Topic summary
Bris
Extracted from the Wikipedia article Brit milah.
Notes and references
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In order to prevent the obliteration of the "seal of the covenant" on the flesh, as circumcision was henceforth called, the Rabbis, probably after the war of Bar Kokba (see Yeb. l.c.; Gen. R. xlvi.), instituted the "peri'ah" (the laying bare of the glans), without which circumcision was declared to be of no value (Shab. xxx. 6).
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Protagonists and critics of male circumcision agree on some things and disagree on many others... They also do not underestimate the importance of male circumcision for the relevant communities... Even the most critical voices of male circumcision do not suggest putting a blanket ban on the practice as they understand that such a ban, very much like the 1920–1933 prohibition laws in the United States, would not be effective... Protagonists and critics of male circumcision debate whether the practice is morally acceptable... They assign different weights to harm as well as to medical risks and to non-medical benefits. The different weights to risks and benefits conform to their underlying views about the practices... Protagonists and critics disagree about the significance of medical reasons for circumcision...
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- ^ , Bodily Integrity and the Politics of Circumcision, Dordrecht: Springer Netherlands, pp. 37–47, doi:10.1007/978-1-4020-4916-3_3, ISBN 2020
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- ^ This article incorporates text from a publication now in the public domain: Singer, Isidore; et al., eds. (1901–1906). "Morbidity". The Jewish Encyclopedia. New York: Funk & Wagnalls.
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- ^ . J Child Neurol. 17 (5): 400–01. doi:10.1177/088307380201700520. PMID 12150593. S2CID 2169066.
- ^ 27. doi:10.2165/00148581-200709020-00006. PMID 17407368. S2CID 45481923.
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- ^ 02. Archived from the original on 2010-06-29.
- ^ The Jerusalem Talmud there adds: "and is punished kareth!".
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the rabbis go on to dedicate all of chapter 19 to circumcision .. milah, peri'ah, and metsitsah. This is the first text specifying peri'ah as an absolute requirement. The same chapter is where we first find mention of the warning that leaving even "shreds" of foreskin renders the procedure "invalid".
(note: section 19.2 from Moed tractate Shabbat (Talmud) is quoted) - ^
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Metzizah b'peh — loosely translated as oral suction — is the part of the circumcision ceremony where the mohel removes the blood from the baby's member; these days the removal of the blood is usually done using a sterilized glass tube, instead of with the mouth, as the Talmud suggests.
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The poskim consulted by the RCA agree that the normative halacha permits using a glass tube, and that it is proper for mohalim to do so given the health issues involved.
The person performing metzizah b'peh must do the following: wipe around the outside of the mouth thoroughly, including the labial folds at the corners, with a sterile alcohol wipe, and then discard in a safe place. Wash hands with soap and hot water for 2–6 minutes. Within 5 minutes before metzizah b'peh, rinse mouth thoroughly with a mouthwash containing greater than 25% alcohol (for example, Listerine) and hold the rinse in mouth for 30 seconds or more before discarding it.
The meetings have been extremely helpful to me in understanding the importance of metzizah b'peh to the continuity of Jewish ritual practice, how the procedure is performed, and how we might allow the practice of metzizah b'peh to continue while still meeting the Department of Health's responsibility to protect the public health. I want to reiterate that the welfare of the children of your community is our common goal and that it is not our intent to prohibit metzizah b'peh after circumcision, rather our intent is to suggest measures that would reduce the risk of harm, if there is any, for future circumcisions where metzizah b'peh is the customary procedure and the possibility of an infected mohel may not be ruled out. I know that successful solutions can and will be based on our mutual trust and cooperation.
The mohel brings the baby's organ into his mouth immediately after the excision of the foreskin and sucks blood from it vigorously. This action lowers the internal pressure in the tissues of the organ, in the blood vessels of the head of the organ and in the exposed ends of the arterioles that have just been cut. Thus, the difference between the pressure in the blood vessels in the base of the organ and the pressure in the blood vessels at its tip is increased. This requirement has deep religious significance as well as medical benefits....Immediately after incising or injuring an artery, the arterial walls contract and obstruct, or at least reduce, the flow of blood. Since the arterioles of the orlah, or the foreskin, branch off from the dorsal arteries (the arteries of the upper side of the organ), cutting away the foreskin can result in a temporary obstruction in these dorsal arteries. This temporary obstruction, caused by arterial muscle contraction, continues to develop into a more enduring blockage as the stationary blood begins to clot. The tragic result can be severe hypoxia (deprivation of the supply of blood and oxygen) of the glans penis.28 If the arterial obstruction becomes more permanent, gangrene follows; the baby may lose his glans, and it may even become a life-threatening situation. Such cases have been known to occur. Only by immediately clearing the blockage can one prevent such clotting from happening. Performing metzitzah immediately after circumcision lowers the internal pressure within the tissues and blood vessels of the glans, thus raising the pressure gradient between the blood vessels at the base of the organ and the blood vessels at its distal end—the glans as well as the excised arterioles of the foreskin, which branch off of the dorsal arteries. This increase in pressure gradient (by a factor of four to six!) can resolve an acute temporary blockage and restore blood flow to the glans, thus significantly reducing both the danger of immediate, acute hypoxia and the danger of developing a permanent obstruction by means of coagulation. How do we know when a temporary blockage has successfully been averted? When the "blood in the further reaches [i.e., the proximal dorsal artery] is extracted", as Rambam has stated.
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