Medical symptoms and the laws regarding their treatment

List of Bodily Medical symptoms and their respective laws regarding their treatment on Shabbos:

Important Note:

The laws here on the most part relate to classical symptoms which are a mere ache, and what treatments are defined as recognized medical treatments and thus may not be done.  This however does not negate any of the laws explained in the previous chapter of the different levels of illnesses and their respective laws. Thus if in any of the below mentioned cases one has reached a severity of illness as those mentioned above which allow desecration of Shabbos to a certain extent, then all those laws apply.

 

Eye care:

A. Placing ointment in ones eye

 Placing tasteless saliva on one’s eyes:[1]

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].

 

Applying collyrium to one’s eyes:[2]

Soaking it before Shabbos: One may soak liquidly and clear collyrium[3] 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[4].  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.[5]

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].

 

Placing wine in the eye:[6]

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[7] 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.

Summary-Placing ointment in one’s eyes for healing[8]:

May only be done if it is not evident that one is doing so for healing purposes.

 

B. Treatment for one who is unable to open his eyes:[9]

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.

 

Summary- One who is unable to open his eyes[10]:

May wet them with even medical ointment as doing so is not considered a treatment.

 

C. Treating eye irritation:[11]    

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].

 

Mouth and Teeth ailments:

A. Removing an aching tooth:[12]

A toothache which has made one weak: Based on the laws of the different levels of severity of illnesses listed in Chapter 2, one who has a tooth ache which causes him 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 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] then 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 was explained [in Halacha 328/20])  [See Q&A regarding tooth which its majority has begun coming out]

       

B. Taking medicine:[13]

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. [The same applies to taking any medicine, that doing so is forbidden, unless the ache is so strong that he is bedridden due to it as will be explained next.] 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 minor [tooth] ache, however if he is in so much pain that his entire body is weakened because of it, then he is permitted [take medicine[14] and may] do through a gentile [even Biblical prohibitions, and if his entire body is not weakened but he nevertheless feels pain to the point that he is slightly sick then a gentile may nevertheless do for him[15]] anything which is only Rabbinically prohibited, as was explained above.

 

Summary:

Removing the tooth: If it hurts to the point that one’s entire body feels weak, then he may ask a gentile to pull it out. According to some even if ones entire body is not weak from the pain, but is more than a mere ache, then one may ask a gentile to remove it.[16]

Gargling vinegar: If it is a mere ache then one may not even gargle vinegar and the like and then spit it out. Although he may gargle it and swallow it or dip his bread in it and eat it, as then it is not noticeable that he is eating it as medicine.[17] If however the pain is so strong that one feels week in his entire body then all medicine may be taken.

Medicine: Is forbidden unless one is bedridden or weak throughout his entire body.

 

Q&A

May one pull out a loose tooth?[18]

If majority of the tooth has already detached and pulling it out will not release blood, then it is allowed to be pulled out if it is causing one pain. [19]

 

C. Chewing medicinal gum and applying toothpaste to ones teeth:[20]

For medical purposes: One may not chew a species of resin called Mastichi[21] 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].[22]

 

Summary-Chewing medicinal gum and applying toothpaste to ones teeth:[23]       

One may not do so for medical purposes. However one may do so in order to remove bad odor from one’s mouth.

 

Q&A

May one brush his teeth on Shabbos?

One may place thin creamy toothpaste on his hand and then smear it on his teeth.[24] It is forbidden to place it directly on a toothbrush and then smear it as doing so is a mundane act.[25]

Practically the custom is to avoid brushing one’s teeth at all on Shabbos. [See Piskeiy Teshuvos 326/3 for all details]

 

May one use mouthwash to remove bad odor?[26]

Yes, this is permitted.

 

May one floss his teeth on Shabbos?

One may floss his teeth so long as he bewares not to cause bleeding. Likewise it is forbidden to cut the piece of floss off on Shabbos due to the prohibition of Tikkun Keli.

 

A sore throat:[27]  

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[28].

Other Opinions: [However] there are opinions which prohibit to even swallowing 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, as then it is recognizable that he is doing so for healing.    

 

Summary-A sore throat:

Gargling oil: One who has a sore throat may not gargle oil, even if he intends to swallow it. However he may swallow the oil in an area where it is common to drink oil, and if he gets healed in the process, so be it. However in places where this is not common then it is forbidden. However it is permitted to place a lot of oil in beet juice and then swallow it, although one must swallow it immediately and may not retain it in his mouth, or spit it out.

Medicine: Is forbidden unless one is bedridden or weak throughout his entire body.

 

Q&A

May one drink a hot tea to sooth a sore throat?

Yes as it is not recognizable that one is doing so for healing purposes.

 

May one gargle salt water for a salt throat?

No, as it is recognizable one is doing so for medical purposes. If however one is bedridden or weak in his entire body, then this is allowed.

 

Stomach care:

A. Inducing vomiting:[29]

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.

 

Summary-Inducing vomiting:[30]

Is forbidden for a non-healing purpose even during the week because doing so wastes the food that was in his stomach. However if one is in pain from having eaten too much then during the week it is permitted to induce vomit even using a medication. 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. 

 

B. Treating stomach pains with a vessel of hot water[31]

A large amount of water: One who has stomach pains is forbidden to place on his stomach a vessel that has hot water

The reason for this is: because he may come to spill it on majority of his body and it will thus be considered as if he has washed majority of his body in hot water.

A small amount: [Furthermore] even if there is only a small amount of hot water [in the vessel] which is not enough to wash majority of one’s body [if it were to spill], then nevertheless if it were heated on Shabbos even a little, [even if this were] to the point that it is not [yet] Yad Soledes, it is forbidden [to place in a vessel on one’s body for the reason] explained [in the Laws of Bathing Halacha 1, that one may not bathe even minority of one’s body in water heated on Shabbos].

On a weekday: [Furthermore] even on a weekday this is not allowed to be done because of the possible danger [that it involves] as at times the water is very hot [and may come to spill on one’s body and give him a serious burn].

Placing hot clothing on it: However it is permitted to heat up clothing and place them on ones stomach even on Shabbos. [See Q&A regarding am electric heating blanket]

Placing a hot empty cup over an aching stomach:[32] 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].

The Reason that the above is allowed to be done is:[33] 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 [thus we allow it to be treated] because] one has pain from the above[34]. [However if there is no pain involved then it would be prohibited due to it being a mundane act.[35]]

 

Summary-Placing hot items over an aching stomach:

Is allowed if there is no hot water in it, even if it still contains steam.[36] However if it has hot water in it then it is forbidden even during the week due to worry that one may receive a burn if it were to spill.[37] On Shabbos this is forbidden also due to the bathing prohibition, unless it were heated before Shabbos and does not contain enough water to wet majority of one’s body if it were to spill. [However, nevertheless it would remain forbidden due to danger.]

 

Q&A

If the water is placed in a closed bottle may one place it on his stomach?

Yes, as there is now no suspicion that it will spill.[38] [As well there is no medication prohibition involved here as is seen from the fact that Admur makes no mention of it.]

 

May one place an electric heating blanket [which was left on from before Shabbos] over an aching stomach?[39]

Yes.[40]

 

C. Dealing with constipation-Inducing Diarrhea:

Pressing down on the stomach[41]: 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.[42]]

 

Inducing diarrhea on Shabbos:[43]

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.

 

Treating constipation with a rectum insert:[44]      

It is forbidden to place a string[45] 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.[46]

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[47] 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.

 

Summary- Dealing with constipation:

It is forbidden to press down on the stomach[48] or do anything or eat anything which will have a laxative affect on ones stomach and cause one to have diarrhea even if it does not appear that one is doing so for this purpose.[49] One may however place an insert into his rectum to help with the constipation as long as one inserts it with an irregularity which is defined as using two of one’s fingers as opposed to ones hand. However it is forbidden to insert an enema.[50]

 

Q&A

May one take a laxative drug to help with constipation?[51]

No[52], unless the constipation is causing one pain to the point that his entire body feels weak.

 

May one insert a rectal suppository to treat constipation?[53]

Being that this contains medicine it may only be done through a large irregularity, such as placing it in from the wide side. However to place it in with two fingers is not considered enough of an irregularity.

There is no prohibition in cutting the suppository in half.[54]


May one who has hemorrhoids apply ointment to the area?

See Tzitz Eliezer 11/37

 

May one who has hemorrhoids soak his bottom in hot water?

Yes[55]. However some Poskim[56] question whether this is allowed in case that one is not bedridden or feeling weak due to the pain.[57]

 

Dislocated or broken arm or leg:[58]

Note: In all cases that doctors say that the dislocation or break is lethally dangerous one may obviously desecrate Shabbos to heal it immediately as explained in Chapter 1.

 

A. Dislocation:

Rubbing it with water:[59] One who dislocated his arm or foot, which is defined as that the bone came out of its socket, he may not rub it a lot with cold water being that this heals it[60]. 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[61].

Returning it to its socket:[62] 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]). [See footnote for opinion of Michaber[63]] Even to rub it a lot with cold water is forbidden as explained above. [See Q&A regarding if there is fear for the limb or if one is in extreme pain]

 

B. Returning a broken bone to its proper positioning:

However a bone which has broken may be returned to its place 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. [See Q&A regarding making a cast and x-ray]

 

Summary- Dislocated arm or leg on Shabbos:

Dislocated bones may not be returned to its socket on Shabbos due to a building prohibition [unless one is in bedridden in which case a gentile may do so].[64] As well one may not rub the area with a lot of cold water, although may wash it regularly.[65] However if the dislocation is due to a break in the bone then one may return it on Shabbos as the limb is considered to be in danger.[66]

 

Q&A

If one is in great pain and there is fear that the limb will not be able to function properly any more if it is not returned to its socket may one be lenient to return it?[67]

Yes[68], it may be done regularly by a Jew as this is considered that the limb is in danger.[69]

 

If one is in extreme pain but there is no fear of damaging the limb what is he to do?

If one is in extreme pain then he may tell a gentile to return the limb to its socket, as explained in Chapter 2 Halacha 3.

 

May a cast be made for a broken limb?[70]

No as doing so involves Biblical prohibitions. The limb is rather to be placed in a sling until after Shabbos.

 

May an x-ray be taken? [71]

Doing so involves a Biblical prohibition. [72]



[1] 328/26

[2] 328/27

[3] In [4] Lit. Deal with healing on Shabbos

[5] However today that no one washes with wine shouldn’t we say that it does appear like healing to the onlooker?

[6] 328/25

[7] Seemingly this refers to placing it on the eye lid when closed. See Rashi on Shabbos 108b

[8] 328/27

[9] 328/26

[10] 328/26

[11] 328/51

[12] 328/3

[13] 328/38

[14] As explained in Chapter 2 Halacha 2

[15] 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 328/100.

[16] 328/3

[17] 328/38

[18] Sheivet Halevy 5/39, brought in Piskeiy Teshuvos 328/24

[19] As this is similar to a nail which has peeled off its majority which ideally may be removed. [Although practically may not due to what will be explained in the Halacha dealing with it.]

[20] 318/42

[21] This is a type of resin with a pleasant smell which comes out of a tree. [Mishneh Berurah 328/114]

[22] See next Halacha note 31

[23] 318/42

[24] Doing so is not a problem of smearing being that the prohibition only applies if one smoothens out the bumps of which there is no concern regarding ones teeth. However a thick toothpaste is forbidden due to Nolad as it becomes liquidly when placed in the mouth.

[25] Ketzos Hashulchan 138 footnote 31

[26] Piskeiy Teshuvos 328/26 based on 328/42

[27] 328/39

[28] Lit. “then he gets healed”

[29] 328/44

[30] 328/44

[31] 326/5

[32] 328/45

[33] 328/45

[34] So rules also Michaber.

[35] So rules M”B [328/136] in name of Magen Avraham .

[36] 328/45 and chapter 326 Halacha 5

[37] Chapter 326 Halacha 5

[38] Beir Moshe 1/33-15

[39] Piskeiy Teshuvos 328/32

[40] Igros Moshe 3/50

[41] 328/47

[42] Ketzos Hashulchan 128 footnote 20

[43] 328/49

[44] 328/55

[45] Any cylindrical body such as made of wax or fat or paper or other materials [Mishneh Berura 151]

[46] Vetzaruch Iyun why is this not forbidden due to the medicine prohibition? How does doing it with a Shinui help in this regard? Why is only an enema forbidden and not this?

[47] The insertion of a liquid into the bowels via the rectum as a treatment, especially for constipation.

[48] 328/47

[49] 328/49

[50] 328/55

[51] Piskeiy Teshuvos 328/29; SSH”K 34/11

[52] As is evident from the ruling above

[53] Piskeiy Teshuvos 328/39; Ketzos Hashulchan 138 footnote 31

[54] SSH”K 33 footnote 30 in name of Rav SZ”A being that this is similar to food which does not contain a cutting prohibition.

[55] So rules Tzitz Eliezer 12/44 and Beir Moshe 1/33, and so is implied from fact that one may bathe in hot water to relive pain. [See Ketzos Hashulchan 133 footnote 1, mentioned above in Chapter 2 Halacha 7 Q&A there.]

[56] Nishmas Avraham 22

[57] Seemingly due to that they hold this is recognizable that it is done for healing.

[58] 328/36

[59] 328/36

[60] Now although as explained in Chapter 2 Halacha 7 that the medicine prohibition only applies in cases that the healing is done thru medicine, while here it is not done through medicine, nevertheless since it is possible to heal it through washing it regularly it is therefore forbidden to do it in a way that is noticeable. [Ketzos Hashulchan 138 footnote 18]

[61] Lit. “it heals”

[62] 328/52

[63] This follows the ruling of the Magen Avraham. However the Michaber [47] argues and hold that even a dislocation is permitted to be returned on Shabbos.

[64] 328/36

[65] 328/52

[66] 328/52

[67] Ketzos Hashulchan 138 footnote 18; Piskeiy Teshuvos 328/38

[68] The M”B writes that according to all if the doctor says that there is danger of a limb involved then a Jew may replace it. [Mishneh Berurah 145] This applies as well if one knows the danger of the dislocation even if there is no doctor.  [Ketzos Hashulchan ibid]

[69] Why is an irregularity not required is this not a biblical prohibition?

[70] Sheivet Halevy 6/25; Piskeiy Teshuvos 328/38

[71] Piskeiy Teshuvos 328/38

[72] However the Beir Moshe [7/50] rules that x-rays involve only a Rabbinical writing prohibition being that the x-ray is only understandable by experts.

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