The writer has resorted to circumcision in many cases to improve the temper and disposition of children, with the best of results, and in one case, in association with another physician, performed the operation on a lunatic, whose lunacy ran to women and girls, with whom he would fall desperately in love, without any encouragement or provocation, or even acquaintance; finally reaching spells of such incoherence of action and speech that confinement would be required. The peculiarity of his hallucinations called attention to the genital organs. This man had never masturbated, and was, when well, a compactly-built, active, and intelligent man. By occupation he was a contractor, and a man of more than usual executive ability besides. On examination it was found that he was a subject of congenital phimosis, never having been able to uncover the glans. He had been in the habit of washing out the preputial cavity by the aid of a flat-nozzled syringe. The prepuce was long, but not thick; nevertheless, it was inelastic and very firm. The examination seemed to have a good mental effect upon the man, as it made him quite rational for the moment. He entered into the idea that this condition had some connection with his derangement very intelligently, even suggesting many symptoms and attacks that he had suffered from childhood up as probably gradual-stepping processes through which his present condition had been reached. He cheerfully submitted to a thorough circumcision, which had the effect of ameliorating his condition. He was subsequently sent to an asylum, where, after a short time, he was discharged well. Some years afterward, conscious of feeling a return of the mental derangement, he voluntarily applied for admission to the same institution and remained until better.
This case is very instructive. The patient readily connected his mental trouble, by a retrospective view through a series of gradually-increasing troubles, that originated in the preputial condition, to the phimosed condition of that appendage, and he was certain that this prepuce had been at the bottom of all the physical and mental trouble he had experienced. The reflex nervous train of affections had undoubtedly produced some localized lesion in the brain-structure. The natural sound, healthy organism of that organ, and the bright, active nature of his mind, however, prevented a total wreckage of the mental faculties. It is safe to assume that, had he had the ordinary listless, unresisting mind, disposed to brood, and easily cast down, he would, from the first derangement, have become a hopeless and demented lunatic. The circumcision could not undo all the mischief that had been accomplished, some of which had certainly left a permanent taint, but the mildness of his future attacks and the better exercise of his volition were the undoubted results of the operation.