Traditional Circumcision: Part II: Understanding the pathogene of gangrenous lesions

Abstract

In Part I of this article we looked at the presentation of a patient utbo bad undergone a traditional circumcision. The context of ltis illness tuas discussed in terms of the traditional practices of the Xhosa nation, and a three-stage diagnosis was made, In this part we look at the pathogenesis of the lesions tbat ue see, and both they present clinically. We can place tbe development of complications into tbree groups, namely debydration, septicaenria and gangrene. I have rather chosen to focus here on the pathogenesis of gangrenous Lesions and a description of the roles a number of factors play in tbis process. A strategy has been developed for dealing with these issues and this is discussed. Lastly, the managentent of problems related to the traditional circumcision practice is evaluated in terms of the principles of family practice as described by McWhinney.