Anyone hear of this before? Administer this before? Metzitzah B'PehEdit The ancient method of performing metzitzah—metzitzah b'peh, or oral suction—has become controversial. The process has the mohel place his mouth directly on the circumcision wound to draw blood away from the cut. The majority of Jewish circumcision ceremonies do not use metzitzah b'peh, but some Haredi Jews use it. It has been documented that the practice poses a serious risk of spreading herpes to the infant. Proponents maintain that there is no conclusive evidence that links herpes to Metzitza, and that attempts to limit this practice infringe on religious freedom. The practice has become a controversy in both secular and Jewish medical ethics. The ritual of metzitzah is found in Mishnah Shabbat 19:2, which lists it as one of the four steps involved in the circumcision rite. Rabbi Moses Sofer (1762–1839) observed that the Talmud states that the rationale for this part of the ritual was hygienic — i.e., to protect the health of the child. The Chasam Sofer issued a leniency (Heter) that some consider to have been conditional to perform metzitzah with a sponge to be used instead of oral suction in a letter to his student, Rabbi Lazar Horowitz of Vienna. This letter was never published among Rabbi Sofer's responsa but rather in the secular journal Kochvei Yitzchok. along with letters from Dr. Wertheimer, the chief doctor of the Viennese General Hospital. It relates the story that a mohel (who was suspected of transmitting herpes via metzizah to infants) was checked several times and never found to have signs of the disease and that a ban was requested because of the "possibility of future infections". Moshe Schick (1807–1879), a student of Moses Sofer, states in his book of Responsa, She’eilos u’teshuvos Maharam Schick (Orach Chaim 152,) that Moses Sofer gave the ruling in that specific instance only because the mohel refused to step down and had secular Government connections that prevented his removal in favor of another mohel and the Heter may not be applied elsewhere. He also states (Yoreh Deah 244) that the practice is possibly a Sinaitic tradition, i.e., Halacha l'Moshe m'Sinai. Other sources contradict this claim, with copies of Moses Sofer's responsa making no mention of the legal case or of his ruling applying in only one situation. Rather, that responsa makes quite clear that "metzizah" was a health measure and should never be employed where there is a health risk to the infant.