuce that covers the glans penis, but Greek writers occasionally used this word (or any of its variations, such as ποσθιη or ποσθια) in a general sense to designate the entire prepuce or, by extension, the entire penis. <cite>Akroposthion</cite> (or any of its alternative forms, such as ακροποσθια and ακροποσθιη) designates the tapered, tubular, visually defining portion of the prepuce that extends beyond the glans and terminates at the preputial orifice. When we speak of the iconographic representation of the long prepuce, we are really speaking of the long <cite>akroposthion</cite> for the <cite>posthe</cite> can never be larger than the unchanging surface area of the underlying glans penis. Rufus of Ephesus, a physician under Trajan (98–117 <span class="bce">C</span>.<span class="bce">E</span>.), describes the penis accordingly:</p>
<span class="page">[page 378]</span><br />
<p class="quote">The tip of the shaft is called the glans [<cite>balanos</cite>], and the skin around the glans [is called the] prepuce [<cite>posthe</cite>], and the extremity of the prepuce is called the <cite>akroposthion</cite>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n7">7</a></sup></p>
<p class="2">In the Hippocratic <cite>Aphorisms</cite>, the akroposthion is presented as having a special nature:</p>
<p class="quote">When a bone, cartilage, sinew, the slender part of the jaw, or the <cite>akroposthie</cite> is severed [διακοπη], the part neither grows nor unites.<sup><a href="http://www.cirp.org/library/history/hodges2/#n8">8</a></sup></p>
<p>This aphorism, most likely a reflection of the limits of reparative surgery during the fifth century <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>. seems to imply that a completely severed (circumcised) <cite>akroposthion</cite> could not be successfully reattached to the penis from which it was amputated.<sup><a href="http://www.cirp.org/library/history/hodges2/#n9">9</a></sup> The seventh-century commentary of Stephanus of Athens, referring to the blood vs. semen dichotomy in the Galenic theory of embryology,<sup><a href="http://www.cirp.org/library/history/hodges2/#n10">10</a></sup> explains that the akroposthion does not unite or grow because it originates from semen.<sup><a href="http://www.cirp.org/library/history/hodges2/#n11">11</a></sup> Aristotle, having the advantage of living closer to the era in which the <cite>Aphorisms</cite> made their first appearance, attempts to explain it through comparative anatomy:</p>
<p class="quote">Now the eyelid is encased with skin; and that is why neither the eyelid nor the akroposthia will reunite, because both are skin without flesh.<sup><a href="http://www.cirp.org/library/history/hodges2/#n12">12</a></sup></p>
<p class="2">Although in later centuries Greek physicians would demonstrate that a severed <cite>akroposthion</cite> could be repaired—at least in a limited sense—the deeper meaning that underlies this aphorism is that the <cite>akroposthion</cite> shares characteristics with anatomically and physiologically analogous structures, such as the eyelid—thus providing a solid scientific foundation for a preexisting common high regard for the prepuce.</p>
<span class="page">[page 379]</span><br />
<p class="heading1">Positive References to the Prepuce in Literature</p>
<p>The cultural significance of the prepuce is also reflected in literature. In the domain of pleasures, for instance, the longer prepuce often serves as the object of erotic interest and as a signifier of the sexually attractive male, as demonstrated by the following ribald passage from the <cite>Lexiphanes</cite> of Lucian:</p>
<p class="quote">"Surely," I said, "you don't mean that notable Dion, that lusty, low-scrotumed, cuntish, and mastic-chewing youth who masturbates and gropes whenever he sees someone with a large penis [πεωδη] and a long prepuce [ποσθωνα]?"<sup><a href="http://www.cirp.org/library/history/hodges2/#n13">13</a></sup></p>
<p>Lucian is not satirizing the fact that a long prepuce should function as the visual cue that triggers Dion's erotic responses. On the contrary, he is satirizing Dion's general lack of decorum and self-control in the face of such self-evident visual stimulants. The desirability of the long prepuce, hence, remains beyond question.</p>
<p class="2">The eroticization of the prepuce is also evident in the <cite>Thesmophoriazusae</cite> of Aristophanes, where the lusty father-in-law, pressing to his face a garment owned and worn by the young and handsome poet Agathon, exclaims: "By Aphrodite, this has a pleasant smell of [a little] prepuce [ποσθη]!"<sup><a href="http://www.cirp.org/library/history/hodges2/#n14">14</a></sup> The diminutive <cite>posthion</cite> (ποσθιον), as opposed to the standard word <cite>posthe</cite> (ποσθη), is most likely used here as a term of endearment.</p>
<p class="2">In addition to a diminutive form of <cite>posthe</cite>, the Greeks had a form to express the opposite state. In the <cite>Peace</cite> of Aristophanes, the descriptive noun <cite>posthon</cite> (ποσθων), meaning a male with a large prepuce, is used to designate a little boy: "Tell me, O large foreskinned one [ποσθων], are you singing about your father?"<sup><a href="http://www.cirp.org/library/history/hodges2/#n15">15</a></sup> The scholiast notes that <cite>posthon</cite> was a common nickname for young boys.<sup><a href="http://www.cirp.org/library/history/hodges2/#n16">16</a></sup> In his commentary on this word, Jeffrey Henderson draws our attention to Freud's observation of the widespread tendency to equate children with the genitals and the genitals with children.<sup><a href="http://www.cirp.org/library/history/hodges2/#n17">17</a></sup> Here as elsewhere, the prepuce serves as a sign for the boy's whole being and as a synecdoche for the whole penis.</p>
<span class="page">[Page 380]</span><br />
<p class="2">This process is most clearly attested in a hortatory verse in Aristophanes' comedy <cite>Clouds</cite>. In the first prescriptive part of the oration, Socrates' <cite>Better Argument</cite> states:</p>
<p class="quote">If you follow my recommendations,<br/>And keep them ever in mind,<br/>You will always have a rippling chest, radiant skin,<br/>Broad shoulders, a wee tongue,<br/>A grand rump and a petite <cite>posthe</cite> [ποσθη].<sup><a href="http://www.cirp.org/library/history/hodges2/#n18">18</a></sup></p>
<p>Here, the allusion to the <cite>posthe</cite> clearly, although humorously, summons up an image of the entire penis, albeit one that conforms to the aesthetic ideal seen in artistic depictions of gods and heroes. The imprecise use of the word <cite>posthe</cite> serves the humorous context because, as others have shown, the Greeks valued the longer over the shorter prepuce in relation to the length of the entire penis, and the smaller over the larger penis as a whole.<sup><a href="http://www.cirp.org/library/history/hodges2/#n19">19</a></sup> Even if one were to argue that the word <cite>posthe</cite> was being used precisely here, the rules of proportion, as deduced from art, would require that a petite <cite>posthe</cite> be part of a proportionally even more petite penis.</p>
<p class="2">For comedic purposes, it seems also to have been possible for the prepuce to serve as a visual hereditary link between father and son, and, in this capacity, as proof of paternity. In the <cite>Thesmophoriazusae</cite> again, the father-in-law tells a racy story in which an old nurse tries to deceive a man, her former charge, into believing not only that his wife has just given birth to a child, but that the child is his. She cries out:</p>
<p class="quote">You're the father of a lion, a lion! He's the very spitting image of you in every way, including his [cute little] prepuce [ποσθων] —it's just like yours, twisted like a pine catkin.<sup><a href="http://www.cirp.org/library/history/hodges2/#n20">20</a></sup></p>
<p>Given that this is a humorous context in which the audience is meant to laugh at the old woman's impertinence and colorful language, the notion that the prepuce could serve as a standard against which to measure family resemblance should not be injudiciously extrapolated to Athenian society as a whole. Still, whatever the case may have been, the larger issue <span class="page">[Page 381]</span> here is the remarkable frequency with which the prepuce is referenced in various contexts.</p>
<p class="heading1">The <cite>Kynodesme</cite> as Protector of Public Morals</p>
<p>The association between the longer prepuce and respectability was so strongly felt that Greeks took steps to prevent unwanted exposure of the glans. In this regard, the consistent artistic portrayal of the adult penis with a generously proportioned <cite>akroposthion</cite> may well represent an anatomical ideal peculiar to Greeks, but, in some cases, it could accurately represent a penis whose <cite>akroposthion</cite> has been elongated—either deliberately or accidentally—through the continuous, long-term application of traction. Such traction may have come from the use of the <cite>kynodesme</cite> (κυνοδεσμη, literally a "dog leash"), a thin leather thong wound around the <cite>akroposthion</cite> that pulled the penis upward and was tied in a bow, tied around the waist, or secured by some other means.</p>
<p class="2">Tethering the <cite>akroposthion</cite> with the <cite>kynodesme</cite> is frequently confused with preputial infibulation, which had different objectives and was achieved by surgically piercing the prepuce and using the holes so created for the insertion of a metal clasp (<cite>fibula</cite>) in order to fasten the prepuce shut. Celsus, whose work was most likely composed during the reign of Tiberius (14–37 <span class="bce">C</span>.<span class="bce">E</span>.), disapprovingly describes infibulation as being performed on adolescents "for the sake of the voice, or for health's sake."<sup><a href="http://www.cirp.org/library/history/hodges2/#n21">21</a></sup> There is no suggestion that it improves the appearance of the penis.</p>
<p class="2">Vase paintings and statues frequently portray <a href="http://www.cirp.org/library/history/hodges2/hodges16.jpg">nude athletes wearing the <cite>kynodesme</cite></a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n22">22</a></sup> One of the most informative iconographic representations is found on an Attic red-figure calyx-krater painted by Euphronios, <span class="page">[page 382]</span> dating from 520–510 <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>. which shows <a href="http://www.cirp.org/library/history/hodges2/hodges17.jpg">a young athlete in the process of grasping the lips of his <cite>akroposthion</cite></a> with the fingers of his left hand and pulling the prepuce taut while his right hand is poised ready to <a href="http://www.cirp.org/library/history/hodges2/hodges18.jpg">loop the <cite>kynodesme</cite> around the neck of the <cite>akroposthion</cite></a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n23">23</a></sup></p>
<p class="2">Because of the frequency with which the <cite>kynodesme</cite> is seen in athletic settings, some scholars have speculated that it was worn for athletic protection<sup><a href="http://www.cirp.org/library/history/hodges2/#n24">24</a></sup>—but, as Paul Zanker maintains, this explanation fails to encompass all of the facts.<sup><a href="http://www.cirp.org/library/history/hodges2/#n25">25</a></sup> Athletes are not the only group regularly depicted wearing the <cite>kynodesme</cite>.The case for its more general use is supported by the nonspecific definitions recorded by ancient lexicographers. For instance, Julius Pollux, the second-century <span class="bce">C</span>.<span class="bce">E</span>. grammarian and sophist, states simply: "The cord with which they tie up the foreskin, they call the dog leash,"<sup><a href="http://www.cirp.org/library/history/hodges2/#n26">26</a></sup> while Hesychius, the fifth-century <span class="bce">C</span>.<span class="bce">E</span>. grammarian of Alexandria, defines it merely as an "<cite>akroposthion</cite> band."<sup><a href="http://www.cirp.org/library/history/hodges2/#n27">27</a></sup> The second-century <span class="bce">C</span>.<span class="bce">E</span>. grammarian Phrynichus Arabius, however, in an etymological and demographic mood, defines <cite>kynodesmai</cite> as "the thing with which the people of Attica who have their glans exposed bind their penis. They call the penis <cite>kyon</cite> [dog]."<sup><a href="http://www.cirp.org/library/history/hodges2/#n28">28</a></sup> The lexicon of Photius (ca. 820– 91) goes even further and adds a moral dimension, stating that the <cite>kynodesme</cite> is "the little piece of hide with which the prepuce of those is bound, who in undressing disgrace themselves."<sup><a href="http://www.cirp.org/library/history/hodges2/#n29">29</a></sup> Photius is unspecific about the exact nature of this disgrace, but we can safely assume that it <span class="page">[Page 383]</span> lies in the unseemly externalization of the glans that a deficient or loose-lipped prepuce is unable to prevent. The <cite>kynodesme</cite>, then, is a means by which any male so affected can maintain his dignity when in the nude.</p>
<p class="2">In <a href="http://www.cirp.org/library/history/hodges2/hodges19.jpg"><cite>komos</cite> scenes</a>, <a href="http://www.cirp.org/library/history/hodges2/hodges20.jpg">mature <cite>komasts</cite></a>, or revelers, are frequently portrayed wearing the <a href="http://www.cirp.org/library/history/hodges2/hodges21.jpg"><cite>kynodesme</cite></a> as well.<sup><a href="http://www.cirp.org/library/history/hodges2/#n30">30</a></sup> A striking example is a statue of the poet <a href="http://www.cirp.org/library/history/hodges2/hodges22.jpg">Anacreon</a>, in the guise of a <cite>komast</cite>, in which <a href="http://www.cirp.org/library/history/hodges2/hodges23.jpg">his akroposthion is bound with a kynodesme and drawn upward</a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n31">31</a></sup> Noting that this custom was widely practiced, Zanker observes that preventing unwanted exposure of the glans was a "sign of the modesty and decency expected in particular of the older participants in the symposium."<sup><a href="http://www.cirp.org/library/history/hodges2/#n32">32</a></sup></p>
<p class="2"><a href="http://www.cirp.org/library/history/hodges2/hodges24.jpg">Satyrs are sometimes painted</a> wearing the <cite>kynodesme</cite>, though certainly the intent is a humorous depiction of an <a href="http://www.cirp.org/library/history/hodges2/hodges25.jpg">unsuccessful imitation of human <cite>komasts</cite></a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n33">33</a></sup> Additionally, <a href="http://www.cirp.org/library/history/hodges2/hodges26.jpg">the hair-skirted satyr character of the theater wears the <cite>kynodesme</cite></a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n34">34</a></sup> This is most clearly illustrated in a quartet of <a href="http://www.cirp.org/library/history/hodges2/hodges26.jpg">larger-than-life marble satyr telamon figures</a> from the theater of Dionysos in Athens (now on display in the Louvre) in which <a href="http://www.cirp.org/library/history/hodges2/hodges28.jpg">the <cite>kynodesme</cite>, which is clearly visible, is noosed around the <cite>akroposthion</cite></a>, pulling the penis upward, and the cord is secured to the belt of the hair skirt.<sup><a href="http://www.cirp.org/library/history/hodges2/#n35">35</a></sup></p>
<span class="page">[Page 384]</span><br />
<p class="2">For those who continuously wore the <cite>kynodesme</cite>, the resulting traction on the <cite>akroposthion</cite> would have the benefit of permanently elongating it. It is conceivable, then, that the lengthening of the prepuce could have been the primary object, at least in some cases: aesthetics would be improved, and morals preserved.</p>
<p class="heading1">Greco-Roman Views on Alien Rites of Preputial Ablation</p>
<p>The intensity with which the Greeks esteemed the prepuce was equalled by the intensity with which they deplored its ablation as practiced in certain communities scattered throughout the southeastern fringes of the known world. Indeed, medical writers such as Oribasius and Paul of Aegina found but a single medical use for circumcision, mentioning it only as part of the surgical management of dire cases of penile gangrene.<sup><a href="http://www.cirp.org/library/history/hodges2/#n36">36</a></sup> Celsus similarly states:</p>
<p class="quote">Sometimes through such an ulceration the penis is so eaten away underneath the foreskin that the glans falls off; in which case the foreskin itself must be cut away all round. It is the rule, whenever the glans or any part of the penis has fallen off, or has been cut away, that the foreskin should not be preserved, lest it come into contact, and adhere to the ulceration, so that afterwards it cannot be drawn back, and further perhaps may choke the urethra.<sup><a href="http://www.cirp.org/library/history/hodges2/#n37">37</a></sup></p>
<p>This rare instance of medical circumcision is clearly not a rationale for the indiscriminate amputation of the healthy prepuce of healthy infants in any context.</p>
<p>The Greeks were highly skeptical about any of the religious rationales used by certain foreigners in an attempt to justify their blood rites of penile reduction. The <cite>History</cite> of Herodotus (484–420 <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>.) is the earliest Greek text reporting the practice of genital mutilation of various degrees, such as circumcision. Herodotus ascribes circumcision to the Colchians, Ethiopians, Phoenicians, Syrians, and Macrones, as well as to the Egyptian priestly caste.<sup><a href="http://www.cirp.org/library/history/hodges2/#n38">38</a></sup> He also reports, however, that the salutary influence of Greek culture induced the Phoenicians to abandon circumcision.<sup><a href="http://www.cirp.org/library/history/hodges2/#n39">39</a></sup> In an oft-repeated passage, always quoted out of context, <span class="page">[Page 385]</span> Herodotus describes the topsy-turvy world of the Egyptian priestly caste with obvious disapproval:</p>
<p class="quote">Everywhere else in the world, priests have long hair, but in Egypt they shave their heads. In times of mourning, it is the norm elsewhere for those most affected by the bereavement to crop their hair; in Egypt, however, in the period following a death, they let both their hair and their beards grow, when they had previously been shaved. Everywhere else in the world people live separately from their animals, but animals and humans live together in Egypt. Other people live off barley and ordinary wheat, but Egyptians regard it as demeaning to make those grains one's staple diet; their staple is hulled wheat, or "emmer" as it is sometimes known. They knead dough with their feet and clay with their hands, and they pick up dung with their hands too. Other people, unless they have been influenced by the Egyptians, leave their genitals in their natural state, but the Egyptians practise circumcision.<sup><a href="http://www.cirp.org/library/history/hodges2/#n40">40</a></sup></p>
<p>Later in the following paragraph, Herodotus repeats the revelation about the circumcision of the priests and places it in the context of their impenetrable cultic fastidiousness:</p>
<p class="quote">Because they are exceedingly religious, more so than any other people in the world, they have the following customs. Everyone, without any exceptions, scrubs clean the bronze cup he uses for drinking every day. The linen cloaks they wear are always freshly washed; this is something they are very particular about. Their concern for cleanliness also explains why they practise circumcision, since they value cleanliness more than comeliness.<sup><a href="http://www.cirp.org/library/history/hodges2/#n41">41</a></sup></p>
<p class="2">The ironic tone of this passage, which has hitherto been poorly appreciated, underscores Herodotus's dismay at the Egyptian priestly caste's illogical notions of cleanliness and religiosity and their unfathomable disregard for physical beauty. Clearly, he is emphasizing that the notions of genital cleanliness that he ascribes to a people who routinely handle dung bare-handed and prepare food with their bare feet are necessarily at variance with those of the civilized Greeks.</p>
<p class="2">An important clue to the Greeks' assumptions about the association of circumcision with the Egyptian priesthood is to be found on the fifth-century <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>. Attic red-figure <cite>pelike</cite> by the Pan painter, depicting <a href="http://www.cirp.org/library/history/hodges2/hodges29.jpg">Herakles overthrowing Busiris</a>, a mythological priest-king of Egypt, and his bald-headed priestly attendants who have attempted to make of Herakles a human sacrifice.<sup><a href="http://www.cirp.org/library/history/hodges2/#n42">42</a></sup> The painter has taken great pains to depict the priests <span class="page">[Page 386]</span> as having fat, ugly, wrinkled, circumcised penises with a bulbous externalized glans, which contrast sharply with the neat and attractive penis of Herakles, with its elegantly long and tapered prepuce. Likewise, the snubbed noses and monkey-like faces of the Egyptians could hardly be more dissimilar to the heroic Greek profile of Herakles. To paraphrase K. J. Dover, if a circumcised penis goes with a hideous face and a long and tapered prepuce goes with a handsome face, it is the long and tapered prepuce that was admired.<sup><a href="http://www.cirp.org/library/history/hodges2/#n43">43</a></sup></p>
<p class="2">Later Greek writers, such as Strabo (b.64 <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>) and Diodorus Siculus (first century <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>, horrified their readers with accounts of the genital mutilation practices of various primitive, sometimes cave-dwelling tribes living around the Red Sea, as well as those of the Hebrews and Egyptians.<sup><a href="http://www.cirp.org/library/history/hodges2/#n44">44</a></sup> While some of these tribes amputated only the prepuce, others amputated the glans,<sup><a href="http://www.cirp.org/library/history/hodges2/#n45">45</a></sup> and still others amputated the entire penis.<sup><a href="http://www.cirp.org/library/history/hodges2/#n46">46</a></sup> Strabo also provides a secular account of the origin of circumcision among the Hebrews. He writes that they are partly descended from Egyptians who left their homeland to follow an apostate priest named Moses, who was displeased with the state of affairs in Egypt and sought to worship his "Divine Being" divorced from animal imagery. Moses led his followers to Judaea and established an autocratic theocracy at what is now Jerusalem:</p>
<p class="quote">His [Moses'] successors for some time abided by the same course, acting righteously and being truly pious toward God; but afterwards, in the first place, superstitious men were appointed to the priesthood, and then tyrannical people; and from superstition arose abstinence from flesh, from which it is their custom to abstain even to-day, and circumcisions and excisions [of females] and other observances of the kind.<sup><a href="http://www.cirp.org/library/history/hodges2/#n47">47</a></sup></p>
<p class="2">Strabo's statement that the Hebrew priesthood imposed male and female circumcision for tyrannical and superstitious reasons supports Wilhelm Reich's theory of circumcision as a mechanism of social con- <span class="page">[Page 387]</span> trol.<sup><a href="http://www.cirp.org/library/history/hodges2/#n48">48</a></sup> Additionally, these Greek accounts of the bodily mutilations practiced by some primitive Near Eastern tribes underscore the association between circumcision and more severe penile mutilations. They also highlight the association between the circumcised penis (and, therefore, the exposed glans) and the linked concepts of primitiveness, barbarity, backwardness, superstition, and oppression.</p>
<p class="2">The association between the circumcised penis and slavery is illustrated in an unusual sixth-century Corinthian painted clay tablet that depicts four slaves at work in a mining excavation, heaving pickaxes and gathering lumps of stone or clay into baskets.<sup><a href="http://www.cirp.org/library/history/hodges2/#n49">49</a></sup> <a href="http://www.cirp.org/library/history/hodges2/hodges30.jpg">One slave, a pickax-wielding, Herculean mammoth, is clearly circumcised</a>. His enormous penis swings between his legs. The glans is externalized and painted black like the rest of his body, and the artist has inscribed two fine, wrinkled, cicatrix lines behind the weathered corona glandis. The other workers, though not obviously circumcised, have stumpy little penises without the elegant taper of a Greek prepuce; perhaps the painter meant to portray these slaves as sexually disfigured in some way as well. It is quite clear that these mutilated, misshapen, and misfortunate slaves fail to live up to Greek ideals of male beauty.</p>
<p class="2">Another source, albeit an unobjective one, that attests to the Greeks' ethical opposition to circumcision is the <cite>Special Laws</cite> of Philo Judaeus of Alexandria (d.ca.50 <span class="bce">C</span>.<span class="bce">E</span>). Philo claimed that circumcision was the "object of ridicule among many people."<sup><a href="http://www.cirp.org/library/history/hodges2/#n50">50</a></sup> His dismissal of opposition to circumcision as "childish mockery " betrays his failure to understand the philosophical and aesthetic underpinnings of the Greeks' high regard for the cultivation of physical health and beauty—that is, the philosophy of <cite>kalokagathia</cite>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n51">51</a></sup> Similarly, the Greeks would have found incomprehensible, ludicrous, and chilling the alien ideological milieu in which Philo could formulate a rationalization for the circumcision of children by an appeal to the alleged necessity for "excising pleasures" and "banishing conceit."<sup><a href="http://www.cirp.org/library/history/hodges2/#n52">52</a></sup> Circumcision for Philo was a surgical means of obtaining moral objectives through a deliberate numbing, desexualization, <span class="page">[Page 388]</span> disinvigoration, and uglification of the body. The Greeks did value modesty, moderation, and restraint, but the idea of cutting off part of the genitals to achieve these moral objectives would have appeared to be counterproductive, to say the very least, for by permanently and artificially externalizing the glans, the remnant penis and its possessor would be cast into a permanent state of lewdness. Considering the antithetical nature of the Hebrews' concept that morality could be surgically engineered, it is immediately apparent why the Greeks would have viewed the circumcision of children, the ideology behind the circumcision of children, the advocates of the ideology of circumcision, and the circumcised penis with antipathy.</p>
<p class="heading1">Legal Responses to Genital Disfigurement</p>
<p>Considering that the name of the part being cut off—<cite>posthe</cite>—could also designate the whole penis, the idea of circumcision might well have evoked the same feelings aroused by penile castration. Freud points out the widespread tendency to equate penile castration with circumcision, which, he maintained, must have been a relatively milder substitute that was designed to take the place of penile castration in primeval days.<sup><a href="http://www.cirp.org/library/history/hodges2/#n53">53</a></sup> Thus, to the Greeks and Romans, both mutilations must have seemed to be the ultimate in mindless, barbaric irreverence, excess, and depravity. In this context, it is immediately understandable why the Seleucid and later the Roman imperial administrations, charged with the self-imposed task of civilizing the known world, unhesitatingly criminalized the ritualized disfigurement of the penis.</p>
<p class="2">For instance, in the Hellenistic era, the Seleucid king Antiochus IV Epiphanes (175–165 <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>.) consolidated the empire of Alexander and, according to Tacitus, "endeavoured to abolish Jewish superstition and to introduce Greek civilization."<sup><a href="http://www.cirp.org/library/history/hodges2/#n54">54</a></sup> Although the corroborative accounts of Josephus and the first book of Maccabees are afflicted with a bias that undermines their value as historical sources, it is notable that one product of superstition that these sources name as being banned by Antiochus was the ritual circumcision of infants.<sup><a href="http://www.cirp.org/library/history/hodges2/#n55">55</a></sup> Clearly, the Hebrew religious <span class="page">[Page 389]</span> element emphatically disagreed with the Greeks' positive evaluation of the prepuce. Although it is most likely a convenient post hoc rationalization of ritual male circumcision rather than the original reason for its introduction into Hebrew religious ritual, there can be no escape from the devastating cultural implications of the Talmudic dictum, echoing the Mishnah: "The foreskin is disgusting."<sup><a href="http://www.cirp.org/library/history/hodges2/#n56">56</a></sup> Here we witness one of the fundamental and irreconcilable points of discord between the Greek and Hebrew views of the body.</p>
<p class="2">With evident hostility, Josephus and the authors of 1 Maccabees also report that circumcised Hebrew males during this era voluntarily sought foreskin restoration therapies, interpreting this as an illicit attempt at assimilation into Greek culture.<sup><a href="http://www.cirp.org/library/history/hodges2/#n57">57</a></sup> It is regrettable that, if any Hellenophile Israelites committed alternative perspectives to writing, nothing of this nature seems to have survived. What has survived, however, is documentary evidence that the Romans picked up where the Greeks left off in the campaign to rid the world of sexual disfigurements of all degrees.<sup><a href="http://www.cirp.org/library/history/hodges2/#n58">58</a></sup> Upholding a standard of beneficence all their own, the Romans united the Greeks' high regard for the intact body with a greater gift for administration. Accordingly, Emperor Domitian (81–96 <span class="bce">C</span>.<span class="bce">E</span>.) and his successor Nerva (96–98) issued proscripts against the castration of citizens and slaves.<sup><a href="http://www.cirp.org/library/history/hodges2/#n59">59</a></sup> Although there remains no direct and indisputable contemporary Roman legal or literary confirmation for it, Hadrian's late biographer, Aelius Spartianus, as well as modern scholars, have argued convincingly that, around 132 <span class="bce">C</span>.<span class="bce">E</span>., Hadrian issued a universal decree <span class="page">[Page 390]</span> outlawing circumcision, under penalty of death.<sup><a href="http://www.cirp.org/library/history/hodges2/#n60">60</a></sup> There is, however, conclusive documentation that Hadrian reiterated the ban on castration, and he and his successors seem not to have made any ethical distinction between castration and circumcision, for the wording of the laws as well as the extreme penalties for both crimes are nearly identical: forfeiture of all property and execution of the perpetrators—or, for those of higher rank, deportation to an island.<sup><a href="http://www.cirp.org/library/history/hodges2/#n61">61</a></sup> The fact that circumcision was punished with the maximum penalty allowed under the law attests to the strength of Greek and Roman views on the subject.</p>
<p class="2">Taking into account the compassionate spirit of the almost identically framed laws banning castration, the ban on circumcision was most certainly motivated by humanitarian and ethical considerations rather than by a purely theological discord with those groups, such as the Hebrew priesthood, whose rationale for the ritualized circumcision of infants was defended (ineffectively, as far as the Greeks were concerned) by an appeal to the supernatural. Yet, of the various peoples affected by this ruling, apparently only the conservative religious element among the Hebrews took umbrage, leaving behind a series of elaborated, mythologized, and, not untypically, contradictory accounts, alleging the interdiction to have been religiously motivated.<sup><a href="http://www.cirp.org/library/history/hodges2/#n62">62</a></sup> It is interesting to note, however, that the abundance of special rules and regulations regarding the cultic activities of "uncircumcised" Hebrew priests, as preserved in the Talmud, strongly hints that even in the highest circles of the Hebrew ruling classes there existed, for a period, a measure of active pluralism on the question of infant circumcision that was independent of Roman legal persuasion.<sup><a href="http://www.cirp.org/library/history/hodges2/#n63">63</a></sup></p>
<p class="2">The <cite>Digest of Justinian</cite> (a legal compilation collected by learned jurists at the behest of Justinian in 533), however, documents that, around 140, <span class="page">[Page 391]</span> Emperor Antoninus Pius at least modified the ruling of Hadrian to allow only the Hebrews to circumcise their children, while upholding the legal protections from circumcision for all other peoples:</p>
<p class="quote">Jews are permitted to circumcise only their sons on the authority of a rescript of the Divine Pius; if anyone shall commit it on one who is not of the same religion, he shall suffer the punishment of a castrator.<sup><a href="http://www.cirp.org/library/history/hodges2/#n64">64</a></sup></p>
<p>While Pius limited the exemption to Hebrews, papyrological documents in Greek, dating from 155 to 189 <span class="bce">C</span>.<span class="bce">E</span>. indicate that complex bureaucratic mechanisms were provisionally established to grant individual exemptions to this edict for certain members of the Egyptian priestly caste.<sup><a href="http://www.cirp.org/library/history/hodges2/#n65">65</a></sup> Few such exemptions, however, appear to have been granted. The widespread approval for the abolition of circumcision was limited by neither space nor time, for by the end of the third century, Pius's interdiction against circumcision was enhanced by the enactment of an additional legal prohibition:</p>
<p class="quote">Roman citizens, who suffer that they themselves or their slaves be circumcised in accordance with the Jewish custom, are exiled perpetually to an island and their property confiscated; the doctors suffer capital punishment. If Jews shall circumcise purchased slaves of another nation, they shall be banished or suffer capital punishment.<sup><a href="http://www.cirp.org/library/history/hodges2/#n66">66</a></sup></p>
<p>The incorporation into the <cite>Digest</cite> of Pius's more recent revisions of the law banning circumcision would explain why the sixth-century compilers of the <cite>Digest</cite> did not include the obsolete original decree of Hadrian. The two rescripts of Pius, coupled together, were reenacted under Constantine the Great in the fourth century,<sup><a href="http://www.cirp.org/library/history/hodges2/#n67">67</a></sup> and, of course, under Justinian in the sixth century. Simultaneously, the church adopted these as well as additional bans on circumcision into canon law and into its regional legal codes. Furthermore, the secular Roman law of the Byzantine Empire and the countries of Western Europe, at least through the Middle Ages, preserved and enhanced laws banning Hebrews from circumcising <span class="page">[Page 392]</span> non-Hebrews and banning Christians or slaves of any religious affiliation from undergoing circumcision for any reason.<sup><a href="http://www.cirp.org/library/history/hodges2/#n68">68</a></sup></p>
<p class="2">It is important to note that one of the reasons for the seemingly continuous need to reenact laws banning Hebrews from circumcising non-Hebrews stems from the unavoidable conflict that arose over the issue of Hebrew religious freedom. From the pagan reign of Emperor Antoninus Pius and through the Christian imperial administrations of the Middle Ages, with a few notable and isolated exceptions, the freedom of the Hebrews to practice Judaism was guaranteed by law.<sup><a href="http://www.cirp.org/library/history/hodges2/#n69">69</a></sup> Hebrew law, however, requires that Hebrews circumcise their slaves and servants, although this circumcision does not constitute a conversion to Judaism.<sup><a href="http://www.cirp.org/library/history/hodges2/#n70">70</a></sup> The Torah, the Talmud, and the later <cite>Schulchan Aruch</cite> all attest to the Judaistic imperative for forcibly circumcising non-Hebrews in this context.<sup><a href="http://www.cirp.org/library/history/hodges2/#n71">71</a></sup> Although the periodic need to reenact anticircumcision laws indicates that they were frequently violated (and specific instances of violation have been preserved),<sup><a href="http://www.cirp.org/library/history/hodges2/#n72">72</a></sup> Roman and church law agreed in principle that the absolute freedom of the Hebrews to practice Judaism ended at the beginning of the preputial epidermis of non-Hebrews.</p>
<p class="heading1">The <cite>Psolos</cite> Male</p>
<p>In the classical era, the association between the denuded glans and criminal impropriety is reflected in the vernacular, for in the plays of Aristophanes we find use of the derisory adjective <cite>psolos</cite> (ψωλος).<sup><a href="http://www.cirp.org/library/history/hodges2/#n73">73</a></sup> The <span class="page">[Page 393]</span> scoliasts suggest that <cite>psolos</cite> can simply mean "having an erection,"<sup><a href="http://www.cirp.org/library/history/hodges2/#n74">74</a></sup> a situation that can inadvertently cause the prepuce to evert, exposing the glans, but this definition does not take into account the varied contexts in which the word is used. The <cite>psolos</cite> male need not necessarily be circumcised either, as in the following slander: "He's come back here with an old man who's filthy, hunchbacked, wretched, wrinkled, bald, toothless, and, by God, I think he's <cite>psolos</cite> too!"<sup><a href="http://www.cirp.org/library/history/hodges2/#n75">75</a></sup> When applied to certain foreigners of ill repute, however, <cite>psolos</cite> can very well imply that circumcision is the cause of the offender's lewdness. In the <cite>Birds</cite>, for instance, in the context of an uncharitable speech dealing with the Egyptians and the Phoenicians, a reading of "circumcised" for <cite>psolos</cite>, when it is used here to denote these peoples, may well be intended.<sup><a href="http://www.cirp.org/library/history/hodges2/#n76">76</a></sup> Whether the glans was exposed through preputial slackness, inappropriate erection, or preputial amputation, the affront to good taste was the same. The public exposure of the glans was unsightly and indecent.</p>
<p class="2">In vase painting, except in some erotic scenes or in humorous depictions of old men, the eversion or amputation of the prepuce to expose the glans was, as Zanker has observed, "shameless and dishonorable, something we see only in depictions of slaves and barbarians."<sup><a href="http://www.cirp.org/library/history/hodges2/#n77">77</a></sup> Greek artists also took pains to represent <a href="http://www.cirp.org/library/history/hodges2/hodges31.jpg">ugly, decrepit old men, barbarian slaves, lecherous old satyrs, and comics as having a large, ungainly penis, sometimes with an exposed glans</a>, even when unerect, lending an effect of comic lewdness.</p>
<p class="2">Even in the private sphere, eversion of the prepuce and exposure of the glans seems to have been desirable only under certain exceedingly intimate circumstances. For instance, there are only a small handful of vases depicting an <a href="http://www.cirp.org/library/history/hodges2/hodges32.jpg">exposed glans</a> (albeit only partial exposure) in an attractive youth who, in these instances, <a href="http://www.cirp.org/library/history/hodges2/hodges33.jpg">is erect</a> and <a href="http://www.cirp.org/library/history/hodges2/hodges34.jpg">about to engage in <span class="page">[Page 394]</span> irrumation.</a><sup><a href="http://www.cirp.org/library/history/hodges2/#n78">78</a></sup> <a href="http://www.cirp.org/library/history/hodges2/hodges35.jpg">Portrayals of irrumation by attractive, young, human males</a> generally depict the <a href="http://www.cirp.org/library/history/hodges2/hodges36.jpg">prepuce as unretracted, teat-like, and neatly tapered</a>;<sup><a href="http://www.cirp.org/library/history/hodges2/#n79">79</a></sup> consequently, preputial eversion alone, without erection, must have been deemed unseemly in public precisely because it was so strongly associated with erection. An exposed glans was also undesirable because of its superficial resemblance to the permanently externalized glans of the circumcised penis. Hence, we see that in the Greek cultural constellation of symbols, the image of the exposed glans was remarkable for the intensity and sheer abundance of negative imagery associated with it.</p>
<p class="2">One final note on the word <cite>psolos</cite>, however, would be in order. The definition in the tenth-century Byzantine <cite>Suidae Lexicon</cite>, which, like the earlier lexicon of Photius, was most likely compiled to clarify the meanings of increasingly obscure words in classical texts, reads: "ο λειποδερμος [<cite>ho leipodermos</cite>]"—that is, one suffering from <cite>lipodermos</cite>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n80">80</a></sup> Thus, we have concrete evidence, although from a late source, that the condemnatory moral view of the penis with an exposed glans—the lewd <cite>psolos</cite> penis—had at some point been subsumed into a new framework: it had been transformed into a medical concept, but it was more than this. Immorality, impropriety, and genital unattractiveness were now diseases, for which the medical profession offered cures.</p>
<p class="heading1">The Appearance and Definition of <cite>Lipodermos</cite></p>
<p>As we have seen, a mutually reinforcing synthesis between preexisting Greek cultural views of the prepuce and Greek reactions to the anti-preputial practices of certain Near Eastern peoples who had been incorporated into the Seleucid and Roman empires converges in a single medical concept: <cite>lipodermos</cite> (λιποδερμος, or, alternatively, λειποδερμος) literally, "lacking skin"—the pathological disorder of the penis whose symptom was an artificially or congenitally externalized glans penis.</p>
<p class="2">The spurious but genuinely ancient <cite>Definitiones medicae</cite>, a work written by an unknown hand but frequently cited by Renaissance scholars of <span class="page">[Page 395]</span> Galen, provides the following definition of <cite>lipodermos</cite>, linking it with this useful distinction between <cite>posthe</cite> and <cite>akroposthion</cite></p>
<p class="quote"><cite>Lipodermos</cite> is a defect of the skin cover of the glans such that it can be laid bare no further. That which covers the glans (balanos is called the posthe or the akroposthia.<sup><a href="http://www.cirp.org/library/history/hodges2/#n81">81</a></sup></p>
<p>Lipodermos could be used as an adjective, describing a male (or a penis) characterized by a deficient prepuce, and it could also be used as a noun, signifying the name of this disorder.</p>
<p class="heading1">The Treatment of <cite>Lipodermos</cite></p>
The extant writings of a significant number of Greek and Roman physicians feature discussions of <cite>lipodermos</cite> and its treatment. According to Galen, the now-lost medical work of Crito, a physician at Trajan's court, contained a section on the treatment of <cite>lipodermos</cite> as well.<sup><a href="http://www.cirp.org/library/history/hodges2/#n82">82</a></sup> In accordance with the severity of the condition or its cause, <cite>lipodermos</cite> was treated with topical medications, traction, or surgery.<br />
<p class="heading2"><cite>Medicinal Treatment</cite></p>
<p class="2">In his <cite>Materia medica</cite>, Dioscorides of Anazarbus (41–68 <span class="bce">C</span>.<span class="bce">E</span>.) recommended the curative and soothing properties of honey in combination with repeated soakings of the affected part in warm water to make the penile skin more supple and to allow stretching of the prepuce: "<cite>Lipodermos</cite>, if not due to circumcision, is cured by honey, if for thirty days the <cite>posthe</cite> is softened with honey, especially after a bath."<sup><a href="http://www.cirp.org/library/history/hodges2/#n83">83</a></sup> Dioscorides' second herbal treatment for congenital <cite>lipodermos</cite> involves a preparation from the rubefacient plant thapsia (<cite>T. garganica</cite>). Physicians attributed to this plant the property of augmenting the volume of the parts onto which it was applied: "[Thapsia] is useful for the prepuce (επαυωυιον) of those suffering from <cite>lipodermos</cite>, providing it not be as a result of circumcision. It induces swelling, which when bathed and anointed, restores the defect of the <cite>posthe</cite>....<sup><a href="http://www.cirp.org/library/history/hodges2/#n84">84</a></sup></p>
<span class="page">[Page 396]</span><br />
<p class="2">Galen also advocated the use of thapsia and hinted that there were several topical preparations that were helpful for the treatment of lipodermic men. In <cite>De compositione medicamentorum per genera</cite>, Galen attributes such a preparation to a certain Epidauros:</p>
<p class="quote">Another of Epidauros' Treatments for the Lipodermic<br/><span class="menu">Ingredients:</span><br/><span class="menu">thapsia root, 3 drachms</span><br/><span class="menu">black or long pepper, 1 drachm</span><br/><span class="menu">fat of a calf, 12 drachms</span><br/><span class="menu">frankincense, 4 drachms</span><br/><span class="menu">balsam, 2 drachms</span><br/><span class="menu">pine resin, 16 drachms</span><br/><span class="menu">beeswax, 8 drachms</span><br/><span class="menu">Pour the melted [ingredients] over the dry..<sup><a href="http://www.cirp.org/library/history/hodges2/#n85">85</a></sup></span></p>
<p>The ingredients in this cerate were commonly used in medicinal preparations, especially emollients.<sup><a href="http://www.cirp.org/library/history/hodges2/#n86">86</a></sup> The fat as well as the aromatic pine resin, frankincense, and balsam were thought to have, among other things, cleansing properties. The beeswax was a carrier, and the thapsia and pepper (the dried berries of <cite>Piper nigrum</cite>, as opposed to the New World <cite>Capsicum</cite> were counterirritants used to treat bruises and other complaints, when applied externally. This cerate presumably would have facilitated the manual stretching of the penile skin while simultaneously inflaming it.</p>
<p class="heading2"><cite>Tractional Treatment</cite></p>
<p>The medical sources affirm that the use of the preputial ligature was not limited to athletes or <cite>komasts</cite>. The Ephesian physician Soranus, who lived under the reigns of Trajan and Hadrian (98–138 <span class="bce">C</span>.<span class="bce">E</span>.), has left us indication of both a wider use of a ligature and the more general cultural diffusion of the concept of <cite>lipodermos</cite>. In his <cite>Gynecology</cite>, Soranus justifies the medically prescribed stretching of the foreskin by an appeal to aesthetics. He advises wet nurses to massage the newborn child periodically, and to pay particular attention to performing manipulations designed to improve the appearance of the congenitally lipodermic penis:</p>
<p class="quote">If the male neonate appears to be lipodermic (λειποδερηος), she [the wet nurse] should gently draw the <cite>akroposthion</cite> forward or even hold it together with a strand of wool to fasten it. If gradually stretched and continuously <span class="page">[Page 397]</span> drawn forward, it easily stretches and assumes its normal length, covers the glans penis and becomes accustomed to keep the natural good shape.<sup><a href="http://www.cirp.org/library/history/hodges2/#n87">87</a></sup> Preserved in their original setting in <cite>De methodo medendi</cite>,<sup><a href="http://www.cirp.org/library/history/hodges2/#n88">88</a></sup> Galen's nonsurgical methods of elongating the prepuce involve different applications of traction and tension. The abridged account of Galen's exposition that appears in Oribasius's compilation states:</p>
<p class="quote">When the skin of the penis needs only a short stretch in order to give it a natural appearance, I have often obtained the desired result through simple tension: I roll around the circumference of the penis a strip of strong and soft papyrus, after having coated the skin with glue. It is clear that it is necessary to glue the end of the strip of papyrus to the part of the same strip placed on the underside of the end. In effect, this device dries quickly and pulls without discomfort. One places under the skin of the <cite>posthe</cite>, on the interior fold, a rounded object of suitable dimension, that one can easily remove when the strip of papyrus is adhered. When I have no such object at my disposal, I often roll up and introduce a piece of papyrus of average size to serve as a support for the one with which I surround the penis. I want to be careful to provide the patient with a way to urinate easily when the paper rolled around his penis is completely solidified and the supporting one is removed. Some of those who use thapsia to return the <cite>posthe</cite> over the glans construct the round object in question in the form of little lead spout. They stretch the skin of the posthe over the exterior of this spout and secure it with a soft leather cord.This procedure can sometimes also be useful for those individuals who are missing a large amount of <cite>posthe</cite>. I also treat this surgically.<sup><a href="http://www.cirp.org/library/history/hodges2/#n89">89</a></sup></p>
<p class="2">The alternative method that Galen outlines, that of inserting a lead spout under the prepuce and holding it in place by binding the enveloping prepuce with a leather cord (<cite>himas</cite> [ιμας]), would have added weight and perhaps tension, depending on the length of the lead spout, to the restorative technique.</p>
<p class="2">Like the technique of Soranus, Galen's method of manually stretching the deficient preputial skin over the glans and winding a leather cord around the "<cite>akroposthion</cite>" would have a similar effect to that of the <cite>kynodesme</cite>. These techniques depend for their efficacy on the principles of tissue expansion, today a major reconstructive technique. Given sufficient application of constant tension, new and permanent skin can be induced to grow. Penile skin, noted for its great elasticity, is especially responsive to expansion techniques.</p>
<span class="page">[Page 398]</span><br />
<p class="heading2"><cite>Surgical Treatment</cite></p>
<p>The surgical techniques developed in antiquity to repair the lipodermic penis have been described in modern medical journals,<sup><a href="http://www.cirp.org/library/history/hodges2/#n90">90</a></sup> but these papers erroneously portray these operations as having the sole objective of surgically repairing the <cite>circumcised</cite> penis rather than the <cite>lipodermic</cite> penis, which, as the ancient sources show, need not necessarily have been caused by circumcision. For instance, Celsus prefaces his account of his surgical technique by specifying that it is to treat "those in whom the defect is natural,"<sup><a href="http://www.cirp.org/library/history/hodges2/#n91">91</a></sup> rather than those in whom it is caused by circumcision. The Latin translation omits the term <cite>lipodermos</cite>, but the subject matter and composition fit so well with other explicitly denominated descriptions of <cite>lipodermos</cite> repair (see below)that the attribution may be taken to be legitimate:</p>
<p class="quote">And, if the glans is bare and the man wishes for the look of the thing to have it covered, that can be done; but more easily in a boy than in a man; in one in whom the defect is natural, than in one who after the custom of certain races has been circumcised; and in one who has the glans small and the adjacent skin rather ample, while the penis itself is shorter, rather than in one in whom the conditions are contrary.<br/> Now the treatment for those in whom the defect is natural is as follows. The prepuce around the glans is seized, stretched out until it actually covers the glans, and there tied. Next the skin covering the penis just in front of the pubes is cut through in a circle until the penis is bared, but great care is taken not to cut into the urethra, nor into the blood vessels there. This done the prepuce slides forwards towards the tie, and a sort of small ring is laid bare in front of the pubes, to which lint is applied in order that flesh may grow and fill it up. <It is seen that a large enough part of the penis has been bared, if the skin is distended little or not at all, and if> the breadth of the wound above supplies sufficient covering. But until the scar has formed it must remain tied, only a small passage being left in the middle for the urine. But in one who has been circumcised the prepuce is to be raised from the underlying penis around the circumference of the glans by means of a scalpel. This is not so very painful, for once the margin has been freed, it can be stripped up by hand as far back as the pubes, nor in so doing is there any bleeding. The prepuce thus freed is again stretched forwards beyond the glans; next cold water affusions are freely used, and a plaster is applied round to repress severe inflammation. And for the following days the patient is to fast until nearly overcome by hunger lest satiety excite that part. When the inflammation has <span class="page">[Page 399]</span> ceased, the penis should be bandaged from the pubes to the corona; over the glans the plaster is applied with the other end of the probe. This is done in order that the lower part may agglutinate, whilst the upper part heals without adhering.<sup><a href="http://www.cirp.org/library/history/hodges2/#n92">92</a></sup></p>
<p class="2">In addition to the surgical technique outlined by Celsus, the compilations of Paul of Aegina and Oribasius contain abridged accounts of a similar surgical treatment, originally from the <cite>Cheirourgoumena</cite> (preserved only in fragments), a lost work by Antyllus, a second-century <span class="bce">C</span>.<span class="bce">E</span>. Greek physician.<sup><a href="http://www.cirp.org/library/history/hodges2/#n93">93</a></sup> Unlike Celsus, Antyllus freely uses the term <cite>lipodermos</cite>, but like Celsus, he stresses that this operation is of little value in circumcision-caused <cite>lipodermos</cite>. In a brief commentary, however, Paul of Aegina voices his disapproval of Antyllus's operation, expressing his doubt that anyone would choose to submit to its dangers.</p>
<p class="heading1">The Identity of Lipodermic Patients</p>
<p>Having marshaled the evidence, a few general questions left unanswered in the sources can be posed. It is worth asking who would have been a candidate for <cite>lipodermos</cite> treatments and surgical restoration of the prepuce at this time, and what their motivation would have been.</p>
<p class="heading2">Hebrews</p>
<p>The available sources do not specify the demographics of treatment seekers, but the most obvious candidates among those whose lipodermos was attributable to circumcision would seem, at first, to have been Hebrew males, circumcised involuntarily at eight days of age, who wished to solidify their assimilation into Greco-Roman society. The ban on Hebrew circumcision instituted by Antiochus Epiphanes in Jerusalem could not have lasted long, and the Seleucids soon lost control over the region. Still, then, as now, not all Hebrews lived in Palestine, and even among those who did, it is difficult to imagine that all would have been indifferent to the reinstatement of compulsory circumcision. If we are to trust the account of Josephus (37–100? <span class="bce">C</span>.<span class="bce">E</span>.), "many of the Jews, some willingly, others through fear of the punishment which had been prescribed, followed the practices ordained by the king."<sup><a href="http://www.cirp.org/library/history/hodges2/#n94">94</a></sup> In his first epistle to the Corinthians (1 Cor. 7:18), Saul of Tarsus (St. Paul) alludes to Hebrews <span class="page">[Page 400]</span> who stretched their remnant penile skin to create a facsimile prepuce, but without mentioning the cure of <cite>lipodermos</cite> as the incentive. The Talmud as well, which traditionally dates, in its oral form, from about this period, alludes to Hebrew priests among others in whom "the prepuce is drawn forward to cover up the corona."<sup><a href="http://www.cirp.org/library/history/hodges2/#n95">95</a></sup></p>
<p class="2">Given that the native Hebrew sources on Hebrew history are almost exclusively biased toward the religious perspective, it is easy to lose sight of the possibility that these sources may not represent a majority view. There is little basis for the assumption that Israelite society was any less pluralistic than any other. The religiously oriented sources (and Josephus, as an apologist for the religious oligarchy, must be included in this category as well) acknowledge the existence of a divergent view on infant circumcision within Israelite society, but they denigrate that view.</p>
<p class="2">The situational nudity in the transplanted culture of the Greek conquerors of the Near East and the prevalence of the nude in public art throughout the Greek and Roman cities of the Empire would have served as a reminder to the Hebrew of the physical alienation that had been imposed upon him by his hieratic overlords. From the medical point of view, however, circumcision had not merely alienated the Hebrew: it had afflicted him with a sexual pathology as well. A regular regime of thapsia-laced unguents, a discreet weight suspended from the remnant penile skin, or even reparative surgery may have seemed a fair price for the restoration of a more biologically natural-looking penis and access to the cultural advantages that it represented.</p>
<p class="heading2">Slaves</p>
<p>The second group of candidates that comes to mind is manumitted slaves of Hebrews (or unmanumitted slaves, once owned by Hebrews and later sold to non-Hebrews) who had been forcibly circumcised in accordance with Mosaic law. Bearing the mark of Hebrew slavery, it is understandable that they might have been eager to erase the physical reminder of their degradation. A self-deprecating verse of Martial (40–104 <span class="bce">C</span>.<span class="bce">E</span>.) hints at a complex tale of an unmanumitted slave who was in the process, it is tempting to think, of curing his <cite>lipodermos</cite>:</p>
<p class="quote">Your slave stands with a black strap round his loins whenever you submerge your whole self in the warm water. But my slave, Laecania, to say nothing of me, has a Jewish weight under his lack of foreskin.<sup><a href="http://www.cirp.org/library/history/hodges2/#n96">96</a></sup></p>
<span class="page">[Page 401]</span><br />
<p>We see in this verse documentation that the conical, leaden <cite>antilipodermos</cite> weight described by Galen may have been known as the <cite>pondus judaeus</cite>, which indicates that Hebrews were more closely identified with its use. That the presumably Roman speaker of this poem should also be wearing the <cite>pondus judaeus</cite> raises interesting questions that should be considered, at least in part, in relation to <cite>lipodermos</cite>.</p>
<p class="heading2">Egyptians</p>
<p>It is often alleged that male circumcision was a widely observed custom among the Egyptians, and if this were so, one would expect some Egyptians of the Greco-Roman era to have sought treatment for <cite>lipodermos</cite>. On closer inspection, however, it emerges that there is no concrete proof at all that circumcision was widely practiced in Egypt.<sup><a href="http://www.cirp.org/library/history/hodges2/#n97">97</a></sup> It is not necessary for our purpose to consider this question in detail, but a general survey of the evidence has to be presented before one can fully understand the impact in Egypt of both the Roman legal prohibitions on circumcision and the Greco-Roman medical concept of <cite>lipodermos</cite>.</p>
<p class="2">The modern assumption that circumcision was widely practiced in Egypt originated, for the most part, in the work of early-twentieth-century scholars whose primary interest was in confirming the classical sources (especially their misreading of Herodotus)and in confirming and authenticating the "historical basis" of the Bible. <a href="http://www.cirp.org/library/history/hodges2/hodges37.jpg">A few examples of Old Kingdom (2649–2134 <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>.) statuary present some adult males</a>—usually priests, functionaries, or low-status workers<sup><a href="http://www.cirp.org/library/history/hodges2/#n98">98</a></sup>—as having under-gone a vertical slit on the dorsal aspect of the prepuce, although <a href="http://www.cirp.org/library/history/hodges2/hodges38.jpg">no flesh has been removed</a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n99">99</a></sup> Similarly, a sixth-dynasty (2323–2150) tomb relief—the <a href="http://www.cirp.org/library/history/hodges2/hodges39.jpg">Mastaba of Ankhmahor at Saqqara</a>—depicts something happening in the vicinity of the penis of a "<cite>ka</cite>-priest": no flesh has been cut, and there is little reason to imagine that a preputial amputation must follow; the hasty interpretation of this as a "circumcision scene" and as "proof" that circumcision was routine in ancient Egypt would seem to be an <span class="page">[Page 402]</span> injudicious and unwarranted extrapolation.<sup><a href="http://www.cirp.org/library/history/hodges2/#n100">100</a></sup> Ann Macy Roth convincingly argues that at least the <a href="http://www.cirp.org/library/history/hodges2/hodges40.jpg">right side panel of the Mastaba of Ankhmahor most likely depicts the ritual pubic shaving of the <cite>ka</cite>-priest</a> rather than a circumcision.<sup><a href="http://www.cirp.org/library/history/hodges2/#n101">101</a></sup> She suggests that the left scene could involve penile cutting, but the vertical angle of the oval object in the right hand of the squatting man—assuming that it is a knife—shows that the incision about to made cannot be a circumcision, which requires a horizontal cut; if any cutting is about to take place, and this is by no means definite, it can only be a vertical dorsal slit. Roth conventionally translates the caption to this left-hand scene as "circumcising <cite>ka</cite>-priest," but acknowledges that there are unusual problems with the hieroglyphics that make a conclusive translation impossible.<sup><a href="http://www.cirp.org/library/history/hodges2/#n102">102</a></sup></p>
<p class="2">By the time Herodotus visited Egypt, sometime after 460 <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>. the dorsal slit may have indeed mutated into a full preputial amputation, but it seems to have been restricted to certain males of the priestly caste. Still, some skepticism about the accuracy of Herodotus's observation seems pardonable and prudent. The opportunities to make a detailed and comprehensive examination of the penises of members of the Egyptian priesthood are likely to have been severely limited, especially for a foreigner. And whether they experienced full preputial amputation or merely a dorsal slit, there is still disagreement on how prevalent such practices were among the priests, and how long they persisted. Egyptian civilization spanned millennia: it is unwise to assume that any customs, especially ones as restricted as penile incision or circumcision, would necessarily have endured unchanged over such a long time span. The only indisputable documentary support for the existence of circumcision among the Egyptian priesthood remains the Roman-era papyrological evidence cited above.</p>
<p class="2">Evidence suggesting that, at least in later centuries, the Egyptian masses enjoyed freedom from any degree of penile cutting is manifested, among other places, in the thirtieth-dynasty (380–343 <span class="bce">B</span>.<span class="bce">C</span>.<span class="bce">E</span>.) limestone relief of Horhotep, which shows a scantily clad procession bringing tribute to Horhotep, the high priest of Buto.<sup><a href="http://www.cirp.org/library/history/hodges2/#n103">103</a></sup> Apart from the seated <span class="page">[Page 403]</span> priest, who wears a kilt, all of the males in this scene, young boys as well as strapping adult men, are indisputably in full possession of robust prepuces. It may also be observed that the remarkable wealth of statues, statuettes, and reliefs of <a href="http://www.cirp.org/library/history/hodges2/hodges41.jpg">nude Egyptian youths</a> and young gods such as Horus and Harpocrates, dating as early as the Old Kingdom, uniformly feature a <a href="http://www.cirp.org/library/history/hodges2/hodges42.jpg">generously proportioned <cite>akroposthion</cite></a>.<sup><a href="http://www.cirp.org/library/history/hodges2/#n104">104</a></sup> It is not surprising, then, that modern radiological methods have disproved the early-twentieth-century claims that Egyptian mummies bear the mark of circumcision.<sup><a href="http://www.cirp.org/library/history/hodges2/#n105">105</a></sup></p>
<p class="2">Further corroboration is provided by Josephus, himself an Alexandrine, who, in defending ritual Judaistic circumcision against criticism voiced by Apion, an Alexandrine Egyptian academician, declares that the Egyptian priests of his day were circumcised—implying that all other Egyptian males were free from circumcision.<sup><a href="http://www.cirp.org/library/history/hodges2/#n106">106</a></sup> Support for this .nal point can be deduced from Josephus's ungracious allegation about the fate of Apion's prepuce.<sup><a href="http://www.cirp.org/library/history/hodges2/#n107">107</a></sup> Thus, we have a strong case that even before the edict of Hadrian, outside the priestly caste, circumcision was not a feature of secular Egyptian life. Few if any Egyptians would have been diagnosed with circumcision-induced <cite>lipodermos</cite>, although some could well have been diagnosed with a degree of congenital <cite>lipodermos</cite>.</p>
<p class="heading2"><cite>Miscellaneous Near Eastern Peoples</cite></p>
<p>What of the other peoples at the fringe of the Empire who circumcised children prior to Hadrian's abolition of circumcision? Intriguing evidence is fortuitously preserved in a unique Syriac text, <cite>The Book of the Laws of Countries</cite>, a dialogue concerning Bardaisan of Edessa (154–223 <span class="bce">C</span>.<span class="bce">E</span>.), written down by his pupil Philippus. Bardaisan states:</p>
<p class="quote">Recently the Romans have conquered Arabia and done away with all the laws there used to be, particularly circumcision, which was a custom they used. For a man of his sovereign free-will submits himself to the law laid upon him by another, who also possesses sovereign free-will. But I shall tell you another <span class="page">[Page 404]</span> thing too, more convincing than all the rest to fools and unbelievers: all the Jews that have received the law of Moses, circumcise their male children on the eighth day, without waiting for the coming of stars and without regard for the local law.<sup><a href="http://www.cirp.org/library/history/hodges2/#n108">108</a></sup></p>
<p class="2">Evidently, even by the beginning of the third century, the news that the Roman authorities had exempted Hebrews from the abolition had not yet reached this corner of the world. No sources have yet emerged to verify whether Greco-Roman physicians practicing in Arabia diagnosed or treated <cite>lipodermos</cite>. Still, given that Greek medical texts found currency here, it would be surprising if lipodermos were not occasionally diagnosed, at least in the few remaining centuries before the rise of Islam.<sup><a href="http://www.cirp.org/library/history/hodges2/#n109">109</a></sup></p>
<p class="heading1">Conclusion</p>
<p>After this survey of the evidence, some conclusions about Greek views of the prepuce can now be drawn. In the multinational Seleucid and Imperial Roman eras, the medical support for a preexisting ethos of male genital aesthetics that favored the longer, securely closed prepuce was confirmed and intensified. This led to concerted and concerned action to address violations of that ethos.</p>
<p class="2">Through the development of the concept of <cite>lipodermos</cite>, Greek medicine gave to Greek civilization a scientific reinforcement of its disapproval of the violations of genital integrity occurring in the Near East. This ethos posited not only that a circumcised penis is a deviation from the natural—although that is of real importance—but that a circumcised penis is a defective and disfigured penis, one that can be repaired by medical treatment. Medicine and law thereby entered into a mutually supportive relationship: circumcision was against the law because it mutilated its victims, but, taken to the next logical level in this medico-ethical argument, it was also against the law because it necessarily inflicted a state of <cite>lipodermos</cite> on its victims.</p>
<p class="2">The effect of recognizing the circumcised penis as defective through the concept of <cite>lipodermos</cite> was not merely the addition of a medical dimension to the Greeks' critical view of circumcision: it also led the Greeks to view the intact penis in a more critical light. While a circumcised penis would necessarily have been considered lipodermic and thus <span class="page">[Page 405]</span> pathologically disfigured, the intact penis with a congenitally insufficient <cite>akroposthion</cite> that risked exposing the glans was also regarded as suffering from a degree of <cite>lipodermos</cite>. The lipodermic penis, as we have seen, was not only the stigma of slaves and unpopular foreigners from the Near East, but a provocative focal point for criticism. Moreover, during the Roman era, where circumcision was a capital crime that was associated with the rejection of Greek or Roman civilization, the poorly proportioned lipodermic but intact penis with its glans exposed to one degree or another, because of its superficial resemblance to the circumcised penis with its surgically externalized glans, would have been seen as a sign of criminality, apostasy, and unpatriotic rebellion. These must have been impelling incentives to seek treatment. Mercifully, Greek medical writers reassured their readers that congenital <cite>lipodermos</cite> was much easier to alleviate than accidental or surgically induced <cite>lipodermos</cite>.</p>
<p class="2">The Greeks obviously attached great importance to attainable ideals of physical beauty. Expressions of physical pride stand as one of the hallmarks of their literature and art. Judging by the way they depicted themselves in their figurative art, and taking into account the general use of the <cite>kynodesme</cite> and its accompanying ethos that exalted the well-proportioned, sleek, tapered, protective, beautifying, and propriety-preserving <cite>akroposthion</cite>, one may surmise that they would have agreed with a recent commentator in the <cite>British Journal of Urology</cite> who wrote: "One can never be too rich or too thin or have too much foreskin."<sup><a href="http://www.cirp.org/library/history/hodges2/#n110">110</a></sup></p>
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<div class="notes"><p>I would like to thank the editors as well as the anonymous reviewers for the <cite>Bulletin</cite> for their very helpful suggestions. I am indebted to existing translations in most cases, but where this is not indicated the translations are my own.</p>
<br/><a name="n1" id="n1"></a> </div>
Uncircumcision: A Historical Review of Preputial Restoration Dirk Schultheiss, M.D., Michael C. Truss, M.D., Christian G. Stief, M.D., and Udo Jonas, M.D. Hannover, Germany
tag:travelingwithintheworld.ning.com,2011-01-30:2185477:Topic:97190
2011-01-30T19:34:52.049Z
Dept of PMM Artists & things
https://travelingwithintheworld.ning.com/profile/Artistsandthings
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<tbody><tr><td><p align="justify"><font><b>Throughout history, demands for restoration of the prepuce after circumcision were most commonly related to the political or religious persecution of the Jewish people. The first evidence for such a procedure is mentioned in the Bible: Under the reign of Antiochus IV (168 BC) Hellenistic ideals, such as public nakedness at athletic games or in public baths, emerged in Judea and forced Jews to stretch their shortened…</b></font></p>
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<tbody><tr><td><p align="justify"><font><b>Throughout history, demands for restoration of the prepuce after circumcision were most commonly related to the political or religious persecution of the Jewish people. The first evidence for such a procedure is mentioned in the Bible: Under the reign of Antiochus IV (168 BC) Hellenistic ideals, such as public nakedness at athletic games or in public baths, emerged in Judea and forced Jews to stretch their shortened foreskins with a special weight, the <i>Pondus Judaeus,</i> to cover the glans (I. Maccabees 1). Similar efforts are reported in the Talmud during the time of Hadrian (132 AD).</b></font></p>
<p align="justify"><font><b>Celsus (25 BC-50 AD) was the first to give a detailed description of two surgical techniques for uncircumcision in his <i>De medicina libri octo.</i> Subsequent works, for example by Galen (131-200 AD) and Paulus Aeginata in the seventh century, only contained a repetition of these methods without presenting any new aspects.</b></font></p>
<p align="justify"><font><b>Ambroise Paré gave a new impetus in the sixteenth century, suggesting the insertion of a catheter into the distal urethra to guarantee free passage of urine during postoperative healing. In this past century, Johann Friedrich Dieffenbach was the first to dedicate a whole chapter to the problem of "posthioplastice" in a modern textbook of plastic surgery.</b></font></p>
<p align="justify"><font><b>Almost no written documents exist of uncircumcision during the Nazi era; nevertheless, surgical treatment seemed to be widespread as every circumcised man was in danger of being denounced as a Jew. Personal reports of patients and doctors performing surgical restoration of the prepuce are presented.</b></font></p>
<p align="justify"><font><b>Nowadays, reports on surgical foreskin restoration are still rare and alternative methods of nonsurgical skin-expansion have become more common. Several organizations were founded in America against routine infant circumcision and give advice to foreskin restoration seekers. <i>(Plast. Reconstr. Surg.</i> 101: 1990, 1998.)</b></font></p>
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<p align="justify">Circumcision has been widespread since the beginning of civilization and was reported in the medical literature of the earliest cultures. It is not surprising, therefore, that the first illustration of a surgical procedure, a bas-relief from a tomb in Sakkara (Egypt; about 2200 BC), depicted a circumcision scene.)<a href="http://www.cirp.org/library/restoration/schultheiss/#n1">1</a></p>
<p align="justify">In most cases, this procedure was performed with a ritual or religious intention, e.g., as a sacrificial act for a god or as a token of the "covenant" as in Jewish religion. Furthermore, hygienic and medical reasons were of importance at all times. In ancient days, circumcision or even more extensive mutilation of the external genitalia was carried out on defeated enemies, captives, or slaves as a sign of subjugation.<a href="http://www.cirp.org/library/restoration/schultheiss/#n2">2</a>,<a href="http://www.cirp.org/library/restoration/schultheiss/#n3">3</a></p>
<p align="justify">The demand for surgical or nonsurgical restoration of the prepuce after circumcision, the so-called uncircumcision, was usually associated with the persecution of the Jewish people. This association is documented from the times of the Old Testament until the darkest period of our century.</p>
<p align="justify">By some authors, the procedure of restoring the lost or missing foreskin was called decircumcision (e.g., Celsus) or posthioplasty (e.g., Dieffenbach). Because these terms were partly used for the same operative technique, there is no uniform definition for them; therefore, they are more or less exchangeable.</p>
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<p align="center">FIRST WRITTEN EVIDENCE FOR RESTORING THE PREPUCE</p>
<p align="justify">The first sign of evidence for uncircumcision among the Jews can be seen in a passage of the Old Testament (I Maccabees 1: 14-15): "Whereupon they built a place of exercise at Jerusalem according to the customs of the heathen. And made themselves uncircumcised (sibi praeputia fecerunt), and forsook the holy covenant, and joined themselves to the heathen, and were sold to do mischief."<a href="http://www.cirp.org/library/restoration/schultheiss/#n4">4</a>,<a href="http://www.cirp.org/library/restoration/schultheiss/#n5">5</a> This passage was written at the time of the reign of Antiochus IV (168 BC), when the hellenization of Palestine and, therefore, the oppression of the Jewish religion and culture came to a first climax. Hellenistic ideals gained popularity, and it was, for example, common to exhibit the naked body at athletic games or at public baths. Jews were forced to hide their genitalia or restore their prepuces, so as not to be persecuted and to improve their social and economic position. This situation culminated in a law by Antiochius dictating that the act of circumcision was to be punished by death sentence (I Maccabees 1:63-64).</p>
<p align="justify">The restoration of the prepuce was either done operatively, as it will be described below, or bloodlessly with the help of the so-called <i>Pondus Judaeus.</i> Both methods took advantage of the common way of symbolic circumcision among Jews at that time, the <i>milah.</i> Only the distal part of the foreskin was cut off, leaving a short prepuce that partly covered the glans. The <i>Pondus Judaeus</i> was a special weight made of bronze, copper, or leather, which was fixed to this rudimentary preputial skin and pulled it downward. When it was applied for a longer period, the foreskin was lengthened and covered the glans totally as desired.<a href="http://www.cirp.org/library/restoration/schultheiss/#n3">3,</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n6">6,</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n7">7</a> This device could, therefore, be referred to as an ancient tissue expander, rather a tissue stretcher, keeping in mind that similar methods for uncircumcision are still offered in our days. Unfortunately, no detailed description or illustration of such a Jewish weight exists.</p>
<p align="justify">The successful Jewish revolt against Antiochus IV in 141 BC led to the establishment of the Hasmonean or Maccabean reign in Judea, making uncircumcision unnecessary for the following period. Later in 63 BC, the Romans took over the supreme authority and, together with the rise of Christianity, a new desire for hiding the state of circumcision appeared. Obviously, many Jews who converted to the Christian religion underwent uncircumcision to emphasize the break with their old religion and to be fully accepted in the Christian community. The Apostle Paul condemned this practice by saying: "Is any called being circumcised? Let him not be uncircumcised. Is any called being uncircumcised, let him not be circumcised" (I Corinthians 7:18).</p>
<p align="justify">The Roman tolerance toward circumcision among Jews came to an end with the hellenophilic emperor Hadrian, who was proclaimed emperor in 117 AD and once again urged a law forbidding circumcision. The Talmud gives proof that during his reign many of the circumcised turned to uncircumcision for obvious reasons.<a href="http://www.cirp.org/library/restoration/schultheiss/#n8">8</a> This habit was rejected by orthodox Jews and, therefore, after the law against circumcision was loosened again about 140 AD, they introduced radical circumcision to the Jewish community, the so-called <i>periah.</i> It left the glans totally uncovered and made it almost impossible to perform the above-mentioned methods of restoring the prepuce.<a href="http://www.cirp.org/library/restoration/schultheiss/#n3">3,</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n7">7</a></p>
<p align="justify">In Greek terminology, a person who had undergone the procedure of stretching the prepuce was known as <i>epispastikós,</i> the stretched one (epispasmós = pull-over). Similarly, the Romans addressed him as <i>recutitio,</i> the reskinned (cutis = skin), not differentiating by this term whether it was done surgically or nonsurgically.<a href="http://www.cirp.org/library/restoration/schultheiss/#n3">3</a></p>
<p align="justify">Uncircumcision is also mentioned in Roman poetry of the first century. Petronius (died 66 AD) in <i>Trimalchio's Dinner</i> from his work <i>Saturae</i> told us of a slave who had "two defects, without which he would be priceless: he is reskinned and he snores (recutitus est et stertit)."<a href="http://www.cirp.org/library/restoration/schultheiss/#n3">3</a></p>
<p align="justify">In one of his epigrams (Epigrammaton Libri 7:30) Marcus Valerius Martialis (38/41-100 AD) portrayed a Roman prostitute named Caelia.<a href="http://www.cirp.org/library/restoration/schultheiss/#n3">3-</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n5">5</a> She was never pleased by a Roman man but preferred to make love to Parthians, Germans, Dacians, Cilicians, Cappadocians, Egyptians, and Indians.<a href="http://www.cirp.org/library/restoration/schultheiss/#n3">3-</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n5">5</a> This list is continued with the passage, "Nor do you shun the reskinned Jewish private parts (recutitorum inguina Judaeorum)." Martial also mentioned the <i>Pondus Judaeus</i> and gave a short description of it (Epigrammaton Libri 7:35).</p>
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<tbody><tr><td><p align="center">CELSUS' METHODS OF OPERATIVE UNCIRCUMCISION</p>
<p align="justify">The first detailed description of an operative procedure for uncircumcision was given by the Roman medical writer Aulus Cornelius Celsus (25 BC-50 AD), seen on a later portrait in Figure 1. His comprehensive encyclopedic work <i>De medicina libri octo</i> was written during the reign of Tiberius (14-37 AD). It can be valued as the most important written document in the early history of medicine, which was not questioned until the scientific innovations of the Renaissance established modern medicine. In <i>De medicina</i> 7:25:1 he differentiated between two methods of prepuce reconstruction, which he referred to as "decircumcision."<a href="http://www.cirp.org/library/restoration/schultheiss/#n9">9</a></p>
<p align="center"><img height="414" width="375" src="http://www.cirp.org/library/restoration/schultheiss/uncirc1.jpg" align="top" vspace="10" hspace="20"/></p>
<p align="center"><font face="arial, helvetica, helvetica" size="-1"><b>FIG. 1. Aulus Cornelius Celsus (25 BC-50AD) (from: Sambucus, Icones veterum aliquat ac recentium medicorum, 1574).</b></font></p>
<p align="justify">The first procedure he recommended mainly for children or for those with a congenitally shortened foreskin (Fig. 2). The skin of the penis was incised around the root and after mobilization, stretched over the glans. Ligation at the tip prevented any recession into the original position. Thus a physiologic double-layered prepuce was reconstructed, and the proximal skin impairment was reepithelialized during the course of the healing process.</p>
<p align="center"><img height="197" width="375" src="http://www.cirp.org/library/restoration/schultheiss/uncirc2.gif" align="top"/></p>
<p align="center"><b><font face="arial, helvetica" size="-1">FIG. 2. Celsus' first method of <i>"Decircumcision"</i> (after: Rubin, J.P. Celsus' Decircumcision Operation. <i>Urology</i> 16: 121, 1980).</font></b></p>
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<tbody><tr><td><p align="justify">If the patient had been circumcised after the customs of certain races <i>(qui quarundam gentium more circumcisus est),</i> mainly the Jewish <i>milah,</i> Celsus suggested the second method. A coronary incision was made, and the penile skin was mobilized along the whole length of the penis to the root (Fig. 3, <i>above).</i> The skin was thus stretched over the glans and recession was now prevented by means of a bandage fixed securely over the penile shaft from the pubis to the glans (Fig. 3, <i>below).</i> Only a single layer of skin was obtained over the glans, and adhesion was counteracted by the application of additional saturated dressings and plasters.</p>
<p align="justify">To avoid an erection during the healing period, Celsus advised a strict diet. The indication for the procedure of uncircumcision was described by him as <i>decoris causa,</i> an aesthetic reason without any medical necessity.<a href="http://www.cirp.org/library/restoration/schultheiss/#n8">8,</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n9">9</a></p>
<p align="center"><img height="436" width="375" src="http://www.cirp.org/library/restoration/schultheiss/uncirc3.gif" align="top"/></p>
<p align="center"><font face="arial, helvetica" size="-1"><b>FIG. 3 Celsus' second method of <i>"Decircumcision"</i> (after: Rubin, J.P. Celsus' Decircumcision Operation. <i>Urology</i> 16: 121, 1980).</b></font></p>
<p align="justify">Celsus did not point out the possible risks and failures of his methods. It is unlikely that he never experienced severe wound infection performing this kind of genital surgery and not knowing the principles of asepsis. Furthermore, both methods suggest a significant risk of postoperative failure, as, e.g., Dieffenbach pointed out in his comment on Celsus work.<a href="http://www.cirp.org/library/restoration/schultheiss/#n10">10</a> When the new prepuce is not permanently tightened at its tip, retraction of the scars may pull the skin backward with the glans remaining uncovered again. A simple dressing might not be able to prevent this effect until wound healing is completed.<a href="http://www.cirp.org/library/restoration/schultheiss/#n6">6</a></p>
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<p align="center">MEDICAL LITERATURE FROM GALEN TO DIEFFENBACH</p>
<p align="justify">A complete review on the medical literature dealing with uncircumcision is given in the remarkable <i>Zeis Index</i> of 1863, a detailed history of plastic surgery by the surgeon and historian Eduard Zeis from Dresden.<a href="http://www.cirp.org/library/restoration/schultheiss/#n4">4</a> He had also introduced the term <i>plastic surgery</i> (Plastische Chirurgie) into the medical terminology with the first textbook on this subject in 1838.<a href="http://www.cirp.org/library/restoration/schultheiss/#n11">11</a> The following text presents the important and relevant highlights of the history of uncircumcision; in addition Table I gives a more extensive overview of medical authors dealing with foreskin restoration between the second and the nineteenth century:<br/><br/></p>
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<p>TABLE I</p>
<p>Overview of Medical Authors Dealing with Uncircumcision from the Second Century AD to the Nineteenth Century (According to the "Zeis Index")</p>
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<tr><td>Claudius Galenus</td>
<td>131-200 AD</td>
<td>Methodus medendi; Lib. XIX</td>
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<tr><td>St. Epiphanius</td>
<td>4th century</td>
<td>De ponderibus et mensuris liber</td>
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<tr><td>Paulus Aegineta</td>
<td>7th century</td>
<td>Lib. VI; Ad tegendam glandem colis si nuda est</td>
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<tr><td>Gabriel Fallopius</td>
<td>1523-1562</td>
<td>De praeputii brevitate corrigenda</td>
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<tr><td>Ambroise Paré</td>
<td>1510/17-1590</td>
<td>Opera chirurgica; De curtiore praeputio, deque Recutitis</td>
</tr>
<tr><td>Fabricius ab Aquapendente</td>
<td>1537-1619</td>
<td>De chirurgicis operationibus; Ad tegendam colis glandem detectam</td>
</tr>
<tr><td>Johann von Jessen</td>
<td>1601</td>
<td>Institutiones chirurgicae; Sect. IV, Cap. IV</td>
</tr>
<tr><td>Marcus Aurelius Severinus</td>
<td>1643</td>
<td>De efficaci Medicina; De Lypoderma</td>
</tr>
<tr><td>Thomas Bartholin</td>
<td>1672</td>
<td>De morbis biblicis Miscellanea medica; De praeputio adducendo</td>
</tr>
<tr><td>Jobus Ludolfus</td>
<td>1691</td>
<td>De praeputio rursus superinducendo</td>
</tr>
<tr><td>Pierre Dionis</td>
<td>1708</td>
<td>Cours d'opérations de chirurgie; De l'opération des recutiti</td>
</tr>
<tr><td>Gabriel Groddeck</td>
<td>1733</td>
<td>De Judaeis praeputium attrahentibus</td>
</tr>
<tr><td>Eduard Zeis</td>
<td>1838</td>
<td>Handbuch der plastischen Chirurgie; Von der Posthioplastik</td>
</tr>
<tr><td>Johann Friedrich Dieffenbach</td>
<td>1845</td>
<td>Die operative Chirurgie; Posthioplastice</td>
</tr>
<tr><td>Antoine-Joseph Jobert</td>
<td>1849</td>
<td>Traité de chirurgie plastique; Autoplastic du prépuce</td>
</tr>
<tr><td>Aristide Verneuil</td>
<td>1858</td>
<td>L'histoire de l'atioplastie</td>
</tr>
<tr><td>Jean Louis Petit</td>
<td>1873</td>
<td>Oeuvres complètes; Du paraphimosis</td>
</tr>
</tbody>
</table>
</center>
<p> </p>
<center><table width="80%">
<tbody><tr><td><p align="justify">Claudius Galenus (131-200 AD), the next great contributor to ancient medicine after Celsus, only reported his methods without modifications.<a href="http://www.cirp.org/library/restoration/schultheiss/#n12">12</a></p>
<p align="justify">The same is to be said about Paulus Aeginetas description: <i>Ad tegendam glandem colis si nuda est</i> (middle of the seventh century). He stated that there was almost no need for uncircumcision in his time and, therefore, it was hardly ever performed.<a href="http://www.cirp.org/library/restoration/schultheiss/#n13">13</a></p>
<p align="justify">This belief is also confirmed by most surgeons of the Renaissance: Gabriello Fallopio (1523-1562) commented on uncircumcision as follows: "I can testify that I have never cut nor found anyone so foolish as to be willing to suffer this torture."<a href="http://www.cirp.org/library/restoration/schultheiss/#n14">14</a></p>
<p align="justify">Fabricius ab Aquapendente (1537-1619) declared it "to be unnecessary and objectionable, as it is only carried out to improve the appearance, and this is a part which is not exposed."<a href="http://www.cirp.org/library/restoration/schultheiss/#n15">15</a></p>
<p align="center"><img height="333" width="200" src="http://www.cirp.org/library/restoration/schultheiss/uncirc4.jpg" align="middle"/></p>
<p align="center"><font face="arial, helvetica" size="-1"><b>FIG. 4 Frontispiece from the first English translation of the work of Ambroise Paré (from Paré, A. <i>The Workes of that famous Chirurgion Ambrose Parey.</i> T. Johnson, trans. London, 1634).</b></font></p>
<p align="justify">Only the second method of Celsus is quoted by Ambroise Paré (1510/17-1590), who was the first to suggest the insertion of a catheter ("pipe") into the distal urethra to allow free passage of urine during postoperative healing. Figure 4 shows the frontispiece of the first English translation from 1634 with a portrait of Paré at the top. Figure 5 shows the chapter dealing with uncircumcision "Of the too short a Prapuce, and of such as have bin circumcised."<a href="http://www.cirp.org/library/restoration/schultheiss/#n16">16</a></p>
<p align="center"><img height="246" width="425" src="http://www.cirp.org/library/restoration/schultheiss/uncirc5.gif"/></p>
<p align="center"><font face="arial, helvetica" size="-1"><b>FIG. 5. "Uncircumcision" from the first English translation of the work of Ambroise Paré (from Paré, A. <i>The Workes of that Famous Chirugion Ambrose Parey.</i> T. Johnson, trans. London, 1634).</b></font></p>
<p align="justify">The founder of modern plastic surgery, Johann Friedrich Dieffenbach (1795-1847, Berlin, see Fig. 6), dedicated a whole chapter in both of his surgical textbooks, from 1829 and 1845,<a href="http://www.cirp.org/library/restoration/schultheiss/#n10">10</a> on the problem of how to restore the prepuce. He entitled this operation "posthioplastice". After recapitulating Celsus methods, he offered technical improvements to prevent postoperative failure. In the first method of Celsus, for example, he suggested a distal narrowing of the new prepuce to avoid retraction over the glans. This method could be done by triangular excision of skin or by fixation of a metal clamp at the preputial tip. Dieffenbach quoted Celsus indications for posthioplastice such as "luxury, religion, shame or politics". On the other hand, he called it "a disgrace to the medical profession to perform it with the intention of creating a male virgin, comparable to the surgical restoration of a new hymen in women." He additionally described the closure of the divided prepuce in hypospadias and reconstruction in a totally cicatrized inner foreskin layer after balanitis. In the second case, he made a circular incision at the tip of the foreskin retracting the penile skin back to the shaft. The remaining inner layer of the prepuce cicatrized to the glans was then separated with the scalpel. Finally, the penile skin had to be inverted and kept in this position by sutures with the former outer layer now becoming the inner layer of the new prepuce.<a href="http://www.cirp.org/library/restoration/schultheiss/#n10">10</a></p>
<p align="center"><img height="439" width="375" src="http://www.cirp.org/library/restoration/schultheiss/uncirc6.jpg"/></p>
<p align="center"><font face="arial, helvetica" size="-1"><b>FIG. 6 Johann Friedrich Dieffenbach (1792-1847) (from: Meade, R. H. <i>An Introduction to the History of General Surgery,</i> Philadelphia: Saunders, 1968.)</b></font></p>
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<tbody><tr><td><p align="center">UNCIRCUMCISION DURING THE NAZI ERA</p>
<p align="justify">The persecution of Jews under the Nazi regime made the state of being circumcised a life-threatening fact, making no difference whether the person had lost his foreskin for religious reasons or because of a congenital or acquired phimosis. So every circumcised man at that time was in danger of being denounced and, therefore, had to hide his genital state or have it uncircumcised. No description of a surgical technique can be found in the official medical literature of this time, but there exist several personal reports of patients undergoing and doctors performing uncircumcision during this time. One example is the work of Tenenbaum who knew several of these doctors and also examined some of the patients treated.<a href="http://www.cirp.org/library/restoration/schultheiss/#n17">17</a></p>
<p align="justify">From the memoirs of Jonas Turkow, a famous actor at that time, we hear the story of his nephew being uncircumcised twice without success. He pointed out that several "Aryan doctors" made a good living from this procedure by asking large sums of money for the treatment.<a href="http://www.cirp.org/library/restoration/schultheiss/#n18">18</a></p>
<p align="justify">Feriz performed several operations on circumcised patients in occupied Holland. After a circumferential incision at the base of the penis the penile skin was pulled over the glans, forming the new prepuce. The proximal skin defect was then covered by burying the penis under a tunnel of ventral scrotal skin. In a second stage operation about 10 days later he mobilized the penis and closed the new skin layer at the underside of the penis. The scrotal defect was easily closed in all cases. In his publication from 1962, Feriz reported no complications, and all of his patients were satisfied with the postoperative result; none of them requested a reversal of the surgery after the war.<a href="http://www.cirp.org/library/restoration/schultheiss/#n19">19</a></p>
<p align="justify">In 1965, <a href="http://www.cirp.org/library/restoration/tushmet1/">Tushnet</a> reported three different procedures to restore the prepuce depending on the age of the patient, the remaining preputial skin, and the skill of the surgeon.<a href="http://www.cirp.org/library/restoration/schultheiss/#n6">6</a> These facts were also investigated by interviewing patients and doctors who remained unnamed. The first and crudest method was to pull forward the penile skin over the glans, scarify the new prepuce edges, and avoid recession by suturing them together, thus producing a phimosis. This implied a high failure rate because the sutures were often extruded and the skin was retracted to the former position. The second method was quite similar to the second procedure of Celsus, resulting in a single-layered new prepuce. The main disadvantage of this way of foreskin restoration was the high infection rate. Finally, the last and most sophisticated method was performed by using a skin graft from the area over the iliac crest serving as the new prepuce.</p>
<p> </p>
<p align="center">MOTIVATION FOR PREPUCE RESTORATION IN OUR DAYS</p>
<p align="justify">During the past 30 years, a new movement of foreskin restoration has emerged mainly in the United States not originating from social, religious, or political demands. With routine male infant circumcision being established in America, more and more adult circumcised males are disturbed by the fact that the shape of their body had been altered after birth. Their main complaint is the loss of function; the prepuce is not just seen as a part of the human skin but referred to as a sensory organ of the body.<a href="http://www.cirp.org/library/restoration/schultheiss/#n20">20</a> Circumcision results in a lack of this organ and furthermore in a decrease of lubrication and sensibility of the glans because of increasing keratinization of the epithelium. That is why many circumcised men feel that their sexual pleasures are reduced. Others are more disturbed by the outer appearance of their circumcised penis and want to regain the natural status of a covered glans for physical and emotional wholeness and aesthetic body imaging. A minority is additionally irritated by the imagination that they had been mutilated as an infant without the chance to have a free choice of their genital status. A high percentage of these patients even resent their parents, doctors, or culture for their circumcision.<a href="http://www.cirp.org/library/restoration/schultheiss/#n7">7,</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n21">21,</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n22">22</a></p>
<p align="justify">On the one hand, this development has led to the organization of several movements against routine circumcision in America. <a href="http://www.nocirc.org/">NOCIRC</a> (National Organization of Circumcision Information Resource Centers) and <a target="_blank" href="http://www.noharmm.org/">NOHARMM</a> (National Organization to Halt the Abuse and Routine Mutilation of Males) were founded by "circumcision victims". Others were initiated by doctors or nurses who did no longer agree with the general attitude toward infant circumcision: D.O.C. (Doctors Opposing Circumcision) and Nurses for the Rights of the Child. Furthermore, <a href="http://www.norm.org/">NORM</a> (National Organization of Restoring Man) provides information, literature, and material about nonsurgical and surgical methods of foreskin restoration. Most of these organizations have spread to other continents and are easily accessible by means of the Internet (see Internet references<a href="http://www.cirp.org/library/restoration/schultheiss/#n23">23</a>).</p>
<p align="justify">The first report of uncircumcision for psychological reasons was reported by <a href="http://www.cirp.org/library/restoration/penn1/">Penn</a> in 1963.<a href="http://www.cirp.org/library/restoration/schultheiss/#n24">24</a> This article and the ones of the following years failed to give detailed information on the patient's motivation, and the authors were to a certain extent criticized for performing such a procedure at all.<a href="http://www.cirp.org/library/restoration/schultheiss/#n25">25</a></p>
<p align="justify">In 1981, Mohl presented the first detailed analysis of psychiatric aspects in a group of eight patients seeking prepuce restoration.<a href="http://www.cirp.org/library/restoration/schultheiss/#n26">26</a> He described several psychological disorders in these patients as narcissistic and exhibitionistic body image, depressions, major defects in early mothering, and ego pathology. Uncircumcision is compared with the request for augmentation mammoplasty in women. One of the main arguments of the modern uncircumcision movement, the loss of prepuce function in sexual activity, is not mentioned at all. Furthermore, all of the patients were currently or had in the past been exclusively homosexual.</p>
<p align="justify">Nowadays the understanding of the psychological motivations for uncircumcision is increasing, and the problem is dealt with more seriously. Actually, it is no longer only a matter of the homosexual community because the majority of the males performing skin-stretching is heterosexual.<a href="http://www.cirp.org/library/restoration/schultheiss/#n27">27</a></p>
<p> </p>
<p align="center">MODERN TECHNIQUES OF UNCIRCUMCISION</p>
<p><i><b>Skin Expansion</b></i></p>
<p align="justify">Despite the antique reports on the <i>Pondus Judaeus,</i> modern techniques of stretching penile skin have become famous only as lately as in the 1980s.<a href="http://www.cirp.org/library/restoration/schultheiss/#n7">7</a> Today, foreskin-stretching is estimated to be performed by over 10,000 individuals in the United States for the above-mentioned reasons.<a href="http://www.cirp.org/library/restoration/schultheiss/#n27">27</a> All methods depend on some kind of tape that is attached to the skin. The best overview with detailed instructions for skin-expansion is given in the work of Bigelow.<a href="http://www.cirp.org/library/restoration/schultheiss/#n7">7</a></p>
<p align="justify">The easiest way to start with is to pull the residual foreskin or the skin of the penile shaft over the glans as far as possible. The skin is fixed in this position by one or two tape straps that run from one side of the stretched penile skin over the tip of the glans to the other side of the shaft. If there is enough foreskin to cover the whole glans it is also possible to apply a tape ring around the distal skin of the new prepuce that makes it impossible to retract. The tape is either changed daily or in most cases left until it gets off the skin. In these simple methods simple pressure from the glans will start stretching the skin.</p>
<p align="justify">After sufficient skin has been obtained some kind of extension device can be attached to it to get more tension on the tissue. A simple weight might be fixed to the tape stretching by gravity but only works when the patient is in a standing position. Alternatively a stretched elastic strap is attached to the back of a garter belt under the knee or at the waist to perform permanent tension. Finally rubber cones in graduating sizes can be worn within the foreskin which is held in position by a tape ring.</p>
<p align="justify">The skin-expansion method is very time consuming. The period to regain a prepuce varies from about half a year to several years and depends on how much skin was left after circumcision, how persistently one is stretching, and what length of the new prepuce is desired. The problems of skin irritation through the tape can be diminished by correct hygiene and technique.</p>
<p align="justify">The natural narrowing of the tip of the prepuce, the so-called frenar band, can be additionally reconstructed by minor plastic surgery, e.g., tissue-removal techniques, transverse incision with vertical suturing or a circumferential purse-string suture.</p>
<p><i><b>Surgical reconstruction</b></i></p>
<p align="justify">The very first case report in modern medical literature about foreskin reconstruction was published in 1898.<a href="http://www.cirp.org/library/restoration/schultheiss/#n28">28</a> Mercier from Canada only performed construction of the frenulum and narrowing of the "new" foreskin in a patient 2 years after moderate circumcision that left enough skin at the penile shaft to cover the glans.</p>
<p align="justify">Several surgical procedures practiced during the Nazi era have been reported above.</p>
<p align="justify">In 1963 <a href="http://www.cirp.org/library/restoration/penn1/">Penn</a> from Johannesburg, after performing a proximal circular incision and pulling forward the penile skin to form a new prepuce, covered the denuded shaft with a "free graft", not indicating from where he took this graft.<a href="http://www.cirp.org/library/restoration/schultheiss/#n24">24</a></p>
<p align="justify"><a href="http://www.cirp.org/library/restoration/goodwin1/">Goodwin</a><a href="http://www.cirp.org/library/restoration/schultheiss/#n29">29</a> covered the same defect in 1990 by implantation of the penis into the scrotum first and then liberating it in a second stage. This procedure is almost identical to the method of Feriz mentioned earlier<a href="http://www.cirp.org/library/restoration/schultheiss/#n19">19</a> and had been slightly modified before by <a href="http://www.cirp.org/library/restoration/greer1/">Greer</a> in 1982.<a href="http://www.cirp.org/library/restoration/schultheiss/#n30">30</a> A pedicled island scrotal flap was used for the same purpose by Lynch and Pryor in a one-stage procedure in 1993.<a href="http://www.cirp.org/library/restoration/schultheiss/#n31">31</a></p>
<p align="justify">All these publications are single case reports stating no severe complications, and it is not known whether the patients were fully satisfied with the result. Bigelow was able to reinvestigate a few patients operated on by the method of Greer and Goodwin.<a href="http://www.cirp.org/library/restoration/schultheiss/#n7">7</a> Some of them were extremely pleased with the result and others disliked their new genital status; there was even one patient who underwent recircumcision afterward.</p>
<p align="justify">Despite the possible complications of surgery and the inevitable presence of scars, the main disadvantage seems to be the different color and texture of the original penile skin and the graft. This outcome may not be what the patient had expected; therefore, most foreskin restoration seekers nowadays prefer skin expansion systems, which avoid these problems</p>
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<center><table width="80%">
<tbody><tr><td><p align="center"><img height="451" width="200" src="http://www.cirp.org/library/restoration/schultheiss/uncirc7.jpg"/></p>
<p align="center"><font face="arial, helvetica" size="-1"><b>FIG. 7 David (Michelangelo Buonarroti, 1501-1504, Accademia, Florence).</b></font></p>
<p> </p>
<p align="center">A CLOSING REMARK: UNCIRCUMCISION AND THE FINE ARTS</p>
<p align="justify">Lastly, another historic example dealing with the matter of circumcision and uncircumcision can be presented from the fine arts, surprising us that this problem is of any relevance in this field. From 1501 to 1504 Michelangelo Buonarroti created the statue of David (Fig. 7), which is today one of Florence’s main cultural and tourist attractions. One might be rather surprised that this representative of the Jewish people is shown with his penis not circumcised. Was Michelangelo just submitting to the aesthetic taste of his time, thereby making use of artistic liberty, as he had done before?<a href="http://www.cirp.org/library/restoration/schultheiss/#n32">32</a> Or did he fear any discredit of the Church or his customers by presenting such an obvious sign of Judaism as a circumcised penis? Some authors even postulated that Michelangelo had in mind to attach the face and weapons of David to the statue of Goliath.<a href="http://www.cirp.org/library/restoration/schultheiss/#n33">33</a> Because this question cannot be answered definitely, the reader is asked to make up his own mind.</p>
<p><i>Dirk Schultheiss, M. D.<br/>Department of Urology<br/><a href="http://www.mh-hannover.de/">Medizinische Hochschule Hannover</a><br/>Carl-Neuberg-Str. 1<br/>30625 Hannover, Germany</i></p>
<p> </p>
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<tbody><tr><td><p align="center">REFERENCES</p>
<ol>
<li><a name="n1" id="n1"></a>Hanafy, H. M., Sadd, S. M., and Al-Ghorab, M. M. Ancient Egyptian medicine. <i>Urology</i> 4: 114, 1974.</li>
<li><a name="n2" id="n2"></a>Bolande, R. P. Ritualistic surgery-circumcision and tonsillectomy. <i>N. Engl. J. Med.</i> 280: 591, 1969.</li>
<li><a name="n3" id="n3"></a>Edwardes, A. <i>Erotica Judaica.</i> New York: The Julian Press, 1967.</li>
<li><a name="n4" id="n4"></a>Zeis, E. <i>Die Literatur und Geschichte der Plastischen Chirurgie.</i> Leipzig: Verlag von Wilhelm Engelmann, 1863.</li>
<li><a name="n5" id="n5"></a>Zeis, E. <i>The Zeis Index and History of Plastic Surgery.</i> J. S. Patterson, trans. Baltimore: Williams & Wilkins, 1975.</li>
<li><a name="n6" id="n6"></a>Tushnet, L. <a href="http://www.cirp.org/library/restoration/tushmet1/">Uncircumcision</a>. <i>Medical Times</i> 93: 588, 1965.</li>
<li><a name="n7" id="n7"></a>Bigelow, J. <i>The Joy of Uncircumcising!</i> Aptos: Hourglass Book Publishing, 1995.</li>
<li><a name="n8" id="n8"></a>Schneider, T. <a href="http://www.cirp.org/library/restoration/schneider/">Circumcision and Uncircumcision</a>. <i>S. Afr. Med. J.</i> 50: 556, 1976.</li>
<li><a name="n9" id="n9"></a>Rubin, J. P. <a href="http://www.cirp.org/library/restoration/rubin/">Celsus' decircumcision operation</a>. <i>Urology</i> 16: 121, 1980.</li>
<li><a name="n10" id="n10"></a>Dieffenbach, J. F. <i>Die Operative Chirurgie.</i> Leipzig: F. A. Brockhaus, 1845.</li>
<li><a name="n11" id="n11"></a>Zeis, E. <i>Handbuch der Plastischen Chirurgie.</i> Berlin: G. Reimer, 1838.</li>
<li><a name="n12" id="n12"></a>Galen, C. <i>Methodus Medendi.</i> Lib. XIV, Cap. 16: Editio Kuhniana. Vol. X. Lipsiae, 1825.</li>
<li><a name="n13" id="n13"></a>Paulus Aegineta. <i>Des besten Arztes sieben Bucher.</i> Leiden: E. J. Brill, 1914.</li>
<li><a name="n14" id="n14"></a>Fallopius, G. <i>Operum Tomus II. Opera Johann.</i> Frankfurt: Petri Maphaei, 1600.</li>
<li><a name="n15" id="n15"></a>Fabricius ab Aquapendente. Opera chirurgica in Pentateuchum et operationes chirurgicas distincta. <i>Patavii</i>, 1666.</li>
<li><a name="n16" id="n16"></a>Pare, A. <i>The Workes of that Famous Chirurgion Ambrose Parey.</i> T. Johnson, trans. London, 1634.</li>
<li><a name="n17" id="n17"></a>Tenenbaum, J. <i>In Search of a Lost People.</i> New York: Beechhurst Press, 1948.</li>
<li><a name="n18" id="n18"></a>Turkow, J. <i>In Kamf farn Lebn.</i> Buenos Aires: Tsentral-Farband fun Poylishe Yidn, 1949.</li>
<li><a name="n19" id="n19"></a>Feriz, H. Eine einfache Methode zur Plastik des Praputiums nach radikaler (ritueller) Zirkumzision. <i>Munch. Med. Wochenschr.</i> 31: 1406, 1962.</li>
<li><a name="n20" id="n20"></a>Taylor, J. R., Lockwood, A. P., and Taylor, A. J. <a href="http://www.cirp.org/library/anatomy/taylor/">The prepuce: Specialized mucosa of the penis and its loss to circumcision</a>. <i>Br. J. Urol.</i> 77: 291, 1996.</li>
<li><a name="n21" id="n21"></a>Hammond, T. <a target="_blank" href="http://www.noharmm.org/bju.htm">Awakenings: A preliminary poll of circumcised men</a>. San Francisco: NOHARMM, 1994.</li>
<li><a name="n22" id="n22"></a>NOCIRC Annual Report. 11(1), 1997.</li>
<li><a name="n23" id="n23"></a>National Organization of Circumcision Information Resource Centers. Available at: NOCIRC <a target="_blank" href="http://www.nocirc.org/">http://www.nocirc.org/</a>.<br/>National Organization to Halt the Abuse and Routine Mutilation of Males. Available at: <a target="_blank" href="http://www.noharmm.org/">NOHARMM</a> <a href="http://eskimo.com/~gburlin/noharmm/">http://eskimo.com/~gburlin/noharmm/</a><br/>Doctors Opposing Circumcision. Available at: D.O.C. <a target="_blank" href="http://weber.u.washington.edu/~gcd/DOC/">http://weber.u.washington.edu/~gcd/DOC/</a><br/>National Organization of Restoring Man. Available at: <a href="http://www.norm.org/">NORM</a> <a href="http://www.geocities.com/HotSprings/2100/">http://www.geocities.com/HotSprings/2100/</a>.</li>
<li><a name="n24" id="n24"></a>Penn, J. <a href="http://www.cirp.org/library/restoration/penn1/">Penile reform</a>. <i>Br. J. Plast. Surg.</i> 16: 287, 1963.</li>
<li><a name="n25" id="n25"></a>Schoen, E.J. Uncircumcision technique for plastic reconstruction of a prepuce after circumcision (Letter). <i>J. Urol</i>. 146: 1619, 1991.</li>
<li><a name="n26" id="n26"></a>Mohl, P. C., Adams, R., Greer, D. M., and Sheley, K. A. Prepuce restoration seekers: Psychiatric aspects. <i>Arch. Sex. Behav.</i> 10: 383, 1981.</li>
<li><a name="n27" id="n27"></a>Hammond, T. Personal communication, 1997.</li>
<li><a name="n28" id="n28"></a>Mercier, O. F. Restauration d'un Prepuce. <i>L' Union Medicale du Canada</i> 3: 264, 1898.</li>
<li><a name="n29" id="n29"></a>Goodwin, W. E. <a href="http://www.cirp.org/library/restoration/goodwin1/">Uncircumcision: A technique for plastic reconstruction of a prepuce after circumcision</a>. <i>J. Urol.</i> 144: 1203, 1990.</li>
<li><a name="n30" id="n30"></a>Greer, D. M., and Mohl, P. C. <a href="http://www.cirp.org/library/restoration/greer1/">Foreskin reconstruction: A preliminary report</a>. <i>Sexual Medicine Today.</i> April 17, 1982.</li>
<li><a name="n31" id="n31"></a>Lynch, M. J., and Pryor, J. P. Uncircumcision: A one-stage procedure. <i>Br. J. Urol.</i> 72: 257, 1993.</li>
<li><a name="n32" id="n32"></a>Crosby, W. H. Michelangelo's David (Letter). <i>J.A.M.A.</i> 219: 1212, 1972.</li>
<li><a name="n33" id="n33"></a>Dock, W., and Crosby, W. H. Michelangelo's David (Letter). <i>J.A.M.A.</i> 219: 1212, 1972.</li>
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<br/><br/><hr/>Citation:
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<li>Schultheiss D, Truss MC, Stief CG, Jonas U. Uncircumcision: a historical review of preputial restoration. <i>Plast Reconstr Surg</i> 1998;101(7): 1990-1998.</li>
</ul>
History of ancient Medicine in Mesopotamia & Iran By: Massoume Price, October 2001
tag:travelingwithintheworld.ning.com,2011-01-30:2185477:Topic:97219
2011-01-30T19:32:52.068Z
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<font class="first">S</font>cience including medicine has a long history in Middle and Near East and goes back to the ancient Mesopotamian period (Beginning with Sumer 3000BC). There are many cuneiform tablets from cities as ancient as Uruk (2500 BC). The bulk of the tablets that do mention medical practices have…
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<font class="first">S</font>cience including medicine has a long history in Middle and Near East and goes back to the ancient Mesopotamian period (Beginning with Sumer 3000BC). There are many cuneiform tablets from cities as ancient as Uruk (2500 BC). The bulk of the tablets that do mention medical practices have survived from the library of Asshurbanipal at Nineveh (668BC) Assyria. So far 660 medical tablets from this library and 420 tablets from the library of a medical practitioner from Neo-Assyrian period, as well as Middle Assyrian and Middle Babylonian texts have been published. The vast majority of these tablets are prescriptions, but there are a few series of tablets that have been labeled "treatises". One of the oldest and the largest collections is known as "Treatise of Medical Diagnosis and Prognoses." The text consists of 40 tablets collected and studied by the French scholar R. Labat. Although the oldest surviving copy of this treatise dates to around 1600 BC, the information contained in the text is an amalgamation of several centuries of Mesopotamian medical knowledge. The diagnostic treatise is organized in head to toe order with separate subsections covering convulsive disorders, gynecology and pediatrics. To the non-specialist they sound like magic and sorcery. However, the descriptions of diseases demonstrate accurate observation skills. Virtually all expected diseases exist, they are described and cover neurology, fevers, worms and flukes, venereal disease and skin lesions. The medical texts are essentially rational, and some of the treatments, (such as excessive bleeding) are essentially the same as modern treatments for the same condition. <br/><br/>Mesopotamian diseases are often blamed on pre-existing spirits: gods, ghosts, etc., and each spirit was held responsible for only one disease in any one part of the body. Ancient mythologies tell stories of diseases that were put in the world by supernatural forces. One such figure was Lamashtu the daughter of the supreme god Anu, a terrible she-demon of disease and death. It was also recognized that various organs could simply malfunction, causing illness. Medicinal remedies used as cures were specifically used to treat the symptoms of the disease, and are clearly distinguished from mixes or plants used as offerings to such spirits. <br/><br/>There were two distinct types of professional medical practitioners in ancient Mesopotamia. The first type of practitioner is called ashipu, who in older texts is identified as a sorcerer or the witch doctor. One of the most important roles of the ashipu was to diagnose the ailment. In the case of internal diseases or difficult cases the ashipu determined which god or demon was causing the illness. He also attempted to determine if the disease was the result of some error or sin on the part of the patient. He prescribed charms and spells that were designed to drive out the spirit causing the disease. The ashipu could also refer the patient to a different type of healer called an asu. He was a specialist in herbal remedies, and in texts is frequently called "physician" because he dealt with empirical applications of medication. For example in case of wounds the asu applied washing, bandaging, and making plasters. The knowledge of the asu in making plasters is of particular interest. <br/><br/>Many of the ancient plasters (a mixture of medicinal ingredients applied to a wound often held on by a bandage) seem to have had some helpful benefits. For instance, some of the more complicated plasters called for the heating of plant resin or animal fat with alkali. This particular mixture when heated yields soap which would have helped to ward off bacterial infection. The two practitioners worked together and at times could function in both capacities. <br/><br/>Another textual source of evidence concerning the skills of Mesopotamian physicians comes from the Law Code of Hammurabi (1700 BC). There are several texts showing the liability of physicians who performed surgery. These laws state that a doctor was to be held responsible for surgical errors and failures. Since the laws only mention liability in connection with "the use of a knife," it can be assumed that doctors were not liable for any non-surgical mistakes or failed attempts to cure an ailment. According to these laws, both the successful surgeon's compensation and the failed surgeon's liability were determined by the status of his patient. Therefore, if a surgeon operated and saved the life of a person of high status, the patient was to pay a lot more as compared to saving the life of a slave. However, if a person of high status died as a result of surgery, the surgeon risked having his hand cut off. If a slave died the surgeon only had to pay enough to replace the slave. At least four clay tablets have survived that describe a specific surgical procedure. Three are readable, one seems to describe a procedure in which the asu cuts into the chest of the patient in order to drain pus from the pleura. The other two surgical texts belong to the collection of tablets entitled "Prescriptions for Diseases of the Head." One of these texts mentions the knife of the asu scraping the skull of the patient. The final surgical tablet mentions the postoperative care of a surgical wound. This tablet recommends the application of a dressing consisting mainly of sesame oil, which acted as an anti-bacterial agent. <br/><br/>It is hard to identify some of the drugs mentioned in the tablets. Often the asu used metaphorical names for common drugs, such as "lion's fat" (much as we use the terms "tiger Lilly" or "baby's breath"). Of the drugs that have been identified, most were plant extracts, resins, or spices. Many of the plants incorporated into the asu medicinal repertoire had antibiotic properties, while several resins and many spices have some antiseptic value, and would mask the smell of a malodorous wound. Beyond these benefits, it is important to keep in mind that both the pharmaceuticals and the actions of the ancient physicians must have carried a strong placebo effect. Patients undoubtedly believed that the doctors were capable of healing them. Therefore, visiting the doctor psychologically could reinforce the notion of health and wellness. Temples belonging to gods and goddesses of healing were also used for health care. Gula was one of the more significant gods of healing. The excavations of such temples do not show signs that patients were housed at the temple while they were treated (as was the case with the later temples of Asclepius in Greece). However these temples were sites for the diagnosis of illness and contained libraries that held many useful medical texts. The primary center for health care was the home. The majority of health care was provided at the patient's own house, with the family acting as care givers. Outside of the home, other important sites for religious healing were nearby rivers. These people believed that the rivers had the power to care away evil substances and forces that were causing the illness. Sometimes a small hut was set up either near the home or the river to aid the patient and their families. <br/><br/>While many of the basic tenants of medicine, such as bandaging and the collection of medical texts, began in Mesopotamia, other cultures developed these practices independently. In Mesopotamia many of the ancient techniques became extinct after surviving for thousands of years. It was Egyptian medicine that seems to have had the most lasting influence on the later development of medicine, through the medium of the Greeks. In the fifth century BC the Greek historian and traveler Herodotus commented on current medical practices in Egypt; <i>"the art of healing is with them divided up, so that each physician treats one ailment and no more. Egypt is full of physicians, some treating diseases of the eyes, others the head, others the teeth, others the stomach and others unspecified diseases".</i> <br/><br/>The ancient Egyptian texts of the Old Kingdom (2635-2155 BC) contain at least 50 physicians, mainly from their names on tombs. The later periods also give detailed information about physicians and their practice. Though most physicians were men, female physicians existed as well. The title ‘Lady Director of Lady Physicians’ proves the existence of a group of women who practised as doctors. Physicians were literate, some were scribes and others were priests at the same time. Most inherited the profession from their fathers but needed to be trained in the field. The profession was organised hierarchically with the Chief Physician at the top and lesser titles following, such as Master of Physicians, Director of Physicians, Inspector of Physicians, Plain Physicians and auxiliaries such as Bandage personnel etc. Texts deal with diagnosis, treatments and prescriptions. Surgery and mummification processes used by ancient Egyptians still amazes the modern experts. All major and expected diseases are known and treated, ailments are attributed to spirits, ghosts and revenge by gods and goddesses. Texts dealing with gynaecology cover fertility, sterility, pregnancy, contraception and abortion. Women were tested to decide whether they could conceive or not. However the Egyptians were behind Babylonian doctors who had gone further and designed the first pregnancy tests known in history. This test involved placing in the women’s vagina a tampon impregnated with the juice of various plants in a solution of alum. This was left in position either overnight or for three days. Pregnancy or non-pregnancy was indicated by colour changes between red and green. The test used the pH value of the woman’s secretions in vagina to determine pregnancy. Rational thinking and sound medical observation were used alongside magic and sorcery. Magic was based on the assumption that an object with certain qualities, or an action of a certain kind, could be used to create sympathetic action (healing) or to repel something evil. Magical elements were included in medical texts and were added to the prescriptions and medicines appropriate for treatment of diseases. Some conditions like sterility and impotence in men used magic extensively while other easier ailments relied mainly on medicinal treatments. Heart was extensively studied with arteries however it is not clear if they fully understood the circulation of blood. In fact heart was considered to be the organ of reason instead of the brain though this later organ was extensively studied as well. Anatomy was well understood and dissection was a common procedure. <br/><br/>There are many medical papyri providing detailed descriptions of surgical procedures and other topics related to medicine. The collections are massive and medical knowledge is organised and detailed. Such organisation of knowledge is a prerequisite for major advances in science. Indeed Greeks made extensive use of Egyptian science and medicine and created their own school of medicine that dominated the ancient civilisations for centuries to come. By the time Hippocrates began his scientific medicine in his native city Cos, the city was already the headquarters of the Asclepiadae, a professional association of physicians under the patronage of Asclepius, the god of healing. They were all familiar with Mesopotamian and Egyptian medical knowledge and used such texts extensively. However the Greeks based medicine on empirical knowledge and separated the supernatural from the scientific information. <br/><br/>The first major Iranian dynasty <a href="http://www.iranchamber.com/history/achaemenids/achaemenids.php"><b><u>Achaemenid</u></b></a> (550 BC) promoted the development of culture and science extensively. The great scholars such as the philosopher Heraclitus of Ephesus, the Babylonian astronomer Kidinnu and even the historian Herodotus were Persian subjects. The ancient cultures of the Egyptians, Babylonians, Elamites, and others continued to exist and develop. Babylonian Physicians were all over the territories and served all people including Persians. Xenophon relates that when the Greek soldiers who served under Cyrus the younger passed through the territory of Babylonia, they found sufficient number of Physicians even in the villages to treat the wounded warriors. Texts describe how physicians used medicine, prayers and magic, they would often model images of evil spirits out of clay and shatter them, in order to restore the invalid to health. <br/><br/>Achaemenid made Babylon one of their major capitals and extensively used the texts at the temple libraries. The library and museum at the Persepolis was build to rival the Babylonian archives famous in the ancient world. Greek and Egyptian physicians were invited to join the Achaemenid court and served the royal household. Persians also adopted the tradition of paying the physicians according to the rank and gender. The archives at Persepolis indicate that physicians and midwives who delivered boys were paid double the amount they got when the baby delivered was a girl. The records do not indicate severe punishments if the sick person died, as was the case under Hammurabi. Texts also show lists of plants, herbs and other substances used for medicinal purposes. Drugs are taken internally; mercury, antimony, arsenic, sulfur and animal fats are also prescribed. All are basically the same as Babylonian medicine and prescriptions. <br/><br/>At one point Darius orders a representative to return to Egypt in order to restore the department of the ruined house of life dealing with medicine; " While his majesty was in Elam he ordered me (Udjahorresne) to return to Egypt. I gave them every useful thing and all their instruments indicated by the writings, as they had been before. His majesty did this because he knew the virtue of this art to make every sick man recover". The subsequent Seleucid and <a href="http://www.iranchamber.com/history/parthians/parthians.php"><b><u>Parthian</u></b></a> dynasties followed the same trends with more Greek influence science and art due to massive presence of Greeks in the area. However the flourishing of science and technology happened in the <a href="http://www.iranchamber.com/history/sassanids/sassanids.php"><b><u>Sassanian</u></b></a> period with major centers of learning and the famous university Jundaishapur. <br/><br/>The Sassanian king, Khosrow Anoshirvan is mentioned by many historians and biographers to have been a major promoter of all sciences including philosophy and medicine. In a Pahlavi text (Karnamag) he is quoted the following; <i>"We have made inquiries about the rules of the inhabitants of the Roman Empire and the Indian states. We have never rejected anybody because of their different religion or origin. We have not jealously kept away from them what we affirm. And at the same time we have not disdained to learn what they stand for. For it is a fact that to have knowledge of the truth and of sciences and to study them is the highest thing with which a king can adorn himself. And the most disgraceful thing for kings is to disdain learning and be ashamed of exploring the sciences. He who does not learn is not wise".</i> <br/><br/>Greek Philosophers Syriac speaking Christians and Nestorian Christians fleeing persecution by Byzantine rulers were received by Anoshirvan and were commissioned to translate Greek and Syriac texts into Pahlavi. Paul the Persian dedicated Works of logic to the king. The Greek philosopher Priscianus Lydus wrote a book in response to the king’s questions on a number of subjects in Aristotelian physics, theory of the soul, meteorology and biology. The Sassanian religious text, Dinkard shows familiarity with all these topics, especially Aristotelian physics. It is apparent from the text that Aristotle’s famous article ‘On Coming to be and Passing away’ was well known by the compilers of Dinkard. Becoming, decay and transformation the three fundamental concepts in the article are mentioned and discussed. Pahlavi texts also indicate that the doctors were paid according to the rank of the patient. Books in medicine, astronomy, Almagest (by Ptolemy), Aristotle’s Organon and a number of texts in crafts and skills were translated from Greek. Syrian Christians in particular played a significant part in communicating Greek sciences and knowledge to the Persians. <br/><br/>The famous university and the hospital at Jundaishapur built earlier reached its peak at Anoshirvan’s time. The Muslim historian Qifiti (12/13th century AD) in his book ‘History of Learned Men’ quotes the following; <i>"In the twentieth year of the reign of Khosrow II (Anoshirvan) the physicians of Jundaishapur assembled for a scientific symposium by order of the king. Their debates were recorded. This memorable session took place under the presidency of Jibril Durustabad, the physician in ordinary to Khosrow, in the presence of Sufista’i and his colleagues, together with Yuhanna and a large number of other medical men"</i>. It is likely that the medical teaching resembled those at Alexandria with some influence from Antioch. This hospital and the medical center were to become the model on which all-later Islamic Medical Schools and hospitals were to be built. Earlier Muslim historians such as Maqdisi (10th century) mention the medical school in Khuzistan and name it’s famous associates and practitioners. The famous writer and translator, Burzoy who translated the Indian book of fables the Panchatantra (later, Kalila wa-Dimna) for Anoshirvan was also a well-known physician from Nishapur. The first recorded Muslim Physician Harith bin Kalada had studied at Jundaishapur Medical School. In Jundaishapur Greek, Indian and Persian scientific traditions were assimilated. Indian scientific material in astronomy, astrology, mathematics and medicine were also translated into Pahlavi along with Chinese Herbal medicine and religion. The books were kept at the university and the royal libraries and Greek medicine based on works by Hippocrates and Galen dominated the discipline. <br/><br/>The later Muslim historians refer to the Sassanian Imperial library as the House of Knowledge (Bayt al Hikmat). The library functioned as both a place where accounts of Iranian history and literature were transcribed and preserved. At the same time it was a place where qualified hired translators, bookbinders and others worked to preserve, purchase, copy, illustrate, write and translate books. It was such texts that made their way into the Islamic period. Many books in sciences and philosophy were translated by the Persians, Greeks, Syriac and Aramaic-speaking scholars into Arabic and eventually made their way into Muslim Spain and Western Europe. Persia and Byzantium dominated the area before Islam. The later was a continuation of the Eastern Roman Empire and the seat of Greco-Roman art, culture and civilization. Alexandria and Constantinople were major centers of intellectual activities with theaters, libraries and universities. In addition to Major cities like Alexandria Constantinople and Jerusalem, intellectuals and scientists moved and carried ideas from Edessa in the west, through Nisbis and Mosul (Iraq) to Marv and Jundaishapur in Western Persia. <br/><br/>The conquest of Islam in 7th century united east and west, improved trade and boasted book publishing by introducing advanced paper making techniques from China. However major cities and libraries were destroyed, Arabic eventually became the universal language of the empire and forced conversions into Islam threatened national identities and local cultures. The Imperial library at Ctesiphon was lost; the whole city was totally destroyed and never rose again. The destruction of such major libraries with the rise of Arabic language made it clear to the scholars and intellectuals that all pre-Islamic knowledge and national identities were in danger of total destruction and they had to be preserved. Massive and heroic efforts were made and the result was the formation of a dynamic and significant translation movement for almost two hundred years till 10th century. The movement started in Damascus in Umayyad times and flourished in Abbasid Baghdad (754 AD). All major surviving Greek Syriac Persian and Indian texts were translated into Arabic and Neo Persian. Pre-Abbasid translations from Pahlavi included major religious, literary, scientific and historical texts. Nawbakht the court astrologer and his son Abu Sahl and other colleagues Farazi and Tabari and many others sponsored by the Barmakid family (the chief ministers to the early Abbasids who were murdered later) translated and promoted Pahlavi texts into Arabic and Neo-Persian. They were all Iranians and aimed to incorporate Sassanian culture into Abbasid ideology and guarantee the continuity of the Iranian heritage. Christian and Jewish learned families of Sassanian Persia such as Bukhtishu and Hunyan families were also great translators of Syriac Greek Pahlavi and other texts into Arabic. Both families had served at Jundaishapur University for generations and were instrumental in founding the Adudi Hospital and Medical School in Baghdad. <br/><br/>The Nestorian physician, Jabrail ibn Bakhtishu was the head of the Jundaishapur University when he was called to Baghdad in 148 AD as the court physician to Caliph al-Mansur. He was later charged with building the first hospital (Bimarestan or Maristan) in the city based on the Syro-Persian model already established at Jundaishapur. He went back to Iran but many members of his family served the Abbasids for a long time. <br/><br/>Baghdad, a suburb of Ctesiphon was built in 762 by al-Mansur. The Royal library at Baghdad was based on the Sassanian model and was also called the house of knowledge (Bayt al-Hikmat) and like the Persian royal library became a center of learning and attracted scientists and intellectuals alike and many of its’ directors were either Iranian or from Iranian descent. Baghdad itself became hire to the Alexandrian and Persian scientific traditions and thought. The ‘Adudi’ hospital was built under the instructions of the great Iranian Physician <a href="http://www.iranchamber.com/personalities/mrazi/mrazi.php"><b><u>Razi</u></b></a> (Latin Rhazes, he was from Ray) and resembled the great hospital in Jundaishapur. It is said that in order to select the best site for the hospital he had pieces of meat hung in various quarters of the city and watched their putrefaction and chose the site where the putrefaction was the slowest and the least. At its inception it had 24 physicians on staff including specialists categorized as Physiologists, oculists, surgeons and bonesetters. Various historians have mentioned that the hospital was ‘like a great castle’ with water supply from the Tigris and all appurtenances of Royal Palaces. <br/><br/>Medicine remained dominated by the Greek tradition, the first to rid the science from supernatural powers and spirits. Around 450 BC, the Italian-born Greek natural philosopher and physician Alcmaeon began forwarding the new theory that disease was caused by a fundamental imbalance in the body between certain opposed qualities, such as heat and cold (sardi/garmi), or wetness and dryness (tari/khoshki). This theory was picked up and elaborated by Hippocrates (460-377BC) who completely disregarded the presumption of the spiritual causes of disease. He proposed that health resulted from the equal influence of four bodily "humours" that was analogous to the four elements of Greek physics (earth, water, air and fire). Blood, phlegm, and two kinds of bile were associated with four major organs heart, brain, liver and spleen – and with the four seasons and the four ages of man: childhood, youth, maturity and old age. Deviations from perfect balance among the four produced diseases. Therapies consisted of attempting to restrain the overactive humour while encouraging the others. <br/><br/>Five centuries latter the great Greek physician, Galen (130-200AD) concluded that blood was manufactured in the liver from material provided by the stomach. He also posited two other systems of essential fluid. One originated in the heart and was carried by the arteries. The other ‘anima’ (soul or the life principle) proceeded from the brain by way of the nerve tracts. Though none are correct nevertheless Galen’s meticulous anatomical studies and logical method provided a point of departure for the development of modern medicine. Once this Greek heritage and knowledge was translated into Arabic it became universal and replaced most of the older traditions and schools. Greek, Persian, Arab and Indian scholars refined the assimilated ideas and by the 12th century slow progress was made toward understanding the organic cause of disease. The brilliant Iranian scientist Raze (845-925 AD) distilled alcohol and clearly distinguished smallpox from measles. <br/><br/>The celebrated Iranian physician and philosopher <a href="http://www.iranchamber.com/personalities/asina/asina.php"><b><u>Abu Ali Sina</u></b></a> (Avicenna, 980-1037) wrote 100 books in many subjects including his most famous compendium, Canon of Medicine. His magnum opus is one of the classics of medicine ever written. He extensively studied herbal medicine from China, India and Persia. Avicenna like his predecessor Farabi (another well known Iranian) was an outspoken empiricist and insisted that all theories must be confirmed by experience. He argued against the blind acceptance of any authority and improved distillation techniques. Alchemists tried to convert one substance into another in order to make gold. In the process they uncovered a host of medicinal compounds and improved distillation and sublimation techniques. Another major Greek tradition based on theories of Plato and Euclid on light opened the way to the science of optics. Human eye became the focus of study and major advances were made and eye care was improved. The Jewish Physician Masawayh practicing at Jundaishapur joined the medical school at Baghdad at the invitation of Caliph Harun-ul-Rashid and wrote a detailed book on Ophthalmology. Masawayh family produced three more prominent physicians with the most famous, Yuhanna ibn Masawayh, who wrote prolifically and 42 works are attributed to him. Another great Jewish physician who had served at Jundaishapur was Hunain ibn Ishaq. He translated entire collection of Greek medical works including Galen and Hippocrates. His original contributions included 10 works on ophthalmology. He was appointed the director of the royal library by Caliph al Mutawakkil. Tabbari another major physician migrated from Persia to Baghdad in the first half of the 9th century AD. His major work called ‘Paradise of Wisdom’ contained extensive information from all extant sources including Greek, Syriac, Persian and Indian and contained an extensive treatment of Anatomy. <br/><br/>Like their Greek predecessors the new genre of physicians produced Encyclopedias of medical knowledge based on observation and experience. The main topics included anatomy, classification and causation of disease, symptoms and diagnosis. Urine, sputum, saliva and pulse were observed and used to aid diagnosis. External or visible manifestations of disease and internal symptoms like fever, headache etc were listed and studied. Hygiene was observed dietetics, cosmetics, therapy with drugs and herbs were used to improve the patient’s conditions. Female practitioners and nurses that existed before Islam remained for a while but soon lost their position and only midwives continued and most had no proper training. <br/><br/>The flourishing of sciences and the translation movement did not last long for a number of reasons including foreign military attack. The sciences including medicine were foreign imports as far as many Arabs were concerned and met with opposition from various quarters. From the time when the translation movement began to the end of the Islamic middle ages, these sciences were either frowned upon or openly attacked by practitioners of indigenous religious and Arabic disciplines. Aristotelian logic was rejected and the adherents of the religious tradition of Kalam had no use for Neo-platonic doctrines of the followers of Greek philosophy. The ‘foreign sciences’, which included mathematics, astronomy, medicine, alchemy and astrology were generally felt by religious people to constitute a serious threat to religious beliefs and values of religious life. The influential religious thinker al-Ghazali (he died in 1111AD) wrote a popular refutation of philosophy and repeatedly warned against exposing Muslims to potentially misleading rational sciences and practices. <br/><br/>The Hanbali jurist Ibn Taymiyya (1328) launched a passionate and uncompromising attack on Greek logic. There were defenders as well like Ibn Hazm who maintained a literalist view of Islamic law, but did not openly attack Greek tradition. The other was al-Kindi (870 AD) an Arab aristocrat who supported the Greek scientific tradition which in his time was identified mainly with non-Muslims and non-Arabs. Though the rational sciences remained for a while but at the end they lost specially after the conquest and destruction of Baghdad by the Mongols (1258AD). Medicine along with other sciences was soon to be forgotten and once again magic, superstition and prayers with rudimentary medicine replaced the brilliant scientific traditions. Magicians, sooth-sawyers, exorcists and self-trained herbalists replaced qualified trained medical practitioners and the concept of hospitals faded from the memory. Religious leaders fiercely opposed anatomy and no new knowledge emerged till the advent of modern medicine and importation of European medical knowledge into the Muslim countries in the 19th century. <br/><br/>The second half of the 19th century is the beginning of major political and ideological transformations in Iran and the start of modernization processes. Modern sciences and western ideas of democracy civil society enlightenment human rights and emancipation of women were introduced through translation of European texts into Persian. The Armenians of Isfahan for their exclusive use imported the first printing machine in 1641. However the first printing machine in Persian started work in Tabriz in 1813 and the book industry was changed forever. The first modern school Dar ul Fonoun (the Institute of technology) started work in 1851 with a few European instructors and texts were translated from a number of European languages to introduce Iranian pupils to modern sciences. <br/><br/>Educated Iranians joined and in no time tens of books in Geography, Engineering, Medicine, Military, Biology, Mathematics and other disciplines were translated. The modernization movement resulted in the constitutional revolution (1906) and secularization movement began in the country. Iranian students were sent to Europe with government sponsorship and the first modern doctors were educated in Europe. For the first time since Sassanian period a major University with different faculties was built. In 1934 a new legislation was passed and a budget was allocated to build the first University in Tehran. The medical School at Tehran was the first faculty and soon more modern universities followed in other parts of the country. In 1936 for the first time 12 women were admitted into Tehran University. They entered all faculties, included was Dr. Frough Kia who later joined the faculty of medicine. The medical schools were built on European models and were staffed with qualified educated practitioners and physicians. Nursing schools were followed and new modern hospitals were built throughout the country. In the 1970’s foreign doctors were employed mainly from India and were sent into rural clinics. The medical schools at the major universities enjoyed a high standard and graduates of these universities had no problems continuing postgraduate studies in any of the major medical schools in Europe or North America. <br/><br/>The closure of the universities after the Islamic revolution of the 1979 created havoc and damaged the universities. Once opened, to follow the ‘Muslim first’ policies many highly qualified lectures, teachers and instructors were forced into early retirement and many left voluntarily. With the medical schools there was confusion about the legitimacy of anatomical studies and dissection and whether the practices were acceptable in Islam. Dissecting Muslims was ruled out as unacceptable for a while but was re-instated with caution and bodies of non-Muslims were imported as well mainly from India. <br/><br/>There were attempts to segregate sexes by sending women to female doctors only. However since there are not enough female physicians in the country despite persistence and even legislation the practice has failed. In the second decade after the revolution many new medical schools were established in cities and rural areas. However the standards have remained low with inadequate facilities, management and tutors. Currently too many physicians are trained and some have not been able to find employment in the medical field. Contrary to the earlier Islamic periods empirical and applied sciences have persisted and the medical sciences have remained entirely modern and western oriented.
Menstruation, Menstrual Hygiene and Woman's Health in Ancient Egypt by Petra Habiger
tag:travelingwithintheworld.ning.com,2011-01-30:2185477:Topic:97188
2011-01-30T19:31:18.027Z
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<h4 align="center">©1998 Petra Habiger</h4>
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<h3>One of the most important milestones of the history of mankind is the development of <font color="#FF0000">writing</font>. It is the written language which helps give us evidence of ancient cultures, and subjects such as…</h3>
<h4 align="center">©1998 Petra Habiger</h4>
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<h3>One of the most important milestones of the history of mankind is the development of <font color="#FF0000">writing</font>. It is the written language which helps give us evidence of ancient cultures, and subjects such as menstruation.</h3>
<h3>Many myths accord <font color="#FF0000">menstrual blood</font> a life-giving nature:</h3>
<blockquote><h3>Some South American Indians, for instance, thought that all mankind was created out of "moon blood."</h3>
<h3>The Mesopotamian mother goddess Ninhursag was said to make men out of loam and her "blood of life." She taught women to make loam dolls for use in a conception spell by painting them with their menstrual blood.</h3>
<h3>In the Bible's "Genesis" the name Adam is derived from "adamah," which can be translated as "bloody loam."</h3>
</blockquote>
<h3>Many associate the <font color="#FF0000">moon</font> with menstruation. The Babylonians, Romans, Indians and Moslems based their calendar systems on the <font color="#FF0000">lunar year</font>.</h3>
<h3>In many civilizations the moon god is female (Ishtar (Assyrian/Babylonian), Quilla (Inca), Dschan (Thailand), Selene (Greece), Luna (Roman Empire), and very often the moon goddess is as well the goddess of fertility and motherhood. Furthermore, the crescent moon was in many cases associated with a virgin goddess like the Greek Artemis or the equivalent Roman Diana and later with the Virgin Mary. The Roman goddess Juno was also associated with the new moon.</h3>
<h3>In ancient Egypt the moon was closely tied to the ibis-headed god Thot, <font color="#FF0000">who was also regarded as the inventor of writing</font>. A pyramid inscription of 2300 B.C. makes the moon equal to Tefnut, the daughter of the creator god Atum. Then, during the Greek-Roman period (3rd cent.-4th cent. C.E.) the Egyptian Nechbet was associated with the Greek moon goddess Selene. In a small temple of Ramses II in Abydos archaeologists found for the first time a picture of a female moon godhead. As far as Egypt is concerned, we can at least speak of a gradual "feminizing" of the moon through the centuries.</h3>
<h3>Fertility was very early attributed to the moon.</h3>
<h3>Egypt was a male-dominated society. But although public life was men's domain, and their wives' tasks were mostly private, public administrative functions among women had been common during the Old Kingdom (before 2155 B.C.E.).</h3>
<h3>Although research about women in antiquity is still in its infancy, the first evidence for menstruation has come down to us from ancient Egypt.</h3>
<h2>Linguistics</h2>
<h3>As far as I know menstruation was not the subject of any relief graphics. But there are some very interesting passages in ancient texts about it.</h3>
<h3>The old Egyptian word for menstruation was <font color="#FF0000">hsmn</font>, presumably pronounced "hesmen." But that is not certain, because vowels were usually left out.</h3>
<table width="450" cellspacing="2" border="1">
<tbody><tr><td align="right" width="221" valign="top"><p><img height="42" width="50" src="http://www.mum.org/menshor1.jpg" align="bottom"/> </p>
<p><b>The hieroglyph <font color="#FF0000">hsmn</font>, <i>menstruation</i>, short version</b></p>
</td>
<td width="221" valign="top"><p> <img height="39" width="200" src="http://www.mum.org/menlon2.jpg" align="bottom"/></p>
<p><b><font color="#FF0000">hsmn</font>, the spelling of a later period (1) <font color="#006600">(see the numbered notes at the end of the article)</font></b></p>
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<h3>The decoding of hieroglyphics is made more difficult because they could be written either from top to bottom or vice versa, or from right to left or the other way around. The Egyptians loved beauty and pleasing proportions in many facets of their life, and would alter their writing for to satisfy this desire. (See also the essay of Dr. Friederike Schneider, "Personal Hygiene in Ancient Egypt.")</h3>
<h2>Taboo</h2>
<h3>An inscription at the Hathor temple in Edfu contains a list of gods with their specific dislikes. One god disliked menstruating women.</h3>
<h3>Some Egyptologists tend to assume that there had been strong taboos against menstruation in certain temples but these taboos were not universal. And there is no evidence for menstrual taboo as we know nowadays, though the story of the "laundry man" (described later) can be seen as a negative example.</h3>
<h3>Menstruation was treated ambiguously, because menstrual blood was generally considered to have a healing effect and was used for producing drugs, ointments, etc., as described in the so-called medical/magic papyri (2); but not for men.</h3>
<h2>Women's Health</h2>
<h3>The first case I talk about here comes from the Papyrus Kahun, which was written during the Middle Kingdom period (ca. 1850 B.C.E.), and starts with a diagnostic history that suggests that a physical examination as well as a description of symptoms have already taken place:</h3>
<blockquote><h3><font color="#FF0000">Medicine [for a woman whose eyes] are bad so that she cannot see and whose neck hurts.</font></h3>
<h3><font color="#FF0000">Then you should say: There is material in her eyes overflowing from her uterus.</font></h3>
<h3><font color="#FF0000">Then you should do [the following] against it: you should expose her to the vapor of frankincense and fresh oil; you should expose her vulva to those vapors; you should expose her eyes to the vapor of oriole thighs, then you should see that she eats fresh donkey liver.</font></h3>
</blockquote>
<h3>The donkey was often put on a level with that incorporation of evil, the god Seth; eating its liver symbolized the weakening or extermination of this god.</h3>
<h3>Another case deals with pain around the anus, pubic region and the top of the thighs and is attributed to uterine discharge and treated by a special drink.</h3>
<h3>Perhaps the text is talking about a vaginal ringworm which may cause an inflammatory skin rash.</h3>
<h3>Some other cases ascribe incontinence and even pain in the feet and legs after walking to uterine discharge. [Many American patent medicines in the 19th and early 20th centuries claimed to cure uterine complaints; many doctors and laymen saw the womb as the source of women's problems.]</h3>
<h3>Let's continue with the Papyrus Ebers (3), written in the New Kingdom period (1550-1450 B.C.E.), of which copies were used until Persian times (4th cent. B.C.E.) so that translations into Greek exist from which a good interpretation is possible.</h3>
<h3>Here we find something about uterine bleeding:.</h3>
<blockquote><h3><font color="#FF0000">If you examine a woman who has had a discharge like water and the end of it is similar to baked blood, then you should say: This is a scrape in her uterus. Then you should make her: Nile earth from the water carrier, which you crush in honey and galena; put this on a dressing of fine linen and insert it into her vagina for four days.</font></h3>
</blockquote>
<h3>The translator Wolfhart Westendorf thinks that this passage is about menstruation and believes Seth to be originator of the bleeding wound. But what can really cause a wound in the uterus except a mythological godhead? Would a menstruating women consult a doctor only to obtain menstrual hygiene? And why is a medical ointment used together with the tampon?</h3>
<h3>The text reminds us of a very heavy flow called "hypermenorrhea," which occurs with clots of coagulated ("baked") blood. But tumors can be the reason for such heavy flows.</h3>
<h3>Another passage says:</h3>
<blockquote><h3><font color="#FF0000">If you examine a women who suffers from the side of her pubic region, then you should say: This is an irregularity of her menstruation.</font></h3>
</blockquote>
<h3>A dressing with a mixture of chopped onions, mash and pine sawdust should remedy this.</h3>
<h3>Another case describes a woman who did not menstruate for years; she vomits "something like river water all the time and her belly is under fire." All this is considered to be a "build-up" of the blood in the uterus. The woman should drink a cocktail of gin berries, caraway, frankincense and a certain reed [Cyperus esculentes] for four days.</h3>
<h2>Papyrus Ebers</h2>
<table width="440" cellspacing="2" border="0">
<tbody><tr><td align="center" width="436"><p><img height="556" width="400" src="http://www.mum.org/papebers.jpg" align="bottom"/></p>
<h4>Excerpt from the <font color="#FF0000">Papyrus Ebers</font>, a transcription by Walter Wreszinski</h4>
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<h3>In some medical recipes of the Papyrus Ebers, menstrual blood is used as ingredient.</h3>
<h3>Sagging breasts, for instance, "should be covered with menstrual blood and the woman's belly and her thighs covered as well."</h3>
<h3>Another very informative text is the <font color="#FF0000">Edwin Smith Surgical Papyrus</font> (4), written about the same time.</h3>
<h3>Besides some beauty mixtures it contains three prescriptions for women's illnesses that are obviously a suspension or interruption of menstruation:</h3>
<h3><img height="246" width="800" src="http://www.mum.org/papsm2.JPG" align="bottom"/></h3>
<h4><i>(Above)</i> Excerpt from the <font color="#FF0000">Papyrus Edwin Smith</font>; you can see the word <font color="#FF0000">hsmn</font>, menstruation, at the end of the first line, which is written from right to left. This so-called "hieratic script" is the result of a simplification of the confusing conglomeration of hieroglyphs at about 2900 B.C.E.</h4>
<h3><img height="152" width="300" src="http://www.mum.org/papsm3.JPG" align="bottom"/></h3>
<h3>Above is a transcription of the same text fragment by James Henry Breasted; note the word <font color="#FF0000">hsmn</font> at the end of the second line.</h3>
<blockquote><h3><font color="#FF0000">If you examine a woman suffering in her abdomen, so that the menstrual discharge cannot leave her; and you notice something in the upper part of her vulva: Then you should say: This is a blockage of blood in her womb.</font></h3>
<h3><font color="#FF0000">Then you should make for her [a mixture of]: fruit (5), 20 parts; oil/fat, 1/8; sweetened beer, 40 parts; it should be cooked and then imbibed for four days.</font></h3>
<h3><font color="#FF0000">Then you should make her a laxative for the blood: pine oil; caraway; galena; sweet, aromatic myrrh resin; it should be cooked until a homogeneous consistency is achieved and then her pubic region should be repeatedly rubbed with it.</font></h3>
<h3><font color="#FF0000">Additionally you should administer hyena-ear (6) in oil/fat as follows: After it is rotten you should massage her pelvis region repeatedly with it. Then you should put some myrrh resin and frankincense between her thighs and let the vapours penetrate her vulva.</font></h3>
</blockquote>
<h3>At a first glance this prescription appears strange and I was curious to know what a gynecologist of today would say about it.</h3>
<h3>For Prof. Jael Backe, M.D., of the University of Würzburg, Germany, for instance, the recipe is not comprehensible, although there are some parallels to present-day medicine. In her opinion the diagnosis at the beginning of the papyrus text has to be divided into two parts.</h3>
<h3>The key sentence for the first part is "so that the menstrual discharge cannot escape," indicating a cessation of menstruation (amenorrhea), which is mostly caused by disorders of the central nervous system because of psychological reasons (stress, sorrow etc.) or physical overexertion. Today's treatment would be herbal medicine.</h3>
<h3>If we regard the ingredients of the ancient recipe from this aspect it strikes us that mostly volatile oils and plants are used which have today proved effective on the central nervous system!</h3>
<h3>The second part of the diagnosis, "something in the upper part of her vulva," suggests the existence of warts or something similar on the vulva which have nothing to do with amenorrhea but can be also treated by herbal medication.</h3>
<h3>So you see there might be a slight correlation between today's treatment and that of ancient Egypt.</h3>
<h3><img height="644" width="432" src="http://www.mum.org/papsm1.gif" align="bottom"/></h3>
<h4>This passage of the Papyrus Edwin Smith, <i>above</i>, contains the word <font color="#FF0000">hsmn</font>, menstruation, at the end of the 13th line, which is written from right to left.</h4>
<h2>Menstrual Blood</h2>
<h3>Menstrual blood was supposed to have a cleansing effect [this theory persists today, for example in the ideas of Margie Profet]. A good example is a passage in a story about Prince Setne Chaemwaset in which his wife Ahwere describes her pregnancy by the cessation of her menstruation: "When my time of cleansing came, I was able to cleanse no more."</h3>
<h2>Pregnancy</h2>
<h3>At this time people had a rather good picture of pregnancy, knowing its length and that menstrual cessation was a possible sign of pregnancy.</h3>
<h3>There exist certain receptacles made from alabaster that probably contained oils that pregnant women used to prevent <font color="#FF0000">stretch marks</font>. These receptacles are shaped like a naked human body but lack genitalia. Were they also a magic protection against <font color="#FF0000">premature births</font>?</h3>
<h3>In some "Spells for Mother and Child" <font color="#FF0000">menstrual blood</font> is used as an <font color="#FF0000">ointment to protect newborn from demons</font>.</h3>
<h3>Some medical texts obviously contain <font color="#FF0000">contraception</font> remedies. Perhaps not all had been successful but the insertion of substances like <font color="#FF0000">honey or crocodile dung</font> into the vagina could have effectively blocked a male's semen because of its thick consistency. One recipe talks of pulverized acacia spikes, which contain gum Arabic, and that actually have a chemical effect on sperm and actively retard conception. And breast feeding babies up to their third year would also hinder pregnancy.</h3>
<h3>A <font color="#FF0000">red gemstone</font> served as a contraceptive amulet and as a sign that flowing menstrual blood precluded a pregnancy (7).</h3>
<h2>Menstrual Hygiene</h2>
<h3>Up to now, there have been no artifacts showing any sort of menstrual hygiene in ancient Egypt. But there is a laundry list from which some researchers infer the existence of pad, belt and tampon-like items, but translating from lists is a tough job.</h3>
<h3>Today about 95% of the hieroglyphs are translated; for the rest, researchers try to translate from the context.</h3>
<h3>The translation of a word is regarded as certain when it can be derived from at least three different contexts. Because of the few texts available at the end of the last century when the Dictionary of Egyptology was prepared, the existence of pads and tampons is not proved though such items must have existed.</h3>
<h3>In a "Wisdom Text" there's one more indirect hint about menstrual hygiene. The text describes the high social status of a scribe and also gives some examples of "negative" careers like that of a laundry worker, who even has to wash the "<font color="#FF0000">loincloth of a menstruating woman,</font>" which could easily be a pad with belt or something similar. This story also again implies that menstrual blood was impure and was something a respectable man didn't touch. And, indeed, there is no evidence for the use of menstrual blood as a remedy for men.</h3>
<h3>In Roman Egypt <font color="#FF0000">circumcision</font> of men and women was widespread. Even the total removal of a woman's clitoris was common, as a Greek text of Aëtius tells us (8).</h3>
<h3>In order to stop the bleeding after this surgery a kind of pad was used, made from a compress with a sponge on top. Similar designs might have been also utilized to absorb menstrual blood.</h3>
<h3>There is one example of such above-mentioned pregnancy receptacles showing a kind of tampon inserted into the vagina, probably to catch the blood of a potential miscarriage. It has now been assumed that the so-called <font color="#FF0000">tyet</font> or <font color="#FF0000">Isis knot</font> often used as a protector talisman originally was such a tampon used by the goddess Isis while she was pregnant with Horus; the god Seth had tried to destroy the baby in her womb many times, sometimes by causing premature bleeding.</h3>
<h3>Others suggest that the <font color="#FF0000">Isis knot</font>, a stone carving portraying a cloth that has been rolled up and looped around itself, represents a <font color="#FF0000">menstrual tampon</font>.</h3>
<h3>As flax was cultivated and even exported to other countries, cheap linen could qualify as a raw material for the <font color="#FF0000">tyet</font> and be used by even the poorer groups of people.</h3>
<table width="450" cellspacing="2" border="0">
<tbody><tr><td align="right" width="50%"><p><img height="226" width="163" src="http://www.mum.org/tyet.gif" align="bottom"/> </p>
<p><b>Image of a <font color="#FF0000">tyet</font> taken from the Book of the Dead of Ani (ca. 1250 B.C.E.), <i>British Museum, London</i></b></p>
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<td width="50%"><p> <img height="326" width="150" src="http://www.mum.org/tyetspn.gif" align="bottom"/></p>
<p><b><font color="#FF0000">Tyet</font>-shaped wooden salve spoon with Hathor head, <i>Berlin, Inv.Nr. 1178 (9).</i></b></p>
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<h3>Nevertheless it is generally assumed that ancient Egyptian women fashioned a kind of <font color="#FF0000">throw-away tampon</font> probably from <font color="#FF0000">papyrus or other grass</font>; during the Roman era <font color="#FF0000">cotton</font> probably took the place of these materials, which is also today's component of that kind of menstrual hygiene. This fact was utilized by contemporary tampon manufacturers to combat the widespread opinion that pads are more natural and proven in use. Showing that tampons were used in ancient Egypt is supposed to convince women that that is not true.</h3>
<h3>Here's an o.b. tampon ad taken from the German <font color="#FF0000">Burda</font> magazine from the year 1989:</h3>
<h3><img height="545" width="431" src="http://www.mum.org/obpapbur.jpg" align="bottom"/></h3>
<h3><i>The ad shows the <font color="#FF0000">papyrus plant</font> (cyperus papyrus).</i></h3>
<h3 align="center">Translation:</h3>
<blockquote><h3>This is how a 4000-year-old invention looks today.</h3>
<h3>Tampons are almost as old as earth itself. Because there were always women who, of course, used an internal menstrual protection.</h3>
<h3>The first tampons were handmade from leaves or natural fibers. Today too tampons are manufactured from natural materials. But in contrast to the past an o.b. tampon is far more hygienic and reliable. Now we are able to make this great invention even better.</h3>
<h3>Every o.b. is covered with a very delicate, soft fleece. This makes it smoother and more able to slide. Therefore it can be inserted noticeably easier. Even for light flow or at the end of the period changing the tampon is very easy. So easy that today so many women think o.b. tampons are one of the world's best inventions.</h3>
<h3>o.b. - the small piece of additional freedom</h3>
</blockquote>
<h3> </h3>
<h3>The ad has a very clever structure.</h3>
<h3>At first tampons are generally introduced as something very natural and proven. Even 4000 years ago "women of course used an internal menstrual protection." The transition to our century is also very general, because there are other brands, too, which consist of natural fibers. Then there comes the key sentence where the reader should unconsciously be convinced that o.b. tampons are superior to other brands without really mentioning this ("But in contrast to the past an o.b. tampon is far more hygienic and reliable.") However, what makes o.b. superior is not mentioned. Why is it more hygienic and reliable? What danger does the word "reliable" hint at?</h3>
<h3>And something is omitted: where the tampon can be inserted easier.</h3>
<h3>Last but not least, changing the tampon is "So easy that today so many women think o.b. tampons are one of the world's best inventions." That means that the handling is as easy as that of a pad with which the tampon must compete.</h3>
<h3><i>The following o.b.-ad might also be from the 1980s.</i></h3>
<h3><img height="416" width="360" src="http://www.mum.org/obegypt.jpg" align="bottom"/></h3>
<h3> </h3>
<blockquote><h3 align="center">Translation:</h3>
<h3>Four thousand years ago there were already women ruling countries, winning competitions. And using a completely natural menstrual protection.</h3>
<h3>It is almost unbelievable. But in many ancient cultures the women knew about the advantages of an internal menstrual hygiene. The first tampons were made by rolling up natural fibers such as papyrus or cotton. Women already knew that they couldn't feel them if they were inserted correctly. This shows how natural the tampon actually is. And that it has proved itself for many, many years. Nothing has changed. Only that an o.b. tampon is much more hygienic than the earlier ones. And of course more comfortable. In addition, each o.b. has a very thin fleece covering. Therefore it can be inserted noticeably easier. For today's women tampons are the most natural thing in the world.</h3>
<h3>o.b. - the small piece of additional freedom</h3>
</blockquote>
<h3>For this ad a picture is used that creates the connection to antiquity in order to prove the allegation of the existence of tampons in ancient Egypt. The richly colored image, showing two women walking hand in hand, looks impressive. It suggests scientific competence that is actually not immediately verifiable by the reader.</h3>
<h3><font color="#FF0000">But the picture has nothing to do with tampons at all!</font> It shows a scene from the tomb of Nefertari in Thebes (10). Neferati (right), the "great royal spouse the king truly loves" - clad with the formal dress of the first royal wife -, is taken by the hand by the goddess Isis, who leads her to the next world. (Wags could maintain that if the picture has something to do with tampons, then it must refer to toxic shock syndrome!)</h3>
<h3><font color="#FF0000">The only thing that connects the ad picture with menstruation is the goddess Isis herself.</font></h3>
<h3>Like the Babylonian Ishtar, Isis incorporated the personalities of several minor goddesses until she was elevated to be universal goddess of Egypt as well as other peoples. She was also called Goddess of the Ten Thousand Names. The Isis cult, which could be almost regarded as a monotheistic religion, was spread over the whole Mediterranean and was even practiced in the German Rhine region! Isis, Osiris's sister, whose death she lamented, thereby entering into the ritual of the dead, was thought to have magical powers. She was considered to be the giver of health and she personified femininity, teaching women to grind corn, weave clothes and tame men enough to be able to live together with them. [!]</h3>
<h3>But Isis could be understood as the inventor of the first tampon if we presuppose that the Isis knot (see above) served as such an object.</h3>
<h3>Today we can probably assume that both tampons and pads were used in ancient Egypt. There is no evidence as to which was preferred.</h3>
<h2>Women's Social Position</h2>
<h3>Compared to other ancient cultures women's status in Egypt was pretty <font color="#FF0000">independent</font>. In accordance with the Ma'at, the Egyptian principle of order, theoretically no differences existed between men and women.</h3>
<h3>We don't actually know how much this was reflected in real life.</h3>
<h3>One thing is for certain: Egyptian women and men had been equals with regard to the laws of contract, capital and divorce. Because of his economical superiority, however, men could claim more rights.</h3>
<h3>But with regard to foreigners, who had no rights concerning life or ownership at all, the situation is clear.</h3>
<h3>And for sure today's Muslim women have by far fewer rights and social protection than women in antiquity.</h3>
<h3><i>Concluding Remark</i></h3>
<h3>There are some discrepancies in the old texts; look at the Westendorf translation of the Papyrus Ebers. There must also be more evidence about menstrual hygiene that can be discovered. But perhaps in the past there was no need to verify or even cast doubt upon the conception of the world characterized by male norms.</h3>
<h3>We already know that the "Egyptian Dictionary" was published at the very beginning of this century and the material for it had been collected only up until the end of the 19th century. Sources found or published after the 1909 deadline influence current work little if at all. But as Erich Kästner said, schoolbooks were not written on Mount Sinai!</h3>
<h3>On the contrary, mostly secondary literature today is cited. Current textbooks had been written by our grandparents who on their part again copied what others had written . . . and so on.</h3>
<h3>But there might be light at the end of the tunnel. <font color="#FF0000">Today about 70 percent of all Egyptology students here in Germany are female</font> and they will probably with time hold a similar number of professorships. And this should be the same in other countries.</h3>
<h3>So it rests with women, if they can or are willing, to change this picture of menstruation (and not only this) in the future.</h3>
<hr width="75%" align="left"/><h3><img height="358" width="180" src="http://www.mum.org/backegyp.jpg" align="left"/></h3>
<h3><i>At left is papyrus, one of the most important exports of ancient Egypt. The Egyptians carefully protected the secret of its manufacture. Our word <font color="#FF0000">paper</font> derives from it.</i></h3>
<h3> </h3>
<h3><i>If you have questions about this essay or about menstruation or menstrual hygiene in general, don't hesitate to contact me via <a href="mailto:aehnelt@mail.teleconsult.de">e-mail.</a> Thank you also for criticism and ideas.</i></h3>
<h3>Notes:</h3>
<h3>(1) Spelling according to Erman/Grapow, beginning of the century</h3>
<h3>(2) As you see, in ancient times medicine and magic had been closely melded. This didn't change until the age of the European renaissance when science arose and people slowly began to study and understand human bodies.</h3>
<h3>(3) The Papyrus Ebers, named after the Egyptologist Georg M. Ebers (1837-1898), was written in the so-called New Kingdom period (1550-1450 B.C.E.) and is probably based on former sources.</h3>
<h3>(4) The Edwin Smith Papyrus is named for an American antiques dealer (1822-1906); it was also written in the New Kingdom period but based on earlier sources.</h3>
<h3>(5) According to Prof. Dr. Wolfhart Westendorf, the fruit of an unknown plant</h3>
<h3>(6) Name of a plant</h3>
<h3>(7) Here it is definitely clear: At this time it was known that it was almost impossible to get pregnant while menstruating, a knowledge which was lost again later as the ancient Greeks considered menstruation to be the best time for getting pregnant. This fallacy remained until the 19th century (I will show this in later reports about Greece in antiquity, etc.)</h3>
<h3>(8) Aëtius, 6. cent. B.C.E.</h3>
<h3>(9) Site of discovery: West Thebes, tomb of Queen Mentuhotep, 17th dynasty, about 1600 B.C.E.</h3>
<h3>(10) Thebes, Valley of the Queens, so-called vestibule</h3>
<h3> </h3>
<h3>THANK YOU NOTE:</h3>
<h3>Very special thanks to Orell Witthuhn, from the Philipps University, Marburg, Germany, who fundamentally contributed to the success of this report with his quick and valuable assistance and a remarkable knowledge.</h3>
<h3>I also received valuable encouragement and assistance from Prof. Dr. Jael Backe from the University of Würzburg and Dr. Terry G. Wilfong, Assistant Professor of the Egyptology Department of Near Eastern Studies and Assistant Curator for Graeco-Roman Egypt at the Kelsey Museum of Archaeology of the University of Michigan in Ann Arbor.</h3>
<h3> </h3>
<h3>SOURCES:</h3>
<h3>British Museum, London</h3>
<h3><font color="#006600">The Edwin Smith Surgical Papyrus</font>, Rs 20,13-21,3, translated by James Henry Breasted, The University of Chicago Press, 1930</h3>
<h3>A. Erman, <font color="#006600">Zaubersprüche für Mutter und Kind</font></h3>
<h3><font color="#006600">Der Große Brockhaus</font>, Kompaktausgabe, 18. Auflage, F. A. Brockhaus, Wiesbaden</h3>
<h3>R. Hall, <font color="#006600">Egyptian Textiles</font>, Aylesbury, 1986</h3>
<h3>Wolfgang Helck, Eberhard Otto, <font color="#006600">Lexikon der Ägyptologie</font>, Otto Harrassowitz, Wiesbaden, 1992</h3>
<h3>Mary R. Lefkowitz, <font color="#006600">Aëtius on Clitoridectomy</font>, Wellesley College, 1998</h3>
<h3>Miriam Lichtheim, <font color="#006600">Ancient Egyptian Literature</font>, University of California Press, 1980</h3>
<h3>Patricia Monaghan, <font color="#006600">Lexikon der Göttinnen</font>, Scherz Verlag, 1997</h3>
<h3>Gay Robins, <font color="#006600">Frauenleben im alten Ägypten</font>, C.H. Beck'sche Verlagsbuchhandlung München, 1996</h3>
<h3><font color="#006600">Setne I</font> is preserved in the Cairo Museum Papyrus No. 30646</h3>
<h3><font color="#006600">Papyrus Edwin Smith</font>, Rs 20,13-21,3, translated by Prof. Dr. Wolfhart Westendorf, Verlag Hans Huber, Stuttgart</h3>
<h3>William A. Ward, <font color="#006600">The Egyptian Economy and Non-royal Women: Their Status in Public Life</font>, NEH Lecture, Brown University, 1995</h3>
<h3>Renate Waschek, <font color="#006600">Dieses kleine Stück Watte . . .</font>, Werner Pieper's MedienXperimenrte, Löhrbach, 1991</h3>
<h3>Wolfhart Westendorf, <font color="#006600">Erwachen der Heilkunst: Die Medizin im Alten Ägypten</font>, Artemis & Winkler, 1992</h3>
<h3>Walter Wreszinski, <font color="#006600">Papyrus Ebers Umschrift, Übersetzung und Kommentar</font>, J. C. Hinrichs'sche Buchhandlung Leipzig, 191</h3>
<h3> </h3>
<h3>©1998 Petra Habiger</h3>
MEDICINE IN ANCIENT EGYPT
tag:travelingwithintheworld.ning.com,2011-01-30:2185477:Topic:96881
2011-01-30T19:27:54.385Z
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<p><font face="Footlight MT Light" size="4">Historically, many Egyptologists focused primarily on the very visible aspects of ancient Egyptian society, such as the pyramids, much to the bain of those interested in more than just monumental architecture. From the beginning of the scholarly study of Egypt's past there have been few scholars who recognized the importance of the process of disease and health…</font></p>
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<p><font face="Footlight MT Light" size="4">Historically, many Egyptologists focused primarily on the very visible aspects of ancient Egyptian society, such as the pyramids, much to the bain of those interested in more than just monumental architecture. From the beginning of the scholarly study of Egypt's past there have been few scholars who recognized the importance of the process of disease and health on a population. With the turn of the century, new archaeological discoveries, increased knowledge of Egyptian language and writing, and the advent of more sophisticated medical techniques, new life was breathed into the study of disease and health in the ancient Nile Valley. It was this period that saw the academic study of Egyptian disease segregated into three distinct categories.</font></p>
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<p><font face="Footlight MT Light" size="4">The first is the study of medical Papyri. Early on it was recognized that the textual material of the Dynastic Period pertaining to the recognition and treatment of disease was extremely important for understanding both the state of health as well as the concept of disease in ancient Egypt. The second is the study of the artistic representation of disease in the Nile Valley. The Egyptian's predilection to portrayl life in a relatively realistic manner offers an excellent opportunity for the study of disease. The third, and perhaps most obvious, is the study of human remains, both skeletal and soft tissue, of ancient Egyptians. With the advent of increasingly sophisticated medical techniques at the beginning of the 20th century, as well as those complex medical techniques in use today, the analysis of Egypt's veritable wealth of human remains provided a tremendous boost to the study of the state of disease and health in the ancient Nile Valley. <br/><br/></font></p>
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<p><b><font face="Footlight MT Light" size="5">Medical Papyri <br/></font></b></p>
<p><i><b><font size="4">The Edwin Smith Papyrus</font></b></i></p>
<br />
<p><font face="Footlight MT Light" size="4">The Edwin Smith Surgical Papyrus is, without a doubt, one if the most important documents pertaining to medicine in the ancient Nile Valley. Placed on sale by Mustafa Agha in 1862, the papyrus was purchased by Edwin Smith. An American residing in Cairo, Smith has been described as an adventurer, a money lender, and a dealer of antiquities.(Dawson and Uphill: 1972). Smith has also been reputed as advising upon, and even practicing, the forgery of antiquities.(Nunn 1996:26) Whatever his personal composition, it is to his credit that he immediately recognized the text for what it was and later carried out a tentative translation. Upon his death in 1906, his daughter donated the papyrus in its entirety to the New York Historical Society. The papyrus now resides in the collections of the New York Academy of Sciences.</font></p>
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<p><font face="Footlight MT Light" size="4">In 1930, James Henry Breasted, director of the Oriental Institute at the University of Chicago, published the papyri with facsimile, transcription, English translation, commentary, and introduction. The volume was accompanied by medical notes prepared by Dr. Arno B. Luckhardt. To date, the Breasted translation is the only one if its kind.</font></p>
<br />
<p><font face="Footlight MT Light" size="4">The Edwin Smith papyrus is second in length only to the Ebers papyrus, comprising seventeen pages (377 lines) on the recto and five pages (92 lines) on the verso. Both the recto and the verso are written with the same hand in a style of Middle Egyptian dating.</font></p>
<br/><br/><i><b><font face="Footlight MT Light" size="4">The Ebers Papyrus</font></b></i>
<p><font face="Footlight MT Light" size="4">Like the Edwin Smith Papyrus, the Ebers Papyrus was purchased in Luxor by Edwin Smith in 1862. It is unclear from whom the papyrus was purchased, but it was said to have been found between the legs of a mummy in the Assassif district of the Theben necropolis.</font></p>
<p><font face="Footlight MT Light" size="4">The papyrus remained in the collection of Edwin Smith until at least 1869 when there appeared, in the catalog of an antiquities dealer, and advertisement for "a large medical papyrus in the possession of Edwin Smith, an American farmer of Luxor."(Breasted 1930) The Papyrus was purchased in 1872 by the Egyptologist George Ebers, for who it is named. In 1875, Ebers published a facsimile with an English-Latin vocabulary and introduction.</font></p>
<p><font face="Footlight MT Light" size="4">The Ebers Papyrus comprises 110 pages, and is by far the most lengthy of the medical papyri. It is dated by a passage on the verso to the 9th year of the reign of Amenhotep I (c. 1534 B.C.E.), a date which is close to the extant copy of the Edwin Smith Papyrus. However, one portion of the papyrus suggests a much earlier origin. Paragraph 856a states that : "the book of driving <i>wekhedu</i> from all the limbs of a man was found in writings under the two feet of Anubis in Letopolis and was brought to the majesty of the king of Upper and Lower Egypt <i>Den</i>."(Nunn 1996: 31) The reference to the Lower Egyptian <i>Den</i> is a historic anachronism which suggesting an origin closer to the First Dynasty (c. 3000 B.C.E.)</font></p>
<p><font face="Footlight MT Light" size="4">Unlike the Edwin Smith Papyrus, the Ebers Papyrus consists of a collection of a myriad of different medical texts in a rather haphazard order, a fact which explains the presence of the above mentioned excerpt. The structure of the papyrus is organized by paragraph, each of which are arranged into blocks addressing specific medical ailments.</font></p>
<p><font face="Footlight MT Light" size="4">Paragraphs 1-3 contain magical spells designed to protect from supernatural intervention on diagnosis and treatment. They are immediately followed by a large section on diseases of the stomach (<i>khet</i>), with a concentration on intestinal parasites in paragraphs 50-85.(Bryan 1930:50) Skin diseases, with the remedies prescribed placed in the three categories of irritative, exfoliative, and ulcerative, are featured in paragraphs 90-95 and 104-118. Diseases of the anus, included in a section of the digestive section, are covered in paragraphs 132-164.(<i>Ibid</i>. 50) Up to paragraph 187, the papyrus follows a relatively standardized format of listing prescriptions which are to relieve medical ailments. However, the diseases themselves are often more difficult to translate. Sometimes they take the form of recognizable symptoms such as an obstruction, but often may be a specific disease term such as <i>wekhedu</i> or <i>aaa</i>, the meaning of both of which remain quite obscure.</font></p>
<p><font face="Footlight MT Light" size="4">Paragraphs 188-207 comprise "the book of the stomach," and show a marked change in style to something which is closer to the Edwin Smith Papyrus.(<i>Ibid</i>.: 32) Only paragraph 188 has a title, though all of the paragraphs include the phrase: "if you examine a man with a…," a characteristic which denotes its similarity to the Edwin Smith Papyrus. From this point, a declaration of the diagnosis, but no prognosis. After paragraph 207, the text reverts to its original style, with a short treatise on the heart (Paragraphs 208-241).</font></p>
<p><font face="Footlight MT Light" size="4">Paragraphs 242-247 contains remedies which are reputed to have been made and used personally by various gods. Only in paragraph 247, contained within the above mentioned section and relating to Isis' creation of a remedy for an illness in Ra's head, is a specific diagnosis mentioned. (Bryan 1930:45)</font></p>
<p><font face="Footlight MT Light" size="4">The following section continues with diseases of the head, but without reference to use of remedies by the gods. Paragraph 250 continues a famous passage concerning the treatment of migraines. The sequence is interrupted in paragraph 251 with the focus placed on a drug rather than an illness. Most likely an extract from pharmacopoeia, the paragraph begins: "Knowledge of what is made from <i>degem</i> (most likely a ricinous plant yielding a form of castor oil), as something found in ancient writings and as something useful to man."(Nunn 1996: 33)</font></p>
<p><font face="Footlight MT Light" size="4">Paragraphs 261-283 are concerned with the regular flow of urine and are followed by remedies "to cause the heart to receive bread."(Bryan 1930:80). Paragraphs 305-335 contain remedies for various forms of coughs as well as the <i>genew</i> disease.</font></p>
<p><font face="Footlight MT Light" size="4">The remainder of the text goes on to discuss medical conditions concerning hair (paragraphs 437-476), traumatic injuries such as burns and flesh wounds (paragraphs 482-529), and diseases of the extremities such as toes, fingers, and legs. Paragraphs 627-696 are concerned with the relaxation or strengthening of the <i>metu</i>. The exact meaning of <i>metu</i> is confusing and could be alternatively translated as either mean hollow vessels or muscles tissue.(<i>Ibid</i>.:52) The papyrus continues by featuring diseases of the tongue (paragraphs 697-704), dermatological conditions (paragraphs 708-721), dental conditions (paragraphs 739-750), diseases of the ear, nose, and throat (paragraphs 761-781), and gynecological conditions (paragraphs 783-839)<br/></font></p>
<p><i><b><font face="Footlight MT Light" size="4">Kahun Gynecological Papyrus</font></b></i></p>
<p><font face="Footlight MT Light" size="4">The Kahun Papyrus was discovered by Flinders Petrie in April of 1889 at the Fayum site of Lahun. The town itself flourished during the Middle Kingdom, principally under the reign of Amenenhat II and his immediate successor. The papyrus is dated to this period by a note on the recto which states the date as being the 29th year of the reign of Amenenhat III (c. 1825 B.C.E.). The text was published in facsimile, with hieroglyphic transcription and translation into English, by Griffith in 1898, and is now housed in the University College London.</font></p>
<p><font face="Footlight MT Light" size="4">The gynecological text can be divided into thirty-four paragraphs, of which the first seventeen have a common format.(Nunn 1996: 34) The first seventeen start with a title and are followed by a brief description of the symptoms, usually, though not always, having to do with the reproductive organs.</font></p>
<p><font face="Footlight MT Light" size="4">The second section begins on the third page, and comprises eight paragraphs which, because of both the state of the extant copy and the language, are almost unintelligible. Despite this, there are several paragraphs that have a sufficiently clear level of language as well as being intact which can be understood. Paragraph 19 is concerned with the recognition of who will give birth; paragraph 20 is concerned with the fumigation procedure which causes conception to occur; and paragraphs 20-22 are concerned with contraception. Among those materials prescribed for contraception are crocodile dung, 45ml of honey, and sour milk.(<i>Ibid</i>:35)</font></p>
<p><font face="Footlight MT Light" size="4">The third section (paragraphs 26-32) is concerned with the testing for pregnancy. Other methods include the placing of an onion bulb deep in the patients flesh, with the positive outcome being determined by the odor appearing to the patients nose.</font></p>
<p><font face="Footlight MT Light" size="4">The fourth and final section contains two paragraphs which do not fall into any of the previous categories. The first prescribes treatment for toothaches during pregnancy. The second describes what appears to be a fistula between bladder and vagina with incontinence of urine "in an irksome place."(<i>Ibid</i>. 35) <br/></font></p>
<p><font face="Footlight MT Light" size="5">The Investigation of Disease Patterns Through Human Remains and Artistic Representations <br/></font></p>
<p><i><b><font face="Footlight MT Light" size="4">Parasitic Diseases</font></b></i></p>
<p><u><font face="Footlight MT Light" size="4">Schistosomiasis (bilharziasis)</font></u></p>
<p><font face="Footlight MT Light" size="4">Of the three main species of the platyhelminth worm <i>Schistosoma</i>, the most important for Egypt are <i>S.</i> <i>mansoni</i> and <i>S</i>. <i>haematobium</i>. There is a complex life cycle alternating between two hosts, humans and the fresh water snail of the genus <i>Bulinus</i>. The infection is caught by humans who come into contact with the free swimming worm which the snail releases in the water. The worm penetrates the intact skin and enters the veins of the human host. The main symptom of the presence of the parasite is haematuria which results in serious anemia, loss of appetite, urinary infection, and loss of resistance to other diseases. There may also be interference with liver functions.</font></p>
<p><font face="Footlight MT Light" size="4">One of the finest archaeological examples for the existence of schistosomiasis in ancient Egypt was the discovery of calcified ova in the unembalmed 21st Dynasty mummy of Nakht. Upon medical examination, the mummy not only exhibited a preserved tapeworm, but also ova of the <i>Schistosoma haematobium</i> and displayed changes in the liver resulting from a schistosomal infection.(Millat <i>et al</i>. 1980:79) <br/></font></p>
<p><i><b><font face="Footlight MT Light" size="4">Bacterial and Viral Infections</font></b></i></p>
<p><u><font face="Footlight MT Light" size="4">Tuberculosis (<u><i>Mycobacterium tuberculosis</i>)</u></font></u></p>
<p><font face="Footlight MT Light" size="4">Ruffer (1910) reported the presence of tuberculosis of the spine in Nesparehan, a priest of Amun of the 21st Dynasty. This shows the typical features of Pott's disease with collapse of thoracic vertebra, producing the angular kyphosis (hump-back). A well known complication of Pott's disease is the tuberculous suppuration moving downward under the psoas major muscle, towards the right iliac fossa, forming a very large psoas abscess.(Nunn 1996:64)</font></p>
<p><font face="Footlight MT Light" size="4">Ruffer's report has remained the best authenticated case of spinal tuberculosis from ancient Egypt. All known possible cases, ranging from the Predynastic to 21st Dynasty were reviewed by Morse, Brockwell, and Ucko (1964) as well as by Buikstra, Baker, and Cook.(1993) These included Predynastic specimens collected at Naqada by Petrie and Quibell in 1895 as well as nine Nubian Specimens from the Royal College of Surgeons of England. Both reviewers were in agreement that there was very little doubt that tuberculosis was the cause of pathology in most, but not all, cases. In some cases, it was not possible to exclude compression fractures, osteomyelitis, or bone cysts as causes of death.</font></p>
<p><font face="Footlight MT Light" size="4">The numerous artistic representation of hump-backed individuals are provocative but not conclusive. The three earliest examples are undoubtedly of Predynastic origin. The first is a ceramic figurine reported to have been found by Bedu in the Aswan district. It represents an emaciated human with angular kyphosis of the thoracic spine crouching in a clay vessel.(Schrumph-Pierron 1933) The second possible Predynastic representation with spinal deformity indicative of tuberculosis is a small standing ivory likeness of a human with arms down at the sides of the body bent at the elbows. The head is modeled with facial features carefully indicated. The figure is shown with a protrusion of the back and on the chest.(Morse 1967: 261) The last Predynastic example is a wooden statue contained within the Brussels Museum. Described as a bearded male with intricate facial features, the figure has a large rounded hunch-back and an angular projection of the sternum.(Jonckheere 1948: 25)</font></p>
<p><font face="Footlight MT Light" size="4">As well, there are several historic Egyptian representations which indicate the possibility of tuberculosis deformity. One of the most suggestive, located in and Old Kingdom 4th Dynasty tomb, is of a bas relief serving girl who exhibits localized angular kyphosis. A second provocative example has its origin in the Middle Kingdom. A tomb painting at Beni Hasan, the representation shows a gardener with a localized angular deformity of the cervical-thoracic spine.(Morse 1967: 263) <br/></font></p>
<p><u><font face="Footlight MT Light" size="4">Poliomyelitis</font></u></p>
<p><font face="Footlight MT Light" size="4">A viral infection of the anterior horn cells of the spinal chord, the presence of poliomyelitis can only be detected in those who survive its acute stage. Mitchell (Sandison 1980:32) noted the shortening of the left leg, which he interpreted as poliomyelitis, in the an early Egyptian mummy from Deshasheh. The club foot of the Pharaoh Siptah as well as deformities in the 12th Dynasty mummy of Khnumu-Nekht are probably the most attributable cases of poliomyelitis.</font></p>
<p><font face="Footlight MT Light" size="4">An 18th or 19th Dynasty funerary staele shows the doorkeeper Roma with a grossly wasted and shortened leg accompanied by an equinus deformity of the foot. The exact nature of this deformity, however, is debated in the medical community. Some favor the view that this is a case of poliomyelitis contracted in childhood before the completion of skeletal growth. The equinus deformity, then, would be a compensation allowing Roma to walk on the shortened leg. Alternatively, the deformity could be the result of a specific variety of club foot with a secondary wasting and shortening of the leg.(Nunn 1996: 77) <br/></font></p>
<p><i><b><font face="Footlight MT Light" size="4">Deformities</font></b></i></p>
<p><u><font face="Footlight MT Light" size="4">Dwarfism</font></u></p>
<p><font face="Footlight MT Light" size="4">Dasen (1993) lists 207 known representations of dwarfism. Of the types described, the majority are achondroplastic, a form resulting in a head and trunk of normal size with shortened limbs. The statue of Seneb is perhaps the most classic example. A tomb statue of the dwarf Seneb and his family, all of normal size, goes a long way to indicate that dwarfs were accepted members in Egyptian society. Other examples called attention to by Ruffer (1911) include the 5th Dynasty statuette of Chnoum-hotep from Saqqara, a Predynastic drawing of the "dwarf Zer" from Abydos, and a 5th Dynasty drawing of a dwarf from the tomb of Deshasheh.</font></p>
<p><font face="Footlight MT Light" size="4">Skeletal evidence, while not supporting the social status of dwarfs in Egyptian society, does corroborate the presence of the deformity. Jones (Brothwell 1967:432) described a fragmentary Predynastic skeleton from the cemetery at Badari with a normal shaped cranium both in size in shape. In contrast to this, however, the radii and ulna are short and robust, a characteristic of achondroplasia. A second case outlined by Jones (<i>Ibid</i>.:432) consisted of a Predynastic femur and tibia, both with typical short shafts and relatively large articular ends.<br/><br/><br/></font></p>
<p><font face="Footlight MT Light" size="5">Cited References</font></p>
<p><b>Breasted, J.H.</b></p>
<p><i>The Edwin Smith Surgical Papyrus</i> (University of Chicago Press: University of Chicago, 1930)<br/><br/><b>Brothwell, D.</b></p>
<p>"Major Congenital Anomalies of the Skeleton," in <i>Diseases in Antiquity: A Survey of Disease, Injuries, and Surgery in Early Populations</i> (eds.) A.T. Sandison and D. Brothwell (Charles C. Thomas: Springfield, 1967)</p>
<p><b>Bryan, P.W.</b></p>
<p><i>The Papyrus Ebers</i> (Geoffrey Bles: London, 1930)</p>
<p><b>Buikstra, J.E.; Baker, B.J.; Cook, D.C.</b></p>
<p>"What Disease Plagues the Ancient Egyptians? A Century of Controversy Considered," In <i>Biological Anthropology and the Study of Ancient Egypt</i> (eds.) W,V. Davies and R. Walter (British Museum Press: London, 1993)</p>
<p><b>Dasen, V.</b></p>
<p><i>Dwarfs in Ancient Egypt and Greece</i> (Clarendon Press: Oxford, 1993)</p>
<p><b>Dawson, W.R. and E.P. Uphill</b></p>
<p><i>Who Was Who in Egyptology</i> (Egyptian Exploration Society: London, 1993)</p>
<p><b>Jonckheere, F.</b></p>
<p>"Le Bossu des Mussées Royaux D'Art et D'Histoire de Bruxelles," <i>Chronique D'Égypt</i> (45) 25, 1958.</p>
<p><b>Millet, N.; Hart, G.; Reyman, T.; Zimerman, A.; Lewein, P.</b></p>
<p>"ROM I: Mummification for the Common People," in <i>Mummies, Disease, and Ancient Cultures</i> (eds.) Aiden and Eve Cockburn (Cambridge University Press: Cambridge, 1980)</p>
<p><b>Morse, D.</b></p>
<p>"Tuberculosis," in Diseases in Antiquity: <i>A Survey of Diseases, Injuries, and Surgery in Early Populations</i> (eds.) A.T. Sandison and D. Brothwell (Charles Thomas: Springfield, 1967)</p>
<p><b>Morse, D.; Brothwell, D.; Ucko, P.J.</b></p>
<p>"Tuberculosis in Ancient Egypt," in <i>American Review of Respiratory Diseases</i> (90), 1964)</p>
<p><b>Nunn, J.F.</b></p>
<p><i>Ancient Egyptian Medicine</i> (University of Oklahoma Press: Norman, 1996)</p>
<p><b>Ruffer, M.A.</b></p>
<p>"Potts'che Krankheit an Einer Ägyptischer Mumie aus der Zeiy der 21 Dynastie," in <i>Zur Historischen Biologie der Krankheiserreger</i> (3), 1910</p>
<p>"On Dwarfs and Other Deformed Persons," <i>Bulletin de Societé D'Archéologie D'Alexandrie</i> (13)1, 1911</p>
<p><b>Sandison, A.T.</b></p>
<p>"Diseases in Ancient Egypt," in <i>Mummies, Disease, and Ancient Cultures</i> (eds.) Aiden and Eve Cockburn (Cambridge University Press: Cambridge, 1980)</p>
<p><b>Schrumph-Pierron, B.</b></p>
<p>"La Mal de Pott en Égypt 4000 Ans Avant Notre Ére," Aesculpe (23)1933</p>
New Light Shed on Prehistoric Surgery
tag:travelingwithintheworld.ning.com,2011-01-30:2185477:Topic:97214
2011-01-30T19:24:27.837Z
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<p>September 17, 2000 - National Geographic</p>
<p>Ancient humans recognized that sometimes a hole in the head was exactly what was needed.</p>
<p>Skulls with holes bored in them have been found by archaeologists in virtually every region of the world, and scientists have debated for more than a century about the motivation for the holes. Are they evidence of an emerging medical technology or an artifact of practices involving magic, ritual, warfare, or…</p>
<center><p><img src="http://www.crystalinks.com/surgeryhole1.jpg"/></p>
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<p>September 17, 2000 - National Geographic</p>
<p>Ancient humans recognized that sometimes a hole in the head was exactly what was needed.</p>
<p>Skulls with holes bored in them have been found by archaeologists in virtually every region of the world, and scientists have debated for more than a century about the motivation for the holes. Are they evidence of an emerging medical technology or an artifact of practices involving magic, ritual, warfare, or religion?</p>
<p>"Good evidence exists to show that trepanation was performed as a treatment for skull fractures," says John Verano, a physical and forensic anthropologist at Tulane University in New Orleans, in the September 16 issue of the journal New Scientist.</p>
<p>Verano, who specializes in the prehistoric cultures of the Andes, has compiled a data base documenting the physical characteristics of nearly 700 trepanated skulls from Peru and Bolivia.</p>
<p>Evidence of trepanation - deliberately cutting or drilling a hole in the skull - dates back to 3000 BC, and possibly as far back as 10,000 years ago. Trepanation is discussed in medical texts of ancient Greece; Hippocrates (c. 460 to 355 BC) wrote extensively about when, why and how to perform trepanations.</p>
<p>Until the mid-1800s, though, the received wisdom among archaeologists and anthropologists held that prehistoric trepanations were performed only after death. Scientists attributed the holes to burial rituals or war practices, parading the head of an enemy on a stick or hanging it by a string. Among some early cultures, pieces of bone were carved from the skulls of the fallen mighty and worn as amulets.</p>
<p>In the 1860s, anthropologist Paul Broca recognized signs of healed bone surrounding a hole in a prehistoric skull. This convinced him that surgery had been performed on the living. As old evidence was reviewed and new evidence found, the idea that prehistoric humans practiced trepanation became widely accepted.</p>
<p>The argument as to motivation, however, remained.</p>
<p>Evidence of the Andes</p>
<p>While evidence of trepanning has been found around the world, the most skulls - about 1,000 - have turned up in South America.</p>
<p>Verano's data base includes skulls from Peru and Bolivia spanning nearly 2,000 years, from 400 BC to 1500 AD. These were violent times for the peoples of the Andes. The weapons of choice were slingshots and clubs, and skull fractures were a fact of life. Among skulls found in the central highlands region of the Andes dating from 900 to 1500 AD, more than half the men had at least one skull fracture, as did 32 percent of the women and 27 percent of the children, according to the New Scientist report.</p>
<p>"There was probably a lot of village warfare in which everyone got involved," says Verano.</p>
<p>Verano's data shows not only that trepanned skulls were highly associated with skull fractures but also that surgical techniques improved over time. "The holes got smaller over time," he says. "The earliest were quite large; 4 inches by 4 inches, (10 centimeters by 10 centimeters) or even larger, while some of the later ones are no larger than a single drill hole. It looks like they figured out that they didn't have to take quite so much bone. "</p>
<p>With improved techniques, survival rates also improved.</p>
<p>Surgeons on the southern coast of Peru around 400 BC scraped away the bone around a head wound with stone tools, and had a survival rate of about 40 percent. By 1350 AD, Inca surgeons in the central Andes had developed a range of techniques for performing the surgery - and appear to have had a survival rate of more than 80 percent. Anthropologists can tell whether a patient survived the surgery because, given time, the rim around the hole becomes smooth.</p>
<p>The improved success rate, the development of several techniques for performing the surgery, and evidence that surgeons made choices about which technique to use, combine to show that the surgery was part of an emerging medical repertoire, says Verano.</p>
<p> </p>