Some time ago, a series of babies became infected with serious, life-threatening sores in their groin areas shortly after they were circumcised. It was alleged both by physicians and by some local rabbis that the sores were the result of the mohel performing metzitzah b’peh—the ancient tradition of orally suctioning the wound after incision. The mohel, it was alleged, may have had a communicable disease and passed it on to the children, who, because of their underdeveloped immune systems, were more susceptible to the severe effects of this disease. As a result, some doctors condemned the practice of metzitzah b’peh, and sought government involvement to ban or at least regulate the practice. Some rabbis in the community reacted by defending the practice, and argued that A. This was a religious rite and therefore not within the purview of the medical community, B. That there was no conclusive proof that the children had been infected by their mohel and C. Under no circumstances could a religious Jew deviate from this age-old tradition of metzitzah b’peh.
All these details may sound familiar, because they have appeared in one form or another recently in our media. But the above is not a depiction of recent events—all this occurred in the 1830s.
As we hope to demonstrate, in this particular area of Jewish life, “There is nothing new under the sun.”1 As a matter of fact, so much has been written about metzitzah b’peh in the last century and a half that it is difficult to condense all the material into one short article. Despite the voluminous material, we will still be left with the question of how much we can or cannot learn from the past. Although the facts of the present day seem identical to what went on in the nineteenth century, sometimes “the devil is in the details,” and certain details may drastically alter our perceptions and conclusions about this component of brit milah.
The Situation Today
We are presently facing a significant divide within the Orthodox community over this practice. In the summer of 2004, a clinical study from Israel appeared in Pediatrics, the journal of the American Academy of Pediatrics, apparently demonstrating that the practice of metzitzah b’peh increases the risk of an infant contracting the herpes simplex virus (HSV).2 Early in 2005, news broke that a prominent mohel in the New York area had allegedly transmitted HSV to a small number of infant patients through his practice of metzitzah b’peh. The mohel in question was ordered by the New York City Department of Health and Mental Hygiene to immediately desist from performing metzitzah b’peh. In December 2005, the commissioner of the same New York City department issued an “open letter to the Jewish community.” After documenting the statistically high number of HSV infections in infants who had had metzitzah b’peh the letter concluded:
During metzitzah b’peh the mouth of the mohel comes into direct contact with the baby’s circumcision cut, risking transmission of herpes simplex virus to the infant. While severe illness associated with this practice may be rare, because there is no proven way to reduce the risk of herpes infection posed by circumcision which includes metzitzah b’peh, the Health Department recommends that infants being circumcised not undergo metzitzah b’peh. To help protect their baby, parents should understand the risk of metzitzah b’peh—BEFORE the day of the bris, while there is time to explore other options….
The Department has reviewed all of the evidence and there exists no reasonable doubt that metzitzah b’peh can and has caused neonatal herpes infection. We have always maintained that it is our preference for the religious community to address these issues itself as long as the public’s health is protected. While some medical professionals and others in the Jewish community have called on the Department to completely ban metzitzah b’peh at this time, it is our opinion that educating the community through public health information and warnings is a more realistic approach.3
The negative response by the Chareidi community to this governmental position was swift and passionate. Articles, signed open letters and kol koreh posters accused the Department of Health of overstepping its authority; as a religious rite, brit milah was within the purview of the rabbis, not the government. Additionally, there were insufficient data to correlate metzitzah b’peh to HSV. It was also argued that the motivations of the Department of Health were less than pure; the city department was comprised of secular, anti-religious Jews who had a much larger agenda: The recommendation to refrain from metzitzah b’peh was only one step removed from banning brit milah altogether, or at least banning non-physician mohelim. An editor in a Chareidi newspaper wrote:
Will we become like our Russian brethren in the past century who were forced under the Communists to conduct sacred bris[es] in underground bunkers with sentries standing guard…. Are we about to revisit those days in our own country?4
If anything, the attack on metzitzah b’peh only strengthened the practice within the Chareidi community, as now this was viewed as a milchemet mitzvah—a religious war to defend a centuries-old tradition.
In the meantime, the Rabbinical Council of America had already issued its own public policy statement, recommending, but not requiring, that mohelim desist from doing metzitzah b’peh, and instead suction the blood through other, safer methods. The article, quoting Rabbi Hershel Schachter, a rosh yeshivah of Rabbi Isaac Elchanan Theological Seminary, stated the following:
Rav Yosef Dov Soloveitchik reports that his father, Rav Moshe Soloveitchik, would not permit a mohel to perform metzitza b’peh with direct oral contact, and that his grandfather, Rav Chaim Soloveitchik, instructed mohelim in Brisk not to do metzitza b’peh with direct oral contact.5
And so, for the time being, two camps remain within our people: those who are pro-metzitzah b’peh, the most extreme of whom will not permit a brit milah unless it includes metzitzah b’peh, and those who are anti-metzitzah b’peh, the most extreme of whom will not permit metzitzah b’peh under any circumstances.
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