Dr. Sherwin Nuland, a clinical professor of surgery at Yale University, is the author of the recent well-received biography on the Rambam. He is also a National Book Award-winning author of "How We Die: Reflections on Life’s Final Chapter" (Knopf, 1994) and the author of a memoir, "Lost in America" (Knopf, 2003), among many others. He has written a blistering attack on metzitza b’peh, the oral-to-genital suction of the open circumcision wound done by many haredim as part of the circumcision ceremony:
Under normal conditions, the human mouth is home to streptococcus, staphylococcus and about five other forms of bacteria, several of which are capable of causing serious — and even lethal — infections. Every emergency room physician knows that these germs make a human bite more dangerous than a similar wound inflicted by a dog or cat, so much so that standard medical protocol demands that all such injuries be surgically explored and the damaged tissue cut out. The only exception is a bite on the face, where cosmetic considerations allow some leeway, but only with careful discrimination and close follow-up.
These precautions are in place because of the highly dangerous bacteria, but the herpes simplex virus adds problems of its own. To quote a standard textbook used by medical students and residents in training, "[U]ntreated neonatal herpes simplex has a case fatality rate exceeding 60%, with half of survivors severely damaged," frequently as the result of encephalitis. Other texts provide similar figures.
Fortunately, the disease is rare in the general population — but the general population does not suck on the newly cut penises of its neonates. Who knows the real number of fatalities and illnesses among ultra-Orthodox infants from either viral or bacterial infection, a figure on which the recently reported cases shed no light?
… The Shulhan Arukh, the code of Jewish law, could not be clearer on the matter of circumcision: "The fulfillment of all ordinances [of the brit milah] are suspended if there is danger to human life."
The danger of metzitzah b’peh has been more than amply demonstrated. Were the Rambam alive today, he would certainly agree.