annotated by the
Rabbi Israel Isserth. In all of these sanctions, however, there is no
reason expressed why it should be performed.[62] Maimonides undoubtedly
looked upon this act as having a decided tendency or action in depleting
the immediate vessels in the vicinity of the cut surface, and that the
consequent constriction in their calibre would prevent any future
haemorrhage. That this is the natural result of suction is a fact readily
understood by any modern physician. The depletion of the vessel for some
distance in its length, with the contraction in the coat that follows,
is certainly a better preventive to consequent haemorrhage than the
simple application of any styptic preparation that can only be placed at
the mouth of the vessel, but which leaves its calibre intact. Hot water,
or an extreme degree of cold, will answer to produce this contraction
and depletion, but there is here a local physical reaction that is more
liable to occur than when the contraction has taken place naturally, as
when induced by depletion, instead of by the stimulus of either heat or
cold. So that if, in the light of modern civilization and changed
conditions of mankind, and the existence of diseases which formerly did
not exist, we are now convinced that suction is dangerous, we should not
judge the ancients too hastily or rashly for having adopted the custom,
as it is certainly not without some scientific merit; although,
authorities are not wanting who hold that suction or depletion increases
the danger of haemorrhage.

It can be understood that the results of suction would be in some
measure analogous to those left by the application of an Esmarch bandage
on a limb. The ancients, performing the operation with rude implements
and having no haemostatic remedies or appliances, naturally followed the
best means at their command; they evidently feared haemorrhage, and their
rule in regard to exemption shows us that they recognized the existence
of haemorrhagic diathesis or other transmissible peculiarities of
constitution. This same fear of haemorrhage probably suggested the second
step of the operation being performed, as it is by laceration instead of
by cutting instruments, showing in this an evident desire to limit the
cutting part of the operation to as small a limit as possible. Against
an infant who has decided haemorrhagic tendency, we are about as helpless
as were the ancient Hebrews, and, while the Turkish or some of the
Ara