A proposed relationship between circumcision and neural reorganization.

Humans are intensely biocultural beings. The linkages and causal feedback loops among their symbolic world, their cultural world, and their physical bodies can be exquisitely complex and subtle. It is suggested in this article that one cultural event--circumcision--exemplifies that subtlety and complexity. It is hypothesized that circumcision reorganizes the male's sensory somato-cortex to raise the threshold of sexual excitability/distraction. This threshold shift thereby allows the young men of a social group (a) to be slightly more tractable in executing corporate activities beneficial to the community and (b) to be slightly more restrained sexually and more cooperative in the pair bond. The practice is accepted because the procedure is deeply enmeshed in the ritual and symbolic life of the social group and is applicable to all young males. Suggestions are made on how to test this hypothesis empirically.

An additional facet of the incest taboo: a protection of the mating-strategy template.

It is suggested that sexual intercourse between adult males and girls tends to distort an inherent mating-strategy template: female choice of mating partner. The distortion seems to have long-range consequences in the form of myriad psychopathologies, which, in turn, reduce the afflicted individuals' chances for normative marriage and parenting profiles. In addition, a similar dynamic would hypothetically result from adult-male to boy incest. It is suggested that to minimize the chances of adult-child sexual intercourse, incest taboos have historically been reinforced and extended to nonparental adults, especially men, beyond the immediate nuclear family.

Establishing a link between cultural evolution and sexually transmitted diseases.

It is argued that archaic sexually transmitted diseases influenced cultural traditions by reducing multiple sexual partners within communities. In this article, the adverse consequences of current sexually transmitted diseases are surveyed: Such infections decrease fertility of women and increase infant mortality; those adverse consequences are especially potent when antibiotics are not readily available. Cultural (cross-generational transmission of learned) responses to the threat of widespread infertility and elevated infant mortality rates are hypothesized to include the implementation of expectations for restricted numbers of sexual partners. These expectations, formal or informal, have been instituted within the context of biological predispositions, the "certainty of paternity" model, already-established traditions, and the need for a social father to be aligned with the mother-child dyad. A case study of the contemporary United States is offered as a heuristic example of how and why cultural choices may be developed and sustained.

A biocultural analysis of circumcision.

The phenomenon of circumcision may well serve a range of religious and symbolic functions. In addition to these conceptual categories, we argue that circumcision also serves a more mundane, practical function of lowering excitability and distractibility quotients--sexual arousal--of pubescent males, i.e., biasing young males more toward increased tractability which would enhance group efforts and less toward individual goals of amorous exchanges. Neurological data suggest that early lesions of the prepuce/foreskin tissues would generate a re-organization/atrophy of the brain circuitry. This re-organization/atrophy, in turn, is suggested to lower sexual excitability. Epithelial data indicate that keratinization of the more exposed glans penis would lower the sensibility, hence sexual excitability, of the circumcised male's genitalia. In addition, circumcision removes the foreskin-prepuce which, by secreting smegma, would also minimize any pheromonic qualities which the smegma may generate. Inferential data support the hypothesis that a practical consequence of circumcision, complementary to any religious-symbolic function, is to make a circumcised male less sexually excitable and distractible, and, hence, more amenable to his group's authority figures.

Multicenter clinical trial and laboratory utilization of an enzymatic detection method for gonococcal antigens.

Seven institutions participated in a comparative study evaluating standard culture method and a new enzyme immunoassay (EIA, Gonozyme, Abbott Diagnostics) for the detection of Neisseria gonorrhoeae. Five hundred twenty-three patients were entered from hospitals of various sizes representing different population densities, ethnic and economic sectors, and gonococcal prevalence. Statistical analysis showed sensitivity, specificity, and positive and negative predictive values of 80.3%, 94.6%, 66.2%, and 97.3% for the total population tested. For the high-prevalence (greater than 15%) population the respective values were as follows: 78.6%, 91.5%, 68.8%, and 94.7%. Specimens from females had a lower sensitivity than those from males. In the low-prevalence population (less than 10%) results were as follows: 100%, 97.8%, 50%, and 100%. A cost comparison emphasized the benefit of the Gram's stain and culture. It also indicated that, unless batched or assayed at high volume, Gonozyme is not cost competitive for laboratories using standard culture methods. The impact of the EIA method, in general, and Gonozyme, specifically, on the microbiology section also was investigated. Integration would require altering of established work patterns and loss of flexibility and freedom of standard plating technics. The fact that Gonozyme is a "presumptive" test limits it to being a complementary assay, not an alternative. The authors conclude that Gonozyme is optimally suited to a high-volume laboratory, screening a low-prevalence female outpatient population, where specimen transport is a problem and gonococcal resistance to penicillin has not been demonstrated. This would include sexually transmitted disease clinics, reference laboratories, and state health departments.