internal injury, one may not be treated by them. The Gemara asks: What is the difference between the two versions of Rabbi Yoḥanan’s statement? There is a difference between them with regard to the case of one who was injured on the back of the hand or the back of the foot. As Rav Adda bar Mattana says that Rav says: Injuries to the back of the hand and the back, i.e., the top, of the foot are like an internal injury, and one may desecrate Shabbat for their treatment. מכה של חלל אין מתרפאין מהן מאי בינייהו איכא בינייהו גב היד וגב הרגל דאמר רב אדא בר מתנה אמר רב גב היד וגב הרגל הרי הן כמכה של חלל ומחללין עליהן את השבת
Rav Zutra bar Toviyya says that Rav says: With regard to any injury that requires a medical evaluation to determine whether or not it is fatal, one may desecrate Shabbat for its treatment. Rav Shemen bar Abba says that Rabbi Yoḥanan says: And a burning fever is similar to an internal injury, and therefore one may desecrate Shabbat for its treatment. אמר רב זוטרא בר טוביה אמר רב כל מכה שצריכה אומד מחללין עליה את השבת אמר רב שמן בר אבא אמר ר' יוחנן והאי אישתא צמירתא כמכה של חלל דמי ומחללין עליה את השבת
The Gemara inquires: From what point on the body is a wound considered an internal injury? Rabbi Ami explained: From the lips inward. Rabbi Eliezer raises a dilemma: With regard to afflictions located in the gums [kakhei] or teeth, what is the halakha? Do we say that since they are located in firm parts of the body, they are similar to external injuries, or perhaps we say that since they are situated within the mouth, they are similar to internal injuries? מהיכן מכה של חלל פירש רבי אמי מן השפה ולפנים בעי רבי אליעזר ככי ושיני מאי כיון דאקושי נינהו כמכה דבראי דמו או דלמא כיון דגואי קיימי כמכה של חלל דמו
Abaye said: Come and hear a proof from a mishna (Shabbat 111a): One who is concerned about pain in his teeth may not sip vinegar through them on Shabbat for medicinal purposes, as it is generally prohibited by rabbinic law to perform acts of healing on Shabbat. Abaye infers: It is only when he is merely concerned about pain in his teeth that he may not treat them, which indicates that if it hurts him greatly, it is permitted to seek treatment. The Gemara rejects this inference: Perhaps the tanna also characterizes a situation where it hurts one greatly as one of mere concern. אמר אביי ת"ש החושש בשיניו לא יגמע בהן את החומץ חושש הוא דלא הא כאיב ליה טובא שפיר דמי דלמא תנא היכא דכאיב ליה טובא חושש נמי קרי ליה
The Gemara suggests a different proof: Come and hear the following incident: Rabbi Yoḥanan suffered from the illness tzafdina, which affects the teeth and gums. He went to a certain gentile matron who was a well-known healer. She prepared a medicine for him on Thursday and Friday. Rabbi Yoḥanan said to her: What shall I do tomorrow, on Shabbat, when I cannot come to collect the medicine from you? She said to him: You will not need it. Rabbi Yoḥanan asked her: If I do need it, what shall I do? She said to him: Take an oath to me that you will not reveal the remedy, and I will tell you, so that you can prepare it yourself should you need it. Rabbi Yoḥanan took an oath to her: To the God of the Jews, I will not reveal it. She revealed the remedy to him. On the following day Rabbi Yoḥanan went out and taught it publicly, revealing the secret of the remedy. ת"ש רבי יוחנן חש בצפדינא אזל לגבה דההיא מטרוניתא עבדה חמשא ומעלי שבתא א"ל למחר מאי אמרה ליה לא צריכת אי צריכנא מאי אמרה אשתבע לי דלא מגלית אישתבע לה לאלהא ישראל לא מגלינא גלייה ליה למחר נפק דרשה בפירקא

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The Gemara challenges: But Rabbi Yoḥanan took an oath to her that he would not reveal her secret. The Gemara explains that his vow meant: I will not reveal it to the God of the Jews, which indicates: But I will reveal it to His people, the Jews. The Gemara challenges: But even so, isn’t there a desecration of God’s name, as the matron now thinks that a great man of Rabbi Yoḥanan’s stature violated his vow? The Gemara answers that he revealed it to her at the outset. As soon as she disclosed the remedy to him, he informed her that his vow would not prevent him from publicizing it. והא אישתבע לה לאלהא דישראל לא מגלינא אבל לעמיה ישראל מגלינא והאיכא חילול השם דגלי לה מעיקרא
With regard to the issue at hand, the Gemara infers: Apparently, an affliction that affects the gums is similar to an internal injury, as it was permitted for Rabbi Yoḥanan to prepare the remedy on Shabbat. Rav Naḥman bar Yitzḥak said: Tzafdina is different, since it begins in the mouth, and ends in the intestines, i.e., the disease spreads until it infects one’s intestines, and therefore it is considered an internal affliction even while it is only in the mouth. Consequently, the incident involving Rabbi Yoḥanan affords no proof, and Rabbi Eliezer’s dilemma remains unresolved. אלמא כמכה של חלל דמיא אמר רב נחמן בר יצחק שאני צפדינא הואיל ומתחיל בפה וגומר בבני מעיים
The Gemara inquires: What are the symptoms of tzafdina? If one places an item between his teeth, blood flows from the rows of teeth. From what does it result? It results from the consumption of very cold wheat foods, and from very hot barley foods, and from remains of fried fish [kasa deharsena]. With what remedy did the gentile matron treat Rabbi Yoḥanan? Rabbi Aḥa, son of Rava, said: It was water in which leaven was steeped, olive oil, and salt. And Mar bar Rav Ashi said: She smeared goose fat over his gums with a goose feather. מאי סימניה רמי מידי בי ככי ומייתי דמא מבי דרי ממאי הוי מקרירי קרירי דחיטי ומחמימי חמימי דשערי ומשיורי כסא דהרסנא מאי עבדא ליה א"ר אחא בריה דרבא מי שאור ושמן זית ומלח ומר בר רב אשי אמר משחא דאווזא בגדפא דאווזא
Abaye said: I prepared all of these medicines and was not cured from this ailment until a certain Arab told me the remedy for it: Take olive seeds that are less than one-third ripe, and burn them in a fire on top of a new hoe, and stick them along the row of gums. I did this and was cured. אמר אביי אנא עבדי כולהו ולא איתסאי עד דאמר לי ההוא טייעא אייתי קשייתא דזיתא דלא מלו תילתא וקלנהו אמרא חדתא ודביק ביה דדרי עבדי הכי ואיתסאי
§ It was stated above that Rabbi Yoḥanan sought the medical attention of a gentile. The Gemara asks: And how could Rabbi Yoḥanan do so? But doesn’t Rabba bar bar Ḥana say that Rabbi Yoḥanan says: With regard to any injury for which Shabbat is desecrated, one may not be treated by gentiles. Tzafdina is a disease for which Shabbat is desecrated, and yet Rabbi Yoḥanan was treated by a gentile. The Gemara answers: An important person such as Rabbi Yoḥanan is different, as gentiles would not dare to kill him. ורבי יוחנן היכי עביד הכי והאמר רבה בר בר חנה אמר רבי יוחנן כל מכה שמחללין עליה את השבת אין מתרפאין מהן אדם חשוב שאני
The Gemara questions this: But Rabbi Abbahu was an important person, and yet Ya’akov the heretic placed upon his leg a salve that was actually a poison. And if it were not for Rabbi Ami and Rabbi Asi, who licked his leg to remove the poison, his leg would have had to be amputated. Apparently, Ya’akov the heretic attempted to kill Rabbi Abbahu despite the fact that Rabbi Abbahu was an important person. והא רבי אבהו דאדם חשוב הוה ורמא ליה יעקב מינאה סמא אשקיה ואי לא רבי אמי ורבי אסי דלחכוהו לשקיה פסקיה לשקיה
The Gemara explains: The healer of Rabbi Yoḥanan was an expert physician who would not jeopardize her reputation by harming him. The Gemara rejects this explanation: But the healer of Rabbi Abbahu was also an expert physician. The Gemara answers: The case involving Rabbi Abbahu is different, as heretics establish within themselves the attitude of: “Let me die with the Philistines” (Judges 16:30), i.e., heretics are willing to risk their lives in order to hurt Jews, due to their religious disputes. By contrast, gentiles will not jeopardize their own reputation for this purpose, and therefore it was permitted for Rabbi Yoḥanan to be treated by the matron. דרבי יוחנן רופא מומחה הוה דרבי אבהו נמי רופא מומחה הוה שאני רבי אבהו דמוקמי ביה מיני בנפשייהו (שופטים טז, ל) תמות נפשי עם פלשתים
§ The Gemara lists a series of afflictions and their remedies. Shmuel said: This gash caused by a sword is considered a danger to one’s life, and one may desecrate Shabbat for its treatment. The Gemara asks: What is the remedy for this wound? To stop the blood flow one should consume cress soaked in vinegar. To cause flesh to emerge over the gash, one applies a salve made of yavla scrapings and thornbush scrapings, or a salve made from the worms of the trash. אמר שמואל האי פדעתא סכנתא היא ומחללין עליה את השבת מאי אסותא למיפסק דמא תחלי בחלא לאסוקי גרדא דיבלא וגירדא דאסנא או ניקרא מקילקלתא
Rav Safra said: These grapelike boils are the forerunners [parvanka] of the Angel of Death, i.e., they often precede one’s death. The Gemara asks: What is the remedy? The remedy is either a tigna plant soaked in honey or parsley soaked in wine. In the meantime, while the plants are soaking, one should bring a grape of the same size and rub it on the boil, a white grape for a white boil, and a black grape for a black boil. אמר רב ספרא האי עינבתא פרוונקא דמלאכא דמותא היא מאי אסותא טיגנא בדובשא או כרפסא בטילייא אדהכי והכי ליתי עינבתא בת מינא וניגנדר עילוי חיורתי לחיורתי ואוכמתי לאוכמתי
Rava said: This abscess [simta] is the forerunner of fever. The Gemara asks: What is the remedy? One should snap [itkutlei] the boil sixty times with his fingers, i.e., click one’s fingers on the boil, and then he should tear it vertically and horizontally. The Gemara comments: And this statement applies only in a case where the head of the abscess has not whitened, but if its head has whitened, we have no problem with it, i.e., it is in the process of healing, and it does not pose any danger. אמר רבא האי סימטא פרוונקא דאשתא היא מאי אסותא למחייה שיתין איתקוטלי וליקרעיה שתי וערב והני מילי דלא חיור רישיה אבל חיור רישיה לית לן בה
Rabbi Ya’akov suffered רבי יעקב חש