A Gentile Physician Defends Metzizah B'Peh in 1900

Peter Charles Remondino (1846-1926) was an Italian-American physician, who served on the San Diego Board of Health. Despite not being Jewish, he wrote a remarkably positive book on circumcision, which he supported on medical grounds, titled a History of Circumcision from the Earliest Times to the Present. Among the topics he covers is that of Metzizah B'Peh, the oral suction of the circumcision wound, which has, in recent years been the topic of some controversy. According to Remondino:

Intelligent rabbis, devoted to their religion, are necessarily prone to defend any of the details in its ceremonials that age and practice have sanctioned, and even some of the later writings of Israelism seem to make the mezizah, or suction, a necessary and ceremonial detail. In the "Guimara," composed in the fifth century, Rabbi Rav Popé uses these words: "All operators who fail to use suction, and thereby cause the infant to fun any risk, should be destituted of the right to perform the ceremony." In the "Mishna" it says, "It is permitted on the Sabbath to do all that is necessary to perform circumcision, excision, denudation, and suction." The "Mishna" was composed during the second century. The celebrated Maimonides lent it his sanction, as in his work on circumcision he advises suction, to avoid any subsequent danger. Our modern Israelites are supposed, as a rule, to have taken their authority, aside from previous usage and custom, from the "Beth Yosef," which was written by Joseph Karo, and subsequently annotated by the Rabbi Israel Isserth. In all of these sanctions, however, there is no reason expressed why it should be performed. Maimonides undoubtedly looked upon this act as having a decided tendency or action in depleting the immediate vessels in the vicinity of the cut surface, and that the consequent constriction in their calibre would prevent any future haemorrhage. That this is the natural result of suction is a fact readily understood by any modern physician. The depletion of the vessel for some distance in its length, with the contraction in the coast that follows, is certainly a better preventive to consequent haemorrhage than the simple application of any styptic preparation that can only be placed at the mouth of the vessel, but which leaves its calibre intact. Hot water, or an extreme degree of cold, will answer to produce this contraction and depletion, but there is here a local physical reaction that is more liable to occur than when the contraction has taken place naturally, as when induced by depletion, instead of by the stimulus of either heat or cold. So that if, in the light of modern civilization and changed conditions of mankind, and the existence of diseases which formerly did not exist, we are now convinced that suction is dangerous, we should not judge the ancients too hastily or rashly for having adopted the custom, as it is certainly not without some scientific merit; although, authorities are not wanting who hold that suction or depletion increases the danger of haemorrhage. (Remondino, History of Circumcision, 153-54.)