Brit milah

Brit milah
Halakhic texts relating to this article:
Torah:	Genesis 17:1-14, Leviticus 12:3
* Not meant as a definitive ruling. Some observances may be rabbinical, customs or Torah based.

Brit milah (Hebrew: בְּרִית מִילָה‎ [b'rīt mī'lā], Ashkenazi pronunciation, bris milôh, "covenant of circumcision"; Yiddish pronunciation, bris) is a Jewish religious circumcision ceremony performed on 8-day old male infants by a mohel. The brit milah is followed by a celebratory meal (seudat mitzvah).

Biblical references

Main article: Religious male circumcision

"Isaac's Circumcision", Regensburg Pentateuch, c1300

According to the Hebrew Bible (Genesis 17:10-14) God commanded the Biblical patriarch Abraham to be circumcised, an act to be followed by his descendants:

This is My covenant between Me, and between you and your offspring that you must keep: You must circumcise every male. You shall be circumcised through the flesh of your foreskin. This shall be the mark of the covenant between Me and you. 'Throughout all generations, every male shall be circumcised when he is eight days old. [This shall include] those born in your house, as well as [slaves] bought with cash from an outsider, who is not your descendant. [All slaves,] both houseborn and purchased with your money must be circumcised. This shall be My covenant in your flesh, an eternal covenant. The uncircumcised male whose foreskin has not been circumcised, shall have his soul cut off from his people; he has broken My covenant.

Also, Leviticus 12:3 provides:

On the eighth day, [the child's] foreskin shall be circumcised.

According to the Hebrew Bible, it was "a reproach" for an Israelite to be uncircumcised (Joshua 5:9.) The name arelim ("uncircumcised" [plural]) is used opprobriously, denoting the Philistines and other non-Israelites (I Samuel 14:6, 31:4; II Samuel 1:20) and used in conjunction with tameh (unpure) for heathen (Isaiah 52:1). The word arel ("uncircumcised" [singular]) is also employed for "impermeable" (Leviticus 26:41, "their uncircumcised hearts"; compare Jeremiah 9:25; Ezekiel 44:7,9); it is also applied to the first three years' fruit of a tree, which is forbidden (Leviticus 19:23).

However, the Israelites born in the wilderness after the Exodus from Egypt were not circumcised. Joshua 5:2-9, explains, "all the people that came out" of Egypt were circumcised, but those "born in the wilderness" were not. Therefore Joshua, before the celebration of the Passover, had them circumcised at Gilgal specifically before they entered Canaan. Abraham, too, was circumcised when he moved into Canaan.

The prophetic tradition emphasizes that God expects people to be good as well as pious, and that non-Jews will be judged based on their ethical behavior. Thus, Jeremiah 9:25-26 says that circumcised and uncircumcised will be punished alike by the Lord; for "all the nations are uncircumcised, and all the house of Israel are uncircumcised in heart."

The penalty of non-observance is kareth (spiritual excision from the Jewish nation), as noted in Genesis 17:1-14. Conversion to Judaism for non-Israelites in Biblical times necessitated circumcision otherwise one could not partake in the Passover offering (Exodus 12:48). Today, as in the time of Abraham, it is required of converts in Orthodox, Conservative and Reform Judaism. (Genesis 34:14-16).

As found in Genesis 17:1-14, Brit milah is considered to be so important that should the eighth day fall on the Sabbath, actions that would normally be forbidden because of the sanctity of the day are permitted in order to fulfill the requirement to circumcise. The Talmud, when discussing the importance of Milah, compares it to being equal to all other mitzvot based on the gematria for brit of 612.^[1]

Ceremony

Time and place

It is customary for the brit to be held in a synagogue, but it can also be held at home or any other suitable location. The brit is performed on the eighth day from the baby's birth, taking into consideration that according to the Jewish calendar, the day begins at the sunset of the day before. If the baby is born on Sunday before sunset, the Brit will be held the following Sunday. However, if the baby is born on Sunday night after sunset, the Brit is on the following Monday. The brit takes place on the eighth day following birth even if that day is Shabbat or a holiday. A brit is traditionally performed in the morning, but it may be performed any time during daylight hours. ^[2]

Postponement for health reasons

If the child is born prematurely or has other serious medical problems, the brit milah will be postponed until the doctors and mohel deem the child strong enough.

Kvatter

Set of brit milah implements, Göttingen city museum

The name of Kvatter or Kvatterin (female) among Ashkenazi Jews is for the person who carries the baby from the mother to the father, who in turn carries him to the mohel. This honor is usually given to a couple without children, as a merit or charm that they should have children of their own. The origins of the term may simply be a corruption of "Gevatter", an archaic German word for godfather,^[3] but it is also said to be a Yiddish erroneous combination of the words "Kavod" ("honor" in Hebrew) and "Tor" ("door" in Yiddish), meaning "The person honored by bringing the baby". Another source is a mix of Hebrew and Yiddish meaning 'like the father'.

Seudat mitzvah

After the ceremony, a celebratory meal takes place. At the birkat hamazon additional introductory lines, known as Nodeh Leshimcha, are added. These lines praise God and request the permission of God, the Torah, Kohanim and distinguished people present to proceed with the grace. When the four main blessings are concluded, special ha-Rachaman prayers are recited which request that God bless the parents of the baby, and help them raise him wisely; the sandek; the baby boy to have strength and grow up to trust in God and perceive Him three times a year; the mohel for unhesitatingly performing the ritual; to send the Jewish Messiah speedily in the merit of this mitzvah; and to send Elijah the prophet, known as "The Righteous Kohen", so that God's covenant can be fulfilled with the re-establishment of the throne of King David.

Priah

At the neonatal stage, the inner preputial epithelium is still linked with the surface of the glans.^[4] The mitzvah is executed, only when this epithelium is either removed, or permanently peeled back, to uncover the glans.^[5] On medical circumcisions performed by surgeons, the epithelium is removed along with the foreskin,^[6] to prevent post operative penile adhesion and its complications.^[7] However, on ritual circumcisions performed by a mohel, the epithelium is most commonly peeled off, only after the foreskin has been amputated. This procedure is called 'priah' (Hebrew: פריעה), which means: 'uncovering'.

According to the traditional Jewish sources, the 'priah' is performed, as part of the Jewish circumcision, since the Israelites first inhabited the Land of Israel.^[8] However, the Oxford Dictionary of the Jewish Religion, argues that many Hellenistic Jews had an operation performed to conceal the fact of their circumcision, and that similar action was taken during the Hadrianic persecution, in which period a prohibition against circumcision was issued. Thus, hypothesize the editors, it was probably in order to prevent the possibility of obliterating the traces of circumcision that the rabbis added to the requirement of cutting the foreskin that of priah.^[9] The frenulum may also be cut away at the same time, in a procedure called frenectomy.^[10]

Metzitzah technique

Hemostat (center) is used to keep the two layers of the foreskin together so that they are cut and removed as one. The guard (top center) is slid over the foreskin as close to the glans as possible to allow for maximum removal of the former without any injury to the latter. The scalpel is used to detach the foreskin, and the underlying blue bag is a sterilization pouch for the metal tools. The tube (center left) was used for metzitzah

Less commonly practiced, and more controversial, is metzitzah b'peh, (alt. mezizah), or oral suction,^[11][12] where the mohel sucks blood from the circumcision wound. The traditional reason for this procedure is to minimize the potential for postoperative complications,^[13][14] although the practice has been implicated in the spreading of herpes to the infant.^[15]

A sterilized glass tube is now used.^[16][17] However, the practice has become a controversy in both secular and Jewish medical ethics. The ritual of metzitzah is found in Mishnah Shabbat 19:2, which lists it as one of the four steps involved in the circumcision rite. The Chasam Sofer observed that the Talmud states that the rationale for this part of the ritual was hygienic — i.e., to protect the health of the child. The Chasam Sofer contended that metzitzah with a sponge would accomplish the same purpose as oral suction. His letter was published in Kochvei Yitzchok.^[18] The Maharam Shik, a student of the Chasam Sofer, states in his book of Responsa, She’eilos U’teshuvos Maharam Shik (Orach Chaim 152,)^{[further explanation needed]} that the Chasam Sofer gave the ruling in that specific instance only and that it may not be applied elsewhere. He also states (Yoreh Deah 244) that the practice is possibly a Sinaitic tradition, i.e., Halacha l'Moshe m'Sinai.

The Sdei Chemed claimed the practice to be Halacha l'Moshe m'Sinai and elaborates on what prompted the Chasam Sofer to give the above ruling:.^[19] He tells the story that a student of the Chasam Sofer, Lazar Horowitz, author of Yad Elazer and Chief Rabbi of Vienna at the time, needed the ruling because of a governmental attempt to ban circumcision completely if it included Metztitzah b'peh. He therefore asked the Chasam Sofer to give him permission to do Brit milah without metzitzah b’peh. When he presented the defense in court, they erroneously recorded his testimony to mean that the Chasam Sofer stated it as a general ruling.^[20]

Medical controversy

"Chair of Elijah" used during the brit milah ceremony

Yaakov Aryeh Alter as Sandek

Metzitzah b'peh was implicated in the transfer of herpes from mohelim to eight Israeli infants, one of whom suffered brain damage.^[15][21] When three New York City infants contracted herpes after metzizah b'peh by one mohel and one of them died, New York authorities took out a restraining order against the mohel requiring use of a sterile glass tube, or pipette.^[17][22] However, the mohel's attorney argued that the New York Department of Health had not supplied conclusive medical evidence linking his client with the disease.^[22][23] In September 2005, the city withdrew the restraining order and turned the matter over to a rabbinical court.^[24] Dr. Thomas Frieden, the Health Commissioner of New York City, wrote, "There exists no reasonable doubt that ‘metzitzah b'peh’ can and has caused neonatal herpes infection.…The Health Department recommends that infants being circumcised not undergo metzitzah b'peh."^[25] In May 2006, the Department of Health for New York State, issued a protocol for the performance of metzitzah b'peh.^[26] Dr. Antonia C. Novello, Commissioner of Health for New York State, together with a board of rabbis and doctors, worked, she said, to "allow the practice of metzizah b'peh to continue while still meeting the Department of Health's responsibility to protect the public health."^[27]

In three medical papers done in Israel, Canada, and the USA, oral suction following circumcision was suggested as a cause in 11 cases of neonatal herpes.^[15][28][29] Researchers noted that prior to 1997, neonatal herpes reports in Israel were rare, and that the late incidences were correlated with the mothers not carrying the virus themselves.^[15] Rabbi Doctor Mordechai Halperin implicates the "better hygiene and living conditions that prevail among the younger generation", which lowered the rate of young Israeli Chareidi mothers that carry the virus, to 60%. He explains that an "absence of antibodies in the mothers’ blood means that their newborn sons received no such antibodies through the placenta, and therefore are vulnerable to infection by HSV-1."^[30]

Because of the risk of infection, some rabbinical authorities have ruled that the traditional practice of direct contact should be replaced by using a glass tube between the wound and the mohel's mouth, so there is no direct oral contact. The Rabbinical Council of America, the largest group of Modern Orthodox rabbis, endorses this method.^[31] The RCA paper states: "Rabbi Schachter even reports that Rav Yosef Dov Soloveitchik reports that his father, Rav Moshe Soloveitchik, would not permit a mohel to perform metzitza be’peh with direct oral contact, and that his grandfather, Rav Chaim Soloveitchik, instructed mohelim in Brisk not to do metzitza be’peh with direct oral contact. However, although Rav Yosef Dov Soloveitchik also generally prohibited metzitza be’peh with direct oral contact, he did not ban it by those who insisted upon it,...". The sefer Mitzvas Hametzitzah^[32] by Rabbi Sinai Schiffer of Baden, Germany, states that he is in possession of letters from 36 major Russian (Lithuanian) rabbis that categorically prohibit Metzitzah with a sponge and require it to be done orally. Among them is Rabbi Chaim Halevi Soloveitchik of Brisk.

Additionally, the Talmud explicitly instructs that a boy must not be circumcised if he had two brothers who died due to complications arising from their circumcisions;^[33] this may be due to a concern about haemophilia.^[33] An Israeli study found a high rate of urinary tract infections if the bandage is left on too long.^[34]

Hatafat dam brit

Circumcision alone, in the absence of the brit milah ceremony, does not fulfill the requirements of the mitzvah. In the case of a Jew who was circumcised outside of a brit milah, or an already-circumcised convert, the mohel draws a symbolic drop of blood from the penis.

A brit milah is not considered complete unless blood is actually drawn. This is not the intentional spilling of blood. The standard medical methods of circumcision through constriction do not meet the requirements of the halakhah for brit milah, because they cause hemostasis, i.e., they stop the flow of blood. A brit milah, to be conducted properly, requires the use of a specialized surgical knife, called an izmel, which does allow for dam brit.

Unlike the traditional Jewish method, when circumcision is performed by a urologist or other surgeon the foreskin is removed by constriction, either with the use of clamps or a synthetic ring. This non-Jewish method works by crushing the skin until it is severed. The nerve endings and the blood vessels are severed in the same manner, causing pain and hemostasis.

The expressly ritual element of circumcision in Judaism, as distinguished from its non-ritual requirement in Islam, is shown by the requirement that a child who either is born aposthetic (without a foreskin) or who has been circumcised without the ritual must nevertheless undergo a Brit milah in which a drop of blood (hatafat-dam, הטפת דם) is drawn from the penis at the point where the foreskin would have been or was attached.^[35]

Milah l'shem giur

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A Milah L'shem giur is a "Circumcision for the purpose of conversion". In Orthodox Judaism, this procedure is usually done by adoptive parents for adopted boys who are being converted as part of the adoption or by families with young children converting together. The conversion of a minor is valid in both Orthodox and Conservative Judaism until a child reaches the age of majority (13 for a boy, 12 for a girl); at that time the child has the option of renouncing his conversion and Judaism, and the conversion will then be considered retroactively invalid. He must be informed of his right to renounce his conversion if he wishes. If he does not make such a statement it is accepted that the boy is halakhically Jewish. Orthodox rabbis will generally not convert a non-Jewish child raised by a mother who has not converted to Judaism.^[36]

The laws of conversion and conversion-related circumcision in Orthodox Judaism have numerous complications, and authorities recommend that a rabbi be consulted well in advance.

In Conservative Judaism, the Milah l'Shem giur procedure is also performed for a boy whose mother has not converted, but with the intention that the child be raised Jewish. This conversion of a child to Judaism without the conversion of the mother is allowed by Conservative interpretations of halakha. Conservative Rabbis will authorize it only under the condition that the child be raised as a Jew in a single-faith household. Should the mother convert, and if the boy has not yet reached his third birthday, the child may be immersed in the mikveh with the mother, after the mother has already immersed, to become Jewish. If the mother does not convert, the child may be immersed in a mikveh, or body of natural waters, to complete the child's conversion to Judaism. This can be done before the child is even one year old. If the child did not immerse in the mikveh, or the boy was too old, then the child may choose of their own accord to become Jewish at age 13 as a Bar Mitzvah, and complete the conversion then.^[37]

• The ceremony, when performed l'Shem giur, does not have to be performed on a particular day, and does not override Shabbat and Jewish Holidays.[1] [2]
• In Orthodox Judaism, there is a split of authorities on whether the child receives a Hebrew name at the Brit ceremony or upon immersion in the Mikvah. According to Zichron Brit LeRishonim, naming occurs at the Brit with a different formula than the standard Brit Milah. The more common practice among Ashkenazic Jews follows Rabbi Moshe Feinstein, with naming occurring at immersion.

Where the procedure was performed but not followed by immersion or other requirements of the conversion procedure (e.g., in Conservative Judaism, where the mother has not converted), if the boy chooses to complete the conversion at Bar Mitzvah, a Milah l'shem giur performed when the boy was an infant removes the obligation to undergo either a full brit milah or hatafat dam brit.

Reasons for circumcision

In Of the Special Laws, Book 1, the Jewish philosopher Philo (20 BC - AD 50) gives six reasons for the practice of circumcision.^[38] He attributes four of the reasons to "men of divine spirit and wisdom". These include the idea that circumcision 1) protects against disease, 2) secures cleanliness "in a way that is suited to the people consecrated to God", 3) causes the circumcised portion of the penis to resemble a heart, thereby representing a physical connection between the "breath contained within the heart [that] is generative of thoughts, and the generative organ itself [that] is productive of living beings", and 4) promotes prolificness by removing impediments to the flow of semen. To these, Philo added two of his own reasons, including the idea that circumcision 5) "signified figuratively the excision of all superfluous and excessive pleasure" and 6) "that it is a symbol of a man's knowing himself".

Rabbi Saadia Gaon considers something to be 'complete', if it lacks nothing, but also has nothing that is unneeded. He regards the foreskin an unneeded organ that God created in man, and so by amputating it, the man is completed.^[39]

Maimonides (Moses ben Maimon "Rambam", CE 1135-1204), who apart from being a great Torah scholar was also a physician and philosopher, argued that circumcision acts to repress sexual pleasure and serves as a common bodily sign to members of the same faith.^[40]

The author of Sefer ha-Chinuch^[41] provides three reasons for the practice of circumcision:

1. To complete the form of man, by removing what he claims to be a redundant organ;
2. To mark the chosen people, so their body will be different as their soul is; The organ chosen for the mark is the one responsible for the sustenance of the species.
3. Said completion isn't congenital, but left to the man. This implies, that as he completes the form of his body, so can he complete the form of his soul.

Talmud professor Daniel Boyarin offered two explanations for circumcision. One is that it is a literal inscription on the Jewish body of the name of God in the form of the letter "yud" (from "yesod"). The second is that the act of bleeding represents a feminization of Jewish men, significant in the sense that the covenant represents a marriage between Jews and (a symbolically male) God.^[42]

Reform Judaism

The leaders of Reform Judaism in early nineteenth century Germany at first rejected circumcision, claiming it to be 'barbaric'.^[43] By 1871, rabbinic leadership in the German Reform Movement reasserted "the supreme importance of circumcision in Judaism", though those who had not been circumcised would continue to be considered as Jews. Although the issue of circumcision of converts continues to be debated, the necessity of Brit Milah for Jewish infant boys has been stressed in every subsequent Reform rabbis manual or guide.^[44] Since 1984 Reform Judaism has trained and certified over 300 of their own practicing mohalim in this ritual.^[45][46]

The anti-circumcision movement and brit shalom

Main articles: Circumcision controversies and Brit shalom (naming ceremony)

Some contemporary Jews choose not to circumcise their sons.^[47] They are assisted by a small number of Reform and Reconstructionist rabbis, and have developed a welcoming ceremony that they call the brit shalom ("Covenant [of] Peace") for such children, also accepted by Humanistic Judaism.^[48][49]

This ceremony of brit shalom is not officially approved of by the Reform or Reconstructionist rabbinical organizations, who make the recommendation that male infants should be circumcised, though the issue of converts remains controversial^[50][51] and circumcision of converts is not mandatory in either movement.^[52]

However, the connection of the Reform movement to an anti-circumcision, pro-symbolic stance is a historical one. From the early days of the movement in Germany, some classical Reformers hoped to replace ritual circumcision "with a symbolic act, as has been done for other bloody practices, such as the sacrifices."^[53] As a result, many European Jewish fathers during the nineteenth century chose not to circumcise their sons, including Theodore Herzl.^[54] In the US, an official Reform resolution in 1893 abolished circumcision for converts,^[55] and this ambivalence towards the practice has carried over to classical-minded Reform Jews today. In Rabbi Elyse Wechterman's essay A Plea for Inclusion, she argues that, even in the absence of circumcision, committed Jews should never be turned away, especially by a movement "where no other ritual observance is mandated". She goes on to advocate for an alternate covenant ceremony, brit atifah, for both boys and girls as a welcoming ritual into Judaism.^[56] With a continuing negativity towards circumcision still present within a minority of modern-day Reform, Judaic scholar Jon Levenson has warned that if they "continue to judge brit milah to be not only medically unnecessary but also brutalizing and mutilating...the abhorrence of it expressed by some early Reform leaders will return with a vengeance", proclaiming that circumcision will be "the latest front in the battle over the Jewish future in America."^[57] Nevertheless, it has "remained a central rite" in Reform Judaism,^[58] and the Union for Reform Judaism has, since 1984, trained and certified over 300 practicing mohels under its "Berit Mila Program".^[59]

In Israel, the small minority of Jewish and non-Jewish families that chose not to have their sons circumcised, has formed a support group in the year 2000. Over two and a half years, 200 couples have enlisted.^[60] Meanwhile, Ya'acov Malkin, the academic director of the College of Judaism as Culture in Israel, who circumcised his own son 50 years before "because of habit, because it was a custom, it is a custom of the Jews", says of circumcision: "I don't regard it as a religious act at all... if it's medically not necessary, it's not necessary." The U.S.A based Secular and Humanistic Jews Movement, that also has members in Israel, argues that "circumcision is not required for Jewish identity."^[60]

References

1. ^ Tractate Nedarim 32a
2. ^ http://www.chabad.org/library/article_cdo/aid/144464/jewish/The-Proper-Time-and-Place.htm
3. ^ http://beritmila.org/Glossary.html
4. ^ Øster, Jakob (April 1968). "Further Fate of the Foreskin". ARCHIVES OF DISEASE IN CHILDHOOD. pp. 200–202. http://www.cirp.org/library/general/oster/. Retrieved 2010-11-14. 
5. ^ Mishnah Shabbat 19:6. "circumcised but did not perform priah, it is as if he did not circumcise."  The Jerusalem Talmud there adds: "and is punished kareth!"
6. ^ Circumcision Policy Statement of The American Academy of Pediatrics notes that "There are three methods of circumcision that are commonly used in the newborn male", and that all three include "bluntly freeing the inner preputial epithelium from the epithelium of the glans", to be later amputated with the foreskin.
7. ^ Gracely-Kilgore, Katharine A. (May 1984). "Further Fate of the Foreskin". NURSE PRACTITIONER. pp. 4–22. http://www.cirp.org/library/complications/gracely1/. Retrieved 2010-11-14. 
8. ^ Talmud Bavli Tractate Yebamoth 71b: Rabbah b. Isaac stated in the name of Rab: The commandment of uncovering the corona at circumcision was not given to Abraham; for it is said, At that time the Lord said unto Joshua: 'Make thee knives of flint etc.' But is it not possible [that this applied to] those who were not previously circumcised; for it is written, For all the people that came out were circumcised, but all the people that were born etc.? — If so, why the expression. 'Again!' Consequently it must apply to the uncovering of the corona.
9. ^ Werblowsky, R.J. Zwi & Wigoder, Geoffrey (1997) The Oxford Dictionary of the Jewish Religion. Oxford: Oxford University Press
10. ^ Stuart, Robin (July 2007). "MALE INITIATION AND THE PHIMOSIS TABOOS". APPLIED RESEARCH on CIRCUMCISION (Arc). http://www.phimosis-circumcision.com/welcome.html. Retrieved 2007-10-05. 
11. ^ Nussbaum Cohen, Debra (October 14, 2005). "City Risking Babies' Lives With Brit Policy: Health Experts". The Jewish Week. Archived from the original on 2007-05-22. http://web.archive.org/web/20070522001308/http://www.thejewishweek.com/news/newscontent.php3?artid=11539. 
12. ^ Nussbaum Cohen, Debra; Larry Cohler-Esses (December 23, 2005). "City Challenged On Ritual Practice". The Jewish Week. http://www.thejewishweek.com/news/newscontent.php3?artid=11833&print=yes. Retrieved 2007-04-19. 
13. ^ Talmud Bavli Tractate Shabbos 133b: Rav Pappa said, “A mohel who does not perform metzitzah endangers the baby and is dismissed.”
14. ^ Halperin, Mordechai; (translated by Yocheved Lavon) (Winter 2006). "Metzitzah B’peh Controversy: The View from Israel". Jewish Action (Orthodox Union) 67 (2): 25, 33–39. doi:10.1542/peds.114.2.e259. ISSN 0447-7049. OCLC 5763983. PMID 15286266. http://www.ou.org/jewish_action/article/8987. Retrieved 2007-02-15. "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 ... 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" 
15. ^ ^{a b c d} Gesundheit, B.; et al. (August 2004). "Neonatal Genital Herpes Simplex Virus Type 1 Infection After Jewish Ritual Circumcision: Modern Medicine and Religious Tradition" (PDF). Pediatrics 114 (2): e259–e263. doi:10.1542/peds.114.2.e259. ISSN 1098-4275. PMID 15286266. http://pediatrics.aappublications.org/cgi/reprint/114/2/e259.pdf. Retrieved 2006-06-28. 
16. ^ "Metzitza Be'Peh - Halachic Clarification". Rabbinical Council of America. June 7, 2005. http://www.rabbis.org/news/article.cfm?id=100605. Retrieved 2007-04-06. "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." 
17. ^ ^{a b} Hartog, Kelly (February 18, 2005). "Death Spotlights Old Circumcision Rite". The Jewish Journal of Greater Los Angeles. http://www.jewishjournal.com/home/preview.php?id=13676. Retrieved 2006-11-22. "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." 
18. ^ http://www.thejewishweek.com/top/editletcontent.php3?artid=4591
19. ^ Sdei Chemed vol.8 page 238
20. ^ Kuntres Hamiliuim
21. ^ Rare Circumcision Ritual Carries Herpes Risk
22. ^ ^{a b} Newman, Andy (August 26, 2005). "City Questions Circumcision Ritual After Baby Dies". The New York Times. http://www.nytimes.com/2005/08/26/nyregion/26circumcise.html?ex=1164344400&en=31f8462c34a55f16&ei=5070. Retrieved 2006-11-23. 
23. ^ Clarke, Suzan (June 21, 2006). "State offers new guidelines on oral-suction circumcision". The Journal News. Archived from the original on 2007-08-20. http://64.233.161.104/search?q=cache:ZOCO6Lzh7NsJ:www.lohud.com/apps/pbcs.dll/article%3FAID%3D/20060621/NEWS03/606210352/1197/RSS01+www.lohud.com/apps/pbcs.dll/article%3FAID%3D/20060621/NEWS03/606210352/1197/RSS01&hl=en&gl=us&ct=clnk&cd=1. Retrieved 2006-06-28. 
24. ^ Nussbaum Cohen, Debra (September 23, 2005). "City: Brit Case To Bet Din". The Jewish Week. http://www.thejewishweek.com/news/newscontent.php3?artid=11412. Retrieved 2006-11-23. 
25. ^ Nussbaum Cohen, Debra (February 23, 2006). "Controversy rages in New York over circumcision practice". The Jewish Ledger. http://www.jewishledger.com/articles/2006/02/23/news/news02.txt. Retrieved 2006-11-23. 
26. ^ "Circumcision Protocol Regarding the Prevention of Neonatal Herpes Transmission". Department of Health, New York State. November (revised) 2006. http://www.health.state.ny.us/diseases/communicable/herpes/newborns/circumcision_protocol.htm. Retrieved 2006-11-23. ^{[dead link]}
27. ^ Novello, Antonia C. (May 8, 2006). "Dear Rabbi Letter". Department of Health, New York State. http://www.health.state.ny.us/diseases/communicable/herpes/newborns/2006-05-08_letter_to_rabbis.htm. Retrieved 2006-11-23. "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." ^{[dead link]}
28. ^ Rubin LG, Lanzkowsky P. Cutaneous neonatal herpes simplex infection associated with ritual circumcision. Pediatric Infectious Diseases Journal. 2000. 19(3) 266-267.
29. ^ Distel R, Hofer V, Bogger-Goren S, Shalit I, Garty BZ. Primary genital herpes simplex infection associated with Jewish ritual circumcision. Israel Medical Association Journal. 2003 Dec;5(12):893-4
30. ^ Halperin, Mordechai; (translated by Yocheved Lavon) (Winter 2006). "Metzitzah B’peh Controversy: The View from Israel". Jewish Action (Orthodox Union) 67 (2): 25, 33–39. doi:10.1542/peds.114.2.e259. ISSN 0447-7049. OCLC 5763983. PMID 15286266. http://www.ou.org/jewish_action/article/8987. Retrieved 2007-02-15. 
31. ^ Metzitza Be'Peh - Halachic Clarification Regarding Metzitza Be'Peh, RCA Clarifies Halachic Background to Statement of March 1, 2005
32. ^ The book was originally published in German, Die Ausübung der Mezizo, Frankfurt a.M. 1906; It was subsequently translated into Hebrew, reprinted in Jerusalem in 1966 under the title "Mitzvas Hametzitzah" and appended to the back of Dvar Sinai, a book written by the author's grandson, Sinai Adler.
33. ^ ^{a b} This article incorporates text from the 1901–1906 Jewish Encyclopedia article "Morbidity", a publication now in the public domain.
34. ^ Ilani, Ofri (2008-05-12). "Traditional circumcision raises risk of infection, study shows". Haaretz.com. http://www.haaretz.com/hasen/spages/1043807.html. Retrieved 15 August 2009. 
35. ^ Shulchan Aruch, Yoreh De'ah, 263:4
36. ^ Rabbi Paysach J. Krohn, Bris Milah Mesorah Publications Ltd, 1985, pp.103-105
37. ^ Rabbi Avram Israel Reisner, On the conversion of adoptive and patrilineal children, Rabbinical Assembly Committee on Jewish Law and Standards, 1988
38. ^ Of the special laws, Book I (i and ii), in Works of Philo. Vol. VII. Loeb Classical Library: Harvard University Press. 1937. pp. 103–105. ISBN 0674992504 
39. ^ "article III chapter 10". the Book of Beliefs and Opinions. Yale Judaica. 1958. ISBN 0300044909 
40. ^ Maimonides, Moses; Pines, Schlomo (trans.) (1963). The Guide of the Perplexed. Part III. Chapter XLIX. The University of Chicago Press. http://www.sacred-texts.com/jud/gfp/gfp185.htm. 
41. ^ 2nd commandment
42. ^ Boyarin, Daniel. "`This We Know to Be the Carnal Israel': Circumcision and the Erotic Life of God and Israel," Critical Inquiry. (Spring, 1992), 474-506.
43. ^ The Origins of Reform Judaism, The American-Israeli Cooperative Enterprise, 2010 (retrieved November 11, 2010)
44. ^ "Circumcision of Infants". Central Conference of American Rabbis. 1982. http://data.ccarnet.org/cgi-bin/respdisp.pl?file=54&year=arr. Retrieved 2010-09-12. 
45. ^ Niebuhr, Gustav (June 28, 2001). "Reform Rabbis' Vote Reflects Expanding Interest in Rituals". The New York Times. http://query.nytimes.com/gst/fullpage.html?res=9F07E6DC1639F93BA15755C0A9679C8B63. Retrieved 2007-10-03. 
46. ^ "Berit Mila Program of Reform Judaism". National Association of American Mohalim. 2010. http://beritmila.org/. Retrieved 2010-01-23. 
47. ^ Chernikoff, Helen (October 3, 2007). "Jewish "intactivists" in U.S. stop circumcising". Reuters. http://www.reuters.com/article/domesticNews/idUSN22970720071003?pageNumber=1. Retrieved 2007-11-03. 
48. ^ Reiss, MD, Dr. Mark (2006). "Celebrants of Brit Shalom". Brit Shalom. http://www.circumstitions.com/Jewish-shalom.html. Retrieved 2007-10-03. 
49. ^ Goldman, PhD, Ron (2006). "Providers of Brit Shalom". Jews Against Circumcision. http://www.jewsagainstcircumcision.org/brisshalom.htm. Retrieved 2007-10-03. 
50. ^ Glickman, Mark (November 12, 2005). "B'rit Milah: A Jewish Answer to Modernity". Union for Reform Judaism. http://urj.org/Articles/index.cfm?id=8320&pge_prg_id=29839&pge_id=3450. Retrieved 2007-11-03. 
51. ^ Cohen, Rabbi Howard (May 20, 2002). "Bo: Defining Boundaries". Jewish Reconstructionist Federation. http://www4.jrf.org/showdt&rid=322&pid=15. Retrieved 2007-11-03. 
52. ^ Epstein, Lawrence (2007). "The Conversion Process". Calgary Jewish Community Council. http://www.jewishcalgary.org/page.html?ArticleID=63645. Retrieved 2007-11-03. 
53. ^ Katz, Jacob (1998) Divine Law in Human Hands: Case Studies in Halakhic Flexibility. Jerusalem: Hebrew University ISBN 978-9652239808
54. ^ Stewart, Desmond (1974) Theodore Herzl. New York: Doubleday ISBN 978-0385088961
55. ^ Meyer, Michael "Berit Mila within the History of the Reform Movement" in Barth, Lewis (1990) Berit Mila in the Reform Context. New York: Berit Milah Board of reform Judaism
56. ^ Mark, Elizabeth Wyner (2003) The Covenant of Circumcision. Lebanon, NH: Brandeis ISBN 1-58465-307-8
57. ^ Levenson, Jon (March 2000) "The New Enemies of Circumcision", Commentary
58. ^ adapted from Shamash (2007). "The Origins of Reform Judaism". Jewish Virtual Library. http://www.jewishvirtuallibrary.org/jsource/Judaism/The_Origins_of_Reform_Judaism.html. Retrieved 2007-11-03. 
59. ^ Berit Mila Program of Reform Judaism, Union for Reform Judaism website. Retrieved January 23, 2010.
60. ^ ^{a b} Hilary Leila Kreiger, A cut above the rest, Jerusalem Post, 21 November 2002

External links

• CircCentral, an online museum of circumcision tools
• Jewish Encyclopedia entry on circumcision
• The Initiation Society - The regulatory body for mohelim in the UK. Information on the ceremony and naming of the child, as well as a list of mohelim.
• Circumcision, Jewish Virtual Library
• Circumcision: Is it justified?