A step-by-step narration of how it is done:nnA dorsal slit is necessary to slit the foreskin open to open the preputial cavity. After the fo...
A step-by-step narration of how it is done:nnA dorsal slit is necessary to slit the foreskin open to open the preputial cavity. After the foreskin has been cut open the bell can be inserted and placed on the glans.In order to apply the clamp the foreskin is grabbed with hemostats as the the bell and the glans have to be maneuvered through the bevel hole.nnThe arms of the bell are here maneuvered through the bottom of the bevel hole in the base plate. As soon as the bell arms are through the base plate is worked down over the secured foreskin and the plate is seated onto the bell. The top plate is swung around so that it sits over the base plate and the arms of the bell are lifted onto the yoke. nnNow the nut is tightened down as far as possible, thereby crushing the foreskin between the bell (cone) and base plate. Tightening the clamp forces the rim of the bell down against the frenulum, which responds by either stretching or by tearing or bleeding.nnWith the scalpel blade the crushed foreskin is excised against the bell at the base plate and bell junction. All remaining shreds of foreskin above the plate are removed.nnNow the nut can be loosened releasing the bell arms from the yoke. Removal of the clamp allows the bell arms to drop back down through the plate. Now the penis is circumcised.nnMedical HistorynnInfant circumcision was taken up in the United States, Australia and the English-speaking parts of Canada, South Africa, New Zealand and to a lesser extent in the United Kingdom. There are several hypotheses to explain why infant circumcision was accepted in the United States about the year 1900. The germ theory of disease elicited an image of the human body as a conveyance for many dangerous germs, making the public "germ phobic" and suspicious of dirt and bodily secretions. The penis became "dirty" by association with its function, and from this premise circumcision was seen as preventative medicine to be practised universally. In the view of many practitioners at the time, circumcision was a method of treating and preventing masturbation. Aggleton wrote that John Harvey Kellogg viewed male circumcision in this way, and further "advocated an unashamedly punitive approach." Circumcision was also said to protect against syphilis, phimosis, paraphimosis, balanitis, and "excessive venery" (which was believed to produce paralysis). Gollaher states that physicians advocating circumcision in the late nineteenth century expected public scepticism, and refined their arguments to overcome it.nnAlthough it is difficult to determine historical circumcision rates, one estimate of infant circumcision rates in the United States holds that 32% of newborn American boys were being circumcised in 1933. Laumann et al. reported that the prevalence of circumcision among US-born males was approximately 70%, 80%, 85%, and 77% for those born in 1945, 1955, 1965, and 1971 respectively. Xu reported that the prevalence of circumcision among US-born males was 91% for males born in the 1970s and 84% for those born in the 1980s. Between 1981 and 1999, National Hospital Discharge Survey data from the National Center for Health Statistics demonstrated that the infant circumcision rate remained relatively stable within the 60% range, with a minimum of 60.7% in 1988 and a maximum of 67.8% in 1995. A 1987 study found that the most prominent reasons US parents choose circumcision were "concerns about the attitudes of peers and their sons' self concept in the future," rather than medical concerns. However, a later study speculated that an increased recognition of the potential benefits of neonatal circumcision may have been responsible for the observed increase in the US rate between 1988 and 2000. A report by the Agency for Healthcare Research and Quality placed the 2005 national circumcision rate at 56%. Less