Traditional Jewish Healing in Theory and Practice

By Rabbi Avraham Greenbaum

Chapter 12

The Soul and the Body

1. Simchah and Healing

For Rebbe Nachman, simchah is the essential key to health and healing. He expressed this idea in his teaching on the great mitzvah of always being happy:

"It's a great mitzvah to be happy all the time, and to make every effort to avoid gloom and depression. All the illnesses people suffer come only because of a lack of joy. For there are ten basic types of melodies, and these are the foundation of true joy. Thus it is written, `[It is good to give thanks to God, and to sing to Your Name, O Most High....] With an instrument of ten strings.... For You have made me joyous, O God, through Your work' (Psalms 92:2-5). These ten types of melody enter into the ten different pulses of the human body, giving them life. For this reason, when a person is lacking in joy, which consists of the ten types of melody, his ten pulses become weakened because of the flaw in the ten types of melody, giving rise to illness. For all the different kinds of illnesses are included in the ten kinds of pulse, and all the different kinds of songs and melodies are included in the ten types of melody. The particular illness that arises corresponds directly to the flaw in the joy and the song. Eminent medical authorities have also spoken at length about how all illness is rooted in depression and gloom.

"And joy is the great healer! And in time to come there will be tremendous joy. For this reason our Rabbis said, `The Holy One, blessed be He, will be the Head of the dance circle of the tzaddikim in time to come' (Yerushalmi Succah, Lulav veAravah and Vayikra Rabbah 11 end). That is to say, God will form a dance circle of the tzaddikim, and He will be the Head of the circle, ראש חולה , rosh choleh. For the Divine Presence is above the head (ראש , rosh) of the sick person (חולה , choleh), as our Rabbis learned from the verse, `HaShem will sustain him on the bed of sickness' (Psalms 41:4, Nedarim 40a). For the invalid has no vitality at all: it is only the Divine Presence that gives him life. Through the joy that will reign in time to come, all sickness will be remedied. The sickness of the invalid, the חולה  (choleh), will be turned into חולה  (choleh), a dance circle, and then God will be the ראש חולה  (rosh choleh), Head of the dance circle, because joy is the remedy for the invalid. This is the reason that joy and dance are called choleh: because they are the remedy for illness.

"The main point is that one must make every effort and put all one's strength into being happy at all times. Man's natural tendency is to let himself become depressed and discouraged because of the vicissitudes of life. Everyone has his full share of suffering. For this reason one has to force oneself to be happy at all times and to bring oneself to a state of joy in whatever way possible, even with good-natured fun and jokes. It is true that true contrition over wrongful behavior is a good thing, but only for brief periods. One should set aside time each day to examine oneself and regret any wrong one may have done and open one's heart to God (see Outpouring of the Soul). But one should then be happy for the whole of the rest of the day. The dangers of grieving over one's sins, which can easily lead to depression, are much greater than those of veering from joy into light-headedness. Contrition is far more likely to lead to depression. One should therefore always be happy, and only at set times feel regret for any wrongdoing" (Likutey Moharan II, 24. For Reb Noson's prayer based on this teaching, see Prayers).


Clearly the main thrust of this teaching on simchah is practical: we should do everything we can to keep ourselves in a joyous frame of mind at all times. But brief as the teaching is, it also mentions ideas that are at the very core of Rebbe Nachman's spiritual view of illness and healing, such as that the functioning of the human body depends upon "ten pulses," and that the vitality of these pulses depends on the "ten types of melodies," which themselves are the foundation of simchah. What exactly are the "ten pulses," and what are the "ten types of melody"? What does it mean to say that the ten types of melody give life to the ten pulses? How do the ten types of melody foster health and bring healing?

A further question is how Rebbe Nachman's statements about illness and healing in this teaching are to be reconciled with other statements of his elsewhere. Here Rebbe Nachman says that the underlying reason people become sick is because of a lack of joy. This causes the ten pulses to become weakened owing to the flaw in the ten types of melody that enliven them, resulting in illness. And therefore the great healer is joy. However, elsewhere Rebbe Nachman says that "the main cause of illness is a lack of harmony: the four basic elements making up the body are in conflict, with one element rising up against another" (Likutey Moharan I, 56:8 and see I, 14:13). "Healing comes about essentially through bringing harmony among the elements" (ibid. II, 5:1). What are the "four elements," and how do they relate to the "ten pulses"?

In order to elucidate these concepts we must examine them in the broader context of Torah teachings about the soul and the body and how they are bound together. In this chapter we will first consider the mystical idea that the soul is "clothed" in the body, after which we will focus on the four elements and the ten pulses. Then, in the next chapter, we will turn to the ten types of melody and the healing power of simchah.

In our search for deeper insight, let us bear in mind that the bond between the soul and the body, the spiritual and the physical, is nothing less than an amazing wonder - one for which we daily bless God, "Who heals all flesh and acts wondrously." Some of the material in the sections that follow may be difficult for newcomers to Kabbalah and Chassidut, who may wish to skip passages that they find confusing. As we consider some of the profoundest concepts of the kabbalah, let us remember that we are entering a realm where, when clarity eludes us, we can depend only on faith.

2. The body: garment of the soul

Man's body is not the essential person, the man himself - for man's body is called his "flesh," as in the words of Job: "You have clothed me with skin and flesh, and knitted me together with bones and sinews" (Job 10:11). The essential person is the soul, the אני  (ani) -I (Likutey Moharan I, 22:5). The soul is a particular class of spiritual entity destined to enter a physical body, and this distinguishes it from angels and other purely spiritual forces in the creation, which are not associated with physical bodies.

In the previous chapter we saw that the soul attains its destiny through fufilling the 248 positive precepts of the Torah and avoiding infringement of any of its 365 prohibitions. Each mitzvah enables the soul to earn and incorporate in itself a particular level of true excellence or remove an area of deficiency and darkness. Thus the soul is said to consist of 248 spiritual "limbs" and "organs," which are connected by 365 spiritual channels. Each of the positive mitzvot comes to bring excellence into one of these limbs, while adherence to the prohibitions ensures that none of the corresponding connecting pathways becomes damaged, which would prevent the free flow of vitality to the "limbs."

The soul comes into the physical body in order to carry out the mitzvot, all of which relate in some way to the physical world. The body is by nature drawn to the material aspects of existence, and this is what presents the soul with its challenge in this world. But the soul has the power to harness the body for its own purposes and use it as its tool or instrument to carry out the mitzvot that bring it to its destiny.

R. Chaim Vital (1542-1620), principal disciple of the Ari, explains the relationship between the soul and the body as follows:

"The body is a garment in which the spiritual soul, which is the man himself, clothes itself during his sojourn in this world. Just as a tailor makes a bodily garment to fit the limbs of the body, so the Creator fashioned man's body, which is the garment of his soul, to fit the soul's 248 `limbs' and their 365 connecting pathways. After the formation of the body, God breathed into it the living soul with its 248 spiritual limbs and 365 spiritual pathways. These are then clothed in the 248 physical limbs and organs of the body and its 365 arteries, etc. [The Hebrew גידים  (gidim), often translated as "sinews," includes the arteries, veins, lymph vessels, and nerves.] (For the numbers of bodily limbs and arteries etc. see Ohalot 1:8 and Maccot 23b.)

"The limbs of the soul are then able to carry out their functions through their instruments, the limbs of the body, which are like a hatchet in the hands of the person using it to chop. Thus the physical eyes and ears see and hear only when the soul is in them, but the moment the soul leaves the body, the eyes are darkened and all sensation and vitality departs from its 248 limbs and organs. In the same way, the 365 spiritual channels of the soul are clothed in the 365 bodily arteries, veins and other channels of the body. These carry the physical sustenance - the blood - to the 248 limbs of the body, together with the spiritual food within it to sustain the 248 limbs of the soul. But at death the soul departs, the vitality ceases to flow, and the 365 channels of the body decay and decompose, as do its 248 limbs" (Shaarey Kedushah I:1).

The Torah view of the Human Body

"This is the Torah - man..." (Numbers 19:14). Besides the wealth of esoteric teachings about man's spiritual nature contained in the Bible, Talmud, Midrash and kabbalistic literature, we also find countless references to various aspects of human anatomy and functioning. But while many of these references presuppose a broader view of the nature and workings of the body, it was not the purpose of the talmudic and kabbalistic Sages to write scientific texts. Nowhere in the classic literature do we find a systematic exposition of the underlying system of ideas or a detailed explanation of the meaning of concepts like that of the "four elements" making up the human body or their four corresponding "humors."

Until the 18th century similar ideas were common currency in Europe, as well as in North Africa and large parts of Asia. In fact, the theory of the four humors was espoused as late as the 1870's by the respected Czech medical authority, Carl Rokitansky (1804-78). But since the 18th century, the general tendency has been to reject such ideas as hopelessly primitive, and where they are not ignored completely they are often grossly misunderstood. Nevertheless, today a number of scholars seem more willing to overcome the traditional western myopia when looking at unfamiliar worldviews and to try to understand them in their own terms.

The time may thus be ripe for a re-evaluation of the true significance of Torah concepts like that of the "four elements" etc. However, to date there has been no comprehensive study of Torah teachings about the human body. Julius Preuss' Biblical and Talmudic Medicine gives much valuable information about biblical and talmudic ideas on anatomy and physiology but does not explain the underlying view of the four elements and four humors, and also does not encompass kabbalistic teachings in works like the Sefer Yetzirah, Zohar and Tikkuney Zohar. In these we are in a very different world from that of contemporary anatomy and physiology, not least because details of the human form and functioning are often seen as alluding to aspects of the soul and the higher worlds. Valuable Hebrew sources include Etz Chaim, Shaar Kitzur ABYA #10 and Sefer HaBrit by R. Pinchas Eliahu of Vilna.

In the absence of conclusive evidence, it is meaningless to speculate whether the Torah Sages borrowed some of their ideas from Egyptian, Assyrian, Greek and other cultures or vice versa. However, there is an interesting tradition (Oxford Ms. 2134) that at the time of the destruction of the Second Temple, the Roman Emperor Titus asked Rabban Yochanan ben Zakkai to order the Jewish Sages to set down for him in writing the Jewish healing lore. Rabban Gamliel composed the requisite work, which the Romans later attributed to Galen (129-199 C.E.), whose writings were the dominant influence in European medicine until the 17th century.


At the center of the Kabbalah teaching about the relationship between the soul and the body is the concept of התלבשות  (hitlabshut), where one thing "clothes itself" in something else. The soul is said to "clothe itself" in the body. We can try to understand this through the analogy of a glove puppet. The hand of the puppeteer "clothes itself" in the puppet. The puppet itself moves, but only because of the movements of the puppeteer's hand inside it. If the puppeteer is very expert and we are deeply absorbed in the show, the puppet may at times seem like an independent character. But the truth is that its every movement depends on the movements of the hand inside it. Without the hand, the puppet would be "dead."

A glove puppet is a clear example of "clothing." But in the Kabbalah view, a string puppet is also a case of "clothing," even though the hand of the puppeteer is not literally inside the limbs of the puppet. Even so, the string puppet also only moves because of the puppeteer's hand, which pulls at the attached strings from above. In kabbalistic terms, the movements of the puppeteer's hands are "clothed" in the movements of the strings, and thus in the resultant movements of the puppet. To those watching the string puppet show, only the puppet is visible. The puppeteer keeps out of sight: he is in another "plane," outside the artificial world of the puppet theater. But it is only through his movements that the show can continue "down there."

Using the same terminology, we might say that a person's inner spirit - his thoughts, feelings, desires and intentions - are "clothed" in his words or actions, though it would be quite impossible to detect where "inside them" they are. This is because the sounds coming from his mouth and the movements of his body exist on the physical plane, while the spirit that animates them, his soul, though no less real, exists on a different dimension of reality, albeit one that interconnects with the physical. The link between the person's spirit or soul and his physical words or actions is the body that produces them. In kabbalah terms, the spiritual soul is "clothed" in the physical body.

The divine and animal Souls

It is important to be aware that the term "soul" is used to refer to two different aspects of man's being. One type of soul that man has is similar to that which exists in all living creatures. This is called his "animal soul." This is the animating force of our physical bodies, governing bodily growth, development and functioning, including both those aspects of our physical functioning that are under our conscious control and those that are not. On the level of consciousness, we experience the animal soul as our "worldly ego" - our basic instincts and feelings, and the faculties of will, intelligence, memory, imagination, etc. with which we satisfy our material needs and desires.

Besides this, however, there exists in man a spiritual entity that is very different from this animal soul and spiritually far more exalted. This is the "divine soul," which connects us with the highest spiritual planes of creation. Through it, our thoughts, words and actions have an effect on those planes, and conversely, the divine soul is the channel through which the influences bestowed upon us from those planes are transmitted. From the divine soul, these influences are then transmitted via the animal soul to the physical body. Thus the divine soul is "clothed" in the animal soul, and the animal soul is "clothed" in the body.

This divine soul is often referred to as a single entity, but in fact it consists of a number of parts on different levels, bound together like links in a chain. Just as all the links form a single chain, so do all these levels of the soul constitute a single entity, which is called the divine soul. Its five parts, from the highest downwards, are called: the Yechidah ("unique essence"), chayah ("living essence"), neshamah ("breath"), ruach ("spirit") and nefesh ("soul"). Each of these levels is bound to the one below it, until the lowest one is bound to the animal soul, and the animal soul to the body (Derekh HaShem III:1).

Food of the soul

Although the divine soul is higher than the animal soul and clothes itself within it, we actually experience the two of them as if they exist side by side. They express themselves in our conscious minds in the constant ebb and flow of our different and often conflicting thoughts, desires and impulses. The mission of the divine soul in this world is to harness the faculties of the animal soul and the body for its own purposes, in order to turn even their necessary material functions in this world - eating and drinking, making a living, procreation, etc. - into acts of outreach and connection with God. All the associated mitzvot (e.g. blessings, the laws governing interpersonal relationships, business activities, etc.) are "food" for the divine soul, nourishing and strengthening it.

But to provide the divine soul with its challenge in this world, the animal soul is vested with a will of its own, the "Evil Urge," which craves the material pleasures of this world and seeks to enlist the body to pursue them rather than the mitzvot. Worldly pleasures are the "food" of the animal soul. From the Torah point of view, some of these come into the category of the permissible, while others are strictly forbidden. Those that are forbidden - the "impure food" - cause actual damage to the limbs of the divine soul. But even the pursuit of the permissible can weaken it when carried to excess. In the words of Rabbi Chaim Vital:

"Each of the divine soul's 248 limbs is nourished by its corresponding mitzvah, and if a person fails to fulfil a certain mitzvah, the corresponding limb will lack the nourishment it needs from the four letters of the essential Name of God, the Tetragrammaton, of which it is said `You give life to them all' (Nechemiah 9:6). The mitzvot themselves depend on these four letters (Zohar I, 24a), which are also the roots of the four elements making up the divine soul. [Thus the mitzvot are the channel through which holy vitality comes into the soul.] Therefore, by failing to fulfil a mitzvah, the corresponding limb dies, and when the holiness departs, it becomes clothed in an impure spirit from the four elements of the person's animal soul. This limb is then nourished with impure `bread' from there, and `dies' - for `the wicked are called dead even in their lifetime' (Berakhot 18b, and see Zohar III, 123a). For the divine soul that comes from the living God leaves them, and death - the ultimate source of all pollution - dwells within them.

"So too when a person observes the 365 prohibitions by refraining from what is forbidden, the spiritual sustenance that comes from carrying out the positive commandments is able to flow through the 365 channels of the divine soul to vitalize her 248 limbs. But when a person transgresses one of the prohibitions, the channel corresponding to that sin becomes blocked by the filth of the impure food that becomes stuck there. And when the channel becomes dried up, the limb also dries up, even though it does not fall away completely as it would if the person failed to fulfil one of the positive commandments. But even so, it will be damaged" (Shaarey Kedushah I:1).

The struggle of the souls and bodily health

Rabbi Chaim Vital tells us that the outcome of the struggle between the divine and animal souls for dominion over the body can have a decisive effect on actual physical health. He explains this as follows:

"Know that after the first man sinned and ate from the tree of knowledge of good and evil, both his soul and his body became composed of good and evil. This is the concept of the `filth of the serpent' with which the snake infected Adam and Eve, and through which he caused illness and death to their souls and their bodies. Thus it is written, `For on the day you eat from it, מות תמות  (mot tamut), you will surely die' (Genesis 2:17). The Hebrew expression for `die' is doubled, indicating both the death of the soul and the death of the body. When Adam sinned by eating of the tree of knowledge of good and evil, he caused good and evil to be mixed in all the worlds: there is nothing that is not comprised of good and evil....

"Just as good and evil became mixed in all the worlds, so it was in man's soul. For the soul is hewn out of the four spiritual elements from which all spiritual beings were formed, which are rooted in the four letters of the Tetragrammaton. Of this it is said (Ezekiel 37:9): `From the four directions come, wind (רוח  ruach, which also means spirit).' Man's evil side consists of the four main destructive forces enumerated in Bava Kama (2a), stemming from the evil aspect of the four elements. From this evil side of the soul comes the evil inclination, and when this soul dominates over the good side of the soul, she becomes afflicted with destructive forces, physical maladies and diseases of the soul, and if it becomes extremely dominant it will kill her....

"Man's body is formed out of the four lower, physical elements of fire, air, water and earth, and they are each composed of good and evil. Man's body is formed out of the good in the four elements. But the bad in them causes the formation of the four bodily humors: the white, the black, the red and the green. And when the bad aspect of any of these becomes dominant and prevails over the good, illnesses and afflictions assail the person. And if the bad aspect becomes extremely powerful, it will kill his body" (Shaarey Kedushah ibid.).

In other words, the four constituent "elements" of the body, which we will discuss in more detail presently, have both positive and negative potential. When their positive aspect is dominant, the body functions normally and healthily. But when their negative aspect becomes dominant, bodily functioning becomes pathological, leading eventually to disease and death. Rabbi Chaim Vital's explanation of illness clearly relates to Rebbe Nachman's statement cited earlier that "the main cause of illness is a lack of harmony: the four basic elements making up the body are in conflict, with one element rising up against another." According to Rabbi Chaim Vital, whether the positive or negative aspect of the four bodily elements will become dominant depends upon which of the two souls, the divine or the animal, is allowed to take command of the body.

The divine soul is rooted in the four letters of God's Name, which are the source of creation in general and of the soul's vitality in particular, as mentioned in the passage from Shaarey Kedushah quoted earlier (p. 130), and as we will discuss in more detail below. The mitzvot - the divine soul's "food" - are likewise rooted in the four letters of God's Name. This is because God arranged the various mitzvot as the means through which the souls, the intended recipients of His goodness, can attain this goodness. Each mitzvah is a pathway of action in this world designed in such a way as to enable us to connect with a particular facet of Godliness. Since God is known through His Name, each mitzvah is designed to connect us with one aspect or another of the Name, as can be seen from the mystical literature on the kavanot, the inner intentions of the mitzvot. The various mitzvot channel vitality from the four letters of God's Name to the four spiritual elements which make up the divine soul, giving dominance to the positive aspect of the four physical elements of the body.

The animal soul, on the other hand, receives its vitality from what the Kabbalah calls the sitra achra, literally "the other side," the unholy side of creation that was brought into being to test man in this world by confronting him with desires and temptations that can lead him away from his spiritual destiny. The forces of the "other side" are ultimately evil and destructive, but if this were immediately obvious to all there would be no challenge. Thus the "food" of the animal soul - excessive or forbidden material pleasures, unholy art, music, literature, entertainment, etc. - has a grace and attractiveness of its own. But in the long term this "food" nurtures the destructive elements of the animal soul, which in turn give dominance to the negative aspect of the physical elements of the body, leading to physical malfunctioning, ill health, disease and death.

In order to see how these ideas relate to contemporary understanding of how the body works, let us now turn to a more detailed examination of the kabbalistic doctrine of the "four elements" of which the human body, like the whole of creation, is composed: fire, air, water and earth.

The four elements

The doctrine of the four elements is an integral part of traditional rabbinic thought, and is found both in classic Jewish philosophy and in the Kabbalah (see Mishneh Torah, Hilkhot Yesodey HaTorah chapters 3 & 4, Shaarey Kedushah III:1-2, Etz Chaim, Shaar Kitzur ABYA 10, etc.). It is rooted in the Bible, which tells us that "a river comes out of Eden to water the garden, and from there it divides and becomes four heads" (Genesis 2:10). The "river" alludes to the unitary creative power of God, which contains in potential all the multifarious powers that are manifest in the actual creation. Just as a single beam of white light can be refracted to reveal its constituent colors, similarly the unitary power of God is "refracted," as it were, in the finite creation, dividing into four "heads," alluded to in the four letters of the Tetragrammaton, Yud Heh Vav Heh. [When pronouncing the letters of the Holy Name in sequence, it is customary to say the letter heh as keh in order not even to come close to pronouncing the Holy Name as written, which is strictly forbidden.] These four "heads" are the four elements of fire, air, water and earth (Likutey Moharan II, 67).

It is most important to grasp that the use of the word "elements" here has nothing to do with its use in modern chemistry to refer to the various physical substances of which all natural phenomena are composed. In chemistry, the "elements" are those substances that cannot be resolved by chemical means into simpler substances. The "four elements" of Torah thought, on the other hand, which in Hebrew are called יסודות  (yesodot), "foundations," are not necessarily physical at all, and they are certainly not to be simply identified with physical fire, air, water and earth as we know them.

The Kabbalah pictures the creation as a downward chain of spiritual "worlds" stretching from the most exalted spiritual realms of Adam Kadmon ("Primordial Man") and Atzilut ("Emanation") down to the spiritual world of Asiyah ("Action"), which finally generates the material world in which we live, including our physical bodies. The four "elements" might best be understood as the underlying dynamic principles that govern processes on every level of creation, spiritual and physical, holy and unholy. These "elements" interact in various ways to produce all the different processes and phenomena found in all the different worlds. None of the four elements ever appears alone, but only in combination with all the others. Each of the different natural substances in our world ultimately derives from a unique combination of these elements. Thus the physical water with which we are familiar results from a particular combination of all four elements, but out of the four it is the water element that is dominant, making physical water the appropriate symbol for the basic "water element." The same applies to physical fire, air and earth.

Discussing the four elements as manifested in the physical world in general, Rabbi Aryeh Kaplan writes:

"In the simplest physical terms, `water' represents matter, `fire' is energy, and `air' is the space that allows the two to interact.... Earth, however, is not a basic element, but a confluence of the other three. It is therefore represented by the final heh in the Tetragrammaton, which is actually a repetition of the first heh in this name.... These three elements also relate to the experiential. Fire represents the radiation of energy, while water represents the absorption of energy. These are thesis and antithesis, giving and receiving, which themselves are manifestations of cause and effect. Air, which represents the transmission of energy, is then the synthesis, linking the two" (Rabbi Aryeh Kaplan, Sefer Yetzirah pp. 145f).

Different kabbalistic texts bring out the interrelationship between the four elements in different ways. However, one thing that is abundantly clear from the above discussion is that the four elements of Torah thought are not to be conceived as primitive substances of some kind. The elements of water, fire and air are to be seen rather as dynamic principles governing chains of cause and effect, while the earth element is the medium through which these principles are manifested. This applies on all the different levels of creation, spiritual and physical. In the physical realm, the earth element would be physical substance in general.

The four elements in the human body

Clearly, when the Torah Sages speak of the human body as consisting of the four elements, this should not be taken to refer only to the physical composition of the different bodily tissues. Without doubt the Torah view is that bodily tissues, like all physical substances in general, are indeed the product of various combinations of the four elements. But just as the four elements exist at all levels of creation, so too they exist at all levels of bodily structure and functioning. They may thus be understood as dynamic principles governing the structure and functioning of the various body parts and systems, both in themselves and in relation to each other.

The four מרות  (marot, "humors") mentioned in the above-quoted passage from R. Chaim Vital's Shaarey Kedushah are, in physical terms, four kinds of fluids or secretions involved in bodily functioning. The red humor refers to the blood, the white to the phlegm and mucus, the yellow to the yellow-green bile secreted by the liver and stored in the gall bladder, while the black refers to black bile, congealed blood from the spleen, associated both in Torah literature and in the pre-19th century world in general with "melancholy" - depression (which Rebbe Nachman frequently refers to as מרה שחורה , marah shchorah, "black bile.") Each of the four humors corresponds to one of the four elements. The four humors are all necessary for normal bodily functioning, but they become "bad" when something causes them to exceed their normal levels. As toxic waste which the body is unable to neutralize or eliminate, they cause pathological deviations from the normal, healthy functioning of the various bodily cells, tissues and organs.

Harmony among the elements: homoeostasis

The human body consists of a multitude of diverse substances held together in the various interrelated structures that constitute the tissues, organs and systems of the body: skeletal and muscular, skin, respiratory, cardiovascular, lymph vascular, digestive, excretory, nervous, endocrine (hormonal), immune, reproductive, etc. When all the body systems are functioning harmoniously and the tissues are growing, developing, regenerating and maintaining themselves within their proper limits, we say that the body is "healthy." But when its systems fail to function harmoniously - when they malfunction - and the body tissues degenerate, we say that the body is "unhealthy," "diseased" or "dying."

Physical health is essentially a function of the body's success at maintaining a stable internal environment in the face of the various external changes and provocations to which it is constantly exposed as a result of normal wear and tear, improper diet, inadequate exercise, stress, pollution, radiation, micro-organisms, injury, actual abuse (smoking, drugs, etc.) and so on. Homoeostasis is the contemporary term for the necessary stable equilibrium between the various bodily organs and systems. In Kabbalah terms, this is called "harmony among the elements." And, as we have seen, the Kabbalah view is that the key to this harmony lies ultimately in the ability of the divine soul to keep the animal soul in rein. For the "impure food" of the animal soul causes the negative aspect of one or more of the four bodily elements to become dominant, which may eventually lead to manifest physical malfunctioning and actual illness. On the other hand, the "pure food" of the divine soul channels holy vitality from the Root of all creation, strengthening the positive aspect of the four elements and thereby fostering harmony among them, bringing health to the whole body.

3. "The soul is in the blood"

How does the divine soul influence the workings of the body? We saw earlier that the divine soul is "clothed" in the body. What is the actual point of connection between the two? In the words of Rabbi Moshe Chaim Luzzatto:

"The divine soul directs the lower animal soul, and through it performs its necessary functions.... The divine soul is bound to the animal soul, and the animal soul in turn is linked to the most ethereal element of the blood" (Derekh HaShem III:1).

The saying that "the soul is in the blood" is found in the Bible (Genesis 9:4, Leviticus 17:11 & 14, and Deuteronomy 12:23). What does this mean? There are varying opinions among the Rabbis. One view is that the blood in question is the "last revi'it" (approximately 3 oz.) of blood in the body (Rabbenu Bachya on Leviticus 17:11). Another is that it is the minimal amount of blood with which a person can live (Rashi on Sotah 5a), while others say that this is the amount of blood in the heart (Tosafot ibid.).

For our purposes, the most significant explanation is that of the Ari, who explains that this "revi'it of blood" refers to the highest element in the blood, namely the "life of the brain," and that this in turn is the intermediary between the spiritual and the physical (Shaar Derushey ABYA 1). In the words of Rabbi Aryeh Kaplan:

"We can understand this on the basis of other statements found in the Etz Chaim. The nerves, as well as the veins and arteries, are said to contain a type of `blood,' but that in the nerves is its highest fraction (Shaar HaMochin 5, Shaar Penimiut veChitzoniut 12, Shaar HaChashmal 1). The only thing that flows through the nerves, however, is the neural impulses, and therefore these impulses must be considered the highest fraction of the `blood.' This, of course, is the `life of the brain,' since all mental activity depends on neurological impulses. According to this, the `animal soul,' which is the information in man's brain as well as his ability to process it, would depend on this `blood,' namely the neurological processes. This is the meaning of the statement that the `soul is in the blood'" (Derekh HaShem p.347, translator's note #3).

According to this explanation, the kabbalistic view of the "blood" includes not only the proverbially thick red fluid we tend to think of as blood, but more besides. Even blood as we think of it is far from being a simple, uniform fluid. In its colorless plasma float millions of red cells, white cells and platelets. The red cells transport vital oxygen from the lungs to all the body tissues, and carbon dioxide waste back to the lungs to be exhaled. The various different kinds of white cells play a vital role in defending the body against diseases, while the platelets cause the blood to clot. In addition, blood plasma is the vehicle for transporting the body's main fuels (such as glucose and basic fats), minerals and other nutrients. Besides this, the blood transports hormones around the body: these are the chemical "messengers" that keep the various body parts and systems working harmoniously with each other, and influence our functioning in other ways that medical science is only beginning to uncover.

The red blood is thus crucial to the metabolism of all the cells of the body and to overall bodily functioning. If we then add the "life of the brain" - the neural impulses involved in sensory perception, physical movement and the regulation of a wide variety of different bodily functions - when we talk about the "blood," we are talking about the key to the life of the entire body.

The Pulse

Crucial to all physical functioning is the way the blood circulates around the body. In the words of Rebbe Nachman:

"From the very beginning of life there is a vital spirit in the heart which causes it to contract and beat. This beat affects all the blood and fluids in the body. It beats in all the limbs of the body, and by constantly beating and churning them, it keeps them from stagnating and degenerating, just as the wind blows over the sea and beats and stirs the waters so that they do not stagnate. Most importantly, this beat pulsates in the arms and hands, which are constantly active and therefore need this beating, churning and cleansing more than anywhere else in the body. This is why the doctor can discover everything about a patient's condition by laying his hand on the patient's wrist and taking his pulse. This is because the arms are the main place where it is possible to feel the action of the heartbeat, which is responsible for the life of the whole body" (Likutey Moharan I, 56:9).

A pulse is a recurrent rhythm, a pattern of beats. For most of us, the bodily pulse means the rhythmic throbbing of the arteries as the blood is propelled along them through the pumping action of the heart. The pulse can be felt in a number of the arteries that lie near the surface of the body. The most easily accessible is the radial artery in the wrist, which can be felt on the inner surface of the wrist just below the thumb, but there are also various other points where the pulse can be felt.

When a western physician takes a patient's pulse, what he is mostly interested in is the pulse rate itself and the rhythm. Secondarily, he may also assess its relative strength or weakness. He may then be able to draw certain inferences about the state of the patient's heart and circulatory system. However, oriental medicine makes far more use of subtle pulse patterns as detected at various different pulse points to give precise and detailed information about the state of a wide range of bodily functions. Classical Chinese medicine differentiates between as many as twenty-eight individual pulse patterns, each with its own pathological significance (Manfred Porkert, Chinese Medicine pp. 186-90).

The ten pulses in the Kabbalah

When we turn to the Torah tradition, we find that the kabbalistic masters could discern not only physical pathologies from the pulse pattern, but spiritual pathologies as well. In the words of Rabbi Chaim Vital: "Know that just as physical illnesses can be diagnosed from a person's pulse by physical doctors, so my Master [the Ari], of blessed memory, could discern the maladies of the soul by feeling a person's pulse" (Shaar Ruach HaKodesh 3, and see Chapter 5).

In the Kabbalah view, the pulse is the interface between the spiritual and physical dimensions of our being. Rabbi Chaim Vital brings a kabbalistic teaching of the Ari explaining the matter (Shaar Ruach HaKodesh p. 3. Click here for the full teaching). The Kabbalah teaches that God brought about the creation through the ten sefirot - ten modes of creative power through which God's infinite light was successively "contracted" and muted in order to bring about a finite realm in which man can come to know God. The ultimate source of the entire creation is God's will to bring it about. This is the highest sefirah, Keter, "the Crown." However, the infinite vitality of Keter cannot be revealed directly within the finite creation. The vitality flowing from Keter therefore comes down to the creation through a "garb": it is "clothed" in the sefirah of Chokhmah, "Wisdom," also called Abba, "father," which could be understood as the underlying "conception" or "plan" of creation. All the sefirot below Chokhmah are successive steps in the realization of this plan, and as such they are said to receive their vitality from Abba.

In his teaching on the pulses, the Ari says: "The vitalizing power of Abba extends into the arteries and veins of the human body in the form of the pulse patterns governing the blood circulation. And these pulse patterns are a garb for the supreme vitality of the Infinite, which is concealed and clothed within these pulse patterns. The pulse itself is Abba, while the vitality contained within it is the light and vitality of the Infinite, which gives man life." Each of our souls is ultimately rooted in Abba through the level of the soul called the chayah, the "living essence". From here vitality is channeled down level by level, from the divine soul to the animal soul and from there into the body. We have seen that the soul "clothes itself" in the "blood" - i.e. "the life of the brain," the neurological processes. Thus the Ari's 16th century kabbalistic explanation of the pulse would seem to mesh in well with contemporary scientific understanding of how the hypothalamus in the brain (corresponding to Abba as clothed in the body) ultimately controls the heartbeat via sympathetic and parasympathetic nerves from the cardioregulatory center in the spinal cord.

The vitality flowing into the body from Abba is expressed in the pulse, which in Hebrew is called the דפק  (dofek). The Ari points out that the numerical value of the Hebrew letters of the word דפק  - 184 - is the same as that of the letters of the holy name associated with Abba: this is the "expansion" of the four letters of the Tetragrammaton with yud's -יוד הי ויו הי  (when written by the method of achorayim).

Kabbalistic letter equivalencies are far from being arbitrary. The Kabbalah teaches that the Hebrew letters are the "building blocks of creation." Various combinations of letters make up what we might call the underlying spiritual "formulae" for all the different phenomena in creation. Each of the letters of the Hebrew alphabet has infinite potential. This is expressed in the fact that a simple letter, e.g. י  (yud), can be "filled in" with the other letters that make up its name - in this case ו  vav) and ד  (dalet) - so as to be spelled out in full: יוד . All of these letters can then in turn be filled in with the letters making up their names, and so on ad infinitum. The name of each letter is bound up with its very essence. The "fill-in letters" were contained in the simple letter in potential, and now they are manifest. At the root of all creation are the four letters of God's essential name, the Tetragrammaton. Particular "expansions" of this and related holy names constitute the spiritual roots of all the particular levels and phenomena in creation. The numerical equivalence of the letters of the holy name associated with Abba to those of the word DoFeK, the pulse, demonstrates that Abba is the spiritual source of the vitality of the pulse.

As the underlying conception or plan of the creation, Abba itself contains in potential all the steps that are involved in the realization of this plan - the ten sefirot. Thus Abba is alluded to in the first letter of the Tetragrammaton, yud, which is written with a single dot of ink, yet has the numerical value of ten, alluding to the ten sefirot. Thus Abba has ten sefirot of its own, which are subsequently manifested on successively lower levels in the actual creation. This is why there are ten main pulse patterns. Each one is a manifestation of a particular kind of vitality flowing into the body via the soul from the ten sefirot of Abba. In the words of the Ari, "A given pulse pattern indicates from which aspect of Abba the vital energy in the pulse is coming at the particular moment this pattern appears."

During Rebbe Nachman's stay in Lemberg there was one occasion when the doctor came to visit him and took his pulse. After examining the Rebbe for a few minutes, the doctor took his pulse again, and was surprised to find that it had changed dramatically. Shortly afterwards he took his pulse again, only to find that it had changed yet again. The doctor was quite perplexed, but Rebbe Nachman said, "You see, every moment I live a completely new life!" (Oral tradition)

The ten pulses and the Hebrew vowel signs

A pulse pattern is made up of a series of rhythmic beats or, in the language of the Ari, "dots," which vary in their spacing and intensity. The Ari teaches that the various patterns exhibited by the pulse at different times correspond to the forms of the Hebrew vowel signs, which are themselves made up of dots and short lines in various combinations. The Hebrew vowels, like the letters, are creative forces. In fact, Kabbalah teaches that the vowels are on a higher level than the letters. The twenty-two Hebrew letters are all consonants and cannot be pronounced without vowels. By themselves the letters are "lifeless": it is the vowels that "animate" them. If the letters are the building blocks of creation, it is the vowels that enable them to function together to form meaningful structures - words. Thus the Kabbalah speaks of the Hebrew letters as bodies and the vowels as souls. Just as the vowels "animate" the letters in different ways, so our various pulse patterns - expressions of various spiritual influences - give rise to different rhythms of bodily functioning and different kinds of vitality.

The vowels are said to be "in Abba." This means that, as creative forces, their roots lie in the ten sefirot of Abba, which as we have seen are the roots of our various pulse patterns. There are nine principal Hebrew vowels corresponding to the nine higher sefirot (see table below). The last sefirah, Malkhut, "Kingship," does not have its own associated vowel, but is said to receive from the nine sefirot above it. Thus Malkhut may express itself through the vowel associated with whichever of the higher sefirot is dominant at a given moment. With their roots in the ten sefirot of Abba, the Hebrew vowels as we write them actually correspond in shape to the patterns of "dots" and "lines" that make up our pulses. Thus by identifying the vowel sign formed by a particular pulse pattern and knowing the sefirah that corresponds to that vowel, it is possible to understand what is the spiritual source of the vitality coming into the individual's soul and body at this moment.

The Hebrew Vowels and Corresponding Sefirot

Vowel Signs
o (doll)
Keter (Crown
u (cut)
Chokhmah (Wisdom)
ay (day)
Binah (Understanding)
e (let)
Chessed (Kindness)
e (the)
Gevurah (Power)
o (roll)
Tiferet (Harmony)
i (sit)
Netzach (Victory)
u (rule)
Hod (Splendor)
u (rule)
Yesod (Foundation)
(no specific sign)
Malkhut (Kingship)

4. Health, Sickness and Healing

Why should a particular pulse pattern appear at a given time, indicating the influence of a particular sefirah and giving rise to a distinctive pattern of body functioning and vitality? According to the Ari, our behavior in this world has an influence on the kind of vitality that flows into our souls and bodies through our pulses. Every act of sincere outreach to God, every mitzvah forges a channel for the flow of vitality from the aspect of Godliness - the sefirah - in which that mitzvah is rooted. On the other hand, when a person turns away from the path of connection with God, "any sin or transgression he commits results in a corresponding lack of light and vitality in the pulse" (Shaar Ruach HaKodesh p.3).

Each transgression impedes the flow of blessing from one or more of the sefirot, resulting in a corresponding flaw in the person's pulse. Yet the effects may be paradoxical, as Rabbi Chaim Vital tells us in the name of the Ari:

"If a person's pulse pattern is like the vowel sign kamatz, for example, this indicates that he has committed a sin relating to the sefirah of Keter, and therefore this sefirah is now dominant in order to show its strength. The flow of vitality from the sefirah in question does not simply cease as a result of the sin. On the contrary, when we see that a certain sefirah is dominant, this indicates that the problem lies in that sefirah. This is in accordance with the idea expressed in the verse, `You add to their spirit, they expire' (Psalms 104:29). The verse teaches that immediately prior to death, a person's soul powers are actually enhanced: `You add to their spirit.' This is because it is in the nature of the weak to marshal all their strength to fight back in order to survive. However, there are times when the dominance of a particular sefirah indicates the opposite - that the person carried out a mitzvah relating to this level. We have no one who understands how far this reaches" (Shaar Ruach HaKodesh p. 3).

Rabbi Chaim Vital's closing words here - "We have no one who understands how far this reaches" - are a poignant reminder that a full understanding of the spiritual significance of the different pulse patterns was granted only to select Sages of outstanding saintliness throughout the ages, such as Rabbi Shimon bar Yochai, the Ari, the Baal Shem Tov, and Rebbe Nachman himself (see next chapter). The few references to pulse diagnosis in Kabbalah literature are brief and highly allusive (Tikkuney Zohar #69, 108a, Shaar Ruach HaKodesh p.3 and Likutey Torah, Taamey HaMitzvot, Vayera #2). We have no details about how specific transgressions and related flaws in the pulse might be bound up with particular physical conditions of one kind or another. There is certainly not enough information to form the basis for a practical method of kabbalistic pulse diagnosis that could be used today by healers or spiritual counsellors.

Yet the general contours of the Kabbalah view are clear. It is choices made by the individual - either to embrace the mitzvot or to neglect them in favor of other pursuits - that are the key influence on the vitality of the pulse and consequently on our bodily functioning. This relates to our earlier discussion about the influence of the divine and animal souls on the body through their respective "food," holy or non-holy. We saw that the various mitzvot channel vitality from the four letters of God's Name to the four spiritual elements which make up the divine soul. Observing the mitzvot gives dominance to the positive aspects of the four physical elements of the body. We can now understand that the pulse is the channel through which the soul has an influence upon actual bodily functioning. Conversely, when the animal soul is allowed to dominate, it has a negative effect on the pulse, and this is what gives dominance to the negative aspect of the physical elements of the body, leading to physical malfunctioning, ill health, disease and death.

The ten pulses and the four elements

The ten bodily pulses are bound up with the four constituent elements of the body, just as the ten sefirot are bound up with the four elements of creation in general. We saw earlier that the ten sefirot are the ten modes of creative power through which God brought about the creation as a whole, and they are manifest in various ways on all the different levels of creation, spiritual and physical, holy and non-holy. The four elements, which are also manifest on every level, are even more primary than the ten sefirot: "water," "fire" and "air" can be seen as the underlying principles of activity, passivity and balance governing the functioning of the nine higher sefirot - three groups of three - while "earth," corresponding to the lowest sefirah, Malkhut, is the "vessel" or medium through which the other three elements, as manifest in the higher sefirot, are revealed. [In most kabbalistic texts, Water (which flows downwards) is associated with the right column of Chokhmah- Chesed-Netzach; Fire (which rises upwards) with the left column of Binah- Gevurah-Hod; and Air with the central column of Keter-Tiferet-Yesod.]

Since each of the different pulse patterns is rooted in one of the sefirot, it is therefore bound up with its corresponding element. The general health of the pulse is thus the key to the harmonious balance of the four bodily elements upon which good health depends. Conversely, any flaw in the pulse leads to imbalance among the elements. Thus we can reconcile Rebbe Nachman's statement that all illness involves a flaw in the ten kinds of pulse (Likutey Moharan II, 24) with his saying that the main cause of illness is a lack of harmony among the four elements (ibid. I, 56:8).

The essential flaw, as Rebbe Nachman tells us, is a lack of joy, a "flaw in the simchah," for it is simchah that enlivens the pulses. The power of simchah to enliven the pulse and bring healing will be the subject of the next chapter. But to conclude our exploration of some of the kabbalistic ideas underlying Rebbe Nachman's general view of illness and healing, let us now turn to another teaching of the Ari, "The Bed of Sickness."

The Bed of Sickness

The Ari taught:

"`God will sustain him on the bed of sickness, You have turned all his lying down in his sickness' (Psalms 41:4). The Hebrew for `bed of sickness' is ערש דוי  (EReS DeVoY). The basic reason a person falls sick is because the divine flow of lovingkindness has turned to strict judgment, and the יוד  (YUD) - the ten animating pulses - turns into דוי  (DeVoY), `sickness.' The Hebrew word for ten is עשר  (ESeR), and this ESeR turns into ערש דוי  (EReS DeVoY), the bed of sickness. The Psalm says, `You have turned all his lying down in his sickness': two things are turned around: ESeR and YUD.

"To explain: the person is sick because the light of Chokhmah - Abba - has departed from him. To sustain and strengthen him, it is therefore necessary to bring him sustenance from there. This explains the statement in the Zohar that a sick person's sustenance comes via Wisdom. The explanation is that the sefirah of Chokhmah, Wisdom, corresponds to the yud of the Divine Name. When a person is sick, this YUD is turned around and becomes DeVoY, causing him to be sick and heart-stricken. The numerical value of yud is ten, עשר  (ESeR), and this is turned into EReS, his sickbed, which is called ערש דוי  (EReS DeVoY), the `bed of sickness.'

"For this reason he needs God to support, sustain and nourish him, and through this very support and sustenance that comes from Abba, the yud of the Divine Name, `You have turned all his lying down in his sickness'; i.e. the sickbed he is lying on, the ערש  (EReS), turns back to עשר  (ESeR), ten, and his sickness, דוי  (DeVoY), turns back to being יוד  (YUD), the ten healthy pulses. This is how he is healed, because the reason for his illness was the absence of the flow of vitality from Chokhmah" (Likutey Torah, Taamey HaMitzvot, Vayera #2).

The Ari is telling us here that a person becomes sick because "the light of Abba has departed from him," leading to a flaw in the ten pulses and consequent physical imbalance and malfunctioning. "To sustain and strengthen him, it is therefore necessary to bring him sustenance from there," i.e. from Abba. In other words, the way that sickness -DeVoY - is reversed is by restoring the flow of vitality from the YUD - the ten sefirot of Abba which enliven the pulses, bringing harmony and health to the body.

Now there are many times when healing from sickness comes about spontaneously. This is because "God sustains him on his bed of sickness": God's kindness and compassion reverse the DeVoY and turn it back into YUD without human intervention. But the art of the human healer is to know which steps to take in order to facilitate recovery. The question is: what is there that we ourselves can do to "turn about the sickness" - to reverse God's decree and turn it into kindness? What can we do to restore the flow of vitality from Abba and turn the DeVoY, sickness, back into YUD - the radiant shine of the ten sefirot that vitalize the pulses of the body, bringing health? Rebbe Nachman's answer to this question is to be found in his teachings on the Ten Types of Melody, and it is to these that we will now turn.




By Rabbi Avraham Yehoshua Greenbaum
© AZAMRA INSTITUTE 5767 - 2007 All rights reserved