pinealectomy and posthetomy and frenectomy

I had so much fun and learned so much in the previous essay on "ectomies" (oophorectomy or salpingo-oophorectomy, orchiectomy or orchidectomy and penectomy), that I decided I needed one more essay on the topic. Of course, I will not exhaust the list here of all the precious bodily organs that can be surgically excised, but I will give enough of a sample to show why all spelling bee word selectors will avoid these words like the plague. For example, I bet they won't use clitoridectomy, vulvectomy, vaginectomy or vasectomy, even though they are perfectly good words, though I bet they might, because of pleasant childhood memories of eating sherbet, use tonsillectomy. They probably won't avoid hysterectomy or splenectomy, come to think of it. But I will introduce four or five ectomies here, with pictures where appropriate.

Pinealectomy

The pineal gland has a most fascinating history. Derived from the Latin word for "pine cone," the pineal gland is a red, "somewhat conical body situated behind the third ventricle of the brain, and containing sand-like particles, which secretes melatonin in various mammals and is concerned with photo-periodicity and circadian rhythms." That, indeed, is a mouthful of a definition. The gland is buried deep inside the brain and has been the source of speculation as to its meaning and original function for hundreds of years. Here is a picture of where it is located.

The Century tells us that it is believed to be a vestigial sense-organ, probably of sight. Other names for it are the conarium, pinus or epiphysis cerebri. The literal translation of the last term is "growth upon" or "upper growth of the brain." The Century points out that it is contrasted with the hypophysis cerebri (the "below growth" of the brain), which is more popularly known as the pituitary gland. As early has 1889 a standard textbook in the field could say that "The epiphysis (pineal gland) is not regarded as an important neural ingredient of the brain." And, from 1951: "The pineal body or epiphysis..is considered by many students of the brain as a vestigial organ, related to the parietal eye of lower vertebrates."

But this wasn't always the case. Philosophers and spiritual writers through the centuries have been fascinated with this pine cone-shaped reddish ovoid in the heart of the brain, so to speak. Addision, in 1712 could say: "The Pineal Gland, which many of our Modern Philosophers suppose to be the Seat of the Soul." Who is the most prominent philosopher so believing? Descartes. Why was it so important for Descartes? A 1785 quotation from a Scottish philosopher helps us: "Des Cartes, observing that the pineal gland is the only part of the brain that is single, was determined by this to make that gland the soul's habitation."

This brief history encourages us to pose questions not only about the structure of the brain, but of the history of the terminology used to describe various parts of it and the way that our knowledge of the brain has developed over the years. While scholars 300 years ago felt that the pineal gland housed the soul, scholars today chuckle at that notion. But, today we speak the language of melotonin and glandular secretions into the bloodstream. The fact that we laugh at the most brilliant minds of 300 years ago makes me kind of laugh at our knowledge now--not that it is worthless or unimportant, but that it is only partial and will probably be replaced by alternative systems of seeing the body and the brain--maybe even in our lifetime. In the meantime, however, the detritus of scholarship gives us words that tell us as much about the people who studied the brain as the brain itself.

But this part of the essay is actually about a pinealectomy after all. Pinealectomies are done by scientists mostly on rats and other creatures to see how the lack of a pineal gland might affect certain conditions, such as scoliosis. But it is also performed on humans. One form of cancer suffered by some people today is a pinealoma. Removal of the pineal gland caused split vision in this case; notice that the medical advice given to the parents of a young man suffering from that cancer is circumspect in the extreme. Sounds like legal advice!

Posthetomy (Prepucectomy) and Frenectomy

Let me conclude this essay by probing these two "cuttings." Well, here I am introducing two or three seemingly obscure terms and I find myself smack in the middle of raging debates. For a posthetomy or prepucectomy is a circumcision and a frenectomy is a cutting of a frenum (L. "bridle), which is a "small ligament or membranous fold which bridles or restrains the motion of the organ to which it is attached." The most frequent use of the word frenum is to refer to the frenum of the tongue or a frenum of the gums directly behind the front teeth. Often these need to be clipped or cut to prevent possible gum diseases. But a frenectomy can also refer to the cutting away of a ligament-like portion of skin that attaches the glans of the penis to the shaft. I could show you pictures of this, and some are here, but I have already used my quota of pictures for this article. Care should be taken to differentiate a posthetomy (or posthectomy) and a frenectomy, but often they are done at the same time. A whole dictionary of penile terms, with pictures, is here for your reading and linguistic edification.

The reason I ran into a hornet's nest when studying these words is that the subject of male circumcision in America is a hugely controversial topic now. Begun in earnest in the 1870s by a prominent physician, by the early twentieth century, the practice was almost universal in America. By the way, a quotation about the 1870s doctor, is here:

"Until 1870, medical circumcisions were performed to treat conditions local to the penis: phimosis, balanitis, and penile cancer. In that year, Lewis Sayre, a prominent New York orthopedic surgeon and vice president of the newly-formed American Medical Association, examined a five-year-old boy who was unable to straighten his legs, and whose condition had so far defied treatment. Upon noting that the boy's genitals were inflamed, Sayre hypothesized that chronic irritation of the boy's foreskin had paralyzed his knees via reflex neurosis. Sayre circumcised the boy, and within a few weeks, he recovered from his paralysis. After several additional incidents in which circumcision also appeared effective in treating paralyzed joints, Sayre began to promote circumcision as a powerful orthopedic remedy."

But some of the reason for encouraging the practice was not simply hygienic or medical; some doctors also wanted to reduce the incidence of masturbation and the level of sexual enjoyment for the male. There is a raging controversy now over both the issues of whether there is a medical benefit to the procedure and whether circumcision also cuts away sexual pleasure. Recent studies have shown that fewer than 50% of boys born on the West Coast are circumcised, while the numbers are more than 80% in the South and Midwest.

Well, as you can probably see, there is much more to be said about the topic, but I will call it quits for today, grateful for the knowledge we have gained. I think, too, that I will cautiously now return to the dictionary and do a humdrum essay or two.

1850