The laws of a sick person on Shabbos
The following chapter will discuss the laws of treating illnesses on Shabbos. Healing on Shabbos is in it of itself a Rabbinical prohibition even when done without any other Shabbos transgressions. At times healing is allowed even when it involves transgressing other Shabbos prohibitions in the process, and at times is forbidden even when no other prohibitions are transgressed.
Healing on Shabbos :
One who is not in danger and can walk:
One who has a mere ache in which there is no concern of danger at all and he has strength, and walks like a healthy person, then it is forbidden to do any form of healing for him on Shabbos even through a gentile, with exception to the ways that will be explained.
Furthermore, even to do something which contains no resemblance even of the slightest to any form of even Rabbinically forbidden labor and there is thus no prohibition at all for a healthy person to do so, nevertheless since [the ill person] is doing so for healing and it is recognizable that he is doing so for healing [therefore] it is forbidden to be done.
The reason for this is: due to a decree that he may come to grind herbs for healing if it were to be allowed to deal with medical issues on Shabbos and he will thus be liable for grinding.
A life threatening illness:
One who has a life threatening illness it is a Mitzvah to transgress Shabbos on his behalf [to help heal him] and those which act with alacrity [and do so first] are praised. One who seeks [Halachic advice to verify if he is allowed to save him] is spilling blood [through this delay] and the one who is asked [such a question] is to be ashamed because he should have made a public speech mentioning that it is allowed.
Even a questionable life threatening situation pushes off [the prohibitions of] Shabbos.
The reason for this because: it says [in the verse] “That one should do and live by them” and what is “and live by them” trying to teach us? It is saying that one should see to it that one will for certain live through doing the Mitzvah and should not [do so if] he will come through this [Mitzvahs] to a case of a possible life threatening danger.
Must use a known treatment or one prescribed by a medical expert: Nevertheless even if there is a definite danger one may only transgress Shabbos for medical treatment that is known to all or is done by a professional [doctor]. When it is a known form of healing then even if one does not know if he will be cured through it or not, one transgresses Shabbos out of doubt [that perhaps it will heal].
A wound in an inner limb:
The definition of an inner limb: Any internal wound, which includes all wounds in limbs that are located from ones teeth and inward, including the teeth [and ones gums], one is to desecrate Shabbos on behalf of [healing them].
The definition of a wound: However this only refers to [a type of wound that has] impaired ones teeth or any one of the other inner limbs due to a wound, or that has a blister and the like. However mere aches and pains alone [which one knows is not associated with a wound or blister] are not considered a wound and one may not transgress Shabbos for them even if it involves tremendous pain. [However if one feels great pain and is unaware of whether or not it is a result of a wound or of a blister, then he may desecrate Shabbos to treat it.]
One who is in so much pain that his entire body feels week: [However] if one is in such pain that his entire body feels [week and] sick then it is allowed to desecrate Shabbos through a gentile even by [having him do] a Biblical prohibition.
One who is not in such pain: (If he is not in so much pain then he is [nevertheless] allowed to have done through a gentile any [form of treatment] which is [only] Rabbinically prohibited) as will be explained [in Halacha 20].
A toothache which has made one weak: Therefore one who has such a tooth ache that he is in such pain that his entire body feels sick (is allowed to transgress Shabbos through a gentile) [and] may tell the gentile to remove [the tooth].
The reason it is allowed despite ones assistance that he is giving to the dentist: Now, although the Jew is helps him locate the tooth and slightly assists him to take it out, [nevertheless] this does not pose a problem because his help is not meaningful as even if the Jew were to not help him in this assistance [that he is giving] but would also not stop [the gentile from doing his job] the gentile would be able to do it himself.
A toothache which has not made one weak: (And according to those opinions which say that any action which is not done for its own use is only Rabbinically forbidden then it is permitted to remove [the tooth] through a gentile even if the entire person’s body has not become sick [so long as it is more than a mere ache] as will be explained [in Halacha 20])
An inner wound is assumed to be deadly unless known otherwise:
A wound in an inner limb does not need to be evaluated [by a professional] and rather even by a standard wound in which there is no [available] professional to recognize [the danger in such a wound], that it needs an immediate cure [on Shabbos], as well as [even] if the patient himself does not mention anything, one may do for [this patient] anything which is regularly done for [a sick person] during the week.
The allowance to do everything that is normally done on a weekday: [One may make for him] foods and remedies which are good for a sick person, even if there is no danger at all involved in refraining from doing [these actions], as nevertheless there is danger involved in his illness.
If the inner wound is known to not be of danger: However when one knows and recognizes that this illness [can be] delayed [from being treated now] and thus does not need to have Shabbos transgressed for it, then one is not allowed to transgress Shabbos to treat it even though it is a wound in an inner limb. Certainly this applies if the patient or a medical professional says that it does not need immediate attention.
Other Opinions regarding doing actions which are not a necessity: [However] there are opinions which say that even in a scenario that one needs to desecrate Shabbos a Jew is only allowed to do those forbidden actions which there is possibility that a lack of doing them can put him in danger. However any action that if refrained from doing will not cause danger, then even though the patient requires it and it is accustomed to do so for him during the week one may only do so on Shabbos through gentiles as is the law by the needs of any sick person which is not in danger.
The Final Ruling: (One is to follow the latter opinion in these provinces which are likewise accustomed to be strict even regarding an action in which there is danger if refrained from doing, to not do so through a Jew so long as it could be done through a gentile without any wait and delay at all as will be explained [in Halacha 13], thus by an action in which refraining from doing involves no danger at all one is to do it through a gentile even if there is suspicion that he may take his time doing it. However if there is no gentile available at all then one may rely on the first opinion, although nevertheless every meticulous person should worry for himself regarding [transgressing] a Biblical prohibition).
A wound on in outer limb:
[Regarding] a wound which is not in an inner limb one is to council with a medical professional and the patient. If one of them say that it requires desecration of Shabbos or says that if one does not desecrate Shabbos it is possible that the sickness will get worse, and it is a scenario that is possible that if the sickness were to worsen that it may become lethal, then one transgresses [for the wound].
However if [the illness will] not [eventually become lethal if left untreated] then we do not transgress Shabbos.
A wound on the palms, swallowing a leech, and getting bit by a poisonous creature:
A wound which is on the back of the hand or back of the foot [not including the back of one’s fingers], even if it occurred on its own without getting hit by iron, as well as one who has swallowed a leech, which is a small worm that is found in water and when it comes in contact with the skin of a person it sucks out the blood until it inflames to [the size of a] small barrel, and when a person swallows it in water it sucks moisture out from his stomach and causes his stomach to become swollen, as well as one who was bitten by a rabid dog or one of the deadly creeping creatures, even if it is questionable whether they kill or not, they are considered like an internal wound [of which one is to desecrate Shabbos for].
A wound from iron, blisters, and fever:
As well Shabbos is to be desecrated for any wound that resulted from iron, even if the wound is on the exterior of one’s skin and is not on the back of one’s hand and feet.
As well one is to desecrate Shabbos for boils which sprang up by the rectum and on furuncle (which is called flunkero in the vernacular) and for one who has a very heavy fever or even if it is not such high fever but the fever is accompanied with shivering, meaning with [feeling] cold (called shvidrin in the Yiddish) in a case that the fever and shivering came simultaneously. However the common fever which is at first hot and then cold involves no danger.
Treating blood accumulation:
One who has blood build up (in a scenario that could be life threatening) is to have his blood let even if he is able to walk on his feet, and even if it is the first day that he has had the blood build up.
(And if there is no danger involved then he is allowed to cool himself down in water being that doing so appears like he is cooling himself off and not that he is intending to do so for healing)
One has not yet begun to heal: One who has a pain in his eyes or in one of his eyes and there is fluid in it or there are tears pouring out of it as a result of the pain, or there is blood pouring out of it or it has pus which continuously congeals, or the pain [feels] like the prickling of a needle or it is burning and feverish, then one is to transgress Shabbos on the outset of all these sicknesses.
The reason for this is: as there is danger at that time because if the eyeball will become removed he will die because eyesight is dependent on the heart.
One has begun to heal: However towards the end of all these sicknesses, which is defined as when he is already on his way to being healed and there only remains a small amount of the sickness, [such as that] it [only] slightly burns, then one may not transgress Shabbos even through a gentile with exception to a Rabbinical prohibition, such as to apply [to the eye a remedy of] herbs which had been grinded the day before [meaning before Shabbos] as will be explained [in Halacha 21].
What to do in case of split opinion, and is the opinion of an amateur taken into account?
All Doctors agree that is dangerous: Any illness of which doctors say is life threatening, even if it is located on the outside of the skin, one is to transgress Shabbos to treat it.
A split of opinion amongst two doctors: If one doctor says that [it is life threatening and thus] Shabbos must be transgressed, while a second doctor says that [it is not life threatening and thus] one does not need to desecrate Shabbos for it, then one is to desecrate Shabbos for it because in case of doubt that a life is in danger we rule leniently [against the prohibition and force Shabbos to be transgressed]. [However see chapter 618 Halacha 4 regarding if the patient himself agrees with the doctor claiming it is not lethal, as well see there for other cases.]
An amateur says that the illness may be life threatening: [Furthermore] even if there is no professional doctor [giving an opinion] but there is one person which says that he recognizes the sickness and its appears to him that Shabbos needs to be desecrated, then one is to desecrate Shabbos based on his word because every person is considered to be slightly expertise [in the lethalness of illnesses] and in case of doubt that a life is danger we rule leniently.
([Furthermore] even if [the amateur] says that it is questionable whether one needs to desecrate Shabbos, one is to desecrate it if he says he recognizes this illness).
A split of opinion amongst an amateur and medical professional: Nevertheless, [the opinion of the amateur] does not override the opinion of a professional doctor which says that [the illness] does not require Shabbos to be transgressed even if [the amateur] says that it definitely [is life threatening and] needs Shabbos to be transgressed.
The invalidity of the opinion of an amateur gentile: All the above [leniency to take into account the sole opinion of an amateurs] with regards to a Jewish [amateur], however a typical non- medical professional gentile is not considered like a professional to allow one to desecrate Shabbos based on their opinion when there is no Jew around that recognizes this illness.
One who refuses to accept treatment:
If [the sick person] refuses to accept the treatment because he does not want Shabbos to be desecrated on his behalf, then he is to be forced [into taking it] as this is a ludicrous form of [supposed] piety.
A split opinion between the doctor and patient:
If the patient says that he needs a certain treatment [for his illness to be done on Shabbos as he feels that his illness is life threatening] and the doctor says that he does not require [any immediate medication] then we listen to the patient because [only ones own] heart [truly] knows the [severity of the] pain of his soul.
If the doctor claims the treatment requested is damaging: [However] if the doctor says that the requested treatment will damage him [even further], one is to listen to the doctor.
Who is allowed to desecrate the Shabbos for the ill person and may one delay doing so until after Shabbos?
May a treatment be started on Shabbos if the doctors say that he will regardless be able to live until after Shabbos? A deathly ill person which was diagnosed on the day of Shabbos that he requires a known treatment which contains Shabbos prohibited labor [and the treatment must be] done for the next eight days, then we do not say “let us wait until night [to begin the treatment] in order so we only transgress one Shabbos”. Rather we desecrate Shabbos immediately even though that through doing so one will desecrate two Shabbosim.
The reason: Now, although we know for certain that [the patient] will not die today being that he was evaluated to live through the eight days [of the required treatment], nevertheless we are worried that perhaps he may die after the eight days, if the treatment were not to be started immediately.
Must a treatment that does not involve Shabbos desecration be given over one that does? However in a scenario that one can begin [preparing] the treatment immediately [in a form] that does not contain desecrating Shabbos but [because of this it] will be delayed a slight amount of time [until it is ready to be applied to the patient], then one may not desecrate Shabbos just in order to prepare the treatment in the shortest amount of time possible without any delay, if the situation is that there is no danger at all involved in this short delay [in the application of the treatment].
The reason for this restriction is: because [the prohibitions of] Shabbos are [simply] overruled in a life threatening situation and are not completely revoked [from being in affect], [thus] in any scenario that something can be done to save a person without desecrating Shabbos, Shabbos is not overruled for him.
Must desecration of Shabbos be done by an available gentile or child rather than an adult Jew? Nevertheless, even [in a scenario that] we have in front of us gentiles and children under the age of Mitzvahs we do not say that [since] one is able to [give the treatment] through these people and avoid desecrating Shabbos through a Jew who is above the age of Mitzvahs [therefore it should be forbidden for a Jew above the age of Mitzvahs to do so. Rather we say that an adult Jew is to do it].
The reason for this allowance is: because since the only option in saving him is through doing an action which is forbidden on Shabbos, therefore Shabbos is overruled on his behalf for [all] Jews which are obligated to save him and there is no transgression of Shabbos here at all.
The Rabbinical prohibition in giving over the job to a gentile or child: Furthermore, even if a Jew wishes to be strict upon himself [to not transgress Shabbos and thus wishes] to do the required labor through a gentile or child, or [he wishes to have them do it] because he does not desire to trouble himself [to do so], there is a Rabbinical prohibition in [him refraining from doing it himself].
The Reason: as perhaps the bystanders will now say that with utter difficulty was [transgressing Shabbos] permitted [to be done] for a life threatening situation and [they will think that] initially it is not permitted to transgress Shabbos through a Jew that is above the age of Mitzvahs, and this may then lead to that where a gentile or child cannot be found they will not wish to desecrate Shabbos through an esteemed religious leader.
May women be entrusted the responsibility of saving lives? [Furthermore] even by women which are obligated in Mitzvahs [of Shabbos] and there thus exist no such worry [that if given to them to desecrate Shabbos one may think that doing so is not so suitable] nevertheless we do not place upon them alone the responsibility and duty in dealing [with life threatening situations], that [the treatments] should be done through their hands [alone], as perhaps they will be lazy [in doing so with alacrity] or negligent in it.
Having women take part in the treatment: However women may be joined together with Jewish men, if the man will receive the overall responsibility [of the treatment] and the woman will be directed by the Jewish man, as since the Jewish man is dealing with the treatment she too will do so with alacrity due to his [presence].
Doing all the treatments through Torah Scholars: Nevertheless the greatest form of fulfilling this Mitzvah is to try to have all the [necessary Shabbos desecrations] done through Jews which are great [Torah] scholars and not through the simple folk and women.
The reason for why the treatment should not be done by the simple folk and woman is: in order so that Shabbos not be considered frivolous in their eyes and thus have them come to be lenient even in situations that are not life threatening. As well [another reason that great scholars should do so is] in order to publicly rule through a practical case [that Shabbos is allowed to be desecrated in these situations].
Do the labor with an irregularity: [However] there are opinions which say that since [in life threatening cases the] Shabbos [prohibitions] are [merely] being overruled and the [holiness of Shabbos has not been] revoked at all, [therefore] whatever [treatment] is possible to be done without Biblically transgressing [Shabbos] is required to be done through not transgressing a Biblically forbidden action and therefore if one is able to do [a transgression] without suspension and delay through an irregular form [of action used for that transgression], then one is to do it with an irregularity, as through doing so there is no Biblical transgression.
Have an available gentile do it: As well [they say that], if one is able to do [the transgression] through a gentile without any delay at all, then one is Biblically required to do so through a gentile, [as according to this opinion] it was only [Rabbinically] forbidden to do so through a gentile in a scenario that there is worry that he may do so lazily and thus come to delay and suspend [the treatment], however [they did not prohibit asking a gentile] if a Jew is actively supervising him and hastening him in a way that there is no worry at all [of possible delay].
The Final Ruling:
The main Halachic opinion is like the first opinion, although the custom in these countries is like the latter opinion. Nevertheless, it is best not to follow this custom because there is worry that perhaps since people will now see that the treatments are only done through a gentile they will come to think that it is always forbidden to do so through a Jew, and occasionally there will not be a gentile available and the ill person will be endangered as a result of their delay in waiting for the arrival of a gentile.
[However regarding the dispute in doing the actions with an irregularity the Alter Rebbe here does not give a final ruling, and one thus is to be stringent when there is no delay involved in doing so].
Those who follow the custom must announce to all: At the very least one who wants [to follow the custom and] do so through a gentile is to make it publicly known at that time that it is permitted for a Jew himself to transgress Shabbos [and it is only not being done through a Jew] because a gentile is readily available. [As well when one does the action with an irregularity he is to announce that in truth it is permitted to do even without an irregularity.]
Being swift to transgress Shabbos when necessary:
Whomever is swift to transgress Shabbos for a life threatening situation is praised [for doing so] even if [in the process of doing so hastily] he has done with it an additional [unnecessary] transgression, such as for example one spread out a net to remove a child that fell in a river and consequently caught with fish with it, as well as any case of the like.
A baby which has gotten locked in a room:
If a child has gotten locked in a room one may break down the door and take him out, because there is chance that the baby will get frightened and die.
May a kosher animal be slaughtered if there is non-kosher meat readily available?
If there is a deathly ill person [above the age of Mitzvahs] which needs meat and there is no kosher meat available, then] one slaughters [a Kosher animal or bird] for him.
The reason that: we do not say that he should be fed non-kosher food which contains only a prohibition of a negative command [without the capital punishment] rather than transgress Shabbos which is a prohibition [which contains the penalty] of stoning, [is] because Shabbos has already been overruled with regards to lighting the fire and cooking [the meat].
Another reason: As well, in [eating] non-kosher meat one transgresses on every single kezayis [of meat eaten] and even if one were to [verify that the ill person only] eat less than a kezayis [within the time of Pras], [nevertheless] there is [still] a Biblical prohibition [being transgressed] with every single bite [of the meat]. On the other hand by slaughtering one is only transgressing a single prohibition although that it is [more] severe.
Another reason: Furthermore perhaps the sick person will be disgusted in eating non-Kosher food and will refrain [from eating it] and will thus be endangered.
If one needs to eat meat immediately: Nevertheless if the sick person needs to eat right away and the non-kosher meat is readily available and the slaughtered meat will be delayed [in arriving to him], then he is to be fed the non-kosher meat.
If one needs boiled wine for a deathly ill person: However if [the ill person] needs wine to be heated up for him, then a Jew should fill up [the pot with the wine so that the wine not become Yayin Nesech] and based on the custom explained above [in Halacha 13] the gentile should heat it up supervised [by the Jew] (see Yorah Deah chapter 153 and 155) that he [the gentile] not touch [the wine] prior to it reaching a boil, and even if he touches it there is no problem involved, as even so there will only be a Rabbinical prohibition [involved in drinking it]. This is opposed to if the Jew heats it up in which case he will be doing a Biblical transgression [and thus according to the custom explained above it is better to have a gentile cook it and take the chance of him touching it. However based on the above ruling that one should not follow this custom and rather do the transgression himself, the same applies in this case].
There is no need to worry that [if the gentile were to touch it] perhaps the sick person will be disgusted in drinking it being that its prohibition is not so severe.
If many dates were picked when only one was needed:
[If] the doctors evaluated that [the patient] needs one fig and ten people ran and each one brought back one fig, they are all exempt of liability and they all receive reward from G-d even if [the patient] became better from the first fig.
Three figs on one stem verses two on individual stems:
If [the patient] was evaluated to require two figs and they only found two figs which were attached [to the tree] each one to a separate stem or on their own, as well as [they found] three figs which were all three attached to the same stem, then one is to cut the stem which has the three on it [rather then cut two individual figs] as although that by doing so one is increasing in the amount of figs [that are being detached] nevertheless he is lessening the amount of detaching [that he must do] which is the main aspect of the prohibition [in detaching fruits].
Two on one stem verses three on one stem: However if there were two on one stem and three on another single stem then one may only cut the stem that has two on it because it is forbidden to increase onto the amount [needed for] the forbidden action to be done, even though that [that in this case cutting the stem with three] is not increasing the amount of effort needed for the action being that [all three figs will be cut] simultaneously.
If the matter is urgent: Nevertheless if the matter is urgent then we are not particular about this so one not come to push it off and delay it.
A person which is bedridden or feels weak in his entire body:
Having a gentile do forbidden work: A sick person that is bedridden due to his illness and is not in danger or [a person] that has an ache that pains him to the point that his entire body is weakened due to it, in which case even though he is able to walk he is considered like one who is bedridden, then all of his needs may be done through a gentile, even complete Biblical prohibitions such as to bake for him or to cook for him if he needs this done.
The reason that Bishul Akum has been allowed: Now, although all forbidden foods, even those [forbidden only] Rabbinically, were not permitted for a sick person that is not in danger [to eat from them], nevertheless [the Sages] permitted [this sick person] on Shabbos in which there is no other available option [to eat food cooked by a gentile which contains the prohibition of ] Bishul Akum due to that the food is permitted in it of itself and it is only that an action of the gentile is causing its prohibition.
The prohibition for a Jew to Biblically transgress even when there is a limb in danger: However a Jew may not transgress Shabbos in doing a Biblical prohibition even if there is danger of [losing] a limb, so long as there is no danger of life.
The allowance for a Jew to Rabbinically transgress when there is danger of a limb: [However] for a Jew to transgress Shabbos by doing a Rabbinical prohibition [directly] with his hands, such as for example to administer to him any treatment [of healing] which is prohibited due to the decree of [that he may come] to crush herbs, even though doing so in it of itself involves no remote prohibition even Rabbinically, or even if it itself does involve doing a Rabbinical prohibition in its process, then it is allowed to be done without any irregularities from the way it is typically done during the week if there is a danger of a limb involved even though he is not bedridden and his entire body does not feel sick.
The allowance for a Jew to Rabbinically transgress with an irregularity when one is bedridden: However if there is no danger of a limb although he is bedridden or is in so much pain that his entire body feels week, then we do not allow a Jew to do something for him which is Rabbinically forbidden unless done in an irregular fashion then the normal way that it is done during the week.
Doing even Biblical prohibitions with an irregularity: [Furthermore] when doing an irregularity it is allowed to even do a Biblical prohibition [if it cannot be done through a gentile], such as for example one who is moaning [in pain from the heart] (of which it is permitted for him to suckle the milk of an animal) with his mouth as will be explained [in Halacha 40], as since he is changing from the regular way in which it is done it is only Rabbinically prohibited.
Medicine for one who is bedridden: However if one needs to eat foods which are recognizable that they are administered for healing, then although doing so is a Rabbinical prohibition due to [a decree] that one may come to grind up herbs as will be explained [in Halacha 43], nevertheless since (this is something which is impossible to do through a gentile and he is) sick throughout his entire body, [therefore] [the Sages] permitted for him to do so.
Other Opinions: [However] there are opinions which prohibit [the ill person from taking medicine].
The Final Ruling: Regarding the final ruling, in a [dispute over a] Rabbinical prohibition one may follow the lenient opinion.
One who is in tremendous pain but is not bedridden and does not feel weak throughout his entire body:
Doing a Rabbinical prohibition with an irregularity: If one has not become bedridden [due to his illness] and as well is not suffering so much to the point that his entire body feels weak (but nevertheless is in tremendous pain) then it is allowed to do for him through a Jew any Rabbinical prohibition which will be done with an irregularity even if it is a forbidden action.
Doing a Rabbinical prohibition without an irregularity/Taking medicine: However it is forbidden for him to eat foods which are recognizable that they are being administered for medication, and certainly [to do] other Rabbinical prohibitions without an irregularity [is forbidden] even if they do not contain any resemblance of a Biblically forbidden action. As well [one may not] do a Biblical prohibition through a gentile being that doing so is a complete Rabbinical prohibition which is being done without any irregularity. [However to have a gentile do a Rabbinical prohibition is allowed.]
One who is only slightly ill:
Having a gentile do a Rabbinical prohibition: If one is not in tremendous pain and does not have a sickness which incorporates his entire body but rather [only] a minor illness, then it is permitted for him to do all Rabbinical prohibitions through a gentile even without [having the gentile do so with] an irregularity as was explained in chapter 307 [Halacha 12].
Having a Jew do a forbidden action: However [one may] not [do any forbidden action, even Rabbinical] through a Jew even when done with an irregularity.
Medication: Therefore [on the one hand] it is permitted to have applied an external medical treatment through a gentile which places [the medicine] on him, since he [the Jew] is not doing any action in having this done. As although he does slightly assist [the gentile] [in applying the treatment] [nevertheless] it is meaningless and does not pose a problem as explained above [in Halacha 3] [and thus is allowed due to it being a Rabbinical prohibition done by a gentile].
(However [on the other hand] it is forbidden for [the sick person] to eat foods that are recognizable that they are eaten as medication as will be explained).
One who has a mere ache:
However if one is not even slightly sick but simply has a mere ache it is forbidden to do for him even through a gentile any action which is recognizable that it is being done for healing as was explained above [in Halacha 1].
Giving assistance to a gentile which is giving the medical treatment:
Having the sick person himself assist in his treatment: Anything which is if forbidden to be done [for the ill person] through a Jew is also forbidden to be done by the sick person himself, however if a gentile does it is permitted for the sick person to slightly assist him, such as for example a gentile which is applying ointment to the eye of a Jew towards the conclusion of his sickness in which his [eyes] slightly burn, then it is permitted for him to open and close his eyes in order so that the ointment enter into it well, being that assisting [the gentile] is [considered] meaningless so long as the gentile is capable of doing [the treatment] himself without the help of the Jew and just having the Jew not refrain him from doing it as explained above [in Halacha 3].
[Furthermore] even if the gentile is doing for him a Biblically forbidden action in a scenario where it is permitted [for a Jew to have him do so then] the sick person is allowed to assist him in the way explained [two lines above that the gentile would anyways be able to do it].
The Reason: (Now, although one who assists in doing a Biblical prohibition is [transgressing a] fully fledged Rabbinical prohibition as will be explained in chapter 346 and [thus] even upon assisting in doing a Rabbinical prohibition he [transgresses] at the very least a Rabbinical decree upon a Rabbinical decree [which is also forbidden], nevertheless here since [the Sages] rescinded the Rabbinical prohibition of asking a gentile [to do a forbidden act] for the need of a sick person, so too we rescind the Rabbinical prohibition of assisting him being that this too is for the need of the sick person. As through the assistance the treatment is done much better from how it were to be done through the gentile alone, such as for example [having the patient] close his eyes so that the ointment get absorbed in well and so too to open the eyes for the ointment to be entered into, or to open ones mouth for ones tooth to be removed [in which in all of these cases] although the gentile could have done [these actions] himself nevertheless the Sages did not require this, to place this responsibility on the gentile, and not allow the patient, for whom the treatment must be done to, to comply.)
Having another Jew assist the gentile: (However when the gentile does other matters that are forbidden even Rabbinically then a Jew (other than the patient) may not assist him with the treatment since there is no need at all for his assistance being that the gentile is capable of doing it all himself.
However if there is a need for his assistance that through assisting the treatment will work better than if it were to be done by the gentile alone, then it is permitted for even another Jew to slightly assist him.)
If the assistance is critical for the treatment: [However] if it is impossible to do [the treatment] without the assistance of a Jew then it is forbidden even for the sick person himself to assist.
The status of a child with regards to desecrating Shabbos on their behalf:
It is permitted to ask a gentile to cook a food for a child which does not have anything else to eat, as the typical needs of a child has the Halachic status of the needs of a sick person that is not in danger [which was explained in Halacha 19 above regarding what may be done for him].
It is permitted to feed a child Muktzah [food] even with ones hands if it is impossible to do so in a different way [meaning that no gentile is available].
May one ask a gentile to do an action which will only be needed after Shabbos?
[The Sages] only permitted asking a gentile to do something for a sick person if it is needed on Shabbos, however not if it is only needed for after Shabbos.
Lighting a bonfire for a lethally ill person:
One who let blood: One who has had his blood let and became cold is considered to be in [lethal] danger and one is to make for him a bonfire on Shabbos even in the season of Tammuz [the hottest summer month].
Other ill people: However for other sick people even though they are lethally sick, nevertheless [since] the coldness is not a danger for them as it is possible to warm them up with clothing, therefore one may only make a bonfire for them through a gentile, unless there are no [available] clothes to warm them up with.
Other Opinions: [However] according to those opinions which say any deathly ill person may have done for him through a Jew anything that is normally done during the week [for ill people], even if refraining from doing a particular matter will not cause him danger, (then nevertheless) [here too] one is also allowed to make a bonfire for the patient through a Jew as is done during the week.
The Final Ruling: (It was already explained [above Halacha 4] how one should follow in these countries).
Placing wine in the eye:
One may not place wine into an eye because it is recognizable that one is doing so for healing purposes, although it is permitted to place it on top of the eye because [doing so] only appears like one is rinsing [his eyelid] and not like he is intending to do so for healing purposes.
Closing and opening the eye: [However] this is only [permitted] so long as that one does not open and close his eyes, however if he does open and close [his eyes] so the wine penetrate into it, then it is recognizable that he is intending to do so for healing purposes and it is thus forbidden.
The law today: Today that it is no longer accustomed to rinse [ones eye] with wine it is forbidden [to rinse ones eye with it] under all circumstances [even if he does not open and close his eyes] if his intention in doing so is for healing.
Placing tasteless saliva on one’s eyes:
Tasteless saliva, which is defined as all the saliva that one has after awaking from his sleep [at night] prior to having tasted anything, is potent and has healing powers, and is forbidden to be placed even on the eyelids being that doing so does not appear as if he is rinsing them as it is not common to rinse with saliva due to its repulsiveness.
Saliva mixed with water: However if one washes his mouth with water and then passes it on his eyes, then although that tasteless saliva is mixed into that water it is [nevertheless] permitted being that it is not repulsive to rinse [one’s eyes] with such water [and thus does not appear that one is doing so for healing purposes].
One who is unable to open his eyes: One who is unable to open his eyes is allowed to damp them even with pure tasteless saliva, being that [the Sages] only prohibited doing so when done with intent of healing and this [purpose to help one’s eyes open] is not considered healing.
Applying collyrium to one’s eyes on Shabbos:
Soaking it before Shabbos: One may soak liquidly and clear collyrium before Shabbos and place it over his eyelids on Shabbos for healing.
The Reason: There is no decree here that one may come to grind herbs as since one was required to soak it before Shabbos this thus serves for him as a reminder that he may not make medicines on Shabbos. There is no need to worry that the above gives onlookers a bad impression [and may lead them to think that medication is allowed to be taken on Shabbos] as [rinsing one’s eyes with it] simply appears like one is washing them as since [the collyrium] is liquidly and clear it appears to the onlooker as if it is wine.
Opening and closing the eyes: Nonetheless, one may not open and close his eyes [upon placing it on them] as when done so it is evident that that his intentions [in placing it there][ are for healing purposes.
Thick collyrium: However thick collyrium is forbidden to place on ones eyelids on Shabbos because it is evident that it is done for healing purposes. Although if one placed it [on his eyelids] from before Shabbos then it is permitted [to be left there over Shabbos] as explained in chapter 252 Halacha 14].
Removing scabs and applying ointments to it:
Smearing the wound with oil: One may remove the scab of a wound [with ones hands] and may smear the wound with oil in places that it is common to smear oil also when there is no healing intended [i.e. for pleasure] as explained in chapter 327 [Halacha 1].
Smearing it with fat: However one may not smear it with fat because it [causes it to] melt and is forbidden for the reason explained in chapter 326 [Halacha 10]
Final stage of the wound: Even in the final stage of the wound, which is defined as when it has already healed and one feels no pain from it, it is permitted to remove the scab and to smear it with oil for mere pleasure [even in places that oil is never smeared for mere pleasure].
Applying an oil and water mixture: However one may not apply a mixture of oil and hot water over a wound, and not over a bandage which is to be placed over the wound being that doing so is evident that it is being done for healing purposes. However one may place it on his skin that is on the side of the wound and have it flow and drip onto the wound as when done so it is not recognizable that one’s intention is for healing. Although it is permitted to place on it plain oil in places that it is common to smear oil even [for pleasure,] when there is no intention for healing. As well it is permitted to place on it plain hot water that was heated from before Shabbos.
Applying oil or water to a bandage:
(As well it is permitted to place plain oil) over a pad which will be placed on [the wound]. (However hot water even plain, may not be placed (if the pad is not designated for this purpose) due to a decree that one may come to squeeze it [and be liable for the laundering prohibition], although by oil there is no decree made that one may come to squeeze it as was explained in chapter 320 [Halacha 21].
Placing pads and bandages on a wound on Shabbos:
New: It is permitted to place on a wound a sponge and pieces of dry clothing if they are new being that doing do is not done for healing but rather to prevent ones clothing from irritating the wound.
Old: However one may not place old pieces of clothing on it [being] that they contain healing powers. However this only applies if [the old pieces] were never yet placed on a wound, though if they had already been placed on a wound then they no longer have healing powers despite the fact that they are old, and it is thus permitted to place them on a wound on Shabbos.
Placing leaves on a wound on Shabbos:
One may place a [non-Muktzah] leaf over a wound on Shabbos, as it is only placed as a safeguard [from irritation], with exception to grape leaves being that they are used for healing. The same applies for all leaves which heal [that they may not be placed on wounds].
If one placed them [on the wound] from before Shabbos and removed them from it after dark [i.e. after Shabbos already began] even purposely then it is permitted to replace them.
The reason for this is: As [the Sages] only forbade all healing treatments [from being done] due to a decree that one may come to grind herbs, when [the treatment] is being given on Shabbos for its first time, however not when one already began the treatment from before Shabbos and is only returning it on Shabbos.
Replacing a dressing which contains ointment on a wound on Shabbos:
Removed purposely: However a poultice which one removed from his wound purposely, even while still being held in his hand, is forbidden to be replaced due to a decree that one may come to smear and smoothen the bumps that are in it and will come to be liable for the smoothening prohibition as was explained in chapter 314 [Halacha 21].
Fell off wound but did not hit ground: However if it slipped off the wound on its own after dark [but still remained attached to ones skin] then the Sages did not make a decree in such a case and it is permitted for him to return it. [Furthermore] even if it fell off of him completely it has the same status as if it had slipped away [from only the wound and has remained on his skin].
If fell onto the ground: However this only applies if it fell onto a vessel. However if it fell onto the floor then if he wishes to return it [to the wound] it is as if he is placing it on Shabbos for its first time and is forbidden due to a decree that he may come to smoothen it and due to the decree that he may come to grind herbs.
Replacing it through a gentile: Although through a gentile it is permitted to place it on the wound even initially if it is causing him pain and slight illness as was explained above [in Halacha 20]. However it is forbidden to tell the gentile to initially make the dressing on Shabbos [by smearing ointment on the bandage], as smearing onto the bandage is a Biblical prohibition and doing so through a gentile is a complete Rabbinical prohibition which was only permitted [to be done] if ones entire body has fallen ill or if a limb is in danger [of being destroyed] as was explained above [in Halacha 19].
Removing the poultice to clean the wound: One may open part of the poultice and clean the mouth of the wound and then return it, and then go and open its other side and clean the mouth of the wound and then return it as since he does not remove the entire poultice [in the process] therefore he may return it. However he may not clean the bandage [of the ointment] being that doing so [transgresses the] smearing [prohibition].
Applying a poultice on Shabbos to a healed wound:
A wound which has healed one is allowed to place on it a poultice initially on Shabbos being that it merely protects it from getting irritated by his clothes.
The Reason: [The Sages] were not worried that one may come to smear it or [come to] grind herbs as since it has already healed the person is not so nervous regarding it that he will come to smear and grind herbs [to cure it more].
Puncturing a pimple/boil on Shabbos:
Punctures it to let in air to heal it: One who breaks [open] a boil on Shabbos, if he does so in order to make for it an opening for air to enter through it to heal it, then he is liable for [the prohibition of] “Makeh Bepatish”.
The reason for this is: being that he has fixed for it an opening and anyone which fixes an opening in any item detached [from the ground] is liable for fixing a vessel, which is an offshoot of the “Makeh Bepatish” prohibition as explained in chapter 314 [Halacha 2]. And what difference does it make if one has fixed a vessel or fixed a wound, and thus also in the fixing of a hole in the wound contains the prohibition of “Makeh Bepatish”.
Now, although one is only liable on a hole made to enter and remove [something] thorough it as was explained there, [nevertheless here too one is liable] as this opening too is made to enter through it air and to constantly remove puss through it.
Punctures it to release the puss that is causing him pain: [However] if one breaks it open only in order to remove its puss which is causing him pain and not in order to enter air into it for purposes of healing , then it is permitted.
The reason: Now, although that one consequently creates a hole which is fit to [have something] entered and removed through it, nevertheless since he does not have a need for it this is considered an action done not for its own use [which is not Biblically forbidden]. [Furthermore] even according to those opinions which say that an action which one does not do for its own use one is [also] liable on nevertheless here since the liability is due to fixing the wound thus if he does not care for this “fixing” and does not intend for it, then even though it consequently occurs [through him breaking open the boil], [nevertheless] this is not considered fixing at all and is as if he has done nothing. Albeit there does remain reason to decree against doing so due to that he may come to intend to make the hole [for healing, nevertheless] in a case of pain [the Sages] did not make such a decree.
Other Opinion: [However] there is an opinion which says that [the Sages] only permitted [breaking the boil] if one cares in doing so to merely remove its current puss and does not care if the boil will close back up. However if he desires that it remain open in this form in order for it to constantly remove its puss, then although he does not intend for air to enter through it [for healing] [nevertheless] it is forbidden.
The Final Ruling: It is proper to suspect for this latter opinion and to puncture the boil/pimple through a gentile [when done with intent to remain constantly open].
Scratching a pimple/boil on Shabbos
However it is forbidden to scratch a boil [on Shabbos] as doing so removes blood and contains the prohibition of inflicting a wound.
The difference between scratching and puncturing: This is not similar to [puncturing it to remove puss] being that puss is not attached and absorbed within the skin and is rather as if it is deposited there within a vessel and upon opening the boil to remove [the puss] it is merely like one is opening a vessel to remove its content. This is opposed to blood which is attached and absorbed within the skin.
Widening the hole of a wound on Shabbos and the laws of an Apturah:
A hole that is in a wound which was already opened [from before Shabbos] and one wishes to broaden it on Shabbos even only slightly it is forbidden [to be done].
Unplugging it: However if it had closed up then it remains questionable whether one is allowed to go ahead and reopen it on Shabbos as it was originally just as it is permitted to reopen a hole of a vessel that got plugged as explained in chapter 314 [Halacha 6].
The hole of an Apturah: As well those that have a hole in their arm that is called (aptora) and this hole got slightly stuffed up then there is doubt as to whether or not one is allowed to place legumes inside of it in order to open it.
Placing a poultice on the Apturah: [However] a poultice is allowed to be placed on the (Apturah) being that it is like a wound which has healed which is permissible to place on it a poultice on it (as was explained in this chapter [Halacha 31])
Other Opinion: [However] there is an opinion which prohibits placing [a poultice) on an (Apturah).
The Final Ruling: (One is to suspect for their opinion [and thus be stringent]).
Cleaning the Apturah: If one is certain that cleaning [the Apturah] will extract blood then he may not clean it on Shabbos as [although one has no intention to extract blood, nevertheless] it is inevitable.
Switching the bandage of a wound:
By an Apturah: However it is permitted to switch the current [garment which is covering the Apturah with] a different garment, as if one will not do so then it will smell, and [thus we allow it to be done as we take great precaution] to insure the dignity of people as well as that there is pain from it.
By a wound without a hole: However the above [allowance] only refers to this type of wound [called Apturah] being that it has a hole, however a wound which does not have a hole it is forbidden to change the garment or paper [for another] (because) one draws out puss from the wound (through removing [the cloth] from on it) and it is forbidden due to the “detaching” prohibition, as will be explained [in Halacha 54].
Placing sugar on a wound: Certainly one may not place [sugar] (tzuker zlab) on a wound which does not have a hole.
Applying wine and vinegar to suppress a wound:
Wine for the un-pampered: One who hurt his hand or leg not as a result of iron may constrict it with wine in order to suppress the blood [flow].
Vinegar: However [he may] not [suppress it] with vinegar because it is potent and thus contains the healing prohibition.
Wine for the pampered: If one is pampered then even wine helps [cure the wound] as does vinegar and it is forbidden [to be placed] when the wound is not on the back of his hand or the back of his foot, as if it is then it is permitted to desecrate Shabbos for it by even doing a Biblical prohibition. Similarly if [the wound] resulted from a blow from iron [then it too may have Shabbos desecrated for it] as mentioned above [in Halacha 7].
Dislocated arm or leg on Shabbos:
One who dislocated his arm or foot, which is defined as if the bone came out of its socket, may not rub it with a lot of cold water being that this heals it. Rather he is to wash it regularly [as he washes it during the week] and if it gets healed [in the process] then so be it.
Removing a nail or pieces of skin from ones nail on Shabbos:
If majority of it has begun peeled off: A nail which is in the process of peeling off and cuticles, which are thin strings [of skin] which have [begun] separating off of the skin of the finger that surrounds the nail, if majority of it has peeled off then since they are close to becoming [completely] disconnected [therefore] there is no Biblical shearing prohibition applicable to it even when cut off with a vessel, although it is Rabbinically forbidden [to do so with a vessel].
Removing it with ones hands: However to remove it with ones hand, [being that it] is not the common way of shearing is permitted to do even initially if they are irritating him, so long as they have peeled off towards the top, meaning that it had began to peel off on the side of the nail [as opposed to under the nail].
Other Opinions: [However] there are opinions which say that towards the top means towards the body and not towards the nail.
The Final Ruling: One needs to suspect for both explanations [and thus it is never permitted to peel the skin or nail off even when majority of it has begun to peel off].
If only minority of the nail or skin has peeled off: If majority of [the skin or nail] did not peel off and one took it off with his hand then he is exempt [from Biblical liability] although has done a [Rabbinical] prohibition. [However] if one cut it with a vessel then he is liable for shearing. [Furthermore] even according to those opinions that say that an action which is not done for its own use one is not liable on, [nevertheless] there are opinions which say that by shearing one is liable according to everyone for the reason to be explained in chapter 340 [Halacha 2].
A minor ache: One who has a toothache may not gargle vinegar and then spit it out being that it is recognizable that he is doing it for healing. However he may gargle and swallow it or dip a piece of bread into it and eat it as is normally done during the week.
Even through a gentile it is forbidden to do any [treatment] for him even if there is no resemblance of a forbidden action even Rabbinical, if it is recognizable that [the treatment] is being done for healing.
A major ache: However this only applies by a mere [tooth] ache, however he is in so much pain that his entire body is weakened because of it, then he is permitted to do through a gentile [even Biblical prohibitions, and if his entire body is not in weakened but he nevertheless feels pain to the point that he is slightly sick then a gentile may nevertheless do for him] anything which is only Rabbinically prohibited, as was explained above [in Halacha 19].
A sore throat:
Gargling oil: One who has a sore throat may not gargle oil, which means to retain oil in his mouth [for a period of time] prior to swallowing it as doing so is evident that one’s intentions are for healing.
Swallowing oil: However he may swallow the oil and if he gets healed in the process, so be it.
Other Opinions: [However] there are opinions which prohibit to even swallow the oil because [plain] oil damages the body and it is only common to drink it for healing purposes.
The Final Ruling: It all depends on the place and time that one is [living] in, that if it is not common for healthy people to drink it then it is forbidden [to be done].
Drinking the oil down in a drink: However it is permitted to place a lot of oil in beet juice (Inigrone) and then swallow it as in such a case it does not damage the body and it is not apparent that it is being done for healing but rather simply for drinking. Nonetheless one must swallow it immediately and not retain it in his mouth, and it goes without saying that he may not spit it out a then it is recognizable that he is doing so for healing.
Sucking the milk from an animal:
As a cure for heart pain: One who is moaning from heart pain of which his treatment is to suckle with his mouth from an animal, is permitted to suckle on Shabbos.
The Reason: As doing so is [merely] detaching in an irregular manner as it is not common to suckle milk [from the animal breast] with ones mouth but rather to milk it into a vessel and drink from it, therefore there is no Biblical prohibition involved in this nursing but rather merely Rabbinical and in a case of pain [the Sages] did not make their decree.
Due to hunger: However this allowance only applies to one with heart pain however one who is merely hungry it is forbidden for him to nurse from an animal on Shabbos.
However on Yom Tov it is permitted to nurse [from it] (if it is impossible to milk it through a gentile and also if he does not have food into which he can milk into).
Pumping milk from a woman’s breast on Shabbos:
Into a cup and the like: A woman may not squeeze milk from her breasts into a cup or into a pot in order to nurse [the milk] to her child.
The reason for this is: because one who milks into a vessel is completely detaching and is liable for the threshing prohibition, and it was only permitted to do a Biblical prohibition in a case of life threatening danger.
Trickling milk in order to stimulate her child to nurse: However it is permitted for a woman to squeeze out some milk [and have it trickle down her skin and the like] in order to stimulate her child to take hold of her breast and nurse. [However she may not squeeze the milk into his mouth in order to stimulate him.]
The reason for this is because: as since this milk [that is squeezed] is going to waste it does not contain a Biblical “detaching” prohibition, but rather a Rabbinical prohibition as explained in chapter 320 [Halacha 21] and for the need of a child [the Sages] did not apply their decree.
Squirting milk onto one who is spellbound: However it is forbidden to squirt from her milk onto one who has been overtaken by an evil spell, as he is not in any danger and is not in great pain for us to rescind for him a Rabbinical prohibition to be done through a Jew, as [opposed to] what was permitted by one who has heart ache and the like. See chapter 330 [Halacha 9].
Chewing gum and applying [liquid] toothpaste to ones teeth:
For medical purposes: One may not chew a species of resin called Mastichi and may not rub a drug on ones teeth when ones intention in doing so is for healing purposes.
To remove bad odor: However if he is only doing so to [remove bad] odor from his mouth, then it is allowed [to rub an herb or chew the gum].
Taking medications and foods which are eaten for medication
Eating foods and drinks that are common day foods for medication: All foods and drinks which are foods [eaten] by healthy people is allowed to be eaten and drank for healing even though they have bad side effects for certain things and it is thus slightly recognizable that one’s intention is for healing.
Example: For example [to eat the] spleen [of an animal] which is bad for ones stomach but helps and is good for teeth, or a vetch that is bad for ones teeth but is good to heal the stomach, nevertheless since it is common at times for healthy people to eat it as well when not intending for healing, it is therefore permitted to eat it even when eaten for healing.
Foods which are eaten only for medication: All foods and drinks which are not foods eaten by a healthy person are forbidden to be eaten or drunk for healing due to a decree that one might come to grind spices.
However this [restriction] is only if one has a mere ache and strengthens himself and walks like a healthy person even if it hurts him tremendously, however if his entire body feels sick as a result [of the pain] then even though he strengthens himself and walks, and it goes without saying if he has become bedridden, then it has already explained above [Halacha 19] that there are opinions that permit [him to take medicine].
One who does not intend to eat them for healing: However if one does not have a any ache at all and does not intend at all [to eat an item] for healing but rather for a different usage, such as for example, one who eats sweet resin and swallows a raw egg in order to sweeten his voice, then it is permitted. However when he does so intending for healing then it is forbidden even if he is completely healthy and does not have any ache.
For no medical purpose: It is forbidden to induce oneself to vomit for a non-healing purpose even during the week because doing so wastes the food that was in his stomach, as by doing so he becomes hungry and goes back and eats again.
To relieve a stomach ache during the week: [However] if one is in pain during the week from having eaten too much then it is permitted [to induce vomit] even using a medication.
On Shabbos: [However] on Shabbos it is forbidden to use medication [to induce vomiting] being that this is similar to healing. Although it is permitted to enter ones finger into his mouth until he vomits.
[It is forbidden to induce vomiting on Yom Kippur even if one has a stomach ache. See chapter 608]
Placing a hot empty cup over an aching stomach: One who feels pain in his stomach is permitted to place on it a cup from which hot water had been poured even though [the cup] still contains steam [from the hot water].
Elevating ones ear tendons: As well it is permitted to elevate ones ears, meaning the cartilage of one’s ear which at times droop downwards and cause the cheek [bones] to break up. They may be elevated whether by hand or by using a utensil.
Elevating the cartilage opposite ones heart: Similarly one may elevate the cartilage that is opposite the heart which has drooped inwards towards the heart [and thus interferes with breathing].
The Reason that the above is allowed to be done is: because each one of these issues are never healed using medications and thus there is no worry that one may come to grind [herbs], [and hence we allow it to be treated] because one has pain from the above.
Sobering up on Shabbos using different tactics:
Using an oil and salt mixture: Similarly one who is drunk of which his cure [to make him sober] is to smear [a mixture of] oil and salt on the palms of his hands and feet, it is permitted to smear [the oil] on them on Shabbos for the above mentioned reason [that normally there is no medication administered for this ailment].
Sniffing ash: One may not learn from this the allowance that some places have accustomed themselves to, to sniff ash of a grinded herb into ones nostrils in order to sober up from ones drunken state, because this ash has similar affects to medication regarding other matters as well, and it is thus relevant to decree upon it that one may come to grind herbs.
Massages and exercise on Shabbos:
It is forbidden to massage one’s body with force even for mere pleasure as was explained in chapter 327 [Halacha 2]. It goes without saying [that this is forbidden to be done] in order to exercise and sweat.
Similarly it is forbidden to exercise in other forms in order so one sweats for healing purposes due to a decree that one may come to grind and drink herbs which cause one to sweat.
Dealing with constipation:
It is forbidden to press upon the stomach of a [constipated] baby in order to help the feces come out as one may come to give [the baby] to drink medications which causes diarrhea. [However if the child is in pain and can not release the bowel movement on his own, then certainly one may even give him medicine, as the needs of a child are like the needs of one who is bedridden.]
Bathing for healing purposes:
Waters that are commonly bathed in [on Shabbos]: One may bathe for healing purposes in waters of Gerar and waters of Chamson and waters of Tiberius and in the pure waters of the Mediterranean sea even though that they are salty [and thus have a greater healing affect].
The reason for this allowance is: because it is common to bath in them even not for healing purposes and it is thus not evident that [one is bathing in them] with intent for healing.
Waters that are not commonly bathed in: However [one may not bathe for healing purposes] in foul water of the Mediterranean sea, and not in flax water being that they are repugnant and it is [thus] uncommon to bathe in them for non-medical purposes.
To dip and leave: However this restriction only applies if one remains in the water [for some time], however if one does not remain in them [and rather dips and leaves] then it is permitted [even in the foul waters] being that it simply appears as if he is cooling himself off [in them].
Tiberius hot springs: In places that it is common to only bathe in Tiberius hot springs for healing purposes, then it is forbidden to bathe in them on Shabbos for healing even if he does not remain in the waters [a long time].
Inducing diarrhea on Shabbos:
Through bathing: One may not bathe in waters that have a laxative effect [causing diarrhea], and not in quick sand.
Through drinking: And one may not drink liquids which cause diarrhea even if they are foods eaten by healthy people [and thus are not forbidden due to the decree of coming to grind spices] and one is not drinking it for healing purposes at all.
The reason for this is because: all the above actions cause pain while Shabbos is called a day of pleasure.
One may charm snakes and scorpions on Shabbos so they do not cause injury even if they are not pursuing oneself, and doing so does not contain the trapping prohibition even according to those opinions which hold liable one who does an action that is not needed for itself.
Eye Care on Shabbos:
One may place a vessel over an eye in order to cool [the eye] down as long as the vessel is permitted to be moved [not-Muktzah].
Similarly what is done to a person which feels eye pain in which they surround [his eye] with a ring in order to restrain the inflammation [of the eye is likewise allowed to be done on Shabbos].
Fixing a dislocation or break on Shabbos:
Dislocation: A bone which has become dislocated is forbidden to be returned to its socket [on Shabbos] being that doing so is similar to building (in addition to the fact that all healing treatments are forbidden [on Shabbos when no danger is involved]). Even to rub it a lot with cold water is forbidden as explained above [in Halacha 36].
A Break: However a bone which has broken may be returned to its place [by a gentile] as if one does not return it there on Shabbos the limb will be in danger and in scenarios of danger for a limb [the Sages] did not make their decree.
Treating a bleeding wound on Shabbos:
It is forbidden to place a garment cloth on a wound that is bleeding.
The Reason is: because the blood will dye it. Now, although one is ruining [the cloth in this dying, as he is simply staining it] nevertheless it is Rabbinically forbidden [to be done].
A red cloth: It is certainly [prohibited to place on the bleeding wound] a red garment, being that one is fixing it [by dying it with its natural red color].
Squeeze out the blood: It is not allowed for one to squeeze out the blood from the wound prior [to placing the cloth on it] as doing so consists the wounding prohibition as explained above [in Halacha 33].
Wrapping spider webs around it: Thus how is one to treat a bleeding wound? One is to wrap around it spiders web and cover with it all the blood and the entire wound and afterwards wrap a rag around it.
Other Opinions: There are opinions which question [whether it is allowed] and prohibit wrapping [the wound in] spider webs being that they have healing powers.
Rinsing off the blood: Rather [according to this latter opinion] one is to rinse [off the wound] in water or wine [prior to applying bandage to it] in order to remove the blood which is on the wound and afterwards [one may] wrap a rag on it.
The Final Ruling: It is proper to suspect for this latter opinion, although the main Halachic ruling follows the first opinion.
Kutras Achron in chapter 302:
Cloths that are designated specifically for wiping on: May be used for wiping blood and is not a problem of dying, as we only say a problem of dying when it is not in a way of wiping, or it is but is done to a random cloth.
Sucking out blood from a wound:
It is forbidden to suck blood with ones mouth from the wound due to the wounding prohibition.
Doing Metzitzah by a Bris: By a circumcision [sucking the blood of the circumcised area] was only permitted because [lack of doing so] poses danger.
Sucking the blood in ones gums: Therefore it is forbidden to suck blood which is between the teeth [in ones gums].
The reason: Now, although that doing so is separating [the blood] in an irregular way, nevertheless it is Rabbinically forbidden.
Placing a substance on a wound which draws out puss and blood: Likewise it is forbidden to place on a wound a substance which draws out the blood and the puss due to the detaching prohibition, as although the substance is drawing out [the blood and puss] on its own nevertheless since it is being placed there in order to draw it out, it is as if one is wounding and detaching with ones hands.
Treating constipation with a rectum insert
It is forbidden to place a string into ones rectum as is commonly done for one suffering from constipation, unless one places it with an irregularity, [which is] by grasping it with two fingers and placing it in delicately.
The Reason: [This is needed to be done in order to prevent] tearing membranes [of the rectum] as explained in chapter 312 [Halacha 12].
Inserting an enema: Although it is forbidden to insert an enema even through an irregularity, even if one had prepared it from the day before [before Shabbos] (because of the decree that one may come to grind spices) unless one is sick.
As well even by a sick person one needs to be careful not to come to do a Biblical prohibition (as well) as that if it is possible to do it through a gentile then it is to be done through a gentile.
 Ketzos Hashulchan 126 Halacha 3
 Ketzos Hashulchan 126 footnote 6, and so rules Mishneh Berurah
 see previous note
 Ketzos Hashulchan 126 Footnote 1
 A skin inflammation
 However regarding Yom Kippur the following is Admur’s ruling in chapter 618 “Any person which is sick and knows that the day is Yom Kippur and nevertheless says that he needs to eat is to be fed even if a hundred doctors say that he does not need to eat, even if they say that the eating will make things worse. The reason for this is because we do not assume that the person is a sinner that will eat on Yom Kippur, thus if he is saying that he needs to eat despite the doctors he must really feel he needs to eat, which is something that only he can feel and not the doctors.” Vetzaruch Iyun!
 Rama, in the name of the Ramban and Oar Zarua. The first opinion is the view of the Michaber  in the name of the Rambam.
 So rules Taz.
 So rules also Taz and Mishneh Berurah 37, albeit for the reason that the gentile will do so at a slower pace. However according to Admur, even when we know for certain that a gentile will not do so at a slower pace, nevertheless one is to do so himself.
 Ketzos Hashulchan 135 footnote 10. See there for reasoning.
 Ketzos Hashulchan 135 footnote 10.
 Lit. has fixed another matter
 See end of next note
 Each one of these three reason is itself enough of a reason to slaughter the animal rather than feed non-kosher food to the patient. [Ketzos Hashulchan 135 footnote 6].The Ketzos Hashulchan [135 footnote 6] adds another two reasons 1) The Mordechaiy says because eating non-kosher food is looked down upon [even in such a scenario]. 2) The Nitziv writes that non-kosher food creates evil tendencies in ones nature. Regarding a child, the Ketzos Hashulchan [there footnote 8] based on Mishneh Berurah rules that one is to rather feed him non-kosher then to slaughter for him on Shabbos.
 Meaning that in the following case it is better for the Jew to eat non-kosher rather than have a Jew transgress a Shabbos prohibition.
 However once the wine has reached a boil it is no longer prohibited by the touch of a gentile.
 But the treatment itself does not involve crushing herbs or any other biblical prohibition.
 Now, although earlier we stated that one may ask a gentile to do even a Biblical prohibition, which itself is a Rabbinical prohibition, nevertheless there this is because the Jew is merely commanding the gentile to do so and is not doing any action and thus the Sages were not as strict to require the gentile too to do a Biblical action with an irregularity. [Ketzos Hashulchan 134 footnote 5]
 Ketzos Hashulchan 134 Halacha 4
 Meaning that here the prohibition is in the actual eating the medication which is something that only the patient can do, and thus should ideally be prohibited due to that it cannot be done with an irregularity, nevertheless this itself is the reason to permit it as there is no other way to administer the medication.
 Meaning that even a Rabbinical prohibition which is rooted in a Biblical prohibition is permitted to be done with an irregularity.
 Meaning that his entire body does not feel sick due to the illness.
 Perhaps this refers in truth to 347 Halacha 1 and 3.
 Such as fruits that fell off the tree on Shabbos and the like
 Ketzos Hashulchan 134 footnote 18
 Seemingly this refers to placing it on the eye lid when closed. See Rashi on Shabbos 108b
 However today that no one washes with wine doesn’t even this appear like healing to the onlooker?
 However with a vessel is forbidden [Ketzos Hashulchan 136 footnote 22
 M”B, brought in Ketzos Hashulchan 136 footnote 20
 This refers to a dressing or pad which has ointment smeared over it which is then placed on the wound
 Lit. “it heals”
 Rabeinu Tam. The former opinion is that of Rashi.
 Mishneh Berurah 99
 This insert is placed by the Ketzos Hashulchan (chapter 128 footnote 9). Without it the statement contradicts what was explained above in Halacha 19. So rules also Mishneh Berurah 100.
 Lit. “then he gets healed”
 See reason and footnote below.
 Ketzos Hashulchan 138 footnote 30. See next note.
 Thus one may not squirt the milk into the mouth of the baby as in such a case it is not going to waste. This is unlike the understanding of the Mishneh Berurah [328/112] based on the Shevulay Haleket that one may squirt into the baby’s mouth. In the Sharreiy Tziyon the Mishneh Berurah queries how come this is allowed. According to the Alter Rebbe the query does not apply as in truth it is not allowed.
 This is a type of resin with a pleasant smell which comes out of a tree. [Mishneh Berurah 114]
 See next Halacha note 31
 A leguminous plant with small flowers. Use: silage, fodder.
 This only applies to actions which are also done for pleasure and satiation and thus are not evident that one is currently doing so for healing, although if the action is done for a type of healing which is not Halachicly defined as healing, such as to swallow a raw egg to sweeten ones voice or place mouthwash in ones mouth to remove a bad smell, then when done for healing it is nevertheless forbidden even though it is no recognizable for others. [See Ketzos Hashulchan 134 footnote 16]
 see previous note for the reason why here it is forbidden when done for healing.
 Based on Rashi in Avodah Zara 22b. Vetzaruch Iyun Gadol on the Mishneh Berurah  who quotes Rashi to say that it causes the ears to break up, while in Rashi there the version is “the cheeks”.
 Rashi there “thus putting one in danger” However from the reason mentioned below this does not seem to be the case according to the Shulchan Aruch
 Mishneh Berurah 135
 Seemingly if there were no pain involved we would still prohibit it due to that others may come to think that all forms of healing are allowed just like this one is.
 Mishneh Berurah 128
 Ketzos Hashulchan 128 footnote 20
 Mishneh Berurah 138
 Seemingly although the custom is not to bathe even in cold water on Shabbos, nevertheless for healing it is allowed. Vetzaruch Iyun.
 Lit. Water that had material soaking in it
 This follows the ruling of the Magen Avraham. However the Michaber  argues and hold that even a dislocation is permitted to be returned on Shabbos. According to all if the doctor says that there is danger of a limb involved then a Jew may replace it. [Mishneh Berurah 145] As well if one is in extreme pain then he may tell a gentile to do it, as explained in Halacha 20.
 Or by a Jew with an irregularity as explained above in Halacha 19
 Lit. good
 Kuntrus Achron in 302
 Any cylindrical body such as made of wax or fat or paper or other materials [Mishneh Berura 151]
 The insertion of a liquid into the bowels via the rectum as a treatment, especially for constipation.
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