Traditional Jewish Healing in Theory and Practice

By Rabbi Avraham Greenbaum

Chapter 4

The Rabbinic Tradition

The Talmud reports that the Sages of Israel endorsed King Hezekiah's action in concealing the Book of Remedies (Pesachim 56a). Hezekiah had sought to instill trust in God and faith in the Torah and mitzvot as the exclusive Jewish pathway of healing. To what extent did this remain at the center of the healing lore of the Rabbis of the Talmud and Midrash?

Many rabbinic sayings attest to the superiority of the Torah's healing power over that of natural medicine. "Rav Yehudah the son of Rabbi Chiya said, Come and see the difference between God and human beings. When a human being prescribes a medicine it may be good for one person but harmful to another. Not so the Holy One, blessed be He. The Torah He gave to the Jewish People is an elixir of life for the whole body, as it is said (Proverbs 4:22): `and health to all his flesh'" (Eruvin 54a).

"Rabbi Yehoshua ben Levi said, Someone with a headache should busy himself with Torah, as it is said, `For they shall be a diadem of grace for your head' (Proverbs 1:9). Someone with a sore throat should busy himself with Torah, as it is said, `and chains about your neck' (ibid.). Someone with stomach pains should busy himself with Torah, as it is said, `it shall be health to your navel' (ibid. 3:8). Someone with aching bones should busy himself with Torah, as it is said, `and marrow to your bones' (ibid.). And if his whole body is aching, he should busy himself with Torah, as it is said (ibid. 4:22), `and health to all his flesh'" (Eruvin ibid.).

Not only does the Torah heal: it prevents illness in the first place. The point is brought out in the following midrash: "Is a Jew who is suffering from an ear-ache allowed to have medical treatment on Shabbat? Yes: the Sages taught, Wherever there is a possibility of danger to life one may violate Shabbat. Thus an earache, which can be a threat to life, may be treated on Shabbat. But do you want to avoid getting an earache, or indeed any other pain, in the first place? Then turn your ear to the Torah and you'll inherit life, as it is written, `Incline your ear and come to Me, hear and your soul shall live' (Isaiah 55:3). For as Rabbi Levi said, Man is made up of two hundred and forty-eight limbs, and all of them receive vitality from the ear" (Devarim Rabbah 10:1).

The biblical teaching that injury and illness are sent from God is reflected in many rabbinic sayings. "Nobody bruises so much as a finger here on earth unless it was decreed against him in Heaven" (Chullin 7b). "A snake only bites a person when a command from Heaven forces it to do so" (Yerushalmi Peah 1, 16a). And just as God sends the blow, so God alone can heal. "R. Alexandri said in the name of R. Chiya bar Abba: Recovery from illness is a greater miracle than Chananiah, Mishael and Azariah's being saved from Nebuchadnezzar's furnace (Daniel 3). Anyone can put out a man-made furnace, but the furnace of sickness is made by Heaven - who can put it out?" (Nedarim 41a).

"If you see a Jew who has symptoms of one of the four kinds of leprosy mentioned in the Torah, it comes only to heal him of all his sins, and through his suffering he merits the World to Come" (Tanna de-vei Eliahu 5).

Since it is God Who heals, the sick person's first step must be to turn to Him sincerely. "When a person sees that suffering has come upon him he should carefully examine his behavior" (Berakhot 5a). "R. Alexandri said in the name of R. Chiya bar Abba, One who is sick cannot be healed unless he is first forgiven for all his sins" (Nedarim 41a). "Rabbi Meir used to say, Two people take to their beds with the same illness. One recovers while the other does not. One prays and is answered, the other prays and is not. Why is one answered and the other not? Because this one prayed with true sincerity while the other did not" (Rosh HaShanah 18a).

Besides the prayers of the invalid himself, those of others can also help. "If a person is sick for more than a day, he should let people know so that they will pray for him" (Berakhot 55b). Especially effective are the prayers of the saintly. "Someone who has a sick person in his house should go to a Sage and ask him to pray for him" (Bava Batra 116a). Thus Rabbi Chaninah ben Dosa would pray for the sick, and if his prayers flowed forth without hesitation or error he knew that the patient would recover (Berakhot 34b). Some of the tzaddikim had other ways of channeling the healing power of the Torah. When R. Chiya bar Abba was sick, Rabbi Yochanan stretched out his hand to him and healed him. Rabbi Yochanan did the same to R. Eliezer. Yet when R. Yochanan himself became ill he could not heal himself because "a prisoner can't release himself from prison." But R. Chaninah came to him, stretched out his hand and healed him (ibid. 5b and see below pp. 138 and 149ff.)..

Sanction to heal?

These teachings show clearly that the talmudic Sages viewed physical illness as a manifestation of what is at root a spiritual problem. It follows that true healing can come about only when the spiritual flaw is repaired by the sick person himself with the help of a Tzaddik who prays for him and guides him in his repentance. But does this mean that as long as we attend to our spiritual health we can leave our physical health to take care of itself?

"Take care of yourself and guard your soul diligently" (Deuteronomy 4:9). The Rabbis were emphatic that we have a duty to take all reasonable precautions to guard our physical health and avoid becoming sick in the first place. When they said that "everything is in the hands of Heaven except chills and colds" (Bava Batra 144b), they were not implying that the power of Heaven is anything but total. What they meant is that we must use our common sense and take responsibility for our physical welfare. The world we live in contains good and evil on every level, physical as well as spiritual. Having been created with the freedom to choose between them, we have an obligation to avoid not only cold drafts but all other obvious health hazards as well. The Talmud therefore offers practical advice about general hygiene, healthy elimination, washing and bathing, exercise, and especially diet, since "more people are killed by the cooking pot than suffer from starvation" (Shabbat 33a).

So much for preventive medicine. What about when illness strikes? While taking the biblical viewpoint that the roots of illness are spiritual, did the talmudic Sages follow King Hezekiah in his rejection of all physical strategies of healing?

In fact the Talmud itself contains a wealth of practical medical advice including detailed herbal and other remedies for all kinds of problems from toothache and stomach pains to fever and heart complaints (see Gittin 67b-70b, Avodah Zarah 28a-29a, etc. and Julius Preuss, Biblical and Talmudic Medicine). Moreover, throughout the Talmud and Midrashim there are innumerable references to the רופא  (rophe) or אסיא  (asya), "healer" or "physician," who treated ailments ranging from eye infections, bone fractures and snakebites to gangrene and consumption. Another familiar figure in the world of the Talmud was the אומן  (uman), the "blood-letter." Some physicians are referred to as רופא מומחה  (rophe mumcheh), an "expert healer." There were also scholars who, although they did not practice as professional doctors, were considered authoritative in medical matters, such as Mar Shmuel (c. 200 C.E.), head of the rabbinical academy of Nehardea.

Where the opinions of physicians might have a bearing on questions of ritual, civil and criminal law, they were sought and respected by the Rabbis. But what was the Rabbis' attitude to actual medical treatment? As with any detail of life, before asking if it is desirable, the first question a Jew asks is whether it is permissible. If King Asa was criticized for going to doctors, did that mean that nobody should go to a doctor? In hiding the Book of Remedies was Hezekiah seeking to forbid resort to medicine for all time?

On the general question of the permissibility of medicine, nowhere is there any suggestion that the use of physical therapies is actually forbidden. While the Rabbis unquestionably saw faith, prayer, Torah and mitzvot as the essential elements of the Jewish path of healing, unlike King Hezekiah they made no efforts to prevent resort to medical remedies as long as they did not involve transgression of the prohibitions against idolatry, sexual immorality and murder (Pesachim> 25a). Doctors were consulted on all kinds of medical problems without opposition from the Rabbis, some of whom themselves received treatment on occasion, such as Rabbi Yehudah HaNasi, who was treated by Mar Shmuel for an eye ailment (Bava Metzia 85b). The Talmud itself advises against living in a city that does not have a doctor (Sanhedrin 17b).

In the centuries following the destruction of the Second Temple the talmudic Sages faced very different conditions from those that had existed in Hezekiah's time, when there was no division between state and religion. Hezekiah was at once a spiritual and a political leader, and had sufficient influence to "put away the Book of Remedies" as part of a more general religious revival. But in talmudic times the Jews were already in exile and living side by side with adherents of all kinds of other religions and cults. The medicine of the non-Jews was a mix of physical therapies and idolatrous rites. While the talmudic Sages made every effort to lead the people in the traditional Jewish path of faith, their primary concern in their halakhic deliberations was to clarify what Torah law explicitly forbids and what it permits. The Talmud and later halakhic literature therefore discuss an enormous range of medical questions, such as receiving treatment from a doctor who worships idols, the permissibility of various medical procedures on Shabbat and festivals, abortion when the life of the mother is at risk, the obligation of sick people, new mothers, etc. to fast, the extent of liability in cases of injury, etc.

Whether the talmudic Sages favored the use of medical remedies or not is another question altogether. There is a revealing passage in the Talmud (Berakhot 60a) on the subject of blood-letting, in those days a common procedure used for a variety of conditions. "Rav Acha said: Someone going in for blood-letting should say, `May it be Your will, HaShem my God, that this operation should be beneficial to my health. Heal me, for You, God, are the faithful Healer and Yours is the true healing, because it is not the way of human beings to bring about a cure, but this is the practice."

Commenting on the last part of the prayer, "it is not the way of human beings to bring about a cure," Rashi (ad loc.) explains: "That is to say, people ought not to have recourse to medical treatments but should rather pray for mercy." "But this is the practice" - i.e., despite this, people do resort to medicine because they fear their merit may not be sufficient to allow them to expect to be healed through a miracle. The last part of the prayer is effectively an apology by the supplicant for using a physical strategy of healing instead of relying on God alone (see Turey Zahav on Shulchan Arukh, Yoreh Deah 336:1). The feeling that resort to medicine betrays a lack of faith is clearly an echo of King Hezekiah's tradition.

However, in a rejoinder to this way of thinking, the Talmud (Berakhot ibid.) immediately quotes Abaye: "A person should not say this [last part of the prayer], because the Academy of Rabbi Yishmael deduced from the words `he shall cause him to be thoroughly healed' (Exodus 21:19) that the physician has sanction to heal." According to this second view, there is no question that God is the Healer, but He may grant the physician the power to heal as His agent. This is derived from the biblical passage decreeing that one who causes injury to another has an obligation to "cause him to be thoroughly healed." According to the Oral Law, this means that he must cover the injured party's medical expenses (Bava Kama 83b), implying that medicine is effective.

This latter viewpoint is vividly expressed in a midrash telling of a sick man who approached Rabbi Yishmael and Rabbi Akiva as they were walking in Jerusalem one day. The sick man asked the two rabbis what he should do to be cured. They gave him a number of recommendations, upon hearing which a farmer who had been listening said to them, "You're interfering in something that's none of your business! God afflicted him with illness and you want to heal him?" "But don't you as a farmer do the same?" they replied. "God created the earth, but you have to plow, till, fertilize and weed if you want the land to yield produce. `As for man, his days are as grass' (Psalms 103:15). The human body is the tree, the medicine is the fertilizer and the physician is the tiller of the earth" (Midrash Shmuel 52a #4).

Judaism rejects the fatalistic view that if God sends illness it must be borne with complete resignation without making any efforts to overcome it. It is up to us to take the initiative to seek healing. The question is: what kinds of steps are we to take? The tradition of Rabbi Yishmael, as reflected by Abaye, accepted the use of medical strategies of healing. Certainly we must know that illness is sent from Heaven. We must direct ourselves to repentance and prayer even as we turn to doctors and undergo treatment. We must know that ultimately God is the Healer even when the cure is channeled through the agency of a person, a substance or an operation. But we may resort to doctors and medicine without qualms since "the physician has sanction to heal."

On the other hand, the tradition of King Hezekiah, while certainly rejecting fatalistic resignation, holds that action in the spiritual realm alone has the power to bring complete healing without resort to physicians and medicines. It is up to us to take the initiative, but the very essence of what we have to do is to cry out to God, search our hearts and seek healing through the redemptive joy of the Torah and mitzvot. This view finds an echo in the sentiments expressed at the end of Rav Acha's prayer before blood-letting as Rashi explains them: "People ought not to have recourse to medical treatments but should rather pray for mercy." The same view is expressed even more directly in the rabbinic statements quoted earlier about the power of the Torah to heal the entire body (see p. 29).

These divergent tendencies are reflected in the views of later rabbinic authorities. Many of them took the statement that the doctor has sanction to heal at face value as giving us complete license to resort to medicine. This is accepted by virtually all contemporary rabbis. On the other hand, some of the most outstanding authorities of all times, including the Ramban and Rabbi Eliahu, the Gaon of Vilna, championed King Hezekiah's path of faith. While not disputing that the physician may have sanction to cure, they argued that this does not mean that a Jew has sanction to resort to doctors and medicines when he can achieve complete healing through faith and Torah.

From this point of view exclusive dependence upon physical strategies of healing can be seen as diverting the sick person from the path of true healing. This was why King Asa was criticized for turning to physicians. It may also be among the considerations underlying the much-discussed mishnaic dictum, "The best of physicians are destined to go to hell" (Kiddushin 82a). One of the reasons given for this is that the physician is not afraid of illness and therefore does not turn to God with all his heart (Rashi ad loc.). It could be added that if the physician allows the patient to believe that illness can be conquered by physical means alone he is allowing him to avoid turning to God with all his heart, causing him to evade the very spiritual issues his illness was sent to make him confront.

The question remains, if the Sages of Israel endorsed King Hezekiah's concealment of the Book of Remedies, why does the Talmud itself give explicit details of so many medicines and treatments? This question is addressed by the Maharsha (Rabbi Shmuel Eliezer Aideles 1555-1632) in his commentary on the Talmud:

"Certainly sanction to heal and to know the remedies for all illnesses has been granted. But it is not proper that they should be revealed to everyone because of the unworthy people who will trust not in God but in the doctors. Originally it was forbidden to write down the Talmud itself, but because later generations became so forgetful, permission was given to put the oral traditions into writing (Gittin 60a). For the very same reason, the Sages were permitted to write down these remedies and reveal them publicly. It was impossible to remember them by heart and they were in danger of being completely forgotten. From their inclusion in the Talmud you can see that no branch of wisdom is lacking from it. Those who understand the language of the Sages will find a true and complete remedy for every illness, and no scoffer will be able to say that the Sages of the Talmud lacked healing wisdom" (Maharsha on Gittin 68a).




By Rabbi Avraham Yehoshua Greenbaum
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