Abstract
This chapter is comprised of two submissions: “The Bris” and “The Operating Room Bris.”
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Notes
- 1.
Hebrew, Variant forms from Hebrew include bris, brit, berit, and b’rit (i.e., b´rĭs, b´rēt, b´rĭt; mē´lah, and mēla).
- 2.
Before the Common Era or Before the Christian Era.
- 3.
While the standard worldwide is to recognize the Jewish status by whether or not the mother is Jewish, many in the Reform movement in the USA recognize a baby as potentially being Jewish if the father is Jewish (adopted by the Central Conference of American Rabbis in 1983).
- 4.
With the exception of an infant, most people spend a year or so studying before they finally commit to the conversion, so the circumcision would be postponed until that time.
- 5.
Jewish ritual circumciser. Pronunciations: mohel (mō`hell), moyl (moyl), moel (mō·el); mohelim (mō`hell·ēm) is plural.
- 6.
The eighth day is counted with the first day being the day of birth. Since the Jewish calendar starts at sunset, a baby born on Monday day will have his bris the following Monday. If the baby is born on Monday night, the bris is held the following Tuesday. The bris may only take place during daylight.
- 7.
There are some mohelim that will not do a bris if the bilirubin level is over 10 mg/dL (171 μmol/L). Most mohelim will do a bris if the bilirubin level does not exceed 18 mg/dL (308 μmol/L) and is dropping (i.e., this and other indications are that it is physiologic jaundice).
- 8.
This would require pre-approval from the hospital administration.
- 9.
Some parents are concerned that a bris may be inappropriate for children. The fact of the matter is, children do just fine (usually better than those parents). As with most of life’s trials, being forthright, honest, and upbeat will make the bris a joyous occasion for our children as well.
- 10.
Blessed be he who enters (Hebrew). In baruch (ba·rooch) the ‘ch’ is pronounced as in the name Bach.
- 11.
Where a bris is part of a more elaborate procedure in the operating room, it is appropriate that the mohel make the blessings and first cut (or draw the first blood) and then the surgeon completes the process (see section “Bris in the operating room”). Some mohelim like to finish the process by making the last, final cut.
- 12.
The foreskin here refers to the outer layer and the mucous membrane layer combined.
- 13.
In the Hebrew Bible, Canaan is the land promised to Abraham and the descendents of Isaac and extends from Lebanon southward and across into part of modern Egypt and eastward to the Jordan River Valley.
- 14.
Mogen (מגן) is shield in Hebrew and the common name for this device.
- 15.
To avoid the cloths staining issues associated with iodine solutions, I prefer a clear antimicrobial solution like chlorhexidine.
- 16.
For example, Rabbi Moshe D. Tendler, Professor of Jewish Medical Ethics, Yeshiva University, whose opinions are highly regarded in this area.
- 17.
To deliver a nearly imperceptible DPNB, use plain Lidocaine from an ampule (without preservative). The preservative is more viscous and produces more pain when injected. Also use a 1 cc insulin syringe with an ultrafine, 0.5 in., 30 ga needle. Standard sites of 10 and 2 o’clock are injected by pressing downward (proximally) about 1 cm at the base of the penis so the needle can be inserted close to the Buck’s fascia below the level of the peno-suprapubic junction. This has two advantages. First, it is a relatively insensitive area and, second, it does not lead to any penile distortion. Always check for blood return before you inject.
- 18.
You can either make it yourself; mix two packets of sugar (7 g total) with 30 mL of warm tap water, or you can purchase Sweet-Ease®.
- 19.
This could apply to family physicians, pediatricians, obstetricians, midwives, ER/ED/urgent care physicians, urologists, and any other health-care workers who support these areas.
References
Bible; Proverbs 23:25.
Bible; Genesis XVII, 7–12.
Spinoza B, Theological-Political Treatise. s.l.: R.H.M. Elwes (Latin Translation – 1883), 1670.
Maccabees 2:6,10.
Midrash; Tanchuma, Tazria.
Bible; Genesis XVII, 1.
Code of Jewish law; Shulchan Aruch, Yoreh Deah, 260–6.
Bible; Genesis XXI, 4.
Bible; Leviticus XII, 3.
Maimonides; Yad HaChazakah, Hilchot Milah, 1:18.
Talmud; Shabbos, 130a.
Midrash; Pirkei de Rabbi Eliezer 29.
Gesundheit B, et al. Neonatal genital herpes simplex virus type 1 infection after Jewish Ritual circumcision: modern medicine and religious tradition. Pediatrics. 2004;114(2):e259–63.
Epstein LJ. The haunted smile. New York: PublicAffairs; 2001.
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Bolnick, D.A., Katz, K.E. (2012). Jewish Ritual Circumcision. In: Bolnick, D., Koyle, M., Yosha, A. (eds) Surgical Guide to Circumcision. Springer, London. https://doi.org/10.1007/978-1-4471-2858-8_23
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