1

Said Rav Yitzchok the son of Rav Yehudah, "One should always plead for mercy that he should not get sick, for if one falls sick, he is told, 'Demonstrate your merit and you will be acquitted.'" Said Mar Ukva, "From which verse in the Torah is this inferred?" From the verse, "Lest any man fall from (mimenu) there."1 From within himself (mimenu) he must produce evidence; which means, since he has fallen, he must produce from within himself and from his deeds, evidence of his merit."2 It is also stated in the Talmud,3 "If a person has a headache he should view it as if he were put in chains. If he becomes ill and is confined to bed, he should view it as if he were placed onto a scaffold, (a place where capital cases are tried) for trial. Anyone who is placed onto the scaffold for trial, if he has great advocates, may be saved. But if he has none, he cannot be saved. These are the advocates of man: repentance and good deeds. Even if nine hundred and ninety-nine accuse him, and only one advocate defends him, he is saved, as it is said, "If there be for him an angel, an advocate, [even] one among a thousand, to vouch for man's uprightness, then he is gracious unto him, and says, 'Redeem him from going down to the pit.'"4

א

אָמַר רַב יִצְחָק בְּרֵהּ דְּרַב יְהוּדָה, לְעוֹלָם יְבַקֵּשׁ אָדָם רַחֲמִים שֶׁלֹּא יֶחֱלֶה. שֶׁאִם חָלָה, אוֹמְרִים לוֹ, הָבֵא זְכוּת וְהִפָּטֵר. אָמַר מַר עֻקְבָא, מַאי קְרָאָהּ. כִּי יִפֹּל הַנּוֹפֵל מִמֶּנּוּ, מִמֶּנּוּ לְהָבִיא רְאָיָה. פֵּרוּשׁ, מֵאַחַר שֶׁהוּא נוֹפֵל, צָרִיךְ לִמְצוֹא מִמֶּנּוּ וּמִמַּעַשָיו רְאָיָה לִזְכוּת. עוֹד אִיתָא בַגְּמָרָא, חָשׁ בְּרֹאשּׁוֹ, יְהִי דוֹמֶה בְעֵינָיו כְּמִי שֶׁנְּתָנוּהוּ בְקוֹלָר. עָלָה לַמִּטָּה וְנָפַל לְמִשְּׁכָּב, יְהִי דוֹמֶה בְּעֵינָיו כְּמִי שֶהֶעֱלוּהוּ לְגַרְדּוֹם (מָקוֹם שֶׁדָּנִין דִּינֵי נְפָשׁוֹת) לִדוֹן, שֶכָּל הָעוֹלֶה לְגַרְדּוֹם לִדוֹן, אִם יֶשׁ לוֹ פְּרַקְלִיטִין גְּדוֹלִים, נִצּוֹל. וְאִם לָאו, אֵינוֹ נִצּוֹל. וְאֵלּוּ הֵן פְּרַקְלִיטִין שֶׁל אָדָם, תְּשׁוּבָה וּמַעֲשִׂים טוֹבִים. וַאֲפִלּוּ תְּשַׁע מֵאוֹת וְתִשְׁעִים וְתִשְׁעָה מְלַמְּדִים עָלָיו חוֹבָה, וְאֶחָד מְלַמֵּד עָלָיו זְכוּת, נִצּוֹל, שֶׁנֶּאֱמַר, אִם יֵשׁ עָלָיו מַלְאָךְ מֵלִיץ אֶחָד מִנִּי אָלֶף לְהַגִּיד לְאָדָם יָשְׁרוֹ, וַיְחֻנֶּנּוּ וַיֹּאמֶר, פְּדָעֵהוּ מִרֶדֶת שַׁחַת וְגוֹ'.

2

Rabbi Pinchas, the son of Chama, expounded,5 "Anyone who has a sick person in his house, should go to a Sage and ask him to plead for mercy on his behalf, as it is said, "The wrath of a king is like messengers of death. But a wise man will pacify it."6 It is customary to give charity to the poor on a sick person's behalf, for repentance, prayer, and charity, avert the evil decree. It is also customary to bless the sick person in the synagogue, and if he is critically ill, we bless him even on Shabbos and Yom Tov. At times the name of the sick person is changed, for a change of name may also nullify the decree.

ב

דָּרַשׁ רַבִּי פִּינְחָס בַּר חָמָא, כָּל מִי שֶׁיֵשׁ לוֹ חוֹלֶה בְּתוֹךְ בֵּיתוֹ, יֵלֵךְ אֵצֶל חָכָם וִיבַקֵּשׁ עָלָיו רַחֲמִים, שֶׁנֶּאֱמַר, חֲמַת מֶלֶךְ מַלְאֲכֵי מָוֶת, וְאִישׁ חָכָם יְכַפְּרֶנָּה. וְנוֹהֲגִין לָתֵת צְדָקָה לַעֲנִיִים בַּעֲדוֹ, כִּי תְּשׁוּבָה וּתְפִלָּה וּצְדָקָה, מַעֲבִירִין אֶת רֹעַ הַגְּזֵרָה. גַּם נוֹהֲגִין לְבָרֵךְ אֶת הַחוֹלִים בְּבֵית הַכְּנֶסֶת. וְאִם הוּא מְסֻכָּן, מְבָרְכִין אוֹתוֹ אֲפִלּוּ בְּשַׁבָּת וְיוֹם טוֹב. וְלִפְעָמִים מְשַׁנִּים אֶת שֵׁם הַחוֹלֶה, כִּי גַּם שִׁנּוּי הַשֵׁם, קוֹרֵעַ גְּזַר דִּינוֹ.

3

The Torah permits a doctor to heal the sick, as it is said "And he shall [pay] to have him healed properly."7 Therefore, a sick person should not rely on a miracle, but is obliged to follow the accepted procedure and call a physician to heal him. Many of the world's pious men have been cured by physicians. A person who refrains from calling in a physician (for himself) commits two wrongs: For one, it is forbidden to rely on a miracle in a life-threatening situation. This behavior causes one's sins to be remembered at a time of illness. Secondly, it is arrogant and presumptuous to rely on your righteousness that you will be healed in some miraculous manner. You should call the most competent physician but with all that, your heart should be turned to Heaven, and pray for mercy from the Faithful Healer, blessed is His Name trusting in Him alone.

ג

הַתּוֹרָה נָתְנָה רְשׁוּת לָרוֹפֵא שֶׁיְרַפֵּא, שֶׁנֶּאֱמַר, וְרַפֹּא יְרַפֵּא. וְלָכֵן אֵין לוֹ לַחוֹלֶה לִסְמֹךְ עַל הַנֵּס, אֶלָּא חַיָב לְהִתְנַהֵג בְּדֶרֶךְ הָעוֹלָם לִקְרוֹא לְרוֹפֵא שֶׁיְרַפֵּהוּ. וּכְבָר כַּמָה חֲסִידֵי עוֹלָם נִתְרַפְּאוּ עַל יְדֵי רוֹפְאִים. וּמִי שֶׁמּוֹנֵעַ אֶת עַצְמוֹ מִלִּקְרוֹא לָרוֹפֵא, שְׁתַּיִם רָעוֹת הִנֵּהוּ עוֹשֶׂה, הָאַחַת, דְּאָסוּר לִסְמֹךְ עַל הַנֵּס בְּמָקוֹם שֶׁיֵּשׁ סַכָּנָה, וְדָבָר זֶה גּוֹרֵם שֶׁיִזָּכְרוּ עֲוֹנוֹתָיו בִּשְׁעַת חָלְיוֹ. וְעוֹד, דַּהֲוֵי יֻהֲרָא וְגֵאוֹת שֶׁסּוֹמֵךְ עַל צִדְקָתוֹ שֶׁיִתְרַפֵּא בְּדֶרֶךְ הַנֵּס. וְיֶשׁ לוֹ לִקְרוֹא לָרוֹפֵא הַיוֹתֵר מֻמְחֶה, וּבְכָל זֹאת לִבּוֹ יְהֵא לַשָׁמַיִם, וִיבַקֵּשׁ רַחֲמִים מֵאֵת הָרוֹפֵא הַנֶּאֱמָן יִתְבָּרַךְ שְׁמוֹ, וְאַךְ בּוֹ יִבְטַח לִבּוֹ (ברכי יוסף) (וְעַיֵּן לְעֵיל סִימָן סא סָעִיף ד).

4

It is a mitzvah for the competent physician to heal and is included in the mitzvah of saving a life. If he refrains from doing so, he is guilty of shedding blood, even if the patient has another physician, because not through every physician does a person merit to be cured, and it is perhaps Heavenly ordained that he shall be cured through him. However, one should not practice medicine unless he is an expert and there is no one more competent than him. For otherwise, he is guilty of bloodshed.

ד

וּמִצְוָה הוּא עַל הָרוֹפֵא הַבָּקִי לְרַפֵּא, וּבִכְלַל פִּקּוּחַ נֶפֶשׁ הוּא. וְאִם מוֹנֵעַ אֶת עַצְמוֹ, הֲרֵי זֶה שׁוֹפֵךְ דָּמִים, וַאֲפִלּוּ יֵשׁ לַחוֹלֶה רוֹפֵא אַחֵר, כִּי לֹא מִן כָּל אָדָם זוֹכֶה לְהִתְרַפֵּא, וְאוּלַי הוּא מִן הַשָּׁמַיִם שֶׁיִתְרַפֵּא עַל יָדוֹ. אֲבָל לֹא יִתְעַסֵּק בִּרְפוּאוֹת, אֶלָּא אִם כֵּן הוּא בָקִי, וְאֵין שָׁם גָּדוֹל מִמֶּנוּ, שֶׁאִם לֹא כֵן, הֲרֵי זֶה שׁוֹפֵךְ דָּמִים.

5

A person who is not critically ill, and can possibly be cured by permissable medication, is forbidden to take anything that is prohibited; although he must wait until he can obtain it, we do not permit him to take anything that is prohibited. If he specifically requires a prohibited article, if he must eat it in the way it is usually eaten, he is forbidden to eat it; even if it is only prohibited by Rabbinical ordinance, since his life is not in danger. However [if it can be eaten] in a manner by which he will not derive the usual pleasure, for instance, if a bitter substance is mixed with it, it is permitted. It is permitted to make a plaster of it or something similar, even if it is something the enjoyment of which is forbidden by the Torah, with the exception of kilayei hakerem8 and meat cooked with milk, which is forbidden to use even in a manner that it is not usual. These laws apply so long as no danger to life is involved. Regarding the laws of berachos upon eating and drinking medication, refer to Chapter 50:5 and Chapter 61:4. (Regarding the law when a child must eat chametz on Pesach, see the end of Chapter 117.)

ה

חוֹלֶה שֶׁאֵין בּוֹ סַכָּנָה, אִם יוּכַל לְהִתְרַפְּאוֹת בִּדְבַר הֶתֵּר, אַף עַל פִּי שֶׁצְּרִיכִין לִשְׁהוֹת קְצָת עַד שֶיַשִּׂיגוּהוּ, אֵין מַתִּירִין לוֹ שׁוּם דְּבַר אִסּוּר. וְאִם צָרִיךְ דַּוְקָא לִדְבַר אִסּוּר, אִם צָרִיךְ לְאָכְלוֹ כְּמוֹ שֶׁהַדֶּרֶךְ הוּא לֶאֱכֹל דָּבָר זֶה, אָסוּר לוֹ לְאָכְלוֹ, אֲפִלּוּ הוּא רַק אִסּוּר דְּרַבָּנָן, כֵּיוָן שֶׁאֵין בּוֹ סַכָּנָה. אֲבָל שֶׁלֹּא כְדֶרֶךְ הֲנָאָתוֹ, כְּגוֹן שֶׁמְּעָרֵב בּוֹ דָבָר מַר, וְכֵן לַעֲשׂוֹת מִמֶּנּוּ רְטִיָה וְכַדּוֹמֶה, מֻתָּר, אֲפִלּוּ הוּא דָבָר הָאָסוּר בַּהֲנָאָה מִדְּאוֹרָיְתָא, חוּץ מִכִּלְאֵי הַכֶּרֶם וּבָשָׂר בְּחָלָב, שֶׁאֲסוּרִין אֲפִלּוּ שֶׁלֹּא כְּדֶרֶךְ הֲנָאָתָן בְּמָקוֹם שֶׁאֵין סַכָּנָה. (דִּין הַבְּרָכָה עַל מַה שֶּׁאוֹכֵל וְשׁוֹתֶה לִרְפוּאָה, עַיֵן לְעֵיל סִימָן ג סָעִיף ח וְסִימָן סא סָעִיף ד. וְדִין תִּינוֹק שֶׁצָּרִיךְ לֶאֱכֹל חָמֵץ בַּפֶּסַח, עַיֵן לְעֵיל סוֹף סִימָן קיז).

6

Some Poskim say9 that all things, the enjoyment of which is Rabbinically prohibited, are permitted to be used for a cure, even for one who is not critically ill, and even in the manner by which they are regularly enjoyed, provided he does not eat or drink the forbidden article.

ו

יֵשׁ אוֹמְרִים, דְּכָל אִסּוּרֵי הֲנָאָה מִדְּרַבָּנָן מֻתָּר לְהִתְרַפְּאוֹת בָּהֶן, אֲפִלּוּ חוֹלֶה שֶׁאֵין בּוֹ סַכָּנָה, וַאֲפִלּוּ כְּדֶרֶךְ הֲנָאָתָן (עַיֵּן לְעֵיל סִימָן מז סָעִיף ב), וּבִלְבַד שֶׁלֹּא יֹאכַל וְלֹא יִשְׁתֶּה אֶת הָאִסּוּר.

7

A person who is critically ill may use any forbidden article for his cure, for nothing can stand in the way of saving a life except idolatry, incest, and murder; for which one must give up his life and not transgress. Thus man may not cure himself by transgressing these sins.

ז

חוֹלֶה שֶׁיֵשׁ בּוֹ סַכָּנָה, מִתְרַפֵּא בְּכָל הָאִסּוּרִין, שֶׁאֵין לְךָ דָּבָר הָעוֹמֵד בִּפְנֵי פִקּוּחַ נֶפֶשׁ (וְעַיֵּן לְעֵיל סִימָן צב), חוּץ מֵעֲבוֹדָה זָרָה, גִּלּוי עֲרָיוֹת, וּשְׁפִיכוּת דָּמִים, שֶׁהֵן בְּיֵהָרֵג וְאַל יַעֲבוֹר, וְאֵין מִתְרַפְּאִין בָּהֶן.

8

A physician is permitted to let blood, and feel the pulse, or other parts of a woman even if she is married, and he may feel her vulnerable area, as is customary with physicians, since he does not do so in a sensual and immoral manner, but is merely practicing his profession. However, if his own wife is menstrually unclean, he should be stringent (and refrain from any of the above), if she is not critically ill and there is another doctor available who is as competent as he is. (See Chapter 153:14 where it is explained, whether a woman who is menstrually unclean is permitted to attend her husband when he is sick, or if he may attend her if she is sick, and see Chapter 143:15 if a son is permitted to let blood from his father, and similar laws.)

ח

מֻתָּר לָרוֹפֵא לְהַקִיז דָּם וּלְמַשֵּׁשׁ הַדֹּפֶק וּשְׁאָר מְקוֹמוֹת שֶׁבְּאִשָּׁה, אֲפִלּוּ בְּאֵשֶׁת אִישׁ, וַאֲפִלּוּ בִּמְקוֹם תָּרְפָּהּ כְּדֶרֶךְ הָרוֹפְאִים, כֵּיוָן שֶׁאֵינוֹ עוֹשֶׂה דֶּרֶךְ תַּאֲוָה וְחִבָּה, אֶלָּא שֶּׁבִּמְלַאכְתּוֹ הוּא עוֹסֵק. וְאַךְ בְּאִשְׁתּוֹ נִדָּה, יֵשׁ לְהַחְמִיר כְּשֶׁאֵין סַכָּנָה בַדָּבָר וְיֶשׁ שָׁם רוֹפֵא אַחֵר בָּקִי כָמוֹהוּ (וְעַיֵּן לְעֵיל סִימָן קנג סָעִיף יד וְשָׁם מְבֹאָר, אִם אִשָׁה נִדָּה יְכוֹלָה לְשַׁמֵּשׁ אֶת בַּעְלָהּ כְּשֶׁהוּא חוֹלֶה אוֹ הוּא אוֹתָהּ. וְעַיֵּן לְעֵיל סִימָן קמג סָעִיף טו, אִם הַבֵּן מֻתָּר לְהַקִּיז דָּם לְאָבִיו וְכַיוֹצֵא בּוֹ).

9

In case of abdominal illness, a man may not attend a woman, lest he will be overcome by desire, since he is healthy [and capable.] But a woman may attend a man since he is sick [and incapable.]

ט

בָּחֳלִי מֵעַיִם, אֵין הָאִישׁ מְשַׁמֵּשׁ אֶת הָאִשָּׁה, פֶּן יִתְגַּבֵּר יִצְרוֹ, כֵּיוָן שֶׁהוּא בָרִיא. אֲבָל הָאִשָּׁה, מְשַׁמֶּשֶׁת אֶת הָאִישׁ, כֵּיוָן שֶׁהוּא חוֹלֶה.

10

If you possess medication and your neighbor is ill and needs them, you are forbidden to raise their price unreasonably.

י

מִי שֶׁיֵשׁ לוֹ סַמְמָנִים, וַחֲבֵרוֹ חוֹלֶה וְצָרִיךְ לָהֶם, אָסוּר לוֹ לְהַעֲלוֹת בְּדָמֵיהֶם יוֹתֵר מִן הָרָאוּי.