Posted November 18, 2004
Contents
"The Persians considered those who healed illnesses through prayer alone as the most effective physicians...this, then, was the cultural background upon which Rabbinical law was founded; in this environment of witchcraft and superstition the medical concepts of the Jewish nation and its leaders were first formed."Emanuel Jacobovitch (5626) Medicine and Judaism.
Mosad HaRav Kook: Jerusalem (p. 56)
This essay will examine the medical knowledge of the Babylonian Sages in the third through fifth centuries CE, from the period of Rav and Samuel until the Babylonian Talmud was closed for editing. The Babylonian Talmud has been the main and most important book for the Jewish nation through the generations. The formal Halacha of Jewish law is derived from it, as well as the general permission to heal the sick and not to merely leave them to a Divine cure.[1] Ideas about medicine are scattered around the Talmud, incorporated into Halachic debates, and one who wants to know the Babylonian Sages' methods of healing must read all the books of the Talmud and scout out the medical concepts, like searching for a needle in the haystack of Halacha presented in the Talmud. Beyond the theoretical desire to examine the knowledge of the Sages about medicine, there is a great practical need to investigate Chazal's knowledge in this area, for some rabbis, even in our times, determine practical Halacha from the Talmud, including in the area of pathology.
To understand Chazal's medicine in depth, we should expand somewhat on the background of the ancient world's medical notions. Though the Babylonians lived under Persian Sassanid rule, whose medical methods relied on magic, we should discuss what we know of medical history. Just as all scientific fields underwent a significant revolution in the 16th and 17th centuries, a revolution expressed through the study of nature as it is, of itself, without lending it significance or powers beyond it, so did the field of medicine and all the foundations of medicine. If, until the scientific revolution, the leading physicians still thought illnesses had influences or causes outside the body, like the stars[2], demons, evil spirits, or the theological claim of "Divine punishment," research will now investigate the reason for an illness within the illness itself. Even so, study of the history of medicine shows that even in ancient Egypt there were doctors who specialized in particular diseases, as well as eye doctors and dentists,[3] which reflects a certain method.
In the Greek and Roman periods there was a methodical attempt to heal the ill via a general approach based on observation and investigation. There are those who claim[4] that Hippocrates (462-377 BCE) was the founder of modern medical science and that he was, to a certain extent, free of the belief that illness is caused by supernatural forces -- the gods of Greece, demons, or evil spirits, and that he began the search for a cause within the body.
Greek and Roman physicians wrote many books on medicine,[5] books whose goal was the healing of disease through plants and proper nutrition or guidance in the detection of illness. In contrast, Jewish physicians did not write books or essays devoted to medicine. The first [Jewish] medical texts we know of are by Asaf the physician, who lived in the seventh century and translated Hippocrates' work, and "The Book of Remedies" by Shabbetai Donnolo (10th century), which is also a translation of Hippocrates' work with some additional commentary. The Babylonian Sages did not write medical texts; our knowledge of medical methods amongst the Sages of Babylon is found in the Talmud as incidental remarks in the clarification of Halachic matters. The Talmud is a religious body of work, mainly Halachic rulings and ethics, whose goal is to lead to the fear of Heaven and the worship of God. Sometimes medicine is brought as a consequence of a Halacha, and sometimes to teach a lesson and a moral teaching. There is no special chapter teaching how to heal the sick; all the methods of healing are scattered throughout the sea of Talmud by the editor and compiler of the Talmud, cited in the name of people who lived in various eras, and sometimes by those who were not eyewitnesses to the physician's doings. This means that the Talmud incorporates various and sundry medical approaches, from magical healing to folk medicine to "scientific" healing (scientific in quotations because it is not meant the way we now mean science to be taken). The multiple methods of healing stem from the approaches of the various Sages (like Samuel and Rav) and from the influence of the Hellenists, the Persians, and the common folk. Another thing to be noted is that the Talmud totally ignores the existence of the physicians Galen and Hippocrates and the other writers of medical texts. The only things to be found in the Talmud are specific medical ideas by gentiles, with no mention of the physician's name -- "The matron"[6] (a gentile woman) or "the ass-driver" (a passing Ishmaelite).[7]
It is possible that there was a reason for this, like strengthening the belief in Sages amongst the masses, as is common in closed communities which do not allow the common people the developments of science found in the outside world[8] or which simply did not know of them. On the other hand, the Mishnah and Gemara mention Tudus, a Jewish physician who lived in Rome.[9]
As opposed to the Talmud, which ignored the Greek and Roman physicians, a significant change in the attitude of the rabbis to gentile sages' developments in science and philosophy occurred in the period after the Talmud was sealed, including in the attitude towards medical advances. Asaf the physician, in the 7th century, translated Hippocrates' work. Maimonides, in his medical text Pirkei Moshe, completely ignored the cures found in the Talmud and dealt only with Hippocrates and Galen and the other gentile physicians: "These are the chapters I have gathered, not that I have written them, but I have chosen them, from the works of Galen, from all his books. This is to say that his words, which I cite, are a commentary on the words of Hippocrates."[10]
Rabbi Abraham, son of Maimonides[11] explicitly wrote that one should not accept Chazal's medical teachings without investigation and verification. "Know that you must know: All who wish to uphold the accepted opinion without investigation and understanding whether the issue is true or not follows a bad point of view which is forbidden by the path of Torah and of common sense...Since we find them [Chazal] saying things on matters of medicine in the Gemara which are not verified nor upheld, such as Chazal's anti-abortificant stone[12], whose [efficacy] has not been verified." By the Middle Ages rabbis like Maimonides and his son Abraham could make a clear distinction between Halacha and science. Halacha as determined in the Talmud obligates the religious Jew who has accepted Halacha upon himself, but medical matters, which are physical issues and do not touch upon Halacha, may be debated and do not have to be accepted, just as we do with issues of income, physical labor, and economics, none of which are learned from Chazal. Maimonides explicitly made this distinction and noted that though the Sages erred in discerning illnesses and defects which can lead to an animal's death, we must fulfill the halachot of treifot as determined in the Talmud: "We do not add to these treifot at all, for all incidents which happen to animals or livestock or fowl beyond those which the early sages listed and agreed upon in the Jewish courts may yet be survived, even if according to medical knowledge it cannot live. Also, those listed and said to be treifah, though we see through current medical knowledge that not all will die and they may survive, we have naught but what our Sages listed, for it is said, 'according to the teachings they teach you'.[13]"
The Sages of the Talmud, believers in portents, saw every natural phenomenon as a message from supernatural forces (God), punishment or payment, a lesson to be learned, etc. More than that, the natural world, the heavenly bodies and man, had a purpose and a Divine goal. "No man lifts a finger Below but it is dictated about him Above,"[14] and no blade of grass is without its star in the Heaven which strikes it and tells it "Grow."[15] Heavenly decrees are the prime reason for the acts of man and natural phenomena. Similarly, pollution and bruises to man are caused by his sins. "There is no suffering without sin."[16] Property damage and monetary damages are also the result of man's actions and are not coincidence.[17] The forces which act are evil spirits and witchcraft,[18] and therefore the way to healing is removing the evil spirit, witchcraft,[19] or through the repentance of sins. Rabbi Judah HaNasi, editor of the Mishnah, was ill for six years with fever or urinary tract problems[20] and was ill with scurvy for seven years. Rabbi's illnesses came because he had sinned against an animal. There was a lamb designated for the slaughter, but fearing his fate, he hid beneath Rabbi's cloak and cried. Rabbi told him: 'Go to the slaughter; it is for that which you were created.' The Heavens decreed that since he did not pity the lamb he would be punished with 13 years of illness. His cure came about when he did a good deed. When his maid cleaned the house, she found some gophers and wanted to get rid of them. The rabbi took pity on them and told her to let them be, for "His mercy is upon all His creatures" (even gophers). The Heavens decreed that since he took pity on them, his suffering would end.[21]
The next aggadah will show how seriously Chazal took their view that the reasons for natural phenomena are sins or, alternatively, the commandments: "In one place there was a specific sort of snake which would pester the people. They came and informed Rabbi Chanina the son of Dosa. He told them, "Show me its hole!" They showed him its hole, and he closed it with his heel. The snake emerged and bit him, and the snake died. They carried him to the study hall. He told them: See, my son, the snake does not kill [man], sin kills. [Rabbi Chanina, who was without sin, did not die, though he was bitten by the snake.]"[22] The view of nature and the world as having significance and a specified goal led the ancient researcher to see facts of nature as expressions of some sort of ethics, and that effect was magnified for religious people who did not plan to nor even wish to investigate nature on its own; all they were interested in was how nature exemplifies their religious faith. It is obvious that this faith causes man to investigate and seek reasons for illnesses in the area of the spirit and religion rather than in nature itself. Therefore the modern reader who encounters Chazal's healing methods immediately feels an intellectual discomfort, extending even to oddity and ridicule. You must recall that the cognitive and experiential background of people of religion and faith in ancient times was utterly different. Nature, faith, and wisdom were mixed together and were learned each from the other.
The examples which will be brought in this chapter are just the tip of the iceberg, but reflect the spirit and relationship of Chazal to illness and healing in their era.
The snake, in the Scriptural period, was considered an evil and inciting creature. The snake, a symbol of temptation and enticement, successfully caused a change in Creation; he caused man to sin and led to the punishment of death. The snake, in the Scriptures, was sent as a punishment for the sins of the people of Israel: "The Lord sent the fiery serpents against the people. They bit the people and many of the Israelites died."[23] The healing proffered for snake bites in the Scriptures is through magic: "Moses made a copper serpent and mounted in on a standard; and when anyone was bitten by a serpent, he would look at the copper serpent and recover."[24] In the Talmudic period these two beliefs continued to exist, with a real significance which served as the solution for a theological problem: Why do righteous people who did not sin die? The answer was that it is due to Adam's sin, incited by the serpent, or as Chazal put it, "the snake's bite."[25] In Talmudic times the snake punishes those who violate the words of the Sages: "One who breaches the fence [erected by the Sages][26] will be bitten by a snake."[27] The bite of a snake has religious significance beyond the health risk, and therefore any specific remedy will not help every person. One who breeches the rulings of the Sages will not be healed from the consequences.
The suggestions for healing which are brought in the Talmud are varied and accompanied by stories:
One bitten by a snake should take the fetus of a white donkey, cut it and rest in on bite, as long as the donkey is not found to be terifah[28]. After suggesting a cure for snake venom the Talmud brings the tale of a Jew who was appointed tax collector for the Persian king and who was bitten by a snake. He had 13 white donkeys which were all found to be terifah. There was one white donkey, not terifah, on the edge of Pumbedita, but by the time they reached it, it had been eaten by a lion. Abaye said to them: Perhaps the reason a white donkey was not found is because he transgressed the words of the Sages, and all who transgress the words of the Sages will be bitten by a snake, without cure, as is written, "One who breeches the fence will be bitten by a snake."[29]
This Talmudic section begins with the suggestion of a cure and ends with a story. It is very difficult to assess the opinion of those who wrote this story. Did they really and truly come to teach medicine, or did they make up the story of a snake bite cure to teach a lesson and morality through fear mongering,[30] as is often the case with tales of the Sages' deeds,[31] most of which are aggadah and not historical reality? The demand that the donkey be white and not a terifah shows that Chazal believed in powers beyond the rational. Even if we consider that they thought the donkey fetus had some special matter which would overcome snake venom, why specifically a white donkey, and what is the advantage to a donkey which is not a terifah? One could explain the demand that it not be a terifah by saying that it is a demand which strengthens the laws of the Sages, who had ruled that a terifah may not be eaten, and therefore it is also not capable of effecting a cure for one bitten by a snake. But the demand for a specific color still remains puzzling; one possible conclusion is that Chazal accepted the faith of the masses, who made up their own cures and actions, as they saw fit.
Another method of cure is recorded in the Tosefta[32] brought in the Talmud[33] as determined Halacha. A snake bite is a danger to life and the saving of life overrules the Sabbath, so "for one bitten by a snake [on the Sabbath, one is permitted to violate the Sabbath for him] a doctor should be called from one place to another [despite the prohibition of violating Sabbath boundaries] and a chicken is slaughtered for him[34] and leeks are cut for him [though this violates the law of tearing on the Sabbath]." The Talmud does not detail exactly what should be done with the slaughtered chicken and the leek; it is possible this cure was known to the public. But it seems to me that the lack of detail in this cure for snake bite is the point of the Talmud. The Talmud is a book of law and not a medical text; the Tosefta brought in the Talmud in tractate Yoma is meant to clarify a Halachic point[35] and not a medical one. Therefore the Gemara does not discuss the efficacy of a slaughtered chicken nor does it ask why the Tosefta does not mention the donkey fetus cure.
Not only does the snake bite, harm, and kill, it also desires sex with women, and therefore the Talmud says:
If a woman saw a snake and does not know if the snake desires her, she should take off her clothing and throw them before him. If he curls up in her clothes he desires her. How can she save herself from the snake's desire for intercourse? She should have sex with her husband in front of the snake; this will disgust the snake. There are those who say, though, that if she has sex in front of the snake it will increase the snake's desire for her, and that therefore she must take some of her hair and fingernails and throw them at the snake, saying, "I am a niddah."[36]
The solution suggested by Chazal for banishing a snake via the throwing of hair and nails, which is a disgusting and disgraceful act, is apparently influenced by what is written in the Scripture, "If you see among the captives a beautiful woman and you desire her and would take her to wife, you shall bring her into your house and she shall trim her hair and pare her nails."[37] This command of trimming the hair and doing[38] the nails was dictated so the captive would not find favor in his eyes and he would return her to her father's home.[39]
The instruction that a woman should tell the snake she is menstruating is additional disgrace and disgust[40] to keep him from desiring sex with her. The way Chazal suggest she deal with a "desirous" snake is the mystical path of talking to the snake. In many places Chazal suggest talking to animals[41] or even with a river to ward off bodily illnesses.
This is the suggestion for one who suffers from Quotidana Malaria which strikes daily throughout the course of the disease: Let him sit at the crossroads and when he sees a large ant carrying something, he should take it and throw it into a brass tube closed with lead, and seal it with sixty seals. He should shake it, lift it, and say to it: "Your burden upon me, and my burden [the illness] upon you." If this does not help, let him take a new pitcher, go to the river and say: "River, River, lend me a pitcher of water for the visitor [the malaria] which has come to me. Let him turn it above his head seven times, pour it behind himself, and say: "River, River, take the water that you gave me and this visitor who came to me one day and left that same day."[42] Other illnesses which come from demons may be removed by statements. Chazal warned against drinking river or lake water by night, and if a person does so, he takes his life in his own hands due to the danger of the demon named Shabriri. If a person drank of that water and wants to be saved from the demon, he must tell his friend "so and so, I drank water." If there is no one near him, he should knock with the lid on the jug and say to himself: "So and so, son of such and such a mother, your mother warned you to guard yourself against Shavriri, vriri, riri, iri, ri, I drank water."[43]
Chazal supposed that snakes dropped their venom into various drinks and into fruits and vegetables.
Snake venom in food or drink presents as much of a danger as a snake bite and therefore one must exercise extreme caution not to leave drinks uncovered and not to eat fruits and vegetables which look like they have been bitten[44] lest a snake have eaten from them and left his venom behind.
Already in the times of the Mishnah, written in Eretz Israel, they supposed that the snake drops venom into water, wine, and milk, and that one who drinks of these liquids, which it is feared the snake has dropped venom into if, for instance, they have been left without cover, endangers his life[45]. They even gave an amount of time it was permissible to leave the liquid exposed: "Three liquids are forbidden if exposed: water, wine, and milk. All other liquids are permitted. How much time must they be exposed? Long enough for a snake to come from nearby and drink"[46].
In a discussion amongst the Tannaic sages about what types of liquids the snake is accustomed to drinking and dropping venom into, what is interesting about the discussion is that R' Shimon tells of an incident he witnessed in which a snake drank of grease. The Sages reacted and said that this was a unique occurrence and not typical: "Grease, vinegar, brine, oil, and honey are permitted even if exposed, and R' Shimon forbade them. R' Shimon said: I saw one drink grease in Sidon. They told him that the unique is no proof"[47]. This discussion implies that the Sages often saw snakes drinking wine, water, and milk, which is quite puzzling, for snakes do not tend to drink those.
In general, Chazal did not conduct observations and experiments; even when they saw phenomena which contradicted their understanding, they settled the contradiction through textual analysis. Thus, for example, Chazal's basic assumption was that drinking exposed, uncovered liquids is life-threatening because there might be snake venom in it, yet they knew that many people, like gentiles, drank such liquids without harm. To settle this phenomenon they stated that these people are used to eating eat slightly venomous reptiles and therefore had built up an immunity to even snake venom.[48]
Another example: Chazal supposed that a cat is not harmed by snake venom, because they saw that cats trap snakes and eat them. Therefore they allowed moving[49] exposed water from place to place on the Sabbath -- though they understood it might contain venom and is not suitable for drinking -- because the cat would drink it and not be harmed.[50]
The Talmud brings methods of nullifying the snake venom in exposed water which is suspected of containing snake venom:[51]
The method of nullifying the snake venom in various liquids is learned directly from the ways of healing snakebite, something which in itself is puzzling unless they meant the reader to understand that one who drinks water in which there is venom is like a snake.
The multiplicity of methods for cures shows that Chazal themselves were uncertain about the efficacy of the methods. They are really suggestions for cures which are non-obligatory; for example, the suggestion of cooking a rose in liquor was given in the name of Rabbi Achdayoi's mother, and it appears this was a folk remedy. Eating pinkhead smartweed is mentioned in the Mishnah, and the other medical suggestions are from the Babylonian Sages. Apart from the demand that the goat be white -- a demand which sounds mystical -- the other demands are simply natural remedies.
Scurvy is an illness caused by a lack of Vitamin C (ascorbic acid). The first sign of the disease is bleeding from the gums. Without treatment, there will be bleeding under the skin, in the joints, and in the muscles. Until 1753 there was no cure for scurvy, nor did they know what caused the disease. James Lind, a Scottish Naval surgeon, performed the first significant experiments. He took 12 people, all suffering from scurvy, and tried six remedies on pairs of seamen. The only pair which showed significant improvement was the pair which received oranges and a lemon.[54]
According to Chazal[55] the illness is caused by eating cold food made of wheat, eating hot barley, or leftovers ("which have been left overnight"[56]) of fish fried in its own oil with flour.[57]
The Talmud writes about the cause of scurvy as a simple statement. It does not explain how it knows this or how it reached the conclusion that eating hot barley causes scurvy. The Talmud's first two suggested remedies were brought as a gentile woman's effective cure for scurvy. The Talmud notes that the gentile woman made Rabbi Yochanan (who had developed scurvy) promise not to reveal her wonder cure, yet after he was cured [and believed in the cure's efficacy] Rabbi Yochanan taught the cure to the public in his Sabbath speech. It was considered a quite effective cure. The third suggestion was brought in the name of Abaye (an Amora), who also developed scurvy, and tried the first two cures with no relief. He asked an Arab and was told to take an olive...This teaches that these sages did not involve themselves in research; they asked people who it seems were known as healers, tried their remedies on themselves as scurvy sufferers. Rabbi Yochanan, who was cured, understood that this was an effective cure and publicized it. Abaye, who was not cured, asked other people until he was cured through the suggestion of an Arab passer-by, and then he publicized the cure. This is another example showing how the Talmudic sages were involved in folk medicine.[58]
This illness is expressed as an elevation of uric acid in the blood...Gout's main manifestations are arthritic-type joint pains, characterized by attacks of sharp pain followed by swelling and joint deformity ...The first precise descriptions of gout were written by Hippocrates.[59] Galen was the first to describe tophi (the chalk stones which cause serious inflammatory reactions and tissue degeneration).[60]
One of the important components of treating this disease is colchicines, derived from Colchicum tunicatum. Even in ancient times the importance of this plant and its efficacy as a treatment for podagra.[61] This cure is mentioned in the Ebers papyrus from the 16th century BCE. Use of the plant was through tying chains of bulbs and roots on the affected limbs.[62]
The term shigadon (gout or podara) as such does not appear in the Talmud, and its identification is disputed. In the Mishnah[63] it is written that one may go into the public domain on the Sabbath with a coin on one's leg, for this serves as a gout remedy and is not considered carrying. In the Babylonian Talmud[64] they define the term as tzinit, and Rashi says it is a "wound beneath the foot on which a coin is tied as remedy."
The Palestinian Talmud[65] identified the term as gout: "Go out with a coin above the tzinit -- this is podagra."
Asa's leg disease, noted in I Kings[66]: "All the other events of Asa's reign...are recorded in the Annals of the Kings of Judah. However, in his old age he suffered from a foot ailment." The Babylonian Talmud[67] identifies this ailment as podagra which causes needle-like pains in living flesh. Rashi explains "This is an illness which afflicts the legs and which is called podagra," which is, according to all, gout.
The Raaviah[68] supposed that the two talmuds discussed the same illness: "Tzinit is an illness which is called podagra (gout)."
According to Adin Steinsaltz, a contemporary Talmudic commentator[69] they are two separate illnesses: "It would seem that tzinit is a swelling or callus which is infected, and which is found on the foot...while the Palestinian Talmud specifies that its tzinit is podagra (gout), a painful illness which affects the legs and particularly the toes."
The remedy for gout is brought in the Mishnah: placing a coin on the leg. The Gemara discusses which coin is needed. Since this is an important Talmudic discussion, for it shows how many times Chazal learn of cures for illnesses from verses and not from experimentation and investigation, we will cite the whole passage[70]:
What is tzinit? A growth caused by [pressure from] the soil. And why particularly the coin known as sela'? Shall we say that anything hard is beneficial thereto? Then let a shard be prepared for it. Again, if it is on account of the corrosion [of the metal, which softens the callus] let a metal foil be used. But if it is on account of the figure [on the face of the coin, which may protect the growth] let him use any circular plate [which has the same shape and figure as a coin, but cannot be used as tender]. Said Abaye: This proves that all [these things] are beneficial for it [the hardness, corrosion, and the figure, and only a coin possesses all three].
It is the way of the Amoraim not to doubt the words of the Mishnah, even if some medical issue which is not clear to them is written there, including if some natural remedy which common sense cannot accept is included.[71] They will scrupulously debate and draw linguistic conclusions while utterly ignoring any investigation into the efficacy of the remedy presented in the Mishnah. The demand that the coin have a figure upon it was concluded by the Amora Abaye from the language of the mishnah, in which it was written "a sela on the tzinit" and not "ceramic" or "metal," showing that the coin must be of metal and bearing a figure.[72] He did not conclude so based on an investigation of the use of a coin on the foot.
This is a disturbance in brain function which is characterized by sudden and repeated seizures.
Epilepsy has been a topic of discussion from ancient times. Hippocrates wrote that the illness is natural and based in the brain, contradicting the common view of his day, which held epilepsy to be a supernatural illness. Galen suggested treating epilepsy by drinking a pan of burnt bones.[73]
Hippocrates also wrote: "Epilepsy in young persons is most frequently removed by changes in age, of country, and of modes of life."[74] The Talmud[75] brings different causes for epilepsy:
One who has sexual relations immediately[76] upon coming from a privy, his children will be epileptics, for the demon[77] of the privy accompanies him.
One who stands naked before the candle will be epileptic.[78]
One who has sexual relations by candlelight will have children who are epileptics.[79]
If one has sexual relations on a bed in which an infant up to the age of one year sleeps, the infant will be epileptic.[80]
It is difficult to determine whether Chazal meant to frighten the people into modest behavior or whether they honestly thought that these were the causes of epilepsy. Having sexual relations immediately upon leaving the bathroom is not considered becoming sexual behavior, so it would seem that they truly believed that the accompanying demon can cause a child to become epileptic. On the other hand, Chazal treated epilepsy as a hereditary disease[81], which shows they thought there is some physiological change in a epileptic.[82]
The remedy for epilepsy is the writing of an amulet or hanging herb roots.[83] A magic method which the Talmud treats as a panacea, the amulet is considered an "expert" amulet after it has proven itself by healing at least three times. Chazal treated amulets as true medicine whose efficacy experience has proven.
The yellowing of the skin and the sclera of the eye points to an excess of bilirubin (the orange-yellow color of bile) in the blood. There are three types of jaundice: 1. Obstruction jaundice, in which bile produced by the liver does not reach the intestines because of a blockage in the bile ducts (for example, by gall stones) or cholestasis. The urine is dark, feces light in color, and the patient may itch. 2. Hepatocellular jaundice, which follows disease in the liver cells, such as hepatitis. The liver cannot process the bilirubin in the blood. Urine is dark, but feces do not change color. 3. Hemolytic jaundice, a result of red blood cells breaking down at an accelerated rate.[85]
Hippocrates understood that jaundice is connected to liver function: "In jaundice liver sclerosis is bad."[86]
In the book Pirkei Moshe, Maimonides brings the words of Galen, who wrote that a jaundiced person may be helped by looking at yellow colors, "for this suppresses the red"[87] and "Many people with jaundice have been cured by diarrhetics alone."[88]
According to Chazal jaundice is caused when a man holds back his urine in the middle of urination. "Keeping back urine brings on jaundice."[89] Similarly, holding back when faced with the urge to urinate leads to jaundice[90] and sterility[91]. By way of reproach Chazal suppose that baseless hatred between people leads to jaundice: "A sign of baseless hatred is jaundice."[92]
Remedies suggested by Chazal:
From what we see from the few examples we have gathered of the Babylonian sages as reflected in the Talmud, there was no consistency in investigating medicine. Sometimes they found a remedy for an illness by looking in the text of the Tanaaim's words, without critique or examination, and sometimes they asked passers-by or adopted the accepted folk remedies. A wonderful example of adopting folk remedies is by the Amora Abaye. Abaye was one of the Amoras most often cited in the Talmud. He was raised by a nanny and learned folk medicine from her. Her words are brought in many places in the Talmud, for example, after the Talmud explains that one is allowed to go out in the public domain on the Sabbath with Rubia tenuifolia, a climbing plant which is knotted and hung around the neck as a remedy. Abaye expands on this and details the benefits of knotting the rubia: "My nanny told me that three knots stabilizes the patient so his situation does not worsen, five knots heals the illness, and seven knots works even against sorcery."[96]
Similarly, Abaye suggested for a cow which has calved but does not want to nurse the calf: "Bring a block of salt and put it inside [the cow's] womb so she will recall her travail, take pity on the calf, and nurse it."[97] Abaye recommended that one who has heart problems should take the right thigh of a buck and the excrement of cattle, cast in Nisan. If he cannot find that, he should bring chips of willow and roast the meat over them. He should eat the meat and then drink blended wine.[98] The famous saying "Don't give an opening to Satan" is brought in the Talmud in Abaye's name: "Abaye said...A man should never speak in such a way as to give an opening to Satan."[99]
Using folk and natural medicines, as well as various amulets and charms, was thought to be medicine, plain and simple. Chazal did not distinguish between remedies using natural materials such as herbs and remedies via amulets or other ways which reason cannot agree with. All were permitted for healing, even if taking the remedy involved violating a Torah prohibition. Chazal permitted carrying a chicken egg to heal the thigh, the tooth of a fox to be rid of sleep disturbances, and a nail in the form of a cross if one suffered from an infected wound.[100] Chazal thought that the spit of an eldest son has the power to heal ophthalmologic diseases, and accordingly determined the laws of the Torah. The Talmud discusses the veracity of a father who states that the eldest son is his (and not merely the mother's) in connection to inheritances. One of the testimonies mentioned in the Talmud is that the father customarily tells his friends or neighbors "Go to my son. He is the eldest, his spit heals the eyes." In this case, the Talmud concludes, he is the eldest son of his father and not just his mother, using the claim, "There is a tradition, passed down from our fathers,[101] that the spittle of the firstborn of a father is healing, but that of the firstborn of a mother is not healing." Chazal believed as scientific fact that the spittle of a man's firstborn heals, while that of only a woman does not.[102]
Only in the Middle Ages and in the modern era, in the period after the Talmud, do we hear criticism by rabbis: "And even the natural remedies mentioned by our rabbis OBM in the Shas in several places are far from common sense and deduction."[103] This criticism caused rabbis to distinguish between natural medicine and "charm based medicine," between medicine accepted by common sense and medicine which the mind cannot accept, as we will explain below.
In modern Hebrew the term segulah also serves as an expression of a special and hidden quality a person or thing has. Thus it can now be said that "This grass has a segulah," meaning that the grass heals in a way which is not understood and whose efficacy modern scientific research cannot establish. In other words, anything which is validated by current medical knowledge is called a medicine, and anything which is not validated scientifically yet people use as a remedy can be called a segulah, charm-based.
The sages of Babylon drew no distinction between natural remedies and charm-based remedies. Whatever they saw as healing, be it through magic, witchcraft, incantation, statement, ingestion, drink, salve, etc., was considered a remedy. According to Chazal, all activities are based in the Heavens and on God and there is no difference between the possibility that a plant or specific substance can heal or that a statement or the writing of an amulet can heal; both are through Divine supervision and intervention. The distinction was drawn after the Talmudic period, in the Middle Ages, influenced by philosophical thought[104] like scientific research and rational criticism. But the rabbis of the Middle Ages attributed this distinction to the sages of the Talmud, by accident or on purpose, to save the honor of the Babylonian sages.
To understand this issue, we will first clarify, linguistically, the term segulah and how it has changed, transformed, and had meanings added. In the Scriptures the word segulah means treasured and nice: "You will be My segulah among all the peoples"[105] Onkeles translated: "treasured,"[106] and Rashi wrote, "segulah: treasured possession."[107] "Besides, out of my solicitude for the House of my God, I gave over my segulah [hoard] of gold and silver to the House of my God."[108]
Ibn Ezra explained, "It is a treasured thing whose like is not to be found elsewhere."[109]
In the Talmudic period, aside from its Scriptural meaning -- treasured and nice -- it had the additional meaning of wealth or a deposit. Thus we explain the Talmudic issue of one who harms a minor child. It is impossible to pay him the damages, for he is a minor, so the damages are kept for him by the purchase of property, redeemed when he grows up.
In the Talmud[110] it is written: "Make a segulah [deposit] for him...What is a segulah? Rav Chasda said [buy a] Torah scroll [for him], Rabbah the son of Rav Huna said plant a palm tree from which he will eat the dates when he grows as payment for the damage."
In the Middle Ages the word segulah was given an additional meaning, expressed and interpreted as a spiritual charm which acts with no rational explanation or understanding. Nachmanides, in his commentary on the Scriptures, explains what was special about the mandrake which Reuben brought Leah: "And the root [of the mandrake] is what people say aids conception. If this is true, it is a segulah of the plant, not part of its nature. But I have not seen this in any of the well-known medical texts."[111]
Rabbi Joseph Elbo discusses the reason for people's laughter: "Researchers have said that people laugh through segulah, that there is no known reason for laughter."[112]
It is interesting that in the Kuzari[113] R' Judah HaLevi explains the Scriptural phrase am segulah using the later meaning of a special, wonderful trait, and attributed to the Jewish nation a unnatural charm special only to them, not found amongst all other nations in the world. In the language of the Kuzari this is "the Divine interest" or "the Divine power," and led to far-reaching racist conclusions: "I will explain to you the greatness of the [Jewish] nation...God chose them as a nation and a people, from all other nations in the world...This Divine interest clung to them from their forefathers, through the sons.[114] And Abraham in the past was segulah...and the children of Jacob were all segulah, all worthy of the Divine interest."
From what is written above, it is clear that the use of the term segulah in its later meaning as a spiritual power does not appear in the Talmud. There will be no division between natural medicine and charm-based healing. Chazal made no distinction, ranking, or classification of medical methods based on their value or effectiveness in healing the sick; all you will find in Chazal is religious distinctions. Healing through witchcraft and incantations is discussed in the Talmud in terms of whether it is permitted or forbidden, following the Torah prohibition of "in their ways do not go," forbidding following gentile practices. Chazal called these "Emorite ways," a subset of witchcraft and conjuring. But there was no doubt in their minds that the "Emorite ways" of witchcraft and conjuring were effective and a panacea.
The discussion of whether healing through conjuring, in the "Emorite ways," is permitted is found in the Mishnah[115]: "One goes out [on the Sabbath] with the egg of a chicken and the tooth of a fox and the nail of a cross because they are medicine. Rabbi Meir said that the Sages forbid this even on a weekday, for these are Emorite ways." In the Gemara they ruled that religiously one is permitted to be healed through conjuring.
Abaye and Rabbah both agree: "Anything which is a medicine is not considered to be Emorite ways."[116]
What is being discussed is not whether the tooth of a fox helps sleep problems or not; what is being discussed is whether one may use this method of treatment, though it is like the Emorite ways. The Halacha decides that it is permitted. Thus is it explained in the Sefer HaChinuch.[117] After explaining that witchery is a mixture of supernatural powers which have been banned because they may cause harm and evil he writes, "Anything which has something of medicine about it is not considered Emorite ways; it is not forbidden because of its witchery nature, since it has use [as remedy for the sick]...This is not forbidden, for [witchcraft] was forbidden only for the damage it can do." There is no doubt that the Talmudic sages treated the efficacy of witchcraft as they treated the laws of nature. Phenomena and incidents in nature are guided and work according to the supervision of God, and thus must we handle treatment through incantations and witchcraft; all is from God, who activates and causes everything's power to exist. To strengthen our words we will cite the Rashba[118]: "I see in the Gemara many things to be feared; they permitted snakes and incantations and witchcraft...without number...and in truth, there is none of all this which helps...unless his heart be turned to Heaven and he knows that the true remedy is His...not like those who turn to the ministering angel."
Maimonides, the greatest of Halachic arbiters and philosophers who has ever arisen in Judaism, drew a distinction between natural medicine and charm-based medicine which works through incantations and witchcraft. We should cite his words.
First let us say that Maimonides used two approaches to the issue:
Maimonides, as a rationalist (and opposing what was explicitly written in the Talmud[119]) thinks that witchery has nothing real about it and it does not work, despite what many people think: "Anyone who believes in these things and their like and considers in his heart that they are true and matters of wisdom, but the Torah has forbidden them, is a fool and lacking in sense, like women and children, whose knowledge is lacking. Wise and innocent people clearly know that the things which the Torah has forbidden are not wisdom, they are chaos and nonsense to which those without sense are drawn, abandoning the ways of truth for them. Therefore the Torah spoke and warned against this nonsense, for you shall walk innocently with your God."[120] According to Maimonides true sense rejects acts of witchcraft, and they should not be treated as anything but the nonsense of the ignorant and of the masses.
Maimonides testifies that it is proper to explain the Scriptures in rational ways and the Scriptures should be brought into line with reason, even if it is the complete opposite of the plain meaning of the text, as long as it makes sense. In other words, reason is not handmaiden to the Scriptures, it is the Scriptures which is handmaiden to reason: "Know that we do not reject the eternity of the universe, because certain passages in Scripture confirm the creation; for such passages are not more numerous than those in which God is represented as a corporeal being; nor is it impossible or difficult to find for them a suitable interpretation. We might have explained them in the same manner as we did in respect to the incorporeality of God. We should perhaps have had an easier task in showing that the Scriptural passages referred to are in harmony with the theory of the eternity of the universe if we accepted the latter, than we had in explaining the anthropomorphisms in the Bible when we rejected the idea that God is corporeal."[121] According to Maimonides the interpretation of the Scriptures must match reason, even at the expense of distorting and altering the plain meaning of the text.
In light of these two approaches it will be easier to understand Maimonides, who deviated from the plain and clear meaning of the Talmud and who attributed things to the Talmud which were not said there.
In the Mishnah, in the discussion on healing rabies, a serious infectious disease wherein the nervous system is attacked by a virus[122], there is a disagreement amongst the Sages on whether a rabies patient may eat the liver of the dog who bit him, though it is a food forbidden by Halacha. Matiya the son of Charish permits it, as it is a remedy, and the saving of a life permits the eating of forbidden foods. The Sages forbade it, as it does not heal[123]: "One who was bitten by a wild dog is not fed the dog's liver, and Rabbi Matiya the son of Cheresh permits it."[124]
Maimonides, in his commentary on the Mishnah[125] explained that according to the Sages who forbid eating the flesh of the dog because it has not been proven as effective against rabies, "the Halacha is not as Rabbi Matiya the son of Cheresh, who permits feeding a person the liver of the dog who bit him, for this works only through some charm. The Sages suppose that one does not violate the laws unless it is for a real cure, for natural remedies, the real thing, extracted through wisdom and experience, which are close to truth. But healing with those which heal through their charms is forbidden, for their weak power is not from reason and experience; it is a weak claim by the mistaken. This is the main thing for you to know and remember, for it is a great principle." In his book Guide to the Perplexed[126] Maimonides added that charm-based medicine has nothing real about it and that it is unproven by experience. Therefore it is forbidden from a religious standpoint as witchcraft and Emorite ways: "In order that we may keep far from all kinds of witchcraft...everything that the idolaters, according to their doctrine, and contrary to reason, consider as being useful and acting in the manner of certain mysterious forces...Our Sages say distinctly[127], 'whatever is used as medicine' does not come under the law of 'the ways of the Emorite': they hold that only such cures as are recommended by reason are permitted, and other cures are prohibited...It is not inconsistent that a nail of the gallows[128] and the tooth of a fox[129] have been permitted[130] to be used as cures: for these things have been considered[131] in those days as facts established by experiment. They served as cures...the Law permits as medicine everything that has been verified by experiment, although it cannot be explained by analogy."
We will stay with Maimonides' explanation, "'whatever is used as medicine' does not come under the law of 'the ways of the Emorite': they hold that only such cures as are recommended by reason are permitted, and other cures are prohibited." Maimonides explains the intent of Chazal in the term "ways of the Emorite" as ways which the study of nature does not demand. This is in contrast to the simple meaning of the phrase, which is any action whose goal is healing, even if it is "ways of the Emorite," is not forbidden due to witchcraft and sorcery, but if the goal is not healing and it looks like "the ways of the Emorite" it is forbidden.[132] Another proof is that later on in the Gemara, after they determined the rule "whatever is used as medicine' does not come under the law of the ways of the Emorite," it is said "A tanna recited the chapter of Emorite practices before R. Hiyya the son of Abin. Said he to him: All these are forbidden as Emorite practices, save the following: If one has a bone in his throat, he may bring of that kind [of animal], place it on his head, and say thus: 'One by one go down, swallow, go down one by one': this is not considered the ways of the Emorite. For a fish bone he should say thus: 'You are stuck in like a pin, you are locked up as [within] a cuirass; go down, go down.'"[133] It is clear that these two incantations do not meet the criteria of consideration and reason which Maimonides set, and even so they are permitted, for according to Chazal incantations and natural medicines have the same rules and are permitted, even according to religious views.
Maimonides, later on, answers the contradiction to his words which he finds in the Mishnah, where it is stated that one is permitted to use incantations and amulets, even if consideration does not demand them: "It is not inconsistent that a nail of the gallows[134] and the tooth of a fox[135] have been permitted[136] to be used as cures: for these things had been considered[137] in those days as facts established by experiment. They served as cures...the Law permits as medicine everything that has been verified by experiment, although it cannot be explained by analogy."
With this answer Maimonides threw his own method away. If the determining condition is experience and not necessarily consideration and reason, then he permitted all incantations and witchcraft which "experience" has proven. The most puzzling thing in Maimonides' words is that he brings as an example of something which consideration does not demand and yet which experience has proven the tying of grasses on the neck as helpful to an epileptic, and dog feces as helpful for pus in the throat. With this he threw his lot in with "those who believe chaos and nonsense," for what is the difference between tying grasses on the neck of an epileptic and putting a chicken on the head to remove a bone stuck in one's throat?
The Rashba[138] saw that Maimonides' words held an internal contradiction: If the suggested remedies, be they "natural" or witchcraft and incantations, are not effective and experience disproves them, then they are nonsense, but if experience bears them out and we see that sick people are healed, though we have no satisfactory explanation for the phenomenon, it is medicine for all intents and purposes. "And I ask, as one who doubts the words of [Maimonides] what he would consider demanded by natural consideration. Is it whatever is demanded by the consideration of scholars who wrote nature books, like Aristotle and Galen and their colleagues who wrote books about the nature of the drugs and fortifications which are effective, in their eyes, and whatever they did not see is to be considered forbidden as 'ways of the Emorite'...This truly cannot be accepted by the mind...and yet even the wisest of scholars on the natural world is still a man [limited, and he cannot understand all phenomena in nature]. Just like the magnet, upon which iron jumps...can be understood through the consideration of none of these natural scholars. So all the charms based in nature act as drugs and fortifications [healing drugs and healing herbs] and are not to be considered 'ways of the Emorite,' just as the effective and known remedies by these scholars are not so considered...If this is so, why should we forbid what they say based on charmed nature? Perhaps the consideration of one scholar OBM will demand it, but not the consideration of another natural scholar?"
The fact that the greatest physicians, like Hippocrates and Galen, could not explain natural phenomena is not reason to turn these medical approaches into "ways of the Emorite," for perhaps some scholar in the future will be able to explain these natural phenomena to us. Chazal testified in the Talmud that witchcraft, incantations, and amulets are proven by experience; they "saw" patients being healed from their illnesses and therefore these methods were to be considered medicine, even if it did come through incantations which reasoning and logic reject.
The Sages of Babylon, as reflected in their opinions in the Talmud, did not note a distinction between forms of medicine. They did not deal in methodical medical research, and their words look like a pick and choose anthology of remedies.[139] Their knowledge of medicine, scattered throughout the sea of the Talmud, is a random anthology of what they had heard from their nannies or passers-by, from experts in the writing of amulets and sorcerers expert in incantations, from physicians skilled in healing herbs, and from legends of the Sages' acts. In their opinion, anything which has some potential to heal the sick is not charm, magic, or sorcery. Chazal did not make a distinction between natural remedies and healing through incantations and witchcraft in the scientific realm, only in the religious realm. A historiographer dealing with the history of medicine will not find mention in the Talmud of "Jewish medicine" as he will find mention of local medicine in the writings of Egypt, Greece, and Rome. He will find no school of research, no medical texts, and no details of healing as he will find in the medical texts of Greece and Rome (such as those by Hippocrates and Galen).
This section does not pretend to review the opinion of all Jewish researchers on the issue of Chazal's "cures," it means only to arouse criticism of some of the Jewish researchers who favor Chazal and whose research is dogmatic and biased. I would not be taking a risk to say that they try to use their intellectual gifts to glorify the knowledge of Chazal, the sages of the Jewish nation, and so idealize the historic past of our sages and so glorify the Jewish people. They attribute to Chazal medical knowledge which they never stated nor intended, and medical breakthroughs which only modern medicine truly understood.
Below are a number of examples of this idealization of our sages, the part exemplifying the whole:
Dr. David Margalit wrote many books about medicine and Chazal, including: "The Sages of Israel as Physicians," "The Sages of Israel in Medicine," and "Language and Healing in the Scriptures." One of the conclusions Margalit drew, which serves him as a motif in his books, is that Chazal knew no less medicine than gentile scholars: "The words of Chazal in the Mishnah and the Gemara, surprisingly, give time and again instructions on using complex instruments, on performing complicated operations with anesthetic, for using abortificants, etc. The conclusion to be drawn is that there was a well-developed, steady school of learning and research into the development of humans and animals, experiments, and the development of surgical skills. There are also hints to a cosmetology school...Again: most things were not listed on their own, but incidentally during a discussion of Halacha...and our Sages who dealt with all of these experiments and research as incidental are no less than the professional researchers whose job that was -- in all lands and all periods and times, those whose guiding light was the uncovering of the mysteries of nature."[140]
After the above, Margalit brings an example from the Talmud to support his words:
What is beza turmita? -- Samuel said: The slave who can prepare one is worth a thousand denarii. For it must be placed a thousand times in hot water and a thousand times in cold, until small enough to be swallowed whole. If one is ulcerated, it attracts the matter to itself, and when it passes out the doctor knows what medicine is required and how to treat him. Samuel used to examine himself with a Kulha[141], [which weakened him so] that his household tore their hair [in despair].[142]
And his conclusion: "These examinations are the most wonderful we find in the Talmud...the ambition to research, to know, to answer all troubling questions -- is not just the province of the modern scientific man, even Samuel[143] and his generation wanted this, and that is their greatness: their pioneering spirit."
Margalit admits that Chazal's words about medicine are generally written incidentally, to explain Halacha, and not systematically: "and our Sages dealt with all of these experiments and research as incidental." He also admits that this internal examination is, in practice, ineffective: "It is not the efficacy of the examination which is important -- the attempt is important in and of itself."
The only thing Margalit learned from Samuel's words is Samuel's attempt at examining himself internally using an egg or a Kulha [tube].
Analyzing the issue in the Gemara shows that even Samuel's attempt at an examination was not original to him; he heard about it from another source. I will also show that Samuel could not show that this examination was efficient, and that there is no research method here.
The Gemara clarifies what the beza turmita in question is. Samuel answered that it is an egg placed a thousand times in hot water and a thousand times in cold, until small enough to be swallowed whole for purposes of internal examination, to find the reason for the pain.
But Samuel himself did not use this egg, he used a Kulha [what this Kulha is isn't entirely clear], meaning that Samuel wasn't expert in the making of the egg. On himself he used a Kulha and not the egg, as the Ran writes: "Since he was not expert in making the egg, Samuel examined himself using a Kulha." So the knowledge of internal examinations must have come from a different source and not Samuel, and it is reasonable to suppose that the source of this examination was not his fellow students (the sages of Nahardea). Otherwise he would have asked them how to make the diagnostic egg. Also, cooking an egg a thousand times in boiling water and plunging it into cool water a thousand times is a great deal of work, something which not many people did, so this wasn't a very effective examination to use. Also, it is explained that when Samuel swallowed the Kulha he was in a great deal of pain, to the extent that his household pulled their hair out from worry. That means they did not do this examination, so even they could not say how effective the examination was. In addition, why didn't Samuel write the different signs which show the various illnesses or potential cures after the Kulha or egg is removed so that we would know not only how to conduct the examination, but also what to do with it, following the method of authors of medical texts such as Hippocrates and Galen?
From all the above I can conclude one thing -- Samuel examined himself to discover the location and cause of his stomach pain, using a Kulha -- no more than this. There is no research here, no pioneering or innovation, only an attempted examination already known of from a different source. Moreover, all nations and tribes have always tried to heal their pain and their ill, so what's the big deal about trying to eat an egg in order to find the cause of the pain? A situation in which people try to find remedy for their illnesses is not what is discussed here, nor does it represent any innovation. What Margalit must prove is the method of research; did Chazal, or in this case Samuel, have a method of research, or some establish and developed school of thought as Margalit attributes to them? The mere fact that there was an attempt to find a remedy for an illness does not teach about any method of research.
He continued this dogmatic way in his book "The Jewish Way in Medicine." Not only did he not learn the Talmudic issue in depth, he even quotes it erroneously and misleadingly. First we will bring his words and then the critique.
In the section "The heart and its function in the circulation of blood according to the Ancients" Margalit writes: "Today we can only agree with Rav's supposition [which contradicts Samuel's opinion] that not only is blood found in the aorta, it is in all arteries, as the Gemara concludes: 'There are three large arteries: one leads toward the heart, one to the lungs, and one toward the liver.' As Rashi there explains, 'After the pipe enters the chest it splits into three.' This is a very realistic picture of the large arteries and the movement of all the blood (incidentally, this paragraph is taken from Galen). It is interesting that Lampornati erred in the meaning of the Rashi and claimed in Pachad Yitzchak that Rashi had not checked it out, for he thought that Rashi meant the trachea, and how would it be possible for that to divide off to the heart and the liver? But according to all signs Rashi speaks of the aorta, and of course Rashi is correct" (pp. 101-102).
Critique: Margalit's conclusion that the Talmudic discussion and Rashi referred to the aorta and not the trachea are based on the claim "how would it be possible for that to divide off to the heart and the liver?" Margalit assumes that which he wishes to prove. He assumes that Rashi and the Talmud could not err and think that the trachea splits off to the liver and the heart, and therefore he concluded that Rashi meant the arteries, which do split. We will bring proof that the Talmud does indeed refer to the windpipe and states that it splits into three, one to the lungs, one to the heart, and one to the liver; this is an error.
Margalit's citation from the Talmud, "three arteries," is incorrect. The precise citation from the Talmud is "There are three pipes." I find it very puzzling that an academic would not be especially careful and at least correctly cite the source, especially when the linguistic meaning of the original is just the opposite of his claim. The word "pipe" serves as a placeholder for "windpipe": "The esophagus or the windpipe. Rav Ada the son of Ahava said, the esophagus and not the windpipe."[144] The blood vessels are called veins: "R' Judah says: with birds, until they are slaughtered, the esophagus and the veins! For the esophagus is close to the veins."[145]
Marglit relates the debate between Samuel and Rav to all arteries in the body, while the Talmud shows that the disagreement between Rav and Samuel was on the "heart pipe" and not that which leads to the liver or the lung. According to Margalit's interpretation, the debate is about the artery leading to the heart and not that leading to the liver or lung: "Heart pipe: Rav said partially and Samuel mostly...[the rule about a puncture in the pipe] of the lung as the lung, [the pipe] of the liver as the liver, [the pipe] of the heart -- they were divided [Rav and Samuel disagree].[146]" So Chazal did not treat the arteries [according to Margalit, who states they spoke of arteries] equally; this does not match Margalit's words.
The issue of a needle found in a liver which appears in the Talmud (Chulin 48b) proves beyond a shadow of a doubt that the pipe spoken of here is the windpipe and not arteries as Margalit supposes. The Talmud deals with a needle which is found in the internal organs of a cow, such as the lung, the liver, and the digestive system. There are two reasonable possibilities about how the needle got to the lung or the liver. One is through the esophagus; while eating straw or grass the cow swallowed the needle, or through the windpipe; while eating, she breathed in the needle. Rashi writes (Chulin 48b) that on the one hand it is more reasonable to assume that she swallowed the needle through the esophagus, "Punctured: through the esophagus it [the needle] came in, for through the windpipe it is not customary to swallow," but on the other hand, since the needle is found in the lung, there is room to suppose that she breathed in the needle and it reached the lung, sooner than believe she swallowed it through the esophagus and it reached the lung: Through the windpipe it came to the small bronchial tubes, and from the small bronchial tubes to the flesh [the lung]...though it is not customary for the windpipe to swallow, since we are dealing with the lung, and we see it has no puncture in it, it is reasonable to suppose that the needle got in through the windpipe and not through the esophagus, puncturing the membrane of the lung." This is also the rule when a needle is found in the liver and when the pit of a date is found in the gallbladder. The Gemara concludes that it came in through the windpipe, for if it had come through the esophagus (Chulin 49a) it would have had to cause a puncture, so it is more logical that it came through the windpipe and the small bronchial tubes. Rashi explains: "It must have come through the small bronchial tubes, having originated in the windpipe, for [the date pit] is large and cannot puncture the esophagus to exit it."
From all the above, it is clear that the pipe spoken of here is the windpipe, for a needle certainly cannot reach the arteries without puncturing them. Margalit's conclusion is misleading simply because of his base assumption, that Chazal could not make a gross error and think that the windpipe splits off to the lungs, the heart, and the liver.[147]
There are those amongst today's researchers who act like religious people and bring proofs from the holy writ for their post facto veracity. There is no way to learn anything from the text, but after the event and the phenomenon religious people try to squeeze hints foretelling the event from the Scripture. Similarly, today's researchers in medicine, after obtaining medical knowledge through modern research, try to squeeze it out of the Scriptures or the Talmud, and it is clear that without their earlier knowledge they never would have ascribed to the Talmudic text what they did ascribe to it.
We will bring an example of this from an article written by N. Kass, "Determination of Sex in Medicine and in the Talmud."[148]
"It is said that the Sages knew of the existence of sperm cells and that they have heads, as noted in Niddah 55b and Kallah Rabbati 2. In medicine, their existence was discovered in 1677 by Leeuwenhoek."
A stunning discovery in the history of medicine. The first to know that sperm cells have heads were the Talmudic sages, long before it was discovered by modern medicine.
Critique: Kass brings no citation from the Talmud and makes do with the note "Niddah 55b." I read the source twice and thrice and found nothing there. It seems it would be difficult to fully understand Kass, particularly given what he writes following: "The sex is determined by sperm alone -- by the man. This is a medical fact -- and the same opinion is expressed by the Torah. In Genesis 1:28 the Torah rules, 'Be fruitful and multiply and fill the earth and conquer it.' Rashi explains that the word for 'and conquer it' is spelled defective, to teach that the man must conquer the woman so that she not go out and about,' and the Or HaChayim rules 'and He will bless them,' they will have the power to reproduce. The Gemara in Yevamot 65 says 'and conquer -- it is the man's way to conquer and it is not the woman's way to conquer.' In other words: the Torah and the Talmud explain that the man is the one who conquers the woman to continue the family and fulfill the commandment of 'be fruitful and multiply.' The man has the power to conquer...according to the commandment of 'be fruitful and multiply' -- so these are the sperm -- the man's power acts as the power which determines the sex, and not the woman's. The offspring's sex is, then, determined only by the sperm, and is not dependent on the egg."[149]
This is wonderful testimony how today's researchers who seek scientific knowledge from the Talmud can warp, distort, add, and take away from the text, all to find the tail end of some proof for Chazal's knowledge of science. How, from a statement about a man's wooing of a woman, of the methods of reciprocation between the sexes as a social phenomenon in which a man is the one who woos (conquers) and not the woman does Kass conclude the true intent is that only the male sperm cells determine the sex of the offspring? I wonder.
Another example emphasizes the researcher's desire to attribute medical discoveries or knowledge to Chazal as a primary source.
Eli Turner, in the article "Talmudic sources for the history of diabetes"[150] brings a Talmudic source -- he claims -- for knowledge about diabetes. The Talmud discusses the laws of damages and injuries which one person causes the next. It is ruled that he is required to pay recuperation costs. But in a case where the injured party is negligent or remiss in treating the wound and the wound becomes more severe, the one who caused the injury is exempt from paying recuperation costs, because of the negligence:
"It may be replied that what is meant by 'caused not by the wound' is as taught: 'If the injured person disobeyed medical advice and ate honey for any other sort of sweet things, though honey and any other sort of sweetness are harmful to a wound, and the wound in consequence became gargutani [scabby] [the injurer is exempt from paying for the treatment of the scabby wound]."[151]
Turner writes: "Is the lack of wound healing solely a phenomenon associated with diabetes? Perhaps not, but why not eat honey or other sweet things? An ordinary person might be wounded (even large wounds) and continue to eat normally, yet his wounds are healed! Only a diabetic patient might experience this development. In this paragraph there are two other facts which point to diabetes:
"The doctor ordered the wounded person not to eat sweets before his wound became scabby. Why, then, did the doctor forbid him to eat honey and other sweets? It is clear that the doctor knew that at least some people find the eating of sugar detrimental to the healing of wounds; it is even possible that he knew this person from a previous treatment and forbade him eating sugar even before he was wounded, knowing his tendency to develop necrosis." [His second proof is that the Talmud speaks of a wounded person who had already been diagnosed as having a tendency towards scabbing when eating honey and sweets. I did not copy it to save the reader bother]..."In any case, it is clear [that the Talmud] is a proven and precise source, and that the earliest of the sages describe the phenomena of diabetes." From Turner's words it seems that the very fact that the Gemara mentions the eating of honey and sugared things as causing difficulty for a wound is proof that Chazal understood there to be a link between sweets and wounds, one of the symptoms of diabetes.
Critique: Did we not now know through research that diabetes causes necrosis following damage to the supply of blood, we would not draw this conclusion from the Talmud. First, the Talmud's words relate to a wound which appears on any person, not only a diabetic with a wound, for it is written "honey and any other sort of sweetness are harmful to a wound." Turner made a supposition that Chazal dealt, in their statement, with a diabetic and not with all people, using the excuse "An ordinary person (not a diabetic)...continues to eat as usual and his wounds heal!" Therefore Turner concluded that you must see the Talmud speaks of a diabetic: "Only a diabetic could develop this symptom." But it is this symptom which was known and clarified only thanks to modern research; how is it possible to suppose what you want to prove? One should not ask why Chazal said "honey and any other sort of sweetness are harmful to a wound," for there are many and varied bits of medical statements in the Talmud, short and unclear. We do not know why they supposed that sweets and honey harm a wound, though it is clear to us that it is not true. For exactly that same reason it is not clear to us why, according to Chazal, rubbing honey on a wound helps heal it.[152] The Talmud overflows with healing advice which is unclear and incorrect. What would Turner learn from:
"Eating fish is bad for the eyes"[153]
"One must be careful not to eat meat and fish together, for they are bad for the leper"[154]
"Our rabbis said: spleen is good for the teeth and bad for the intestines. Leek is bad for the teeth and good for the intestines."[155]
Turner himself wrote that none of the Talmudic commentaries related this Talmudic source to diabetes: "I want to bring a new-old source which can shed some light on some of these issues. Thousands of Jews, even Maimonides, have learned it, but despite this no one noticed or connected this source to diabetes." It is clear; it is not possible to tie this statement to the disease of diabetes if you do not first know that wounds are connected to diabetes. One who comes to interpret the Talmud to understand and know history must disconnect from his current knowledge and try to understand what is written from within the text itself and the environment in which the author of the text wrote.
It would be appropriate to end this section with the wonderful and illustrative words of Professor Yeshayahu Leibowitz OBM,[156] "The whole confrontation between science and faith and all the attempts to verify the Torah through decisions of scientific research (natural sciences or historical philological research), and particularly the ridiculous attempts to 'save' (as it were) the veracity of the Torah by placing the results of the use of scientific method in doubt...are all absolute errors in understanding the essence of science and serious errors from the standpoint of religious faith."
There is no doubt that modern medicine since the scientific revolution is not based on ancient medicine. Neither the letters of Hippocrates nor those of Galen, nor those of any of the great men of medicine in ancient times or the Middle Ages serve so, and certainly the medical methods scattered throughout the Talmud do not. These remedies are learned in medical schools as history alone. Though there are various remedies suggested by physicians of various times which have been verified by modern medicine, it should be remembered that we do not live according to them; we follow modern medicine and rely upon it, whether it verifies or denies ancient remedies. Anyone who works in a modern hospital can testify that he relies solely upon modern medicine.
Medical research and the treatment of patients is, like all other every day tasks, a way to earn a living. Would anyone think of making a living working at a job held by the sages of the Talmud? To be a farmer and water the fields with buckets just because that is how they irrigated in Talmudic times? To be a hewer of wood like Hillel the Elder? You see that there are things that are simply everyday matters and not connected to religious faith. In everyday matters the rabbis and religious arbiters do not reign supreme. After Halacha determined[157] that a person must work and earn a living and not be dependent upon the mercies of heaven, people learn professions from professionals and not from the Talmud.
Similarly, the manner of treating the sick is an everyday matter and the physicians in each generation are the ones who determine how to treat illness. Would anyone with scurvy think of being healed by rubbing goose fat on his gums instead of taking vitamin C? Would a patient with jaundice drink the urine of a donkey as the Talmud suggests? It is clear that after it was ruled that one may work in medicine and not merely rely on the Heavens to heal people[158] the method of healing is in the hands of the professional physicians and not the Talmud. Contemporary religious people who have not yet drawn the distinction between holy and secular and for whom the two terms serve as a sort of stew are sitting on the fence. On the one hand they go to hospitals and listen to current medical advice, but on the other hand there are contemporary religious arbiters who try to draw medical definitions out of the text of the Talmud. They treat the sages of the Talmud as a loftier and more trusty-worthy source than modern medicine and have not yet internalized that Chazal's medicine is simply a part of the history of Jewish medicine. We will not bring examples of the confusion and perplexity amongst today's religious arbiters when it comes to medical issues.
One of the implications of modern medicine for Halachic decisions is in the area of desecrating the Sabbath. The Halachic ruling of "saving a life supercedes the Sabbath" determines that it is a great good deed to violate the Sabbath when faced with a sick person whose life is in danger. Who determines what illness is dangerous and demands the immediate loosening of the laws of the Sabbath? Who determines how the patient is treated? Today there is no doubt that doctors who studied in medical school are the ones who determine which illness is dangerous and which medicine effective. Everything written in the Talmud and the rulings of the Shulchan Aruch, relying upon the Talmud, are irrelevant. The only relevant ruling is "All the ill whom a physician says are in danger...for them is the Sabbath violated."[159] This Halachic ruling summarizes all the laws of a sick person on the Sabbath which appear in the Shulchan Aruch; all the other sections are not relevant in practical terms, merely as historic artifacts of medical Halacha. The words of the Shulchan Aruch which state that any person who claims a particular illness is dangerous and permit the violating of the Sabbath are anachronistic and have lost their force: There are those who say that there is no need for an expert, that all people are somewhat expert, and "in saving lives, one is lenient."[160] It might have been proper to consider every person's opinion in his days, but now, in the era of modern medicine, there is no doubt that we do not consider the opinion of any person who did not learn medicine in a properly authorized medical school.
Most of the religious arbiters who wrote books of Halacha after the closing of the Talmud wrote about diseases mentioned in the Talmud, but did not mention the methods of healing mentioned in the Talmud, and this looks like a silent agreement to listen to doctors and not the remedies of the Talmud. Rabbi Joseph Karo related to this topic in dealing with the Talmudic remedy for one who swallows a leech. The Talmud treats the swallowing of a leech as a dangerous thing which can cause death, and therefore they permitted heating water on the Sabbath as remedy:
"Our Rabbis taught: One should not drink water either from rivers or from pools... if he drinks it, his blood shall be upon his head, for it is dangerous. What danger is there? That of [swallowing] a leech. [This statement] supports R. Hanina, for R. Hanina said: For one who swallows a leech it is permissible to get water heated on the Sabbath. There was actually a case of one swallowing a leech, when R. Nehemiah declared it permissible to get water heated for him on the Sabbath."[161]
Rabbi Karo wrote: "We heat water for one who swallowed a leech...it is simply that we heat water for him, for this is what is written in the Talmud as the specific remedy for it, but it is clear that if he needs some other remedy we give it to him."[162] The suggested remedy written in the Talmud is not obligatory, and if there are other effective remedies of course we are to use them and not the remedies written in the Talmud.
Even so, we find amongst the arbiters those who say we should not listen to doctors when they contradict the words of the Talmud in diagnosing whether an illness is serious or not. For example:
Scurvy[163] is listed in the Talmud as a dangerous illness which requires the violation of the Sabbath. Though it is now clear that it is healed by the ingestion of Vitamin C and is not dangerous, the author of the Pri Megadim[164] wrote, "Scurvy, though the patient and the doctor say there is no need [to violate the Sabbath for the patient], they lie, for Chazal said it is a danger."
The Pri Megadim, though he accepted the words of the Talmudic sages above the words of medicine contemporary to him, did not refer to the remedies mentioned in the Talmud, ignoring them completely. It can be asked whether, following his approach, one may now violate the Sabbath for scurvy patients and roast a goose for its fat as an ointment for the gums, or to heat iron on the Sabbath to place an olive pit upon it, "for this is accepted by Chazal as efficacious in treatment."[165]
The question of how to act in practical terms when faced with a contradiction between what is brought by the Talmud and what the doctors say is discussed by many religious arbiters. Thus, for example, the Tzitz Eliezer answers a question of whether one is permitted to violate the Sabbath for those illnesses listed in the Talmud as dangerous, though doctors claim it is not:
"My answer is: Yes, and this is the case for all illnesses for which Chazal say we violate the Sabbath...even if the patient and the doctor say there is no need, we do not listen to them...since the Gemara says it is dangerous."[166] We can also ask whether in his approach a person bitten by a rabid dog on the Sabbath is permitted to kill a hyena on the Sabbath to skin it and write upon it "I, so and so the son of so and so write upon the skin of a male hyena kanti kanti kilrus, though some say it should be kandi kandi kilrus. Lord, Lord, Lord of the Hosts, amen, amen, selah" as the Talmud suggests?[167]
It is clear that it is inconceivable that any religious arbiter would permit slaughtering a goose on the Sabbath for a scurvy patient, or killing a hyena for a person bitten by a rabid dog. If so, what is the difference between diagnosing an illness and treating it? If we are not to rely upon Chazal for means of remedy, we should not rely upon them for diagnosing the extent of illness.
One of the cases which caused great embarrassment to contemporary arbiters is Chazal's demand to suck the blood of a newly circumcised infant to prevent danger to the infant: "Rav Papa said: a ritual circumciser who does not suck the circumcision blood causes danger."[168] Therefore it is permitted to suck the circumcision blood even on the Sabbath, to save a life.
Today's doctors claim that there is no medical necessity for the sucking of blood, and it is preferable not to suck the blood in order to prevent infecting the open wound. According to physicians, the ritual circumciser who sucks the blood on the Sabbath is violating the Sabbath, for there is, in their eyes, no danger.
The great embarrassment in this case is that the sucking of blood has become, over the course of time, part of the circumcision ceremony, and to eliminate it because of an error in the words of the Talmud would create a great spiritual crisis for the believing man. Eliminating a custom which has become strongly rooted in the souls of the believers may shake their faith even in the words of Halacha in the Talmud. Therefore all the religious arbiters, as a man, decreed that one should not change or eliminate the permission for the sucking of blood on the Sabbath, even though doctors think there is no danger. Thus did Rabbi A.Y. Kook answer the question: "They say that according to medicine [not sucking] is not dangerous now...their words are contradicted by Chazal who said that a ritual circumciser who does not suck the circumcision blood causes danger...we do not listen to them at all...for when they come to contradict the words of Chazal they are not trust-worthy at all, and of course their judgment is in error...But in truth it seems that [the physician's] words are considered doubtful, for they themselves cannot hold their own words with any certainty...for all their words are nonsense; what this one builds the other contradicts, and so there words are only estimations, not certainties...Therefore, even if there is a violation of the Sabbath in the sucking, it is simple: we are required to [suck], for it is always suspect of being fatal, and any suspicion of fatality supercedes the Sabbath."
Rabbi Kook, like the other rabbis, treats the sages of the Talmud as though their medical knowledge were more certain than that of modern physicians', and simultaneously completely ignores the means of treatment in the Talmud. In case of illness the rabbis send their followers to hospitals. One who was bitten by a snake rushes to the hospital; he does not drink 86 cc of a white goat's milk or 170 cc of human urine left stand 40 days, as recommended by the Talmud. The rabbis don't notice that the very fact of ignoring the Talmudic cures and daily use of modern medicine is testimony and witness that the words of the physicians are certain and the medical words of Chazal are highly doubtful.
One of the medical topics which has aroused great public debate is the harvesting of organs from the brain dead for transplant. According to physicians death is determined by brain function, but according to the Talmud death is determined by the cessation of breath.
We will cite the words of the Tzitz Eliezer responsa, part 10, 25:4 which serve as a wonderful testimony of their relationship to modern medicine when it contradicts the determination of the Talmud:
The determination of death in these times...is a man's life tied to his heart or his brain?...the determination of death in man is based on the cessation of breath, for it is a rule for all dead; this is the measure we have accepted ever since we became God's congregation, a holy nation [who draw medical knowledge from the ancient tradition of Chazal] and all the spirits in the world [even contemporary physicians] will not move us from our Holy Torah...in the manner that Chazal's words...are spoken truly and justly, that all relies upon the nostrils and we should not move a whit from this. Even if according to the new tests they find some vitality and through this resurrect him several times, even after it seems the breath in his nostrils has already ceased, it only means the determination was inexact and they did not at first notice anything, and he was only in that vegetative state which is close to death...but the fundamental determination from this is that we have naught but the Torah and the tradition of our forefathers, and any who doubt this doubt God...The words of the doctors cannot be different, based on their knowledge of medicine, than what Chazal determined, for we do not judge the laws of our Torah and its commandments based on the sages of nature and medicine; they are not faithful to their words and say Torah is not, heaven forbid, from the Heavens, and they give false signs...we will rely upon Chazal, even if they tell us right is left and left is right, for they received the truth and the interpretation of the commandments one from the last back to Moses our teacher, OBM. We will not believe the Greek and Arab sages who only spoke from their own suppositions and experience, without noticing several doubts...Even today we see this on medical issues; something which a few years ago was adopted as an incomparable remedy is now held to be worthless and even harmful, and the doctors do not hesitate to say that it is possible something is now considered a wonder drug and an unshakeable medical recommendation but, in a few years, based on new tests which will contradict those already run, medicines and recommendations which utterly contradict these may be advised. How can it be conceived, for even a second, to stray from what has been accepted by us for generations, based on the Written Torah and tradition, because of these recommendations and signs made up by the sages of medicine from era to era...let us clarify in what they err...and wish to determine...that vitality depends on the brain...and this is opposed to what Chazal determined for us. How many dead does this determination claim, in this thing now called "clinical death"...they literally kill people, and this is what some doctors now do to make themselves a name in heart transplants. We should shout about this and announce that these people are murderers. In truth, checking the nostrils does not show a cessation of brain activity, it shows a cessation of heart activity. ... Rashi OBM agreed that breath is seated in the heart...we will conclude by saying that...it is clear as the sun that any we see dead, who have no breath, also have no heartbeat, which is the sign of vitality brought in [tractate] Yoma."
That rabbi concludes two important things: one is that we should not rely upon doctors, who change their minds from generation to generation. The second is that one is not to doubt and change the tradition written in the Talmud, even about medicine, "even if they say right is left."
In light of the medicine in the Talmud presented above, there is no doubt that extracting medical definitions or determinations about the moment of death from the words of the Babylonian sages is one of the most ridiculous and humiliating things about Judaism, which comes out strongly against progress and investigation and does not accept the results of research while simultaneously using the medical achievements of modern research. It would not take away from Chazal's honor were we to state that they were not physicians, for they were not meant to be physicians, only experts in Torah and Halacha. If we claim that Supreme Court judges are not expert in medicine, would that take away from their honor and status? One who thinks that Chazal were expert in medicine and we can learn from them about modern medicine, who follows the words of the Talmud in contrast to the opinion of modern medicine, yet who runs to the hospital and to consult with physicians instead of opening the Talmud and being healed by it turns himself into a source of mockery and jest.
We will conclude with the illuminating words of Professor Yeshayahu Leibowitz OBM: "Medicine, as we know it, is an integral part of our modern existence: it is an existential factor for us. Were it not for modern medicine it is doubtful whether any of this honorable public would be here...modern medicine is not a continuation of the medicine of ancient times and the Middle Ages. They have nothing in common but a name...ancient sources do not deal with medicine as we know it. They deal with what was then called medicine, and this interests us from a historical perspective only. Any attempt to draw conclusions from the "medicine" of those days to the medicine of our times is fraud. It is impossible to discuss the problems of Halacha and medicine in our times relying upon what is stated about medicine in Talmudic sources, in the sources of the religious arbiters, etc." (Judaism, the Jewish People, and the State of Israel pp. 369-370).
In conclusion: the sages of Babylon, who lived between the Euphrates and the Tigris, between the third and the fifth centuries CE, under Persian Sassanid rule, were in close contact with the Palestinian sages who lived under Roman rule with Hellenistic influences. No aspiration towards philosophy in its ancient sense -- the study of nature based in reason -- can be discerned amongst them. Chazal did not write systematically or scientifically, and it seems that is not how they thought, either. The sages of Babylon dealt with their religion and their faith only, and all topics upon which they touched or which they discussed were in this context. The field of medicine, which we discussed in this chapter, shows it unequivocally. The sages of Babylon lived in an era in which many medical treatises had already been written in Greece and Rome; if Chazal were interested in knowing the advanced medicine of their times they could have. The Jewish community in Rome had close contact with the Jewish community in Palestine, but they did not try to find out about contemporary medicine because they did not want to. The sages of Babylon were interested only in the survival of the religious community in terms of faith and economics. This is like the separatist Charedi community which now lives in the State of Israel and invests all its might in maintaining the Charedi community, forbidding its members to go to university, not teaching its children what critical, scientific thought is. Thus, too, was the Jewish community in Babylon -- they utterly ignored the progress of their times; even things which would have been healthy for them they preferred to ignore and use remedies from passers-by, incantations and witchcraft, magic, and folktales.
[1] Bava Kama 85a: 'And to heal he shall heal' [is the source] whence it can be derived that authorization was granted [by God] to the medical man to heal."
[2] Hippocrates wrote, "When Sirius begins to be seen before the sunrise (in the summer), purgatives are unsuitable." Joshua Leibowitz (Ed.), 5740, History. M. David, "The Empiricism of Hippocrates," fourth essay, volume 7, pamphlets 9-10, The Israeli Society for the History of Medicine: Jerusalem (pg. 680).
[3] As the Greek historian Herodotus (approx. 450 BCE) wrote: "The practice of medicine is so divided among them that each physician treats one disease, and no more. There are plenty of physicians everywhere. Some are eye-doctors, some deal with the head, others with the teeth or the belly..." Most of our knowledge about medicine in ancient Egypt is based on medical papyri, of which some 15 survive and cover a period of about 2000 years ....Amongst the medical papyri are the Adwin Smith and the Ebers papyri, which were preserved in copies from the year 1550 BCE, though sections may have been written even earlier." "Illness and Healing in Ancient Times" (5756), Reuven & Edith Hecht Museum, Haifa University: Haifa (pg. 10).
[4] Joshua Leibowitz (Ed.), 5740, History. A. Uri, G. Baum, "Respirational aspects of Hippocrates' work," Volume 7, pamphlet 11-12, The Israeli Society for the History of Medicine: Jerusalem.
[5] Hippocrates wrote the Hippocratic Corpus, which includes 70 essays. Galen wrote some 110 medical essays.
[6] Avodah Zara 28a gave a suggestion for curing gum problems.
[7] Ibid.
[8] In Tractate Bava Kama 82b: "Cursed is he who teaches his son Greek wisdom."
[9] Pesachim 53b: "Tudus [the doctor] was a great Roman." Mishnah, Rosh Hashanah 1:7, "An incident which happened to Tuvia the doctor, who saw the renewal of the moon in Jerusalem." During the Roman reign the Jewish community in Rome was involved in the Hellenistic lifestyle. It can be assumed that Tudus the doctor, who lived in Rome, had heard of Hippocrates and Galen, whose names and books were amongst the most famous, even though the Talmud did not find it appropriate to mention them.
[10] Maimonides, Pirkei Moshe [on medicine]. (5719) Medical Writings. Mossad HaRav Kook: Jerusalem, introduction.
[11] In his introduction to the book Ein Yaacov.
[12] Sabbath 66b.
[13] Laws of Ritual Slaughter 10:12-13. The Chazon Ish made a grave error in his explanation of Maimonides, as though the latter had accepted Chazal's medical knowledge, and therefore the Chazon Ish was puzzled: "And [Maimonides'] words are opaque, for it seems he verifies what the physicians say, and if this is so, how does he reconcile them with the words of our Sages, which are as nails driven forever?" Yeshayahu Karelitz (5736). Chazon Ish. Yoreh Deah, Laws of Ritual Slaughter, section 5. Bnei Brak.
[14] Chulin 7b.
[15] Bereshit Rabbah 10.
[16] Rav Ami said: "There is no death without sin and no suffering without wrongdoing..." [The Talmud concludes that] there is death without sin committed by the dead man; his death may have been caused by Adam's sin, as Chazal put it, "the snake's bite." All opinions say that there is a reason for death and suffering -- straying from the correct path (Shabbat 55a).
[17] After Rav Huna's wine barrels soured, his friends reproved him and told him to examine his actions, for the souring of the wine was caused by an act which should not have been done; Rav Huna had not paid a laborer his wage. After he accepted the reproof, the wine barrels which had soured were once again wine. Some say that what happened is that the price of vinegar went up to match the price of wine (Brachot 5b).
[18] In tractate Yoma 83b the Sages debated what causes a dog to become ill with rabies: "Rav says, 'Witches toy with it.' Shmuel says, 'An evil spirit rests upon it'."
[19] One who was bitten by such a dog can be cured by taking the skin of a hyena and writing an incantation upon it. He should take off his clothing and bury it [in the graves by the crossroads]; after a twelve-month he should unearth them and burn them, throwing the ashes at the crossroads. During the twelve-month he should drink water only through a straw made of brass, lest he see the demon [who jumped from the dog to him] reflected in the water and be endangered (Ibid.).
[20] In the Gemara it is written tzmirta, which means a urinary tract blockage due to kidney stones. Steinsaltz, Adin, Gittin, Hasholeach chapter, Glosses and Notes, pg. 208.
[21] Bava Metzia 85a.
[22] Berachot 33a.
[23] Numbers 21:6.
[24] Numbers 21:9.
[25] Shabbat 55b.
[26] Shabbat 110a.
[27] Ecclesiastes 10:8.
[28] A defect or illness in an animal which will cause its death within a year; Chulin 57b.
[29] Shabbat 109b.
[30]
The Jews appointed as tax collector for the Persian government many times did
not heed the decrees of the Sages and instead were beholden to the laws of the
reigning monarch. It is possible that this legend was invented to force them to
heed the Sages' words, and that is why they used the fear tactic of punishment
by snake bite.
This method of scaring
the masses was written about by Ibn Ezra; his words are cited in the Turei
Zahav, Yoreh Deah, 116:5 : "I found it written that one should beware
drinking water at the time of the tekufa because it is dangerous, lest one
be harmed and damaged. The reason is that a drop of blood falls between one tekufa
and the next, but the sage Ibn Ezra answered that this is just a guess...and
there is no danger in it at all. Some of the gaonim said that snakes cannot
harm the Jews, and that the early sages only spoke of this to frighten the
people into returning to the Lord, so that the Lord would save them from the
four tekufot
of the year."
[31]
One of the most amazing things found in the Babylonian Talmud (Bava Metzia 83b)
is the surgical intervention performed on Rabbi Elazar the son of Rabbi Shimon
Bar Yochai to check his righteousness. Rabbi Elazar the son of Rabbi Shimon Bar
Yochai handed over to the Roman authorities Jews who stole or evaded taxes.
Since his acts were questionable, it was decided to investigate his
righteousness using the belief that the bodies of the righteous stay whole
after their deaths; the worms do not eat their flesh. They gave him a sleeping potion,
cut his stomach and removed a piece of fat along with some flesh. Afterwards
they left the fat in the summer sun to see if it would rot. They found that it
did not, as is the case with the righteous.
This story crowns the
tales of the Sages which appear in the Talmud, and we should be quite cautious
in approaching them: do they represent historical reality or are they the
fruits of the author's imagination? See the Open University course on Medrash
and Aggadah; Professor Yona Frankel wrote in the introduction to that course
(pg. 379), "Our conclusion is that many stories about the acts of the
Sages are the inventions of the storytellers and not a historical chronology
reflecting what really happened." This story about Rabbi Elazar the son of
Rabbi Shimon Bar Yochai seems mainly an aggadic story unconnected to historical
reality, and it may have been brought to justify R' Elazar's actions, handing
Jews over to the Roman authorities. In this story there are several
fundamentals which match the literary creations of the sages' doings rather
than tales of historic reality, such as the tale of R' Elazar's death, after
which his body remained in the attic of a house 18 years until its burial (Bava
Metzia 84b).
[32] Tosefta, Shabbat chapter 15, halacha 14, Lieberman edition.
[33] Yoma 83b.
[34] To put on the wound to heal it -- Rashi, Yoma 83b.
[35] The Gemara discusses whether it is preferable for the sick person to eat from food which was not tithed or if it would be preferable to violate prohibitions against work on the Sabbath and tithe the food.
[36] Shabbat 110a. Dishtana, used in this passage, is Persian for "menstruating woman."
[37] Deuteronomy 21:11-12.
[38] In Yevamot 48a they disagreed on the meaning of the word "do." "Rabbi Eliezer says 'cut' and Rabbi Akiva says 'grow'."
[39] Devarim Rabbah 6. "The holy One, blessed be He, said, 'Though I permitted her [the captive] to you, I told you to shave her head and do her nails so that she will not find favor in your eyes and you will send her away'."
[40] Chazal, when they want to express the disgrace of a woman, speak of menstruation as something disgusting: "Woman is a sack full of excrement, her mouth is full of blood -- yet all run after her" Shabbat 152a.
[41] Who apparently "understood" their words. See Gittin 45a and Sefer Halachot Gedolot 39; there were people who were expert in the language of the birds.
[42] Shabbat 66b.
[43] "He whispers and says less and less. The demon named Shavriri leaves when he hears the syllables becoming less, one by one, down to ri." Then the demon runs away. Rashi, Avodah Zara 12b.
[44] Avodah Zara 30b.
[45] Terumot chapter 8, mishnah 4.
[46] Tosefta on Tractate Terumot [Lieberman] 7:12.
[47] Chulin 49b.
[48] Avodah Zara 31b.
[49] Chazal forbade moving things on the Sabbath which have no use, such as stone, dirt, etc. This is what Halacha calls muktze. Therefore water which one is forbidden to drink should have been forbidden to move, for it has no use.
[50] Shabbat 128b.
[51] Shabbat 109b.
[52] Its leaves look like a flute, and therefore it is called obov.
[53] In ancient Egypt they used a lotion of this plant as a cure for poisonous snakebites. Yigal Granat (1994), "Medicinal plants of the Negev -- Medicinal plants in the Hellenistic period," Environmental Education Publishing House: Sde Boker Academy.
[54] Sheet for chemistry teachers: Knowledge of Chemistry. Technology and Society No. 56/57 (1994). "Vitamin C" Editor: Dafna Mandler.
[55] Avodah Zara 28a.
[56] Rashi on Yoma 84a.
[57] Rashi on Avodah Zara 28a: Kisa d'Harsena is fish which has been fried in its own fat and in flour.
[58]
Though the Talmud does not reflect medical knowledge which can be relied upon,
there were rabbis who treated the medical information written in the Talmud as
"the words of the living God" and permitted doing forbidden actions
on the Sabbath based on what is written in the Talmud:
Rabbi Yosef Teumim
(1727-1792, Frankfurt) in Pri Megadim, Eshel Abraham, Orach Chaim Laws of
Sabbath 328:2, "With scurvy, even if both the patient and the doctor say
there is no need [to violate the Sabbath for the patient], they lie, for Chazal
generally stated it was a danger." We will write more about this further.
[59] One who suffers from gout should, after the sharpest pain passes, rest for 40 days '' Joshua Leibowitz (Ed.), 5740, History. M. David, "The Empiricism of Hippocrates," fourth essay, volume 7, pamphlets 9-10, The Israeli Society for the History of Medicine: Jerusalem (pg. 772).
[60] Encyclopaedia Hebraica, entry gout.
[61] Weinberg, Y., Pinchas, Y. (5740) History. Volume 7, pamphlet 11-12, The Israeli Society for the History of Medicine:, Jerusalem. History of Colchicine(pg. 760).
[62] Sde Boker Academy, Division for the Development of Curricula. Environmental Education Publishing House. "Medicinal Plants of the Negev: Summary of Annual Colloquium in Memory of Aiynat Gross." Author: Yigal Granot (1994).
[63] Mishnah Shabbat chapter 6, mishnah 6.
[64] Shabbat 65a.
[65] Shabbat 6, folio 8c.
[66] I Kings 15:23.
[67] Sotah 10a.
[68] R' Eliezer the son of Joel HaLevi (1140-1220), Germany. Raaviah part one, tractate Shabbat 216.
[69] Steinsaltz, Adin (1968). Babylonian Talmud, Shabbat 65a. The Israeli Society for Talmudic Publications: Jerusalem.
[70] Shabbat 65a.
[71] The type of remedies which common sense cannot rationalize were called by Chazal "Emorite ways" and were permitted for medical needs: "Whatever is used as a remedy is not the ways of the Emorite" Shabbat 67a.
[72] Adin Steinsaltz tries to defend this medicine by writing, "The coin attached to the painful spot apparently prevented rubbing. It is also possible that the contact with metal also helped heal the wound. Even in our day some metal dusts are used as remedies" and completely ignored the Talmudic discourse and the demand that there be a figure on the coin.
[73] Encyclopedia Hebraica, entry Epilepsy (pp. 201-202).
[74] Michael David (5740). History. Volume 7, pamphlets 7-8 (5739). "The Empiricism of Hippocrates," second essay, 45, pg. 603. The Israeli Society for the History of Medicine: Jerusalem.
[75] Gittin 8a.
[76] For approximately nine minutes, the time it would take to walk half a mil.
[77] This demon resembles a lamb (Berachot 62a).
[78] Pesachim 112b.
[79] Ibid.
[80] Ibid.
[81] Yevamot 64b: "A man should not marry the daughter of an epileptic family."
[82] Epilepsy is considered a defect which invalidates a cohen from serving in the Holy Temple (Mishnah, Berchorot 7:5). It is considered a defect in a married woman, which, if discovered only after the wedding, allows the husband to divorce her without paying her marriage settlement (Mishnah, Ketubot 7:7).
[83] Shabbat 61a. One who reads Maimonides' Guide to the Perplexed, Part 3 chapter 37 will see that he wrote peony aids epileptics, through experience: "These things have been considered in those days as facts established by experiment. They served as cures, in the same manner as the hanging of the peony over a person subject to epileptic fits, or the application of a dog's feces to the swellings of the throat...For the Law permits as medicine everything that has been verified by experiment, although it cannot be explained by analogy."
[84] Rashi sometimes uses the term yarkon for the damage caused (Deuteronomy 28, 22) and sometimes tzahevet (Berachot 25a).
[86] Michael David (5740). History. Volume 7, pamphlets 11-12 (5740). "The Empiricism of Hippocrates," sixth essay, introduction, pg. 772. The Israeli Society for the History of Medicine: Jerusalem.
[87] Ninth essay, saying 61. This is another example showing that even great ancient physicians like Galen still held to a view of charm-based medicine. See note 1.
[88] Essay 12, saying 30.
[89] Berachot 25a.
[90] Bechorot 44b: "An overabundance of bile leads to jaundice."
[91] Bechorot 44b: "There are two holes in a man, one through which he releases urine and one through which he releases sperm, and there is only the thinnest of separations between them. If they should leak one into the other, he would be sterile."
[92] Berachot 25a.
[93] Yoma 84a. This is the opinion of Matya the son of Cherash on the opinion of the Sages that this remedy is not so effective it overrules the prohibition on eating forbidden meat.
[94] Bechorot 7b. The Gemara notes that this is the custom of people who drink donkey urine to heal jaundice.
[95] Shabbat 110a.
[96] Shabbat 66b. In the Palestinian Talmud, Eiruvin 10:26, it is said that five or seven or nine knots help.
[97] Shabbat 128b.
[98] Eiruvin 29b.
[99] Berachot 19a.
[100] The Mishnah, Shabbat 6:10. "One goes out [to the public domain on the Sabbath, though one violates a prohibition] with the egg of a chicken [for feebleness in the thigh] and the tooth of a fox [which helps with sleep problems] and the nail of a cross [which helps heal infected wounds] because they are medicine."
[101] According to Rashi's commentary on Pesachim 55b, "The tradition of our fathers." Rashi on Yoma 32a, "Halacha given to Moshe at Sinai."
[102]
"According to Talmudic precedent, which has a precedent in the New
Testament and Tacticus, the spittle of a man's firstborn (not just of the
mother) has the power to heal the eyes." Jacobowitz, Emanuel (5726).
Medicine and Judaism. Mossad HaRav Kook: Jerusalem (pg. 62).
Bava Batra 126b: "A
certain [person once] came before R. Hanina [and] said to him, 'I am certain
that this [man] is firstborn'. He said to him, 'Whence do you know [this]?' —
[The other] replied to him: 'Because when [people] came to his father, he used
to say to them: Go to my son Shikhath, Who is firstborn and his spittle heals'.
-- Might he not have been the firstborn of his mother [only]? -- There is a
tradition that the spittle of the firstborn of a father is healing, but that of
the firstborn of a mother is not healing." Thus was it also ruled in the
Shulchan Aruch Choshen Mishpat 277:13, "It is a tradition that the spittle
of a man's firstborn heals, but not that of a firstborn only to his
mother."
[103] Responsa Chavat Yair 234.
[104] The philosophy researcher Tzvi Wolfson wrote that he did not find a single philosophical concept in the whole literature of Chazal. Another researcher of Chazal, Saul Lieberman, answered that Wolfson found no philosophical concepts in Chazal because there were none to be found. Open University, "Jewish Philosophy in the Middle Ages, from Rabbi Saadiah Gaon until Maimonides," Unit 2, pg. 6.
[105] Exodus 19:5.
[106] Exodus, ibid.
[107] Exodus, ibid.
[108] I Chronicles 29:3.
[109] Deuteronomy 7:6.
[110] Bava Kama 87b and in the Tosephta on Bava Kama (Lieberman) 9:8.
[111] Nachmanides on Genesis 30:14.
[112] Sefer HaIkarim, second essay, chapter 16.
[113] Sefer Kuzari, essay one, section 95.
[114] R' Judah HaLevi supposes that the Divine power in the Jewish nation is genetic.
[115] Shabbat chapter 6, mishnah 10.
[116] Shabbat 67a.
[117] Commandment 62.
[118] Rabbi Shlomo the son of Aderet (1235-1310). Responsa of the Rashba, part one, section 413.
[119] The Vilna Gaon, Yoreh Deah 179:13, comes out strongly against Maimonides and writes: "All those who come after [Maimonides] disagreed with him, for there are many incantations in the Gemara. [Maimonides] was drawn to philosophy and therefore wrote that witchcraft and incantations and demons and amulets are all false. But they already knocked him on his head, for we have found many incidents in the Gemara using sacred names and witchcraft...and philosophy led him astray, causing him to interpret the Gemara in mockery and to tear it away from its simple meaning."
[120] Laws of Idolatry 11:16.
[121] Guide to the Perplexed part 2, chapter 25. Benedict Spinoza (Theological-Political Tractate, chapter 7, pg. 91, Hebrew University, Jerusalem, 5722) came out strongly against Maimonides' method of interpreting the Scriptures: "Therefore, the method of Maimonides is clearly useless: to which we may add, that it does away with all the certainty which the masses acquire by candid reading, or which is gained by any other persons in any other way. In conclusion, then, we dismiss Maimonides' theory as harmful, useless, and absurd" (pg. 93).
[122] In Tractate Yoma 83b the sages were divided on the cause of rabies: "Rav said witches toyed with it [the dog], and Samuel said an evil spirit is upon it. Following Samuel, they said to kill the dog by throwing things at it from the other side of the road. If he rubs against it he is endangered, and if he is bitten by it, he will surely die. If he rubs against it he is endangered. What can he do? Throw off his clothing and run. Rav Huna the son of Rav Joshua rubbed against such a dog, threw off his clothing and ran. He said, 'I fulfilled for myself what is written "Wisdom will grant life to its possessors".' One who is bitten will surely die. What can be done? Take the skin of a hyena and write an incantation upon it. He should take off his clothing and bury it [in the graves by the crossroads]; after a twelve-month he should unearth them and burn them in an oven, throwing the ashes at the crossroads. During the twelve-month he should drink water only through a straw made of brass, lest he see the demon [who jumped from the dog to him] reflected in the water and be endangered."
[123] In the Palestinian Talmud Yoma 8:45 they testify that eating the dog's liver does not help against rabies. "The servant of Rabbi Yudan the Nasi was bitten by a wild dog and he was fed the dog's liver, but it did not heal him."
[124] Mishnah Yoma 8:6.
[125] Ibid.
[126] Part 3, chapter 37.
[127] Shabbat 67a.
[128] A nail in the form of a cross helps heal infected wounds.
[129] The tooth of a fox helps one who has sleep problems.
[130] Shabbat 67a.
[131] In many instances Maimonides walks between the cracks--rational wisdom on the one hand and the Scriptures and the Talmud on the other. Thus, on the issue of witchcraft he wrote (Laws of Idolatry 11:16) "Anyone who believes in these things and their like and considers in his heart that they are true and matters of wisdom, but the Torah has forbidden them, is a fool and lacking in sense, like women and children, whose knowledge is lacking. Wise and innocent people clearly know that the things which the Torah has forbidden are not wisdom, they are chaos and nonsense to which those without sense are drawn, abandoning the ways of truth for them. Therefore the Torah spoke and warned against this nonsense, for you shall walk innocently with your God." On the other hand he wrote (Laws of the Fundamentals of Torah 8:1) "Israel did not believe in Moses our teacher because of the miracles he performed, for one who believes in miracles has a defect in his heart; miracles can be worked through magic and witchcraft." In the Vilna Gaon's commentary on Yoreh Deah 179:13 he comes out strongly against Maimonides and writes: "All those who come after [Maimonides] disagreed with him, for there are many incantations in the Gemara. [Maimonides] was drawn to philosophy and therefore wrote that witchcraft and incantations and demons and amulets are all false." It is the same thing with the issue of God's corporeality. On the one hand Maimonides wrote (Guide to the Perplexed part 1 chapter 36) "Therefore bear in mind that by the belief in the corporeality or in anything connected with corporeality, you would provoke God to jealousy and wrath, kindle His fire and anger, become His foe, His enemy, and His adversary in a higher degree than by the worship of idols. If you think that there is an excuse for those who believe in the corporeality of God on the ground of their training, their ignorance or their defective comprehension, you must make the same concession to the worshippers of idols: their worship is due to ignorance, or to early training, they continue in the custom of their fathers." On the other hand Maimonides explained that the Torah wrote things which point to corporeality as the Torah speaking according to the language of man, (Guide to the Perplexed part 1, chapter 26), "That is to say, expressions, which can easily be comprehended and understood by all, are applied to the Creator. Hence the description of God by attributes implying corporeality, in order to express His existence: because the multitude of people do not easily conceive existence unless in connection with a body, and that which is not a body nor connected with a body has for them no existence." He attributed the Torah with teaching corporeality by compulsion, which he later rejected. Thus it seems that Maimonides tried (unsuccessfully) to explain the remedies written about in the Talmud when faced with reason and experience by saying Chazal thought experience proved them out. Why should he not defend the witches and say they thought experience proved them out?
[132] Thus did Rashi explain Chulin 77a: "It has something of medicine about it -- such as a potion or drug or incantation whispered over a wound. It has nothing of medicine about it -- such as an act on an area not affected or burying the placenta at the crossroads."
[133] Shabbat 67a.
[134] A nail in the form of a cross helps heal infected wounds.
[135] The tooth of a fox helps one who has sleep problems.
[136] Shabbat 67a.
[137] In many instances Maimonides walks between the cracks -- rational wisdom on the one hand and the Scriptures and the Talmud on the other. Thus, on the issue of witchcraft he wrote (Laws of Idolatry 11:16) "Anyone who believes in these things and their like and considers in his heart that they are true and matters of wisdom, but the Torah has forbidden them, is a fool and lacking in sense, like women and children, whose knowledge is lacking. Wise and innocent people clearly know that the things which the Torah has forbidden are not wisdom, they are chaos and nonsense to which those without sense are drawn, abandoning the ways of truth for them. Therefore the Torah spoke and warned against this nonsense, for you shall walk innocently with your God." On the other hand he wrote (Laws of the Fundamentals of Torah 8:1) "Israel did not believe in Moses our teacher because of the miracles he performed, for one who believes in miracles has a defect in his heart; miracles can be worked through magic and witchcraft." In the Vilna Gaon's commentary on Yoreh Deah 179:13 he comes out strongly against Maimonides and writes: "All those who come after [Maimonides] disagreed with him, for there are many incantations in the Gemara. [Maimonides] was drawn to philosophy and therefore wrote that witchcraft and incantations and demons and amulets are all false." It is the same thing with the issue of God's corporeality. On the one hand Maimonides wrote (Guide to the Perplexed part 1 chapter 36) "Therefore bear in mind that by the belief in the corporeality or in anything connected with corporeality, you would provoke God to jealousy and wrath, kindle His fire and anger, become His foe, His enemy, and His adversary in a higher degree than by the worship of idols. If you think that there is an excuse for those who believe in the corporeality of God on the ground of their training, their ignorance or their defective comprehension, you must make the same concession to the worshippers of idols: their worship is due to ignorance, or to early training, they continue in the custom of their fathers." On the other hand Maimonides explained that the Torah wrote things which point to corporeality as the Torah speaking according to the language of man, (Guide to the Perplexed part 1, chapter 26), "That is to say, expressions, which can easily be comprehended and understood by all, are applied to the Creator. Hence the description of God by attributes implying corporeality, in order to express His existence: because the multitude of people do not easily conceive existence unless in connection with a body, and that which is not a body nor connected with a body has for them no existence." He attributed the Torah with teaching corporeality by compulsion, which he later rejected. Thus it seems that Maimonides tried (unsuccessfully) to explain the remedies written about in the Talmud when faced with reason and experience by saying Chazal thought experience proved them out. Why should he not defend the witches and say they thought experience proved them out?
[138] Part 1 section 413.
[139] See Responsa Chavat Yair, section 234 [Rabbi Yair Chaim the son of Moshe Shimshon, 1638-1702, Germany]. From his answer it can be argued that even in the 17th century rabbis who dealt with Halacha still relied upon the common people in all connected to remedies: "You asked about incantations; some women know which to apply to which pains and which problems. Are they Emorite ways or not?...[Answer] In practical terms, of whatever has spread amongst the women we have found it said what is popular amongst Israel has probably been proven by experience and we have been taught to permit such things as encircling a child whose fever has risen and is starting to show signs of pox, though not eruptions, with a ring taken off the finger of one dead, etc." This is a wonderful testimony to our statement that there was no methodical research, even after the scientific revolution, and certainly not in the ancient era, in the time of the sages of the Babylonian Talmud; they relied on the customs of women, on incantations, and on placing rings of dead people to cure the pox. From this they ruled Halacha.
[140] Margalit, David (5722). The Sages of Israel as Physicians. Mossad HaRav Kook: Jerusalem. (pg. 38).
[141] According to Margalit, it is a tube as thick as the core of a cabbage, see the note on pg. 39. The Talmudic commentators did not explain it as he does, ibid.
[142] Nedarim 50b.
[143] Margalit writes: "Samuel was a sage and perfect in knowledge of medicine, in keeping with the scientific levels of our own times. His guiding lights were the Greek Hippocrates and the Roman Galen" (pg. 66). Margalit did not bring proof or comparisons of the words of Samuel and those of the Greek physicians, he merely wrote this as an accepted conclusion. It would have been appropriate to bring proof and support for his claims.
[144] Chulin 28a.
[145] Chulin 28a.
[146] Chulin 45b.
[147] See the pamphlet I wrote, posted on the Daat Emet site: http://www.daatemet.org.il/pamphlets/en_pamphlet2.html
[148] In the periodical History by the Israeli Institute for the History of Medicine: Jerusalem, pg. 804.
[149] Ibid. pg. 807.
[150] Turner, Eli. History (5742). Volume 8, pamphlets 3-4, The Israeli Society for the History of Medicine: Jerusalem.
[151] Bava Kama 85a.
[152] The Mishnah in Shabbat 8:1 treats honey as a cure through slathering on wounds. "One who takes out [on the Sabbath]...honey to put it on a wound" and the Gemara (78a) explains that this is special honey, more effective for the treatment of wounds than other liquids.
[153] Nedarim 54b.
[154] Beit Yosef Yoreh Deah 116:2, from the Gemara in Pesachim 76a.
[155] Berachot 44b.
[156] Judaism, the Jewish Nation, and the State of Israel, pg. 339.
[157] Berachot 35b. "And you shall gather in your corn. What is to be learned from these words? Since it says [Joshua 1] 'This book of the law shall not depart out of your mouth,' I might think that this injunction is to be taken literally. Therefore it says, 'And you shall gather in your corn', which implies that you are to combine the study of them with a worldly occupation [work and earning a living]. This is the view of R. Ishmael."
[158] Bava Kama 85a, "'And to heal he shall heal' [is the source] whence it can be derived that authorization was granted [by God] to the medical man to heal."
[159] Shulchan Aruch Orach Chayim 328:10.
[160] Ibid.
[161] Avodah Zarah 12b.
[162] Beit Yosef Orach Chayim 328:6.
[163] See above in the explanation of scurvy.
[164] Rabbi Yosef Teumim (1727-1792, Frankfurt), Eshel Abraham Orach Chayim Laws of Sabbath 328:2.
[165] See above.
[166] Tzitz Eliezer part 19, section 29.
[167] Yoma 83b.
[168] Shabbat 133b.