Monday, April 15, 2024

Jewish Health Advisory- Reflections on Leviticus portions of Tazria and Metzoranecology, Dermatology, and Epidemology


For a link to the video:

Jewish Health Advisory



We have a discussion in the Talmud about best professions:

Rabbi Yehuda says in Abba Gurya’s name: Most donkey drivers are wicked( they let their animals graze and damage others property), and most camel drivers, are of fit character( the dangers of the desert make them pray very well). Most sailors are pious ( when the ship is about to sink, they, too, pray very well—see Jonah).


And then

 The best of doctors is to Gehenna, and even the fittest of butchers is a partner of Amalek.


Doctors and butchers??? Well, the butcher may not give you the choice cut of beef, but the Doctors?


Rashi explains, maybe from his own experience:


The best of doctors is to gehenna - They do not fear disease. They eat the food of the healthy, and they do not act humbly before God. Sometimes they kill, and sometimes they are able to heal a poor person but do not do so.


So why are so many Jews doctors? 14% of US doctors are Jewish ( out of 2% population).


Part of it is recent history—Jews in Europe went in to medicine because it was one of the few professions open to them—it was not consider prestigious in its day.

But much of it may come from the general Jewish attitude to protecting health.




Our Portion for this week and next week, Tazria and Metzora== may read as a Jewish guide to Gynecology, Dermatology, and Epidemology.

Tazria- opening Lev 12 : Speak to the Israelite people thus: When a woman at childbirth bears a male, she shall be impure seven days; she shall be impure as at the time of her condition of menstrual separation.

—Which leads to a Rabbinic discourse on how to guarantee male children by satisfying the woman first, and how the husband has to let his wife alone long enough for her to recover fully. It leads to the Samaritans, who share our Torah, giving the wives full vacation during the week of impurity- so that the women party among themselves and the husband has to clean and cook!

In Yemen, it led to special treatment for the birthing mother for a month, as she sits on her throne and is catered to!


By the way, when it comes to childbirth, Jews and Vatican are miles apart. The Vatican just condemned surrogacy because it exploits women as a child bearing machine—but just the same can be said of adoption. In both cases, there can be abuse, but in both cases, it enables someone who desires a child to have one—and we have in our extended family, adopted children and children from surrogacy. Then, IVF—again, in Jewish practice, it is approved for the same reason-to have a child is a mitzvah, and to make that possible, is a mitzvah.

By the way, as for surrogacy- well, Abraham did it at Sarah’s request, and a third of Jacob’s son’s were from surrogate mothers as well.


Then, we get to Dermatology: Lev 13

When a person has on the skin of the body a swelling, a rash, or a discoloration, and it develops into a scaly affection on the skin of the body, it shall be reported to Aaron the priest or to one of his sons, the priests.

The priest shall examine the affection on the skin of the body: if hair in the affected patch has turned white and the affection appears to be deeper than the skin of the body, it is a leprous affection; .. impure.

But if it is a white discoloration on the skin of the body which does not appear to be deeper than the skin and the hair in it has not turned white, the priest shall isolate the affected person for seven days.  …And another seven days, and then…

On the seventh day the priest shall again conduct an examination: if the affection has faded and has not spread on the skin, the priest shall pronounce the person pure. It is a rash; after washing those clothes, that person shall be pure.

The disease is translated a “leprosy” but it, more correctly ,a kind of Psoriasis.


Epidemology: Lev 13:45

As for the person with a leprous affection: the clothes shall be rent, the head shall be left bare, and the upper lip shall be covered over; and that person shall call out, “Impure! Impure!”

The person shall be impure as long as the disease is present. Being impure, that person shall dwell apart—in a dwelling outside the camp.


Isolation, but note--  it is a temporary condition.


So, maybe from these, we get a Jewish interest in medicine.



There are elements of the Torah that speak to cleanliness, as well as spiritual cleaning, and issues of personal hygiene.

So here are some random examples of Jewish approaches to health.

One of the important actions of  Aaron and his sons is to wash hands and feet in a copper basin before they enter the Mishkan to offer incense - so that they do not die!(Ex 30:17-21)

 An example of washing for purity in the Torah  . Did they know something about copper that we don’t? Viruses last the shortest time on copper. … ( Always, fresh, flowing water, not from a standing pool)

*Which brings us to the idea of Netilat Yadayim: Hand washing. Why the hands?

Talmud Shabbat 14a וְהַיָּדַיִם — מִפְּנֵי שֶׁהַיָּדַיִם עַסְקָנִיּוֹת הֵן

 And the hands; hands are busy. A person’s hands tend to touch dirty or impure objects.  inappropriate for holy food to be touched by dirty hands, the Sages decreed impurity. ( Translation and explanation from


What did your mother teach you?- Wash your hands!


What about bodily waste? I once read a text from a medieval European work, complaining about “ supersticio judeorum”—Jewish superstitions- such as not praying near a spot where there is urination. There is the direct Biblical imperative to bury bodily waste and not leave it in the open. Deut 23:14


Let’s look at some other Jewish health directives:


Our Torah is life oriented, so that life takes precedence over other obligations:

 Yoma 85b

  Rabbi Yosei, son of Rabbi Yehuda “But keep my Shabbatot” (Exodus 31:13). to everyone in all circumstances?; therefore, the verse states “but,” there are circumstances where one must keep Shabbat and circumstances where one must desecrate it, i.e., to save a life. Rabbi Yonatan ben Yosef says that it is stated: “For it is sacred to you” (Exodus 31:14). This implies that Shabbat is given into your hands, and you are not given to  Shabbat.

…. Rav Yehuda said that Shmuel said: If I would have been there among those Sages who debated this question, I would have said that my proof is preferable to theirs, as it states: “You shall keep My statutes and My ordinances, which a person shall do and live by them” (Leviticus 18:5), and not that he should die by them. In all circumstances, one must take care not to die as a result of fulfilling the mitzvot.

How was that employed during the time of plagues>

From  The Rabbi Who Ate on Yom Kippur:Israel Salanter and the Cholera Epidemic of 1848-Ira Taub

Despite the prohibition against doing work on Shabbat (the Jewish Sabbath), Rabbi Salanter set an example for the Lithuanian Jewish community during the cholera epidemic of 1848. He ensured that any necessary relief work on Shabbat for Jews was done by Jews. Although some wanted such work to be done on Shabbat by non-Jews, Rabbi Salanter held that both Jewish ethics and law mandated that the obligation to save lives took priority over other laws. During Yom Kippur (the Day of Atonement), Rabbi Salanter ordered that Jews that year must not abide by the traditional fast, but instead must eat in order to maintain their health, again for emergency health reasons.[9] Some claim that, to allay any doubts, he himself went up to the synagogue pulpit on that holy day, recited the Kiddush prayer, drank and ate - as a public example for others to do the same.

Then , another example:

1836 responsum R. Moses Sofer ( Chatam Sofer) (Schreiber) Father of the Orthodx resistance to modernity. He argued that, when faced with the danger posed by cholera, the prohibition against eating on Yom Kippur could be suspended even for a healthy person, and even where the mere possibility exists that such an action could be life-saving. However, he prefers that less extreme measures be taken where possible, even to the point of avoiding any public prayer on Yom Kippur, rather than suspending the fast.


What about active intervention? Am I meddling in an act of God? Some Christian groups, like Christian Scientists, see illness as something to be dealt with spiritually, for example.

From my colleague: Rabbi Noah Golinkin (3 Shevat 5766)

Question: It says in the Torah “for I the Lord am your healer” (Exodus 15:26). If so, why do Jews practice medicine and consult doctors? Why don’t we simply pray to God to heal us like Christian Scientists?

I) We Should Pray to God and Not Use Doctors

A snake says: “If I was not told by Heaven to bite, I would not bite” (Yerushalmi Peah, Chapter 1, 16a bottom). Hanina ben Dosa, a talmudic wonder-worker said: “The snake does not kill; sin kills” (Berakhot 33a and parallels). A few statements opposed to medicine can also be found in rabbinic literature. The Mishnah (Kiddushin 4:14) says “tov shebarofim l’gehinom” – “the best of physicians to hell” while Avot D’rabi Natan (Version A, Chapter 36, ed. Schechter p. 108) says that “Seven do not have a place in the world to come: a clerk, a scribe, tov shebarofim – the best of physicians, a judge in his city, a magician, a hazzan, and a butcher”.  ( But see item VI below!) [ Again, the poor doctor and butcher are in the same boat!]

II) People Do Not Have the Right to Heal, But it is Their Custom to Do So

Berakhot (fol. 60a at bottom):A person who goes in to bloodlet says: “May it be your will Oh Lord my God that this procedure cure me, for you are a loyal healer and your healing is true, for people do not have the right to heal but it is their custom to do so”

III) A Combination of Prayer, Sacrifices and Doctors

The third approach is found in the book of Ben Sira ,Chapter 38 (verses 1-15, ed. M. Z. Segal, p. 243) that people should honor doctors because God gave them wisdom and they should not refuse medicines which come from the earth and exhibit God’s power. When a person gets sick he should “pray to God for he will heal”, offer sacrifices “and also give a place to the physician for there is need of him too” and one should not oppose him.

IV) ” From Here We Derive That a Physician Has Permission to Heal”

In two places in the Talmud ( Berakhot 60a and Bava Kamma 85a), we find the following passage: It was taught in a baraita in the academy of Rabbi Yishmael: ” Verapo yerapeh – and he shall verily cure him”. [Why the double verb?] From here we derive that a physician has permission to heal. Tosafot comment- this includes injury inflicted by humans and injury inflicted by disease.

V) “Permission to Do a Mitzvah”

In the Shulhan Arukh ( Yoreh Deah 336:1) written in Safed ca. 1550, Rabbi Yosef Karo rules as follows:The Torah gave the doctor permission to heal, and it is a mitzvah , and it is part of pikuah nefesh , and if he avoids healing, he is spilling blood [=a murderer].

VI) A Sage May Not Live in a City Without a Doctor

  A Baraita in Sanhedrin (17b) states: Any city lacking these ten things, a Sage may not live there: a Bet Din. a basket for tzedakah .a synagogue, a bath house, a latrine, a doctor, a bloodletter, a clerk, a butcher, an elementary school teacher.[Now the doctor and the butcher are in a good place together!]

VII) A Doctor Helps God Heal the Sick –

Midrash Shmuel :It happened that Rabbi Ishmael and Rabbi Akiba were strolling in the streets of Jerusalem with another man. They encountered a sick person who said to them, “My Masters, tell me with what should I be healed?”

 They told him: “Take such-and such until you are cured”. The person who was with them said to them:

“Who afflicted this man with sickness”?

They said: “The Holy-One-blessed-be-He.”

 He said to them: “And you interfered in an area which is not yours! He afflicted and you heal?”

They said to him: “What is your occupation?”

He said to them: “I am a farmer, as you can see by the sickle in my hands.” They said to him : “Who created the field and the vineyard?” He said: “The Holy-One-blessed-be-He.” They said to him: “And you interfered in an area not yours? He created these and you eat their fruit?

”He said: “Don’t you see the sickle in my hand? If I did not go out and plow the field, cover it, fertilize it, and weed it, nothing would grow!”

They said to him: “Fool! Could you not infer from your occupation that which is written, ‘as for man, his days are as grass’ (Psalms 103:15). Just as with a tree, if it is not fertilized, plowed, and weeded, it does not grow, and if it already grew but then is not watered, it dies; so the body is the tree, the fertilizer is the medicine, and the farmer is the doctor.” ( Midrash Shmuel 4:1).

VIII) A Sick Person Must Call a Doctor, But He Should Continue to Trust in God

Rabbi Hayyim Yosef David Azulay (the Hida, 1724-1806) ruled that today, a sick person may not rely [on] miracles and must follow the way of the world and call a doctor to heal him. And it is not in his power. to say that he is greater than the pious ones throughout the generations who were healed by doctors, and it is almost forbidden [not to call a doctor] either because of yohara [haughtiness] or because of relying on a miracle. Rather he should follow the common custom of being healed by a doctor, but he should not rely on the doctor but pray to God with all his heart and trust in Him.


Finally, back to our quote about the Jewish doctor going to Gehenna:

IX) It is a Mitzvah for a Doctor to Heal People

This is the approach of Maimonides which he states in at least four places in his writings. He first addressed the issue in his commentary to the Mishnah ( Nedarim 4:4) which he completed in 1168 at the age of 30. The Mishnah says there that if Reuven took a vow that he will not derive any benefit from Shimon, Shimon may still heal him. Maimonides explains that this is “because it is a mitzvah , that the doctor is required by law to heal Jewish patients [as the Sages said] ‘and you shall return it to him’ (Deut. 22:2) – this comes to include his body” (Also see Maimonides, Mishneh Torah, Hilkhot Nedarim 6:8; Commentary to Mishnah Pesahim 4:10; Shemonah Perakim, Chapter 5).

As a doctor once told me, avoid going to doctors, but I don’t think he took it literally  himself. Then, another doctor told me, the worst patients were his Jewish ones== each one had a cousin who is a doctor, and suddenly, they , too, were experts!!

So, above all else, may you be blessed not to have to go to the doctor’s office, and if you do, it should be short, sweet, and productive for good health.

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