Glossary

GLOSSARY

amputation The permanent loss of a normal body structure, resulting from accident, surgical intervention due to irreparable injury or disease, or as religious ritual or medical routine. Circumcision involves the surgical amputation of the foreskin of the penis.

balanitis Inflammation and infection of the glans penis and mucous membrane immediately behind it.

balanoposthitis Inflammation and infection of the glans penis and prepuce, caused by ammonia irritation during the diaper‑wearing period, or by very poor hygiene in the older individual. Usually this can be resolved by simple measures and need not be treated by amputation of the foreskin (circumcision).

brith ‑ A Hebrew word meaning “covenant” or promise (with God). Alternate spellings: “bris,” “brit,” “berith,” or “briss.” Pertains to the Jewish ritual circumcision ceremony which is normally performed on the eighth day of the male baby’s life.

carcinoma Cancer. A growth of malignant cells which may affect almost any part of the body.

carcinogen ‑ A substance which is known to cause or stimulate the growth of cancer.

chordee ‑ Downward curvature of the penis on erection, which is sometimes painful. This can occur as a result of a congenital anomaly, a urethral infection such as gonorrhea, or as a complication of circumcision due to excessive removal of foreskin.

circumcision ‑ (Latin derivatives ‑ “circum” ‑ “around” or “in a circle”; “cisio” ‑ “cutting”)

male circumcision The surgical amputation of the prepuce (foreskin), which normally covers the glans penis.

female circumcision The surgical amputation of the prepuce (“hood”) of the clitoris, so that the glans of the clitoris is exposed. Variations include amputation of the clitoris and labia minora (clitorectomy). Female circumcision is rarely performed in the United States or done to infants.

voluntary circumcision The personal decision of an adult to have his or her foreskin cut off. Usually performed under anesthesia by a doctor.

enforced circumcision The cutting off of an individual’s foreskin against his or her will. Examples: Forcible circumcision of war captives by conquering armies as an act of subjugation and humiliation, forcible circumcision of slaves as a means of identification, forcible circumcision of mental incompetents, infants, and small children. Forcible circumcision is usually performed without anesthesia.

Almost all cases of amputation of the foreskin, throughout history and today, have not been the personal choice of the individual.

Circumstraint ‑ A plastic tray molded to fit the shape of an infant’s body, in which he is placed on his back with his arms and legs secured with straps for the circumcision operation. Manufactured by the Olympic Medical Company, Seattle, WA. (See photo.)

corona (From the Greek word “korone” meaning “crown.”) A structure resembling a crown. Corona glandis ‑ The circular border of the glans penis.

coronal sulcus The circular indented area or groove beneath the corona of the glans penis.

covenant ‑ A promise or pledge. A sacred religious agreement to perform a certain act. In the case of Jewish ritual circumcision, an agreement for the Jews to mark the body in a certain way to show that they are God’s “chosen people.”

dorsal nerve block ‑ A technique of injecting a local anesthetic (lidocaine) into the dorsal nerve of the penis prior to circumcision.

dorsal slit ‑ A procedure in which a hemostat is applied to the foreskin, effectively crushing the blood vessels, after which a slit is made at that site to enlarge the opening of the foreskin.

The dorsal slit can be an effective alternative to circumcision for the purpose of enlarging and loosening a tight, non‑retractable prepuce.

The dorsal slit is the first step in some methods of infant circumcision. When the Plasti-bell and Gomco Clamp devices are used, the normally tiny opening of the infant’s foreskin must first be enlarged before the “bell” can be inserted under the foreskin and over the glans.

The dorsal slit should not be performed on intact infants or small boys for the purpose of loosening the foreskin, as it is painful and unnecessary. The foreskin normally loosens and enlarges spontaneously during the first few years of the child’s life.

episiotomy An incision made in the female perineum at the time of giving birth, for the purpose of enlarging the vaginal opening and enabling the baby to be born more quickly. After delivery this incision is repaired with stitches. Episiotomy is not necessary for the majority of vaginal births, although many doctors perform it routinely.

fistula An abnormal, tube like passage between two parts of the body, or between one part of the body to an outside surface. A fistula may be a congenital defect due to incomplete closure of parts during development, or may result from an injury, abscess, or inflammatory process. A fistula occurring between the urethra and the outside of the shaft of the penis is a rare complication of circumcision.

foreskin The skin which normally covers the glans penis or the clitoris. Technical term ‑ prepuce. (Originally “foreskin” referred only to the portion of penile skin extending beyond the tip of the glans in the infant which usually later “disappears” as the penis grows to fill it.)

frenulum A fold of membrane which connects two parts of the body, one part being moveable, and serves to control the movement of that part.

frenulum preputii The membrane which unites the prepuce to the glans along the underside of the penis. A frenulum develops along the line where two halves of an organ began separately and later joined during prenatal development.

glans (Derived from the Latin word for “acorn” due to physical resemblance.) In the male ‑ the “head” of the penis. In the female ‑ the clitoris. Normally the glans is covered by the prepuce and is essentially an internal organ.

Gomco clamp ‑ A modern circumcision device, invented in 1934 by Aaron Goldstein, and manufactured by the Gomco Surgical Manufacturing Corp., Buffalo, N.Y. (“Gomco” is derived from “GOldstein Medical Company”). Also known as the Yellen clamp, after Hiram S. Yellen, M.D., who developed a precursor to this device during the 1800s. The device consists of a metal “bell” which is inserted under the foreskin and over the glans, and a large metal clamp which is then screwed over the foreskin and bell to crush the foreskin. The Gomco clamp is left in place for five minutes, the foreskin is then cut off and the clamp removed. (See picture display.)

hemorrhage Excessive bleeding from an injury, surgical incision, tooth extraction, childbirth, abortion, menstruation‑any event which causes rupture of blood vessels. Excessive blood loss can result in anemia (insufficient red blood cells). Severe hemorrhage may be treated by blood transfusion. Death can result from hemorrhage. Hemorrhage is an occasional complication of circumcision.

hemostat A scissors‑like clamp frequently used during surgical procedures to pinch off blood vessels or pieces of skin or to hold body tissue out of the way. One method of infant circumcision involves pulling the foreskin up beyond the glans, crushing it straight across with a hemostat, and cutting off the foreskin at that site. The dorsal slit procedure involves inserting a hemostat into the opening of the foreskin to crush the skin and blood vessels, so that it then may be enlarged without undue bleeding.

hypospadias An abnormal opening of the male urethra onto the undersurface of the penile shaft, caused by incomplete closure during prenatal development. An infant born with hypospadias should not be routinely circumcised as the prepuce provides an effective skin graft to correct the defect. In some cases hypospadias can be corrected easily or lived with without surgery or sacrificing the foreskin.

iatrogenic Induced by a doctor or medical practitioner, medical procedure, medication, or condition within a medical establishment. Particularly used to describe an injury, disease, or ailment (usually inadvertently) caused by the above.

infibulation (female) ‑ A form of genital mutilation, usually accompanied by primitive forms of female circumcision (clitorectomy) in which the vaginal opening is stitched closed as a method of preserving virginity. A second operation to open the vagina is required at the time of marriage.

infibulation (male) The stitching or otherwise fastening of the foreskin together in front of the glans as a means of preventing masturbation.

intact Untouched, especially by anything that harms or diminishes. Having no relevant component removed or destroyed. The adjective “intact” is currently being used to describe the individual who has his foreskin.

meatal stenosis ‑ A condition in which the urinary opening of the glans penis becomes constricted due to repeated irritation from ammonia in urine‑soaked diapers. This condition does not occur in the child with a foreskin which covers the glans, as this protects the glans from irritation. This condition only occurs in the circumcised male child whose glans is exposed.

meatal ulceration “Burns” consisting of sores and blisters on the sensitive glans penis, especially around the urethral opening, of the circumcised child. Caused by ammonia irritation from urine as it collects in the diaper. Both male and female children may develop similar “burns” in other parts of the diaper area. The male child with a foreskin may develop similar ulcerations on the less sensitive outside of the foreskin. Urine burns are treated by frequent diaper changing, warm baths, ointments, and use of diaper liners or disposal diapers (which help draw urine away from the skin), but can be a persistent and troublesome problem. Meatal ulceration does not occur in the female child, or the intact male child, as the outer skin protects the more sensitive glans.

meatotomy An operation to enlarge the urinary opening, done to correct severe cases of meatal stenosis, in which the irritated meatus has become so small that it is difficult to pass urine.

meatus ‑ male The opening in the glans of the penis, from which urine and semen are discharged. Female ‑ the passage for urine, located between the clitoris and the vaginal opening.

mezizah ‑ Hebrew term for the third step of the Jewish circumcision ritual, in which the mohel applies his mouth to the freshly circumcised infant’s penis and sucks up the first drops of blood. In more recent times this procedure has been carried out via a tube, as infections, venereal disease, and tuberculosis, sometimes resulting in the death of the infant, have occurred due to contamination of the wound. Most Jewish circumcisors today have eliminated this step from the circumcision ritual. Critics have attributed sadistic and homosexual implications to this practice, while defenders claim that this was simply all that was known during ancient times to stop the bleeding.

micturition The voiding of urine

milah ‑ Hebrew term for the amputation of the prepuce which is the first step of the circumcision ceremony. In ancient times this was done with a sharp stone or knife. In modern times, most mohelim use the same clamps and devices that are used by the medical profession. (Orthodox Jews, however, prohibit the use of clamps, as they believe that not enough blood is shed with these devices.)

mitzvah ‑ A Hebrew term meaning “religious duty.” Also interpreted as “good deed” or “blessed occasion.” The term “mitzvah” is used to describe the circumcision ritual.

mohel (pl. “mohelim’) ‑ A Jewish ritual circumcisor, usually a rabbi, who has special training and certification to do this operation. In former times mohelim learned from each other. In modern times, mohelim usually train in hospitals and learn from doctors who do routine (non‑religious) circumcisions on newborn babies. Mohelim are licensed by their state to perform ritual circumcision on Jewish babies.

mutilate To cut off or permanently destroy a limb or part of, to cut up or alter radically so as to make imperfect.

nachas A Hebrew term for “parental bliss,” which Jewish parents are expected to feel when their newborn infant son undergoes the circumcision ritual.

neonate A newborn baby during the first four weeks of life.

neonatal Of or pertaining to babies during the first four weeks of life.

non‑REM sleep A state of deep sleep without rapid eye movements, described as a “low point on an arousal continuum.” Prolonged sleep beginning with a lengthy, behaviorally inactive sleep period without rapid eye movements is not normally characteristic in the sleeping patterns of newborn infants but is observed as a response following circumcision. This behavior is consistent with a theory of conservation‑withdrawal in response to stressful stimulation.

paraphimosis A condition in which the infant’s normally tight foreskin is forcefully retracted beyond the glans, constricts and becomes stuck. The glans then swells and the foreskin cannot be easily replaced. The condition is extremely painful for the baby. Some doctors will immediately amputate the foreskin of a baby with this condition, although in most cases it can be corrected with warm water to ease the swelling and gentle easing back of the foreskin. If the parents or caretaker know to leave the foreskin alone during infancy this problem will not occur.

periah A Hebrew term for the second step of the Jewish circumcision ritual, in which after the foreskin is amputated, the inner membrane is then torn away from the glans and pushed back with the mohel’s thumbnail. (This step was devised to prevent the individual from later undergoing an operation to become “uncircumcised” ‑drawing his remaining foreskin forward to make it appear that he had never been circumcised, thereby concealing his identity as a Jew.) Modern clamp devices for circumcision eliminate the need for this step as the membranes are first separated before the insertion of the clamp and “bell.”

perineum The external region between the vulva and the anus in the female or between the scrotum and the anus in the male. This is the area that is cut when a woman has an episiotomy.

phimosis ‑ A condition in which the foreskin is either adhered to the glans penis or tightly constricted over the glans and cannot be retracted.

neonatal tightness of the foreskin In the newborn infant the foreskin is normally adhered to the glans and has a very tiny opening. “Phimosis” is an incorrect term for this condition. The opening does not enlarge and the prepuce and glans usually do not separate until months or years later in life. The parent or medical practitioner should not attempt to loosen or retract the foreskin during infancy.

acquired phimosis A complication caused by forceful retraction of the infant’s foreskin before it has separated naturally. Forcefully retracting the naturally tight foreskin of the infant will break adhesions and cause it to bleed. The foreskin and glans may heal together when the foreskin is replaced (much as two fingers, with the skin injured, would join together if bandaged together). With acquired phimosis, scar tissue develops between the foreskin and glans and the foreskin cannot be retracted. This condition can usually be corrected by gradual easing back of the foreskin over time, applying petroleum jelly or similar ointments to prevent the two surfaces from rejoining, or warm baths. However, some doctors prescribe amputation of the foreskin to correct this condition.

congenital or “true” phimosis A rare condition in which the naturally tight foreskin, left alone from infancy, still cannot be retracted during late childhood or teenage years. Like acquired phimosis, this can usually be corrected by gradual easing back of the foreskin and warm baths, although some doctors will prescribe circumcision.

Plasti-bell ‑ A circumcision device manufactured by Hollister Corporation, Chicago, IL. The device consists of a plastic “bell” which is placed over the glans and under the foreskin. A string is then tied over the foreskin and the bell, part of the foreskin is cut off, the handle of the bell removed, and the ring of plastic stays in place. Within ten days the remaining foreskin dries up and the plastic ring normally falls off. (See picture display.)

posthitisInflamed condition of the foreskin.

prepuce ‑ male ‑ The skin which normally covers the glans of the penis, commonly known as the “foreskin.” This piece of skin is what is cut off during circumcision.

female The skin that covers the clitoris, sometimes called the “hood” of the clitoris. This piece of skin is cut off during female circumcision.

priapism Abnormal, painful and continued erection of the penis due to disease and usually without sexual desire.

pseudo ‑ False. Used in this book to describe the modern medical establishment as a “pseudo‑religion.”

raphe ‑ A seam or ridge originating in embryonic development in which two halves of an organ that begin separately are later joined. The raphe of the penis and scrotum is a ridge which extends along the posterior surface of the penis and extends through the midline of the scrotum.

retraction (of foreskin) The pulling back of the foreskin to expose the glans. Usually this is only necessary when washing. Normally in the young boy or adult this procedure is simple. This should not be done to an infant until the foreskin has naturally loosened from the glans and can be retracted easily.

routine ‑ A procedure that is done automatically, without question, especially by a system or organization. Pertaining to hospitals -‑ a procedure that is done automatically to all patients in a given situation. For example: all patients admitted to a hospital will probably have a routine blood sample taken. Routine procedures are usually not essential life‑saving procedures, but are often done as precautionary measures, or simply because that hospital staff always does things in that particular way. Therefore a mother giving birth in a hospital may have a routine enema, routine pubic shave, routine medication, or a routine separation from her baby for several hours after birth.

routine neonatal circumcision All or nearly all newborn male infants born in a hospital have their foreskins amputated, for non‑religious reasons, shortly after birth. While at least one parent is usually asked to sign a consent form, parents are usually inclined to cooperate with hospital procedures and therefore sign it “routinely.”

sandek A Hebrew term meaning “Godfather.” A man who holds the infant during the Jewish circumcision ritual. This is considered to be a position of high honor.

Sheldon clamp A circumcision device manufactured by the Olympic Medical Supplies Company, Seattle, WA. With this method, the infant’s foreskin is stretched up over the glans, smashed by this clamp, and cut off. No protective “bell” is used to cover the glans. (See picture display.) (Author’s update – this device was taken off the market during the 1980’s, probably due to the greater risk of damage to the glans.)

smegma The naturally occurring substance that collects beneath the foreskin of the penis and around the clitoris and labia. It is mainly composed of dead skin cells. Smegma is easily washed away while bathing. If the individual does not bathe for several days, smegma will develop an unpleasant odor (as will feet, mouths, underarms, and all parts of the body). Smegma has not been proven to be carcinogenic despite repeated tests with laboratory animals.

trauma An event which causes great physical pain and/or psychological upset to the individual, which may have lasting repercussions affecting that person’s future and/or nature. Intense fear, anger, shame, or remorse may be emotional reactions to trauma. Amputation of the foreskin (circumcision) is a trauma to a newborn baby. The procedure is also frequently an emotional trauma to new parents.

References: Some of these definitions were found with the help of the following:

1. “Taber’s CYCLOPEDIC MEDICAL DICTIONARY” Edition 13, c. 1977.

2. “Webster’s Seventh New Collegiate Dictionary” C. & C. Merriam Company, Springfield, Ma., c. 1967.