[I had been force to remove this post from my other blog, but now that it’s summer, I’m republishing it.]
The newest edition of Hakirah has an article available online about metzitzah b'peh (in pdf).
In the article he explains the historical medical background to metzitzah - the hellenic system of medicine thought blood was attracted to cuts and could decay and form pus, so it was necessary to get the blood to flow from a cut to prevent disease. (The fact that blood circulates was only discovered in the 1600's and the fact that pathogens cause disease only in the 1800's.) He quotes R' Nachum Rabinovitch who compares the Rambam's requirement for metzitzah to the Rambam’s suggestion to suck the blood out after a snake bite (Yad Peshutah on Sefer Ahava). Modern-day rationals for doing MBP are quoted and refuted. The next part shows that metzitzah b'peh is a danger and many cases are cited where it rchltl’z caused harm to infants. He aslo tells the the history of it, and p'saks about it into the 1800's. He then discusses the p'sak of the chasam sofer who didn't even consider metzitzah b'peh to be a minhag. He concludes that if most of the litvishe gedolim accepted that MBP was a danger, surely now, when we know much more about transmission of diseases, we shouldn't risk it.
Halachic question: note 67 quotes R' Low who in 1850 said you could do MBP on shabbos since it has no benefit so it is only forbidden d'rabanon [mekalkel] which can be allowed since [he considers] it a minhag yisrael. According to those who don't consider it a minhag, would they be allowed to do metzitzah (even not b'peh) on shabbos?
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