Traditional Jewish Healing in Theory and Practice

By Rabbi Avraham Greenbaum

Part II


Chapter 21

Keeping Healthy

"When you go out in the street, you should think of yourself as having been handed over to a policeman to be taken for trial. If you have a headache, you should think of yourself as having had your neck put in chains. If you fall ill and have to go to bed, you should look on yourself as if you've been brought up to the execution block. Anyone on the execution block can be saved if he has sufficiently powerful advocates. If not, there's no escape. And who are a person's advocates? Repentance and good deeds. Even if a person has nine hundred and ninety-nine accusers and only one defender, he will be saved, as it is written (Job 33:23-4): `If he has one defending angel out of a thousand to vouch for his righteousness, then God will show him favor and say, Save him from the pit, I have found a ransom!'"

Shabbat 32a

Rebbe Nachman's healing pathway is very exalted, especially as expressed in "Sound the Shofar - Dominion". Some people may feel that "grasping hold of the Throne of Glory" and "attaining the Word of God" would be far beyond their capabilities. Yet Rebbe Nachman always put the main emphasis on carrying out his practical advice with the utmost simplicity. No one seeking a medical remedy would expect to be cured merely by studying a medical textbook: without some background, the average layman would find such a work quite baffling. As every doctor would tell his patients, after all the explanations, what really counts is actually swallowing the pill. So too with Rebbe Nachman's teachings. In the words of Reb Noson:

"While it is certainly true that the Rebbe's discourses contain awesomely profound ideas, plumbing the deepest mysteries of the Torah, even so, he put the main emphasis on their simple meaning. The Rebbe's lessons are not in heaven. `The main thing is not the theory but the practice' (Avot 1:17). Anyone can carry out what he says and accomplish great things. All that's needed is truth and sincerity. Open your heart to the simple meaning of his words and you will find a pathway to God. You may study some of his discourses and think that they apply only to those who have reached exalted spiritual levels. At first you may not be able to find anything that seems to apply to you personally. But look more carefully. Open your eyes and heart, and you will certainly find guidance and a way that you too can follow" (Rabbi Nachman's Wisdom #131).

Ultimately, all Rebbe Nachman's pathways are simple: sincere personal prayer from the heart in one's own words; turning one's thoughts to the good side of things; inspiring oneself with a joyous melody; making regular gifts to charity according to one's means; mouthing out the words, "I believe in You...."

Can simple methods really help? Rebbe Nachman once said to his followers:

"Didn't the prophet Elishah say to the leprosy-stricken Naaman (Kings II, 5:13), `Wash [in the River Jordan] and be purified'? Yet Naaman didn't want to believe that he could be cured through something so simple, and he said, `Aren't Amana and Pharpar, the rivers of Damascus, better? May I not wash in them and be purified?' But his servants said to him, `My father, if he had told you to do something great, wouldn't you have done it? How much more so when he tells you to wash and be purified.' Only then did Naaman listen. He washed in the Jordan seven times, `and his flesh came back and was clean.' You are the same. You believe that in order for you to be healed I have to prescribe onerous devotions. You don't have faith that through something simple that I tell you to do, you can be completely healed - healed in your very souls!" (Tzaddik #492).

Spiritual healthcare

It's not worth waiting till you fall sick before starting to take care of yourself. By then it can be far more difficult to restore and maintain bodily health, and sometimes it may be just too late. Rebbe Nachman held that even when illness has already struck, it is certainly possible to be healed through the pathway of joy, faith and prayer. Yet it is far preferable to follow this pathway as one of prevention, so that any latent problems are cured long before they develop into actual illnesses.

The key is to develop healthy habits, spiritually and physically, and to make simchah, Torah, prayer, hisbodedus, charity, kindness and all the other mitzvot an integral part of one's life every day. As a way of health and prevention, the spiritual pathway Rebbe Nachman teaches is none other than the path of faith, Torah and prayer discussed in all his writings (see Advice, Rabbi Nachman's Wisdom, etc.). The Rebbe once said, "When you're healthy, devote all your strength to `do and do' in serving God" (Avanehah Barzel p.44 #64). This is because serving God is life, "for they are your life and length of days" (Deuteronomy 30:20). Torah study, prayer, self-development, love of others, kindness, charity and all the other mitzvot connect us with the Life of life. They are our best investment not only for long-term life and sustained good health, but for rich vitality every day.

"One mitzvah leads to another" (Avot 4:2). When we strive to carry out the mitzvot not as soulless acts of duty but as heartfelt gestures of outreach and connection with God on every level of our being, in thought, word and deed, then every successive step we take opens up new dimensions of the mitzvah at hand and other related mitzvot. This leads to higher and higher levels of devotion in prayer and hisbodedus, fresh horizons in our understanding of Torah, and ever-enhanced self-refinement. Making the mitzvot into an all-encompassing pursuit in the home, at work, with family and friends, in the community and in the wider world is the life of simchah that brings glowing health and healing.

The Breslover Chassidim point out that the four Hebrew letters of the word שמחה  (SiMChaH) are the initial letters of the Hebrew words for four key practices that are at the heart of Rebbe Nachman's pathway: ש'ולחן ערוך , Shulchan Arukh - the study of Jewish law; מ'קוה , Mikveh - ritual immersion; ח'צות , Chatzot - Tikkun Chatzot, the midnight lament over the destruction of the Holy Temple, and ה'תבודדות , Hisbodedus - private prayer and meditation.


The single most important spiritual habit to cultivate is daily hisbodedus. In essence, hisbodedus is private time that a person takes from his or her daily activities in order to confront the basic issues of life: "What is my purpose in this world? What am I doing with my life? What are my true goals? To what extent am I achieving them, and if I am not, why not? What are the internal and external problems and obstacles that are holding me back? And how, with God's help, can I overcome them in order to attain complete self-fulfilment?" Facing these questions helps us to accept the fact of our own mortality and value the gift of life so that we live it to the fullest.

Unless we take regular breaks from the immediate business of living in order to work out how to attain what is most important to us, we are liable to become helplessly swept up by one current after another, and we may never come to true fulfilment. Hisbodedus is a daily workshop in which we take ourselves and our lives in hand in a creative partnership with God. It is the time to make contact with our inner thoughts and feelings, to work out our priorities, and to ask God for everything we need, spiritually and physically. As we have seen, man achieves his true dignity when he draws all his needs in life through prayer . Hisbodedus is the time to search for the good points within ourselves and in all the different situations we confront, and this is the very key to joy, health and healing.

The ideal would be to practice hisbodedus for about an hour every day. For those who find this impossible, even sessions of ten to fifteen minutes can be highly valuable, and are certainly far better than nothing. Like life, the agenda of hisbodedus is constantly changing. By definition there is no uniform method, because each person's situation is completely unique. Just about the only rules are (1) to be completely truthful at all times, and (2) to persist. How each person turns to God is a very individual matter, and each of us must find our own way, whether through quiet meditation, contemplation, personal prayer, cries, tears, song or any other appropriate form of self-expression (see Outpouring of the Soul and Under the Table pp. 101-144).

Shulchan Arukh: Jewish Law

"The Academy of Eliahu taught: Everyone who studies halakhot every day is assured of a place in the World to Come."

Megilah 28b

Study of the halakhah, Jewish law, is crucial for sound spiritual development, because without objective guidelines for our choices in life, we become ready prey for our own whims and misconceptions. The halakhah is the guide to what the Torah is actually asking us to do in life, giving clear directives for dealing with any and every situation with which we may be confronted at any time. While the halakhah relating to unusual and intricate cases is the special province of trained Rabbis, every Jew is duty bound to become familiar with the basic laws relating to everyday life, prayers and blessings, Shabbat and festivals, kashrut, family purity, interpersonal relationships, purity of speech, charity, business practice, etc. Moreover, regular study of the halakhah is a most powerful spiritual remedy. In the words of Rebbe Nachman:

"When a person sins, good and evil become mixed together. But a legal opinion is a clear separation between the permitted and the forbidden, the clean and the unclean. When you study religious law, good is once again separated from evil and the sin is rectified" (Rabbi Nachman's Wisdom #29; cf. Likutey Moharan I, 8:6).

Rebbe Nachman teaches that the Torah contains the roots of the entire creation, including all forms of conflict in the world. Even unholy conflict, such as the war of the evil urge against the soul, is also ultimately rooted in the Torah - in this case in the holy disputes between the mishnaic and talmudic Sages. The remedy for these holy disputes is the halakhah, which "makes peace" between the Sages, steering a steady path amidst their opposing viewpoints in order to reach a clear legal decision. "And through study of the halakhah, a person becomes attached to the peace that reigns in the realm of holiness. The holy disputes are resolved, and then the unholy turmoil in his heart caused by the evil urge is automatically removed, and he is able to serve God with all his heart" (Likutey Moharan I, 62:2).

We have seen that, according to Rebbe Nachman, all illness is caused by conflict among the bodily elements. Since the study of halakhah connects one with the holy peace that is the remedy for all forms of conflict in creation, halakhah is clearly a powerful means of promoting peace and harmony within the self and in our very bodies, and thus a way of promoting good health.

Rebbe Nachman urged everyone to study halakhah every day without fail (Rabbi Nachman's Wisdom loc..cit.). Those who are able to study the Shulchan Arukh with its commentaries should aim to go through the entire work in order and then review it again and again. For those who are unable to study the original, a wide variety of clear and easily understandable halakhic texts is available in English covering all the mitzvot of everyday life (see Under the Table pp .293f.). Make a list of the main areas you should be familiar with, and work through the relevant texts one after the other. When you are fully familiar with them, move on to more comprehensive works.


In the absence of the Holy Temple, immersing in the mikveh (ritual bath) is not mandatory today except for married women after niddah (ritual impurity) and for men on the eve of Yom Kippur (the Day of Atonement). However, chassidic literature in general and Breslov literature in particular emphasize the tremendous spiritual benefits that come from regular immersing in the mikveh prior to the morning prayers and in preparation for Shabbat and festivals. It is a practice that leads to the utmost personal sanctity, removing the impurity caused by sin, and bringing freedom from troubles, physical and spiritual. For "God is the hope (מקוה , mikveh) of Israel. He saves them in times of trouble" (Jeremiah 14:8).

Besides the spiritual benefits of the mikveh, Rebbe Nachman also pointed out the physical benefits:

"Immersing in the mikveh is not harmful at all, and any doctor who says the mikveh is harmful is no doctor at all. On the contrary, immersing in the mikveh is very beneficial for physical health. There are innumerable tiny ducts in the skin through which the sweat is secreted. It is important to open them, because if the sweat ducts are closed up, a person can become very weak. Immersing in water opens the sweat ducts, and this is very beneficial for physical health - as long as the water is not excessively cold, because then the water stops up these ducts. But when the water is not too cold, immersing is very healthy" (Likutey Moharan II, 123).

Tikkun Chatzot

Tikkun Chatzot is a special prayer service recited in the small hours of the night throughout the year to express our grief and concern over the destruction of the Temple and the Jewish exile. Interrupting our sleep in the middle of the night for prayer and devotion helps break the darkness of night - the night of exile - thereby initiating the redemption of the individual and the nation and the restoration of Jerusalem (see The Sweetest Hour for full details). Like immersing in the mikveh, Tikkun Chatzot is not a mandatory practice, but it is without question a central element of a life of true devotion and service of God.

The theme of chatzot, "midnight," comes into "Sound the Shofar - Dominion" (#4, and see note 19). We see there that Jerusalem -Yerushalayim - is not only a physical place but also a spiritual ideal that we must seek to realize in our own hearts: yir'ah shalem, complete awe and awareness of God. Thus the Chatzot prayers over the destruction of Jerusalem "do not refer only to the historical past. More important, they refer to what each individual is going through in the present. When you realize this, you can find all your own inner conflicts and your struggles with the evil urge expressed in the prayers of Chatzot" (Likutey Moharan II, 101).

Tikkun Chatzot is the time to look deep into one's heart and, while grieving over one's many flaws and imperfections, to search for the redeeming sparks of good. "`I will remember my song in the night; I will converse with my heart and my soul will search' (Psalms 77:7). This teaches that the main time to search for the `good spirit' is at night. Through the melody and joy that come from searching for the good, one can keep one's mind focussed on one's ultimate purpose in this world. This stirs one to pour out one's heart and speak to oneself about one's eternal destiny in the World to Come, and to seek and find one's good points, in order thereby to return to God" (Likutey Moharan I, 54 end). This is the work of building yir'ah shalem, which, as we see from "Sound the Shofar - Dominion," is the foundation of true prayer. Prayer is the channel for genuine healing and freedom from illness. Thus Tikkun Chatzot, which is all about rebuilding Yerushalayim, yir'ah shalem, is one of the key components of Rebbe Nachman's healing pathway.

Rebbe Nachman said that the time for Tikkun Chatzot always begins exactly six hours after nightfall, both in the summer and in the winter, and continues for two hours (Likutey Moharan I, 149). Even today, many Breslover Chassidim are in the habit of retiring fairly early after the evening prayers in order to get up at the proper time for Tikkun Chatzot, following it with hisbodedus or Torah study. Some go back to sleep afterwards, while others remain awake until the morning, praying with the first light of day and then taking a nap for an hour or more to ready themselves for their daily activities.

Rebbe Nachman had one follower who found it quite impossible to get up at the right time for Tikkun Chatzot. Rebbe Nachman said to him: "Get as much sleep as you need.... Your Chatzot is at 3.00 a.m." (Kokhvey Or p.25). Instead of telling this chassid to abandon the idea of getting up for Chatzot altogether, the Rebbe gave him a way of carrying out the mitzvah that was possible for him. Those who find themselves unable to manage with less than seven or eight hours of uninterrupted sleep at night can still try to get to bed earlier in the evening in order to wake up an hour or two before the light of day for early morning sessions of hisbodedus and Torah study.

Rising regularly for Tikkun Chatzot can be fairly demanding, and some people may feel it to be altogether beyond their capabilities. But even those who feel unable to practice Tikkun Chatzot are urged to explore the possibility of arranging their schedule in such a way that they can rise early in the morning on a regular basis. The very first halakhah in the Shulchan Arukh tells us to "be strong as a lion to get up in the morning to serve your Creator. You be the one to arouse the dawn!" (Orach Chaim 1:1). This attests to the value and importance of early rising in the life of the spiritual seeker. Those who do so regularly know the unique blessing of the quiet hours of the early part of the day, and find that they can accomplish far more of the things that really count in life than they can by staying up very late at night and starting late in the morning (see Azamra! pp.19-46).

Physical healthcare

Does Rebbe Nachman's emphasis on spiritual remedies imply that as long as we devote ourselves to prayer, Torah and mitzvot with all our hearts, our bodies will somehow take care of themselves, so that diet, exercise, hygiene and other aspects of physical healthcare can simply be ignored?

Rebbe Nachman's profound respect for the physical body is expressed in the closing words of his beautiful poem, Shir Na'im ("Pleasant Song"), printed at the beginning of Likutey Moharan:

"Let us apply our hearts to wisdom and seek to understand the design of our body, the proportions of its bones and joints and the arrangement of its organs.

This understanding, which is so necessary, helps one to know the Creator and Former of all these creations,

Who heals all illnesses and each person's pains: the blind, the lame, the leper and the smitten, those who are anxious and those who are in pain.

Let us eat only for the sake of our souls, minimizing our physical lusts."

The body is a living teacher about God. "From my flesh I see God" (Job 19:26): the limbs and organs of the physical body, its structure and proportions all allude to aspects of divinity. Moreover, it is only with the physical body that we can carry out the mitzvot and accomplish our mission in this world. Without doubt, the soul is the essential self, while the body is secondary. But the body has to be properly cared for in order for the soul to be able to carry out its mission.

As a physical organism, the body has needs of its own. As Rebbe Nachman said, "It is completely impossible to be attached to the Torah all the time, day and night, without a moment's interruption. Every Torah scholar and even the greatest spiritual master must necessarily interrupt his devotions for a certain time to attend to the needs of the body, etc." (Likutey Moharan II, 78). Guarding our health is itself one of the mitzvot: "Take care of yourself, and guard your soul diligently" (Deuteronomy 4:9). This is a positive duty. In the Hebrew, the word translated as "diligently" is מאד  (me'od), which literally means "very much." We are duty bound to take the utmost care of our physical health. Good health is a precious gift of God, and it is incumbent upon the recipient to guard and protect it in every way possible.

Moreover, as we have seen, Rebbe Nachman taught in "Why do people get sick?" that "when a person curbs his desires and submits to a medical regime... his soul sees that he has the power to control his impulses in order to achieve a certain goal, and she therefore comes back to him in the hope that he will curb his desires for the sake of the true purpose" (Likutey Moharan I, 268). This implies that a sound regime of diet and exercise, etc. can itself enhance our spiritual powers and become the foundation for a disciplined lifestyle that can lead to complete self-fulfilment. This is attested to by the many people who have found that a sensible program of diet and exercise greatly increases their mental tranquillity, clarity, energy levels and zest for life.


Rebbe Nachman warned his followers never to smoke, and he told them not to drink except on Shabbat, festivals and other religious celebrations, and then only in great moderation. It goes without saying that he would have been opposed to all other kinds of substance abuse. In the ever more complex world in which we live, there are innumerable other things that are hazardous, from asbestos to zirconium. In the words of the Shulchan Arukh:

"It is a positive duty to take all due precautions and avoid anything that may be a danger to life, as it is written, `Take care of yourself, and guard your soul diligently.' The Sages prohibited many things that involve a risk to life. Anyone who violates such prohibitions, saying `I'm only putting myself at risk - what business is that of anybody else?' or `I'm not particular about such things,' deserves a lashing" (Choshen Mishpat 427:8-10).

It is a rabbinic principle that "a danger to life must be treated with greater stringency than a ritual prohibition" (Chullin 10a). Besides obvious physical dangers, the Rabbis also warned against various other practices deemed hazardous to physical and/or spiritual health, such as things that cause forgetfulness and certain other harmful practices in connection with eating and drinking, dress, bathing and grooming, sleep, travel, marriage, illness, death and burial, etc. (see Kitzur Shulchan Arukh #33 and Y. Y. Lerner, Shemirat HaGuf veHaNefesh, passim).


The table, as the place where we eat, should be a central focus in our quest for health and healing. Thus the Hebrew letters of the word ShuLChaN, "table", have the same numerical value as the Yiddish expression Tzu ReFU'AH, "for healing" (Tzaddik #476).

As we have seen, one of the greatest ever Breslover Chassidim, Reb Avraham Chazan, said: "Since the Rebbe warned us against doctors and medicine, we have an obligation to make every effort to eat only healthful foods" (Siach Sarfey Kodesh #3-539). What we eat and, equally, if not more important, how we eat, has a profound effect on our mental states, our thoughts, feelings, moods, general morale, energy levels and, of course, our physical health. Eating the wrong foods, or even the right foods in the wrong ways, can cause mood swings, tension, fatigue, negativity and depression, as well as long-term debilitation and degeneration of bodily organs and tissues.

The talmudic dictum that "more people are killed by the cooking pot than suffer from starvation" (Shabbat 33a) shows that the Rabbis were fully aware of the dangers of bad eating habits. Rebbe Nachman saw proper eating as a mark of basic human dignity: "A person who eats more than he needs is eating like an animal. One of the marks of human dignity is to eat only what one needs. To eat more than that is to act like an animal, who eats and chews the whole day, and this can bring on a fever" (Likutey Moharan I, 263).

Besides pointing to the physical dangers of excessive indulgence, Rebbe Nachman also emphasized its negative spiritual effects: "Eating properly subdues the tendency towards folly, enhancing one's intellectual and spiritual faculties. But when one overindulges and eats like a glutton, folly will get the upper hand and overcome one's intellectual and spiritual faculties" (ibid. I, 17:3). "Our states of mind directly correspond to the food we eat. When the body is pure, the mind is clear and one is able to think properly and to know what to do in life. But impurities in the body cause putrid gases to rise to the brain, throwing the mind into such confusion that it becomes impossible to think straight" (ibid. I, 61:1).

Rebbe Nachman said little about what foods to eat and what to avoid, though he did warn against eating unripe fruits and raw onions (Likutey Moharan II, 88; Rabbi Nachman's Wisdom #265). Rabbinic guidance on basic principles of diet can be found in Kitzur Shulchan Arukh (32:2-19), in the Rambam's Mishneh Torah (Hilkhot De'ot 4:6-13) and at greater length in his Hanhagat HaBri'ut (#1). A more extensive Hebrew compendium of rabbinic lore on various aspects of diet, including the nutritional qualities of many different kinds of foods, is included in Tav Yehoshua (see Sources and Further Reading). However, in view of the innovations in food production in the modern era and the consequent changes in eating habits, we cannot necessarily expect direct guidance from classic Torah sources about how best to nourish ourselves today.

People's physical constitutions vary enormously. Different people have their own individual food needs, and may react to specific foods in very different ways. In the words of the Kitzur Shulchan Arukh: "Every individual should consult with medical experts to choose the foods best suited to his or her particular constitution, place and time" (Kitzur Shulchan Arukh 32:7). For those who wonder what Rebbe Nachman would have thought about turning to medical experts for nutritional advice, it is worth noting that the Ramban, who was equally opposed to going to doctors, considered the giving of such advice to be the one valid function of the medical profession! (Ramban, Commentary on the Torah, Leviticus 26:11) Those unable to turn to a competent nutritionist would be advised to consult contemporary works offering sensible nutritional guidance.

An obvious problem when seeking such guidance is that there are so many controversies among nutritionists of various schools over vitamin and mineral supplements, refined flour and sugar, meat-eating vs. vegetarianism, food combining, pesticides and any number of other issues. There is no option but to pray for clear guidance as to what and how to eat in order to keep ourselves fit and well to serve God. And when we find out which foods are best for us, we must then pray for help to keep to our diets.

Since Rebbe Nachman taught that a person can be healed through bread and water alone, it seems likely that in general he would have advocated simpler foods with a minimum of additives and supplements. When it came to religious stringencies, Rebbe Nachman's advice was not to be unnecessarily strict but simply to follow Jewish law (Rabbi Nachman's Wisdom #235). Presumably he would also have been opposed to turning diet into a fetish. He taught that the food of Shabbat is in a completely different category from that of the six working days, and he encouraged his followers to eat plentifully and enjoy their food on Shabbat (Likutey Moharan I, 276 & 277; ibid. II, 17).

Besides urging moderation, the Rebbe put great emphasis on how we eat. "Be careful not to gulp your food down hurriedly. Eat at a moderate pace, calmly and with the same table manners you would show if an important guest were present. You should always eat in this manner, even when you eat alone" (Tzaddik #515; for a fuller discussion of diet, see Under the Table pp.74-82).


The importance of exercise as an integral part of health maintenance needs particular emphasis, because it is still insufficiently appreciated in many circles. In the words of the Rambam: "Exercise is the most important fundamental in maintaining good health and keeping up our resistance to the majority of illnesses. Through exercise it is even possible to neutralize the damage caused by many bad habits" (Hanhagat HaBri'ut 1:3). "Even if you eat good foods and take proper care of your health in other respects, if you sit back comfortably and do no exercise you will suffer from constant aches and pains and your strength will decrease" (Mishneh Torah, Hilkhot De'ot 4:15).

Rebbe Nachman did not discuss exercise directly. Perhaps he didn't need to: his followers certainly didn't go everywhere by car like many people today, and most of them didn't have their own carriages either. They must have walked about in the fresh air far more than most people in our urbanized, technological world, and they were probably considerably more physically active! Rebbe Nachman recommended going out into the meadows for hisbodedus. This was primarily for the spiritual benefits, but it is also a fact that walking in the countryside is one of the best forms of exercise there is. We find that when he became sick, the Rebbe himself would take walks in the fields for his health (Rabbi Nachman's Wisdom #144).

Rebbe Nachman explicitly mentions that a good sweat helps remove illness-generating toxins from the body and brings a person to joy (Likutey Moharan II, 6). The Rebbe was specifically referring to sweating over a holy task (such as dancing at a wedding, baking matzot, etc.). Exercise enthusiasts might argue that exercising in fulfilment of the mitzvah of "Take care of yourself..." would also come into the same category, and they could cite this teaching as further endorsement of the value of a regular workout!

A Good Sweat

"A good sweat (as when one sweats over a holy task) leads to joy - festive joy, as it is written, `And you will rejoice on your festival' (Deuteronomy 16:14). (This need not necessarily be on an actual festival: any day which contains good is a yom tov, literally a `good day,' i.e. a `festival.') The reason is that joy depends on the state of the blood. Depression is caused by the spleen [whose functions include filtering the blood]. Malfunctioning of the spleen gives rise to impurities in the blood. An excess of impurities in the blood causes illness. When the impure blood in the spleen is within normal limits it is beneficial, because the spleen removes the impurities in the blood-stream, leaving the blood pure. But when too much impurity builds up in the spleen, it causes illness.

"The remedy is to sweat, because the illness-generating toxins in the blood are exuded in the sweat, and the blood is left pure. One can then come to joy. The reason is because depression is caused by the build-up of impurities in the blood and the spleen. Now that the impurities have been flushed out through the sweat, one comes to joy. And thus the letters of the Hebrew word for sweat, ZeY'AH, are the first letters of the words in the phrase Zeh Hayom Asah YHVH), `This is the day God made' (Psalms 118:24). This is the festive joy brought about by a good sweat. This explains what we often see, that as soon as a sick person sweats, he feels happy - because the sweat brings about joy" (Likutey Moharan II, 6; see Reb Noson's prayer bassed on this teaching).

What kind of exercise? The Rambam writes: "Not every bodily movement is `exercise.' Exercise is defined as any form of movement - whether vigorous, gentle, or a combination of both - that involves some effort and causes an increase in one's breathing rate" (Hanhagat HaBri'ut 1:3). This would seem to correspond to what we today would call aerobic exercise: a steady, non-stop activity that leads to an increased pulse rate yet without putting strain on the cardiovascular system. Aerobic exercise helps develop cardiovascular endurance, the sustained ability of the heart, blood vessels and blood to carry oxygen to the cells and remove waste products. A balanced exercise program should also include exercises that promote muscular strength and endurance and flexibility of the joints.

It is essential to tailor a physical fitness program to one's state of health, fitness and other individual factors. No one should begin any program of exercise without first consulting a competent authority. The body is a most wonderful, subtle, delicate instrument that has to be treated with the utmost care and respect. Those who have not exercised for a long time and are out of condition must be very gentle and patient while slowly encouraging stiff joints and weak muscles to start working again.

One of the most perfect forms of exercise is chassidic dance, in which all parts of the body are moved with grace and joy in praise of the Creator. In Rebbe Nachman's teaching on the healing power of joy, he points out that the Hebrew word for a sick person, חולה  (choleh), is also the word for a "dance circle," and thus the dance circle of the Tzaddikim in time to come will mark the ultimate triumph over illness (Likutey Moharan II, 24). The implication is that chassidic dance is a most powerful weapon in our healthcare armory. Reb Noson told one of his students, "I'll give you a pathway to repentance: dance every day!" (Avanehah Barzel p.62 #29). What better way of combining physical and spiritual exercise than to make it a regular practice, six days a week, to play tapes of your favorite nigunim and to dance free-style for seven to twelve minutes or more? (For a fuller discussion of exercise, see Under the Table pp.95-99.)

Relaxation and breathing

The relationship between chronic tension and poor health is now well established. In the stressful world in which we live, it is important to learn how to release anxiety and tension and relax. The best foundations for genuine relaxation are faith and trust that everything in our lives is sent from God and that no matter what might happen, God will always take the best care of us. With these basic attitudes, physical relaxation techniques can be an excellent way of unwinding, getting in touch with one's thoughts and feelings, and re-energizing. Even brief periods of relaxation can be an excellent preparation for prayer, hisbodedus, Torah study and many other activities. (For relaxation techniques, see Under the Table pp.64-72.)

Excessive tension is often a factor in faulty and inhibited breathing, which can give rise to low energy levels, lack of clarity, nervousness and a lowering of resistance to disease. It is most valuable to learn to breathe freely and fully, and to make it a habit to pause periodically in the course of one's daily activities in order to re-energize with a few long breaths. (For a full discussion of breathing, see Under the Table pp.83-95.)

General healthcare

The Rabbis put great stress on general cleanliness and hygiene, not only because of their importance for our physical health but also because "everyone who is careful about these matters brings extra holiness and purity into his soul and refines his soul for the sake of God's Name, fulfilling the command (Leviticus 11:44) to `sanctify yourselves and be holy, for I am holy'" (Mishneh Torah, Hilkhot Maakhalot Asurot 17:32). It is most desirable to gain a basic knowledge of the workings of the human body and to make a study of the fundamentals of self-care, including diet, fitness, dental care, how to prevent injury at home, outdoors and at work, stress management, precautions when traveling, and so on.

On the other hand, Rebbe Nachman was against going to extremes in such matters. For example, there were people who used to spend much time in the lavatory attempting to cleanse their bodies totally prior to their morning prayers. Rebbe Nachman ridiculed this practice because "the Torah was not given to ministering angels" (Berakhot 14a; Rabbi Nachman's Wisdom #30; Tzaddik #498). From his comments on this subject we can infer that while it is clearly desirable to take proper care of ourselves, it would be wrong to allow this to become obsessive.

Preventive medicine

Rebbe Nachman insisted that his followers have their children vaccinated against smallpox. This was a procedure that had proved itself, and it would seem reasonable to infer that Rebbe Nachman would have readily endorsed other tried and tested preventive procedures that have been developed since his time, such as immunization against diphtheria, tetanus, polio and so on. Nevertheless, in view of the controversies among doctors over the necessity and safety of certain vaccinations, one should seek expert advice in all questions concerning immunization.

Regular physical check-ups and screening are obviously recommended since the chances of recovery from cancer and other serious illnesses are far greater when they are detected at an early stage. Diagnostic testing of many different kinds has become increasingly common in contemporary medical practice. Besides well-established blood tests, urine analysis and screening for breast, cervical and colon cancer, many other advanced diagnostic methods are now available using ultrasound, magnetic resonance imaging (MRI), biochemical markers, etc. It is possible to identify many subtle conditions that could not have been found a few decades ago. However, it should be remembered that by no means are all tests offered by medical centers necessary. Studies indicate that certain diagnostic tests often detect trivial anomalies that may well remain dormant for life or even disappear, while the treatment offered may be ineffective or even dangerous.

We should always be aware that our lives are ultimately in God's hands and that our health is a precious gift that we are duty bound to cherish and protect by doing our part. Even when resorting to medical procedures, we should offer a prayer and take the opportunity to inwardly reaffirm our commitment to the spiritual pathway of faith and joy, and to sensible diet, proper exercise and other forms of self-care. Each day, when reciting the blessing said after relieving oneself, we should remind ourselves of God's awesome kindness in giving us our health and contemplate the amazing wisdom with which He fashioned the human body and the wondrous way in which He heals all flesh.




By Rabbi Avraham Yehoshua Greenbaum
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