From Parshat Nitzavim-Vayelech Vol.10
Date of issue: 23 Elul 5760 -- September 23, 2000
Medicine in the Gemara
by Elli Friedman
At Har Sinai, not only was the written law given, but the oral law as well. The oral law, Torah Shebaal Pe, is recorded in the Gemara; hence, one must follow all that is in the Gemara. Furthermore, one is considered an Apikores if he does not adhere to the Gemara (see Rambam Hilchot Teshuva 3:8).
What about when the Gemara deals with non-Halachic issues? Is one obligated to follow these as well? This essay will explore one aspect of this issue, namely the medical practices presented in the Gemara. For example, on Gittin 68b, the Gemara explains the procedure for curing a migraine headache: One would bring a wild rooster and slaughter it with a sharpened Zuz (a certain denomination of coin) of pure silver over the side of the head that aches so that the blood would trickle down the side of the head. Then one would hang the slaughtered hen on the doorpost of one's house so that every time he entered and exited the house he would brush against the hen.
Another example is Chazal's remedy for a nosebleed (Gittin 69b). Chazal says one should bring a Kohen whose name is Levi and should write the name Levi backward for him. A different solution is to bring any man and write, "I, Papi Shila bar Sumki," backwards. Another solution is for him the write, "The taste of a bucket in silver water, the taste of a bucket in tainted water." An alternate cure for a nosebleed is to bring the root of a stalk of Aspasta, the rope of an old bed, rag-paper, saffron, and the red part of a palm branch and burn them together until they turn to ash. Then he should bring a ball of wool, twist the fiber to form two strands, and immerse the strands in vinegar. Then, he should roll the strands in the ashes and insert one strand into each nostril. Another alternative is to find a canal that flows from east to west and to step over it. One should stand with one foot on each side of the stream and take mud with his right hand from beneath his left foot and twist two strands of wool with his left hand from beneath his right foot and immerse the strands in the mud. Then he should insert one strand into each nostril. The last resolution of Chazal is to sit beneath a waterspout while others pour water on him through the spout and say, "Just as these waters stop, so too should the blood of so-and-so son of so-and-so stop." Modern medicine has many different ways to cure migraines and nosebleeds, but Chazal's ways are not included. What should one do?
Opinions That Science May
Override the Gemara
Tosafot in Moed Katan 11a (s.v. Kavra) says that the medical procedures may not be effective nowadays because Nishtane Bateva - the nature and constitution of people and plants have changed throughout the course of history; hence, the remedies that were effective in Talmudic times are not necessarily effective today. For a list of the many authorities who subscribe to this view, see Nishmat Avraham 1:4, footnote 14.
Moreover, the Maharil (cited by Rav Akiva Eiger, Yoreh Deah 336:1, s.v. Nitna) believes that in this day and age one cannot even attempt to use the Talmudic remedies due to the fact that one cannot properly identify the various herbs detailed in the Gemara and does not properly understand the precise directions of how to administer the remedies. Thus, if one tries to use these cures, he is bound to fail, which may lead people to doubt all teachings of the Gemara. As a result, one should not use the remedies in order to prevent questioning of the authenticity of the Gemara. The Maharshal (Yam Shel Shlomo, Chullin 8:12) adds that even if some cures are still effective, they should not be done, in order to reduce the risk of arousing heretical responses from the unlearned.
Similarly, Rav Akiva Eiger (ibid.) rules that
one should ignore these Talmudic texts because one cannot fully
understand them and will consequently misconstrue them and cause
more harm than good.
Rav Sherira Gaon (see Otzar Hageonim Gittin 68b, responsa section no. 37b) held that the sages were not physicians; thus, they were only recommending procedures that were effective at that time. Therefore, one would be foolish to follow these procedures without properly examining them. The Rambam (Hilchot De'ot 4:18) seems to have considered most of the Talmudic remedies to be ineffective. This appears to be the reason that the Rambam does not cite any of the Talmudic cures in his Mishna Torah (see, however, the Kesef Mishna's comment to Hilchot De'ot 4:18). Likewise, Rav Avraham ben HaRambam (Ma'amar Al Ha'agadot s.v. Da Ki Ata) says that Chazal gave these instructions based on the medical knowledge of their time, and they have no Torah basis. Hence, they only carry the weight of a doctor's advice and do not have to be followed. Rav Avraham ben HaRambam's thoughts are printed in the introduction to the Iyun Yaakov. On the same note, the Magen Avraham (O.C. 173:1) suggests that invalid medical advice by the rabbis does not need to be followed. Interestingly, the Magen Avraham suggests that one need not separate meat and fish, as the reason for this common practice is because Chazal considered it unhealthy.
Rav Yitzchak Herzog (cited in an article published by Professor Frimer) adopted the approach that Chazal were not superior in medical knowledge. Whenever possible, however, he tries to try to avoid confrontation between the Gemara's medicine and modern medicine. For instance, when Rav Herzog found out that there was danger in the Mohel sucking blood directly from the baby, Rav Herzog said that the Mohel should use a cloth. Yet, in a case of Shechita, Rav Herzog did not allow the Shochet to tranquilize the animal prior to Shechita, even though it would alleviate much of the animal's suffering (according to modern science). His reasoning was that Shechita is a cryptic and enigmatic Mitzva that represents the most painless form of killing animals (it allows a highly effective flow of blood). Thus, Rav Herzog did not contradict science, but instead he found a way to avoid confrontation (Rav Moshe Sokol, Engaging Modernity).
The Chazon Ish (Y.D. 5:3 and E.H. 27:3) believes that since Har Sinai, Hashem has only revealed Himself to man through science. He constantly reveals new forms of scientific information for our use. Thus, Chazal were not wrong; rather, we have better, "modern" ways to cure people.
Opinions That The Gemara is
Superior to Modern Science
There is a Pasuk in Vayikra that says, "You shall not stand idly by while your brother's blood is shed" (15:16). This Pasuk obligates us to cure one's illness; hence, one should try Chazal's suggestions first.
The Maharsha (Gittin 68b) explains why Chazal recorded medical procedures in the Gemara. He cites the Gemara in Berachot 10b, which says that there was a book of remedies that King Chizkiah hid. The Gemara explains that he did so because the people of his time were too reliant on this Sefer Refuah and stopped praying to Hashem because they forgot that it was Hashem who ultimately provided their healing. However, the secrets of the Refuot still remained with the Tzaddikim, who revealed them to worthy individuals. By the time of the Gemara, explains the Maharsha, Chazal felt that the Refuot were being forgotten, and they consequently wrote the Refuot in the Gemara so that the Gemara would encompass all areas of knowledge and so that people could not say that Chazal were not fluent in medicine.
The Maharam Schick (Y.D. 244) uniquely believes that only regarding a matter of life and death must one follow the Gemara. One must recognize that medical research cannot predict the exact result of a certain action but can only suggest the typical or most likely result. Thus, he holds that we cannot disregard Chazal's words regarding health issues. Hence, only in matters that do not relate to bodily danger may one change the Halacha and use modern medicine.
Hinda Brandwein ("Did Our Sages Write the Nutrition Tips That Modern Research Has Uncovered?" Derech Hateva 1997) believes that the words of Chazal are not contradictory to modern medicine, but modern medicine actually proves much of the information about the medical procedures in the Gemara. For example, Gittin 67b states, "For quotidian fever drink a jug of water." Modern doctors confirm that it is essential for one to drink water to maintain one's health. Furthermore, Gittin 70a states the rule to "eat a third [of the capacity of the stomach], drink a third, and leave a third empty." This rule is accepted nowadays by nutritionists who stress that one should not eat too much. The reason is so that one will not become overweight, which may lead to heart disease, high blood pressure, diabetes, and certain types of cancer, Chas Veshalom. Additionally, Gittin 70a states that meals should be eaten while seated because "to eat or drink standing shatters the body of a man." Doctors today think say that one should be relaxed while eating. Thus, one sees that modern science sometimes proves what Chazal said long ago.
We see that there are many reasons for our practice not to follow the medical advice contained in the Gemara. Rav Shlomo Zalman Auerbach (see Lev Avraham 2:19) believes that eventually we will discover that all of the medical information contained in the Gemara is accurate. He rejects Rav Avraham ben HaRambam's approach to this issue.
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