Avodah Zarah 28a (כח.) — the Talmud in English

And there are those who say:

there are those who say that

Rabba bar bar Ḥana said that Rabbi Yoḥanan said

as follows:

Every

internal injury,

located within the body cavity,

one may not be treated by them.

However, an external injury that is not within the body cavity may be treated by them.

The Gemara asks:

What is the difference between them,

what practical difference is there between these two versions of Rabbi Yoḥanan’s statement? After all, both are discussing the same matter, as with regard to every internal injury one desecrates Shabbat on its account?

The difference between them is

an injury that is on the

back of the hand or the back of the foot.

As Rav Adda bar Mattana said that Rav said: The back of the hand and the back of the foot are considered as

the law of

an internal injury, and one desecrates Shabbat on their account!

And the approaches differ with regard to this matter. According to the first version of Rabbi Yoḥanan’s statement, they may not be treated by them, since Shabbat is desecrated on account of this injury.

However, according to the second version of Rabbi Yoḥanan’s statement, they may be treated by them. The similarity between an injury on the back of the foot or hand and an internal injury applies only with regard to Shabbat; but with regard to medical treatment by a gentile, there is no need to refrain. Since the injury is external, if the gentile causes harm through his treatment, it will be noticed immediately, and a medication or treatment can be administered there to remove the damage caused by the gentile’s malpractice.

And since the laws of treating an injury on Shabbat were mentioned, the Gemara cites additional halakhot concerning the same matter:

Rav Zutra bar Toviyya said that Rav said: Any injury

that is sufficiently severe and dangerous that it

requires an assessment

as to whether he will live or die—

one desecrates Shabbat on its account

in order to treat him.

Rav Shemen bar Abba said that Rabbi Yoḥanan:

And this fever, ishtaa tzemirta

(a condition of high fever that passes through the body)

is considered an internal injury,

and one desecrates Shabbat on its account.

And now the Gemara discusses:

From where,

from which point does the body cavity begin, so that an

injury

in that location is considered an injury

of the internal cavity?

Rabbi Ami explained: When the pain is

located

from the lip

[the lips]

and inward,

toward the body cavity.

Rabbi Eliezer was uncertain

about the following:

Rabbi Eliezer

who felt pain in his

molars

and

teeth,

the teeth,

what is

the ruling with regard to this pain?

Is it

because, since they are hard,

the teeth and gums are hard,

they are considered like an external injury

that is external,

and are considered

not like internal organs?

Or perhaps, since they are located inward,

since they are from the lip inward,

they are considered like an internal injury?

Abaye said: Come and hear

a proof from what is stated in the Mishna, as we learned:

One who feels pain in his teeth

on Shabbat—

may not rinse them with vinegar,

which is a remedy for toothache. And the Sages prohibited taking medicine on Shabbat [where there is no danger], due to a decree lest one grind medicinal substances.

And the Gemara infers: Only when he

feels pain

in his teeth,

he,

in this case is it stated

that he may not

rinse with vinegar.

However,

but if

it hurts him greatly,

the pain is severe,

it is properly considered permitted

for him to rinse. And it is thereby demonstrated that even this ailment of tooth pain warrants desecrating Shabbat on its account.

And the Gemara rejects this: This cannot be proven, because

perhaps the tanna, in a case where it hurts him greatly,

even where the pain is severe,

also calls it “feels pain.”

The tanna also calls this “feels pain.” If so, there is no proof that severe pain differs from a mere discomfort; in both cases it is possible that treatment is prohibited.

The Gemara brings another proof:

Come and hear—

Rabbi Yoḥanan suffered from tzafdina,

an ailment affecting the teeth.

He went to a certain noblewoman,

a prominent gentile woman who was an expert in medicine,

and she prepared five doses,

she prepared a treatment for him to take on Thursday,

and on the eve of Shabbat

on Friday.

He said to her,

Rabbi Yoḥanan said to her: If I require this treatment even on Shabbat,

tomorrow, what shall I do?

What shall I do, as I cannot come to you, since I must lecture before the students!?

She said to him,

that woman said to him:

You will not need it.

You will no longer need this medicine on Shabbat.

He said to her:

If I do need it,

if I nevertheless need it,

what

shall I do?

She said

the woman:

Swear to me that you will not reveal it.

Swear to me that you will not reveal what the treatment is, and I will tell you.

He swore to her,

Rabbi Yoḥanan swore to her, using the following formulation:

“To the God of Israel I will not reveal it”

[that is, I will not reveal it to the God of Israel].

She revealed it to him,

she revealed to him what treatment he should take.

The next day,

on Shabbat,

he went out,

Rabbi Yoḥanan went out,

and lectured publicly,

he stated in his lecture before everyone the treatment that the gentile woman had revealed to him.

And this is astonishing:

But,

after all,

he had sworn to her,

Rabbi Yoḥanan had sworn to her that he would not reveal it!?

And the Gemara answers: He did not swear that he would not reveal it to the public, because the wording of his oath was

“To the God of Israel I will not reveal it,”

and it follows that he swore only not to reveal it to the God of Israel.

But to His people,

to His people,

Israel, I will reveal it,

I will indeed reveal it!

But there is still a difficulty:

But is there not

here an issue of

desecration of the Divine Name,

as she thought that he had sworn not to reveal it at all, and now she would see that he had revealed it!?

And the Gemara answers:

He revealed it to her from the outset.

Already when she revealed to him the secret of the treatment, he said to her: Know that I did not swear that I would never reveal it, for I did not say, “By the God of Israel I will not reveal it”—wording that means an oath by God that I would not reveal it at all. Rather, I said, “To the God of Israel I will not reveal it.” The meaning of this wording is only that I will not reveal it to God. But I did not swear in His name that I would not reveal it at all. Consequently, this was not an oath that I would not reveal it at all.

And from this incident involving Rabbi Yoḥanan the Gemara proves and resolves the uncertainty raised above:

Apparently,

it is demonstrated that tooth ailment

is considered an internal injury.

And therefore Rabbi Yoḥanan wished to use this treatment on Shabbat.

And the Gemara rejects this:

Rav Naḥman bar Yitzḥak said: It is different

from

tzafdina

[the dental ailment from which Rabbi Yoḥanan suffered], which is permitted to treat on Shabbat,

since

this ailment

begins in the mouth and ends in the intestines.

And therefore it is permitted to treat it on Shabbat. But an ordinary pain that is only in the teeth is prohibited to treat.

And the Gemara clarifies:

What are its symptoms,

what are the signs by which we know that the pain results from this ailment?—

He places something between the molars,

he places something in his mouth between the gums,

and blood emerges from between the rows of teeth,

blood emerges from between the rows of teeth.

From what does it result,

what causes this ailment?

From three things:

a.

From very cold wheat preparations.

Food made from wheat that one eats on one of the cold winter days, when the food is very cold.

b.

And

likewise

from very hot barley preparations,

very hot food made from barley.

c.

And from the remnants of kasa de-harsena.

From eating the remnants of fried fish cooked in the fat that emerges from it and in flour.

It was stated above that the gentile woman prepared a treatment for Rabbi Yoḥanan, who suffered from this ailment.

What did she prepare for him,

what treatment did she prepare for him?

Rav Aḥa, son of Rava, said: Water in which leaven was soaked,

water in which leaven was soaked,

and olive oil and salt.

And Mar bar Rav Ashi said: Goose fat,

goose fat melted by heat, and the woman rubbed it on Rabbi Yoḥanan’s teeth from the outside,

with a goose feather,

using one of the goose’s wings.

Abaye said: I performed all of them,

I performed all these treatments,

but I was not cured,

I was not cured of this ailment,

until that Arab said to me,

until that Ishmaelite said to me:

Bring olive pits,

bring olive pits

that have not reached one-third of their growth,

whose growth has not yet reached one-third of the fruit’s growth,

and roast them on a new hoe,

and roast them on a new hoe,

and stick them to the rows of teeth,

and afterward stick the roasted pits to the rows of the teeth, from inside.

I did this, and I was cured,

I did so, and I was cured.

And the Gemara discusses:

But Rabbi Yoḥanan—how did he do this,

how did he do so and become healed by the gentile woman?

But didn’t Rabba bar bar Ḥana say that Rabbi Yoḥanan said: Any injury on whose account one desecrates Shabbat may not be treated by them.

After all, this injury warrants desecrating Shabbat, as we learned above. If so, how was Rabbi Yoḥanan treated by the gentile woman?

The Gemara answers: Rabbi Yoḥanan

was an important person,

and therefore

it is different.

His law is different, and he was permitted to be treated by them, because the gentiles were afraid to kill him.

The Gemara asks:

But

what of

Rabbi Abbahu,

who also

was an important person, and Yaakov the heretic applied to him

and Yaakov the heretic placed on him

a drug and gave it to him,

a drug on his thigh in order to treat him,

and if not

for

Rabbi Ami and Rabbi Asi, who licked his thigh,

who licked and sucked his thigh in order to remove the harmful drug that the heretic had placed there to poison him,

he would have had to have his thigh severed,

they would have needed to amputate his thigh!

If so, we see that even with regard to an important person they are not afraid, and they may harm and kill him. How, then, was Rabbi Yoḥanan treated by the gentile woman?

And the Gemara answers: The gentile physician

who treated Rabbi Yoḥanan was an expert physician,

and therefore there was no concern that she might harm him. As explained above in the Gemara [27a], if the physician is an expert known to the public, it is permitted to be treated by him, since he does not wish to ruin his good reputation.

But there is still a difficulty: The heretical physician

who treated Rabbi Abbahu, too,

he also

was an expert physician. Nevertheless, although expert physicians ordinarily protect their good reputation, that does not prevent them from harming Jews?

And the Gemara answers:

The Gemara answers:

It is different

from the physician who treated

Rabbi Abbahu,

because he was a heretic,

as the heretics fulfill in themselves,

the verse [Judges 16:30]

“Let my soul die with the Philistines.”

They are prepared even to harm themselves, provided that they harm the Sages of Israel!

And the Gemara continues to discuss illnesses and treatments on Shabbat:

Shmuel said: This peda’ata,

a wound from a sword strike,

is dangerous

and constitutes a danger

to life,

and one desecrates Shabbat on its account.

What is the treatment for stopping the bleeding; what remedy is effective for stopping the blood?

The treatment is as follows:

a. In order to stop the flow of blood, one should give him

garden cress in vinegar,

garden cress steeped in vinegar,

b. In order

to raise,

to raise flesh and revive the site of the wound, one should take

the grated root of yivla,

roots scraped from the plant called “yivla,”

and the grated root of the thorn bush,

and likewise roots scraped from a thorn bush; they are made into a bandage and placed on the wound.

Alternatively,

one should place there

the worm of the refuse heap,

worms that chickens peck out of the garbage.

Rav Safra said: This grape-like pustule,

those blisters resembling a grape,

is an agent of the angel of death;

they are his messengers. That is to say, they are dangerous and may cause death.

What is the remedy,

what is the treatment for these blisters?

Take a plant called

“Tigena,”

grind it and mix it

with honey

[in honey].

Alternatively, celery

mixed

with Tilya,

a type of very strong wine.

In the meantime,

while he has not yet managed to obtain and prepare these remedies, what should he do about these dangerous blisters?

Let him bring

a

grape of the same species,

a grape of the same type as the blister: if the blister is large, let him bring a grape of corresponding size, and if the blister is small, let him bring a grape of corresponding size.

And let him roll it over the blister.

He should roll the grape over the pustule.

A white one for a white one,

a white grape for a white blister,

and a black one for a black one,

a black grape for a black blister.

Rava said: This swelling

of an abscess

is a sign of fever.

It is a sign of an illness of fever.

What is the remedy,

what is the treatment for this abscess?

Strike it sixty times with the finger,

striking the site of the swelling sixty times with his finger,

and

afterward

incise it lengthwise and crosswise,

cutting the swelling along its length and across its width.

And this applies

only where

its head is not white,

where the head of the swelling is not yet white and the pus is not ready to emerge. Therefore, the only way to treat it is in this manner.

But,

if

its head is white,

the head of the swelling is white—

there is no concern.

There is no further need to treat it, because the concentration of white pus at the head of the swelling indicates that it will heal on its own.