It in no way detracts from the value of this book to say that one might have predicted its appearance. Independent and joint studies of medicine and sexuality have surely been at the forefront of recent historical scholarship. Even more precisely, studies of male sexuality have trailed in the wake of work on women, and, in the history of medicine, studies of surgery have usually appeared later than histories of physiology and medical theory. Whence we are about on time for a history of male sexual surgery. Robert Darby brings together a great deal of recent scholarship in all these areas to present his empirical findings on the history of male circumcision in Britain, mainly around 1850–1914. For those unfamiliar with the work on which he draws, this is a valuable synthetic study that will introduce the reader to much recent history and historiography. Those who are more in the know will find themselves traversing a great deal of familiar terrain (albeit well presented) before arriving at new material. It takes nothing away from this book to say that it has a popular feel. Quite the reverse, its breadth should serve to introduce general readers to the things modern historians think about.

Male circumcision was virtually unknown as a practice among Christians in Britain before the nineteenth century. It was a ritual reserved, it was said, for Jews and Muslims and barbarous African tribesmen. Before the Victorians there is plenty of evidence, from all classes, for both male and female appreciation of the foreskin as an organ of play and pleasure. For cultivated aesthetes it was a source of delight. Aristocrats and scholars immersed in classical studies easily discovered reference to the satisfaction that the Greeks and Romans found in the depiction of the hooded penis and the distaste they had for the naked glans. According to Darby, by 1900, for the British middle and upper classes, the prepuce had become the source of penile irritability and hence a stimulus to masturbation and, in turn, all its hideous pathological sequelae: notably insanity and venereal disease. The well-known Victorian abhorrence of masturbation is central to Darby's tale.

In the eighteenth century, surgery was the therapy of last resort in any illness. By the end of the nineteenth century, surgeons had become the highest priests of the new secular religion: medicine. Nothing, it seemed, was beyond surgical remedy. Hardly surprising then that circumcision was toted as the sovereign cure for the most foul of practices. The expression “Off with his head” (not spotted by Darby) may well have chilled the Victorian male in more than his neck. Although short on statistics, Darby's rich account of male circumcision, mainly from doctors but also parents, schoolmasters, and victims (clearly how the men quoted here felt about it), is an important contribution to scholarship. Famously, the Victorian sexual “expert” William Acton wrote: “the majority of women (happily for them) are not very much troubled with sexual feeling of any kind.” Never was a thought more misunderstood and less contextualized, says Darby convincingly. Acton meant, “lucky women” (13).

In spite of the impressive reading of secondary sources and the primary material on which it is based, I am far from convinced by some of the theory that underwrites this book. To use Darby's own word, the “demonization” that is going on in this volume is of the medical profession (note the medical title). Of course to our eyes, judging from some of Darby's quotes, the doctors were monsters, and yes, Darby is quite right to situate their activities in the wider context of Victorian discourse and practices with respect to sexuality. Yet beyond this, not quite invisible, Darby is suggesting “if only.” If only Victorian medicine had been based on good science, a massacre of the innocents would never have happened. Circumcision, he argues, was the “child” of “old style `traditional’ medicine” and did not survive the “new approach,” “the rising new style of `scientific’ medicine.” Routine male circumcision, he tells us, “died out in the 1940s, simultaneous with the consolidation of modern medicine and the development of antibiotics” (317). This is all rather unfortunate (what about circumcision's persistence in the United States?). Instead of treating science symmetrically and looking at its part in constructing, or framing (or whatever term you care for), accounts of sex in general and the foreskin in particular in the modern and the Victorian world, it is given two different roles. Then, “science” was ideology because it was used to inflict terrible mental and physical scars on young men, and now it is knowledge, because it shows something that we should disapprove of (Darby's quite clear about that) to be naturally as well as morally wrong. We might well sympathize with Darby's sentiments, but we do not have to endorse his methodology. Interestingly, a key text that is a superb and relevant study of culture, ideology, and science in this period is missing from Darby's bibliography: Roger Smith's Inhibition: History and Meaning in the Sciences of Mind and Brain (London, 1992).

Rich though Darby's account his, his approach lets the Victorians and Edwardians off the hook. The last chapters of the book are particularly suggestive (and allusive and elusive) with regard to the culture of the public school and middle- and upper-class parenting and discipline at the turn of the century. When social historians (often feminists) first turned to midwifery in the eighteenth century, they produced a valuable corrective to the tale of the heroic rise of obstetrics. That story could also be told, they said, as one of medicalization by male accoucheurs. Twenty years further on, notably through the work of Adrian Wilson, it is clear how educated women preferred and encouraged male midwifery in the name of safety (whether real or not) and Enlightenment. Darby's study is waiting for what might be called the “Wilson corrective.” Fathers we know something about, but what (perish the thought) was the role of women and mothers in promoting male circumcision? Noteworthy in this connection is that the work of a fellow Australian, Alison Bashford, on the place of women in the hygiene movement, is missing from this study. Not to finish on too critical a note: read Darby and be provoked.