Chapter 192 : The laws of one who is sick, the doctor and the remedies

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§1

Rabbi Yitzhak the son of Rav Yehuda said: ¹ "A person should always seek mercy so that he shouldn't fall sick" "If he falls sick they say to him bring some merit ² to exempt yourself. ³ " Mar Ockba said: "Where is it written that 'if anyone falls from it' ⁴ from this we can bring proof, meaning that after he falls we need to find from him and from his deeds evidence to his credit." There is more from the Gemara: ⁵ "If he has a headache it will seem to him that he has on a neck-chain" "His (health) deteriorated and he had to stay in bed it will seem to him like being brought upto the gallows" (the place where one is judged for capital offences) "To judge, for all who go upto the gallows to be judged, if he has powerful advocates will be saved but if not won't be saved." And what are the advocates of a man? Repentance and good deeds. Even if nine hundred and ninety nine present his faults and one presents his good deeds, he will be saved. As it is said: ⁶ "If there be an angel over him, an interpreter, one among a thousand, to declare to man what is right. Then he is gracious to him, and says 'deliver him from going down to the pit etc' "

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1. Shabbat 32A
2. Good deeds.
3. To obtain relief from his illness.
4. Deut. 22:8 - lit; "if the one who is going to fall, falls from it". That is, this person was sentenced by Heaven to fall off a roof because of his sins. The Rabbis believed that all bodily harm, including illness, comes on one because of our sinful behaviour.
5. Shabbat 32A.
6. Job 33:23-24.

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§2

Rabbi Pinchas, the son of Chama, preached: "Anyone who has a sick person in his house should go to a (Torah) sage and ask him to plead for mercy on his behalf, as it is said: ¹ "The wrath of a king is as messengers of death, but a wise man will pacify it." It is customary to give charity to the poor on his (the sick person's) behalf, for "Repentance, Prayer and Charity avert the evil decree." It is also customary to bless the sick in the synagogue, and if he is dangerously ill, one blesses him even on Shabbat or a festival. ² Sometimes one changes the name of the sick person because also a change of name can break the evil decree.

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1. Proverbs 16:14.
2. Normally prayers for the sick are only said during the weekly Torah reading on Mondays and Thursdays.

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§3

The Torah has granted permission to a doctor to heal, as it is said: ¹ "And he shall be thoroughly healed." Therefore the sick person should not rely on a miracle, rather he is obliged to act the normal way and call a doctor to heal him. Already several righteous people were cured by doctors, and one who avoids calling a doctor, does two evils. Firstly, that it is forbidden to rely on a miracle when one is in danger, and this may cause his sins to be remembered while he is ill, and (secondly) he shows presumption and pride by relying on his righteousness that he will be cured by a miracle. One should call for the most expert doctor, but nevertheless, his heart should (turn to) heaven and request mercy from the Faithful Healer, Blessed be His name, and only in Him should his heart trust.

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1. Exodus 21:19.

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§4

It is a mitzvah for the competent doctor to heal. This is in the rule of saving a life, and if he avoids doing this, then this is like shedding blood, even if the sick person has another doctor, because not from everybody will he be healed, and maybe he was (chosen) by Heaven to cure him. However, one should not practice medicine unless one is competent and there is no (doctor) more skilled there, otherwise he is (guilty) of bloodshed.

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§5

A sick person who is not in danger, if he can be cured by a permitted substance, ¹ even though he needs to wait a little until it is obtained, is not allowed (to use) a forbidden substance. ² If he especially needs a forbidden substance, if he needs to eat it the normal way it is eaten, he is forbidden to eat it even if it's only prohibited by Rabbinic decree, because he isn't in danger. However, (eating it) without pleasure, for example by mixing it with something bitter, and also to make from it a plaster or the like, is allowed even with a substance that is forbidden to enjoy from the Torah, except for mixed seeds in a vineyard ³ and meat with milk which are forbidden even in a way which doesn't give pleasure as long as there isn't danger. (For the laws of the blessings on what one eats or drinks as medicine see further in Ch. 50:8 and Ch. 61:4 For the laws of a young child who needs to eat Chametz on Pesach see further at the end of Ch. 117). ⁴

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1. Which is kosher.
2. Which is non-kosher.
3. "Kelayim" see Ch. 174:3.
4. Ch. 117:12.

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§6

Some (authorities) say that all substances which are forbidden by Rabbinic decree are permitted for medical use, even for a sick person who is not in danger, and even in a way that gives enjoyment, as long as he doesn't eat or drink the forbidden substance.

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§7

One who is dangerously ill may be treated with any forbidden substance, because nothing stands in the way of saving life except idolatry, incest and murder, about which one must give up one's life rather than transgress, so one mustn't (commit any of these three things) in order to be cured.

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§8

A doctor is allowed to take blood ¹ and feel the pulse and the rest of the places on a woman even a married woman, and even her hymen ² in the way doctors do it, ³ since he is not doing it in a sensual or affectionate way, but carrying out his profession. In the case of his (own) wife when she is having a period, he should be stricter, ⁴ as long as she is not in danger and there is another doctor who is equally qualified. (see further Ch. 153:14 and there it is explained whether a menstruating woman can have physical contact with her husband when he is ill, or whether he can with her, and see further Ch. 143:15 whether a son can take blood from his father and similar actions).

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1. This is blood-letting which was believed in their time to be a treatment for many ailments.
2. lit; "the torn place".
3. Such as gynecologists and urologists.
4. A husband is not allowed to have physical contact with his wife while she is having a period. See Ch. 153:5.

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§9

Concerning one who has a bowel disease the man should not touch the woman, lest his urges overcome him, since he is healthy, but the woman can touch a man because he is ill.

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§10

One who has medicines and his neighbour is ill and needs them, אסור לו להעלות בדמיהם יותר מן הראוי is forbidden to raise their price above the (normal) accepted level.