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Medicine on Shabbos

 

I. Outdated Prohibition?

Medical technology has changed so dramatically over the past century that we can barely imagine the healing process of past years. Presumably, Jewish law should reflect that change, relating to current medicine rather than that of the past. In particular, the prohibition against taking medicine on Shabbos (absent pressing need) seems ripe for reevaluation. While halakhah is not changing, the appropriate rule for the different circumstances must be invoked.

We are forbidden to take medicine on Shabbos out of a concern that we might grind, which is biblically prohibited (Shulchan Arukh, Orach Chaim 328:1). However, medicine today is manufactured commercially and/or mixed at a pharmacy. We do not grind our own medicines but instead take the liquids and pills professionally prepared. If so, does this prohibition still stand?

To be clear, someone with a serious need for medication may certainly take it on Shabbos. There are numerous other exceptions (we’ll briefly mention some below) and you should discuss your personal situation with your rabbi. Good health is unquestionably a religious value. However, sometimes you just have a minor headache or need a little ointment or some other minor medical need that is not pressing. In ancient times, you might have ground yourself some herbs to relieve your pain. Must we retain this outdated concern?

I can imagine some people thinking that raising this question is bordering on heresy, revealing a lack of faith in the halakhic system. Quite the opposite! This is an excellent question that the greatest halakhic authorities of recent times have asked.

II. Permissible Today

R. Avraham Chaim Na’eh (Ketzos Ha-Shulchan 134 n. 7.2) considers the above logic to permit taking medicine in pill form on Shabbos. Since the rabbinic concern for grinding no longer exists, perhaps the prohibition no longer applies. He bases his argument on the Rema (Orach Chaim 339:3) who, quoting Tosafos (Beitzah 30a sv. tenan), permits clapping on Shabbos because we are no longer concerned that this might lead to fixing a musical instrument. Once the reason for the rabbinic decree ceases, the prohibition falls aside. However, because there are still some people somewhere in the world who grind herbal medicine (at the time of his writing and still today), R. Na’eh was not willing to rule leniently.

This general approach is very difficult because the view of the Rema and Tosafos seems to contradict explicit Talmudic passages. While resolutions have been proposed, none are particularly satisfying. As R. Joseph B. Soloveitchik is quoted as saying (Nefesh Ha-Rav, p. 173), we don’t understand the initial permission so how can we expand it to others cases? (See also Pischei Teshuvah, Even Ha-Ezer 13:4, 9; Iggeros Moshe, Orach Chaim 2:100.) For this reason, most later authorities reject R. Na’eh’s permissive theoretical view.

III. Two Approaches

R. Eliezer Waldenberg (Tzitz Eliezer vol. 8 15:15) takes a different path toward leniency. He argues that two general approaches exist to the prohibition against (non-essential) healing on Shabbos. Rashi (Shabbos 53b sv. gezeirah) believes that the Sages enacted a general (obviously rabbinic) prohibition against any type of healing on Shabbos. While the underlying concern was grinding on Shabbos, the prohibition itself is not directly related. We see this in a number of cases, such as the permission to place a plaster on your eyes on Shabbos, which would be forbidden because of healing except that it looks like cleaning your eyes (Rashi, Shabboss 108b sv. ve-nosein). And similarly, Rashi (Shabbos 111a sv. aval) explains that you may not anoint with rose oil because you are clearly doing it solely for medical purposes. None of these examples involve a concern for grinding medicine but are still forbidden because of the general prohibition.

On the other hand, Rambam (Mishneh Torah, Hilkhos Shabbos 21:31) permits certain acts of healing, implying that the prohibition was specifically against taking medicine to treat an illness that is generally healed with privately ground medicine. Even if you do not grind the medicine, taking it is forbidden because grinding is generally involved in treatment.

According to Rashi and those who agree with him, the change in medical technology does not undermine the general prohibition of the Sages. While they may not have enacted such a prohibition today, their ancient enactment remains in force. However, according to the Rambam, this enactment is specifically about grinding medicine on Shabbos that you normally grind during the week. Since we do not personally grind medicine anymore, the prohibition should no longer apply.

IV. Qualified Leniency

Significantly, the Shulchan Arukh (ibid.) adopts the Rambam’s approach. If we follow this view, then today when we do not normally grind medicine for any illness, we may presumably freely take medicine on Shabbos. However, R. Waldenberg is cautious because some people do grind homemade remedies and because there are other interpretations of the Rambam’s position. He therefore decides to be as lenient as possible without being entirely permissive.

He notes that some quote R. Shlomo Kluger as permitting continuing taking a medication on Shabbos that you have already started taking prior. While R. Waldenberg disagrees with R. Kluger, he permits continuing taking medicine if failing to do so will cause severe discomfort. He allows relying on R. Kluger’s view because of, additionally, the above argument to permit taking medicine in general.

Similarly, R. Ovadiah Yosef (Yalkut Yosef 328:52) finds R. Na’eh’s reasoning convincing but, without dismissing the prohibition, allows for great leniency. For example, he permits someone accustomed to swallowing pills to take medicine to relieve pain. R. Eliezer Melamed (Peninei Halakhah, Shabbos 28:5 and in harchavos) also allows taking medicine when suffering from pain that does not render you a choleh she-ein bo sakanah, because of the lenient views. See also She’arim Metzuyanim Ba-Halakhah (Beitzah 5a sv. kol).

V. Stricter Views

However, other authorities disputed R. Waldenberg’s conclusion, which is based on his original interpretation of the Rambam. As mentioned above, R. Joseph B. Soloveitchik opposed leniency on this subject. Similarly, R. Moshe Feinstein (Iggeros Moshe, Orach Chaim 3:53) forbids taking pills on Shabbos. R. Yehoshua Neuwirth (Shemiras Shabbos Ke-Hilkhasah 34:3), Dr. Avraham S. Avraham (Nishmas Avraham, Orach Chaim 328:5) also maintain the Talmudic prohibition against taking medicine.

 

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Gil Student

Rabbi Gil Student is the founder, publisher and editor-in-chief of Torah Musings.

 
The opinions and facts here are presented solely by the author. Torah Musings assumes no responsibility for them. Please address religious questions to your rabbi.
 

34 Responses

  1. IH says:

    That whole section of B. Shabbat 108b – 111b is amazingly eye-opening (pardon the pun, if you’re familiar with the text).

  2. IH says:

    [BTW, I keep meaning to find the time to listen to some of the MP3 Daf Yomi sessions to listen how they handle the sugiya about the woman and the snake on 110a. Wow!]

  3. IH says:

    Gil, Tal, Steve — What does the Brisker mesora have to say about that strange sugiya? Particularly the piece that Artscroll translates as “A woman who was entered by a snake should part her legs and be made to sit on two barrels. One should bring fatty meat and throw it on burning coals. And he should also bring a basket of cress and fragrant wine, and put them there. One should mix [the wine and cress] together. [The woman] should hold a pair of tongs in her hand so that when the [the snake] smells the aroma and comes out of her, she will be able to sieze it and burn it in the fire. For if she does not do so, it will return to her.”

  4. Yannai Segal says:

    It’s always seemed to me that the halacha developed under the assumption ancient medicine was actually pretty much useless if not dangerous, which is probably historically accurate.

    Anyone know if there have been any academic (or halachik) works that have taken that approach.

  5. Mr. Cohen says:

    We live in an era where the Yeshivah world and Chasidim mostly believe that there is no such thing as a valid leniency, and even if there were such a thing, taking advantage of it would indicate spiritual inferiority; in our times, the popular fashion in the world of Orthodox Judaism is “the stricter the better, to Hell with leniencies.”

    There probably are perfectly logical reasons for permitting medicine on Shabbat, but nobody in the Orthodox world will listen to you; in our times, most Orthodox Jews believe that Halachah can only be decided by a tiny number of senior Rabbis, and everyone else must just follow them without question, and applying simple logic to Halachic situations is totally inappropriate, regardless of how valid the logic is.

  6. Mike S. says:

    While the Rav, ZT”L, may have opposed the theoretical leniency of R. Naeh, the one time I asked him a shaila about a pill I was then taking on a daily basis to help control a non-debilitating case of asthma he told me to take it on Shabbat.

  7. Shlomo says:

    Once the reason for the rabbinic decree ceases, the prohibition falls aside.

    In some cases that is obviously not true, for example yom tov sheni.

    Has anyone ever comprehensively investigated when it is the case and when not?

  8. J. says:

    Shlomo – R. Neriah Gutel in his ‘Hishtanus Hatevaim Behalachah’ has a summary of the various opinions on this issue. I think this is an area ripe for further research.

  9. avi says:

    I have often been told that there is a general idea, that we don’t heal on Shabbat, not because of any melacha persay, but because we it’s against the spirit of Shabbat. (Similiar to the claim that we don’t make requests from Hashem on Shabbat)

    A. Is this true?
    B. If it is true, could we learn here from the gemorah, that sometimes, (like using eletricity in general) we are supposed to stretch and find a possible melacha to “attach” a general shabbat prohibition to?

  10. Shlomo says:

    not because of any melacha persay, but because we it’s against the spirit of Shabbat.

    Suffering from an illness is also not in the spirit of shabbat…

  11. avi says:

    “Suffering from an illness is also not in the spirit of shabbat…”

    You can relieve suffering without healing. The Talmud allows us to do many things that relieves suffering. But it doesn’t allow us to heal.

  12. IH says:

    Suffering from an illness is also not in the spirit of shabbat

    But, the gemara is not so clear cut. I have only been doing Daf Yomi, not learning it in depth; but, for example (from 108b, this time using Koren’s trsnslation):

    Ravin asked another question: When one washes himself on Shabbat in water from the Dead Sea, what is the halakha? Is it permitted for him to close and open his eyes in the water so that the water gets inside? Rabbi Yirmeya said to him: That case I did not hear; however, with regard to a similar case, placing wine in one’s eye on Shabbat, I did hear. As Rabbi Zeira said, sometimes he said it in the name of Rav Mattana and sometimes he said it in the name of Mar Ukva, and they both said it in the name of Shmuel’s father and in the name of Levi: One of them said: With regard to placing wine inside the eye on Shabbat, it is prohibited because it heals on the eye, it is permitted. And one of them said: Bland saliva,(h) saliva from one who has not eaten since waking, even placing it on the eye on Shabbat is prohibited because it is commonly used as medicine.

    And the Halacha note, reads: “One may not apply wine directly in his eye on Shabbat. Similarly, one may not apply bland saliva even on his eye because it appears that it is being used for medicinal purposes (Rambam Sefer Zemanim, Hilkhot Shabbat 21:25; Shulĥan Arukh, Oraĥ Ĥayyim 328:20).”

  13. IH says:

    There are other examples, as well, many involving liquids btw.

  14. IH says:

    On 111a there is both Mishna and Gemara about toothaches and the use of vinegar to alleviate the pain. I’ll just quote the Koren Halacha note:

    “One who has a toothache on Shabbat may not sip vinegar and spit it out. However, it is permitted to sip and swallow the vinegar or dip one’s food in vinegar, in accordance with the opinion of Abaye (Rambam Sefer Zemanim, Hilkhot Shabbat 21:24; Shulĥan Arukh, Oraĥ Ĥayyim 328:32).”

    There is also the discussion of hand or foot wounds on 109a and the use of wine or vinegar which makes the distinction between different cases, including one which is הֲרֵי הֵן כְּמַכָּה שֶׁל
    חָלָל, וּמְחַלְּלִין עֲלֵיהֶן אֶת הַשַּׁבָּת

  15. JS says:

    Mike S. I think no proof from your case for Rav Solvoeitchik’s opinion in general, since I would think that any case of asthma would fall under the heter of choleh kol gufo.
    However, someone who learned in YU (I’m assuming about 50 years ago) told me also that the rav paskened generally that you can take medicines on shabbos.

  16. Isaacson says:

    I was never clear how we draw the lines between the medicinal advice provided by chazal that we clearly ignore, and which one would probably be chayav b’nafsho for following nowadays, and this ruling regarding medicine which still, in most ways is in full effect.

  17. Mike S. says:

    JS: I agree one can’t cite a proof from one case. Especially since, if the Rav explained his reasoning, I failed to remember what it was. (Ah well, the folly of youth.) But since the medicine was to prevent an acute episode rather than cure one, I don’t think (this is me talking, I am not citing the Rav) that choleh kol gufo would properly apply since I was generally totally asymptomatic under the medicine. However, neither should one infer from the fact that the Rav rejected R. Naeh’s reasoning that he was generally machmir l’ma’aseh.

  18. joel rich says:

    Has anyone ever comprehensively investigated when it is the case and when not?
    ———————————————-
    I’ve asked at least 2 R”Y at RIETS about the data set. One shrugged and the other said it does not support the simple thesis.

    KT

  19. joel rich says:

    I’m curious how many medicines made today actually involve grinding. If they don’t why wouldn’t we say we can’t extend the original takanna? (Since we don’t say this I’m sure I’m incorrect)
    KT

  20. Hirhurim says:

    Shlomo: Has anyone ever comprehensively investigated when it is the case and when not?

    I don’t know of a comprehensive investigation but there are quite a few bekius-type discussions. I think the Malbim does that in his Artzos HaChaim regarding shaatnez in tzitzis.

  21. Hirhurim says:

    Isaacson: I was never clear how we draw the lines between the medicinal advice provided by chazal that we clearly ignore, and which one would probably be chayav b’nafsho for following nowadays, and this ruling regarding medicine which still, in most ways is in full effect.

    I don’t think there is any connection at all. The decree was on medicine in general (or healing in general) and not specific remedies.

  22. avi says:

    Over shabbat I was reminded that there are times when you might heal yourself from a problem which is not currently causing any pain. (some cases anti-biotics for example)

  23. Shlomo says:

    But, the gemara is not so clear cut.

    Your citations show that the prohibition on medicine even includes those forms of medicine that do not involve grinding. That is universally agreed by everyone. That does nothing to disprove the point that suffering from illness is against the spirit of shabbat (it violates oneg shabbat)…

  24. daat y. says:

    Any medication that you are taking on a regular basis you can continue to take on Shabbos.
    I remember Rav Ahron Soloveichik zt”l stating that though the reasoning for this gezara may rarely in our time be actually used the gezara still stands.However this may explain all the leniences that allow for taking medications on Shabbos,yet leaving the gezara standing.

  25. G. says:

    I will say 2 things, both in their way controversial.

    1) The gemara gives the reason for the issur of refuah as shehiath s’mamanim, but there is a definite sense of discomfort with such a large prohibition being based on a relatively narrow range of cases and a consequent doubt about how far it extends. To my knowledge, no tannaitic source adduces this reason for the issur. I would suggest that the prohibition on refuah is a very old tradition of uncertain origin, for which a clear reason could not be found and, eventually, the danger of grinding was agreed to be the most likely reason.

    There are certainly parallels to this. Everyone knows that hatmanah with mosif hevel is forbidden erev shabbath, lest you come to use hot coals and then rake them on shabbath and that using maamid hevel is forbidden on shabbath because you might come to boil it up – Bartenura says so! This follows a neat statement of Rava (I think), but there is a whole other sugya which gives two different suggested reasons for the prohibition (one of which has to do with digging if memory serves). Clearly the issur is the absolute and the reason is not clear. Everyone knows that takanath Ezra was made to stop talmidei hachamim breeding like chickens, but two dafs of B’rachoth proceeed on the assumption that it is a d’oraitha (of sorts). Why is is problematic to put a dish to catch oil that protrudes from a lamp on shabbath? Bateil davar mehachano? What is that exactly? It’s “like” building? On that note, in what sense is tovelling a keli “like” maceh b’patish? Again, it seems that certain activities that have no real relation to a biblical malachoth or toladoth and which will not lead to one either and hence are not the subject of gezeiroth were considered assur from time immemorial, essentially because they were not, to use our terminology, shabbosdik.

    2) The issur refuah is a perfect example of why we need a Sanhedrin. Regardless of my musings above (which I’d be happy to see disproved) the accepted reason for the gezeirah in p’sak halacha is shehikath samamanim. This is clearly not relevant to our reality and there *should* no longer be such a gezeirah (milta d’lo shecicha lo gazrei beh Rabanan). Two further developments have happened. First, medicine has advanced from being as much a hindrance as a help to being a remarkable tool for improving our quality of life and, secondly, because of our more comfortable existence, we have a much lower pain threshold than previous generations, meaning many more shabbatoth are pointlessly ruined by this issur.

    On the other hand, as this post learnedly demonstrates, the halachic process does not allow us to cancel this prohibition. The answer to this quandary is very simple: a Sanhedrin. Because of the remarkable developments of the past 60 years this is much less of a daunting task than it once was. The two big obstacles are a) most Jews are frei and b) most frum Jews have no desire for a Sanhedrin despite “praying” for it three times a day. What most orthodox Jews seem completely incapable of processing is that the halachic process as it exists today (and for the last 1,880 years) is radically different from the halachic process that should exist. It’s our job to make reality hew to halacha (as well as make halacha he to reality). One of the many, many benefits of doing so will likely be the abolition of this anachronistic prohibition. There’s a lot of work to do before we can get to this stage, but the first step is actually wanting it to happen. Do you?

  26. Hendon says:

    Shlomo: Once the reason for the rabbinic decree ceases, the prohibition falls aside.

    In some cases that is obviously not true, for example yom tov sheni.

    Has anyone ever comprehensively investigated when it is the case and when not?

    Here’s a shiur R. Hershel Schachter gave in London last year discussing this very point:
    http://thebeis.co.uk/shiurim.html#grp36
    The shiur is entitled Beis 20 Sunday Morning Shiur – Davar Shebaminyan

  27. Charlie Hall says:

    ” the view of the Rema and Tosafos seems to contradict explicit Talmudic passages.”

    This is not the only example of that.

    “I’m curious how many medicines made today actually involve grinding.”

    Any pharmacists out there? Don’t hospital pharmacies sometimes grind medicines?

  28. Joshua Josephs says:

    Many medicines today are not ground per se at any time but are made from powders pressed together into pill form. However, there are a wide variety of home remedies people might make that would involve grinding. Furthermore there are remedies that might involve dissolving powders in various liquids. There are also some other cases to consider such as taking a liquid and making a vapor such as with an inhaler.

  29. Ike Sultan says:

    I looked at the Yalkut Yosef inside and I’m not convinced it says like Gil Student quoted. He doesn’t say that anyone in pain may take a pill. The Yalkut Yosef 328:52 says a choleh shein bo sakana (sick in bed) can take pills. He adds that in general someone who is in a lot of pain but isn’t choleh shein bo sakana may not take the pills and only makes two exceptions, for someone who has a big headache and someone who has a big stomach ache.
    Check out this website: http://halachipedia.com/index.php?title=Medicine_on_Shabbat .

  30. Hirhurim says:

    Ike: You have to look in the back of the book. I’ll b”n get you the page numbers over the weekend.

  31. Hirhurim says:

    In Yalkut Yosef, see his response to a question in the back of the book pp. 408-409

  32. Steve Brizel says:

    R Gil-let’s assume that the gzerah still applies. Isn’t there a recognized Kulah for taking a medicine on Shabbos that you either started before Shabbos or that must take every day because of a specific medical condition that without the medicine in question is considered a Pikuach Nefesh She Yesh Bo Sakanah?

  33. Hirhurim says:

    From the post:

    To be clear, someone with a serious need for medication may certainly take it on Shabbos. There are numerous other exceptions (we’ll briefly mention some below) and you should discuss your personal situation with your rabbi.

  34. Ike Sultan says:

    Rabbi Gil, thanks for the reference. In Yalkut Yosef (Shabbat v. 4 pp 408-9) where you referenced, his reasoning is that pain relievers don’t cure anything but simply remove pain. Thus, if you meant that someone who’s accustomed to swallowing pain killers, may do so, then I agree, but your language of “he permits someone accustomed to swallowing pills to take medicine to relieve pain” could be misunderstood to mean a general permit to take medicine, even ones that heal, such as antibotics, as long as one is trying to relieve pain, in which case I’m unsure that Yalkut Yosef agrees.

 
 

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