Avodah Zarah 28

מכה של חלל אין מתרפאין מהן מאי בינייהו איכא בינייהו גב היד וגב הרגל דאמר רב אדא בר מתנה אמר רב גב היד וגב הרגל הרי הן כמכה של חלל ומחללין עליהן את השבת

internal injury, one may not be treated by them. The Gemara asks: What is the difference between the two versions of Rabbi Yoḥanan’s statement? There is a difference between them with regard to the case of one who was injured on the back of the hand or the back of the foot. As Rav Adda bar Mattana says that Rav says: Injuries to the back of the hand and the back, i.e., the top, of the foot are like an internal injury, and one may desecrate Shabbat for their treatment.

אמר רב זוטרא בר טוביה אמר רב כל מכה שצריכה אומד מחללין עליה את השבת אמר רב שמן בר אבא אמר רבי יוחנן והאי אישתא צמירתא כמכה של חלל דמי ומחללין עליה את השבת

Rav Zutra bar Toviyya says that Rav says: With regard to any injury that requires a medical evaluation to determine whether or not it is fatal, one may desecrate Shabbat for its treatment. Rav Shemen bar Abba says that Rabbi Yoḥanan says: And a burning fever is similar to an internal injury, and therefore one may desecrate Shabbat for its treatment.

מהיכן מכה של חלל פירש רבי אמי מן השפה ולפנים בעי רבי אליעזר ככי ושיני מאי כיון דאקושי נינהו כמכה דבראי דמו או דלמא כיון דגואי קיימי כמכה של חלל דמו

The Gemara inquires: From what point on the body is a wound considered an internal injury? Rabbi Ami explained: From the lips inward. Rabbi Eliezer raises a dilemma: With regard to afflictions located in the gums [kakhei] or teeth, what is the halakha? Do we say that since they are located in firm parts of the body, they are similar to external injuries, or perhaps we say that since they are situated within the mouth, they are similar to internal injuries?

אמר אביי תא שמע החושש בשיניו לא יגמע בהן את החומץ חושש הוא דלא הא כאיב ליה טובא שפיר דמי דלמא תנא היכא דכאיב ליה טובא חושש נמי קרי ליה

Abaye said: Come and hear a proof from a mishna (Shabbat 111a): One who is concerned about pain in his teeth may not sip vinegar through them on Shabbat for medicinal purposes, as it is generally prohibited by rabbinic law to perform acts of healing on Shabbat. Abaye infers: It is only when he is merely concerned about pain in his teeth that he may not treat them, which indicates that if it hurts him greatly, it is permitted to seek treatment. The Gemara rejects this inference: Perhaps the tanna also characterizes a situation where it hurts one greatly as one of mere concern.

תא שמע רבי יוחנן חש בצפדינא אזל לגבה דההיא מטרוניתא עבדה חמשא ומעלי שבתא אמר לה למחר מאי אמרה ליה לא צריכת אי צריכנא מאי אמרה אשתבע לי דלא מגלית אישתבע לה לאלהא ישראל לא מגלינא גלייה ליה למחר נפק דרשה בפירקא

The Gemara suggests a different proof: Come and hear the following incident: Rabbi Yoḥanan suffered from the illness tzafdina, which affects the teeth and gums. He went to a certain gentile matron who was a well-known healer. She prepared a medicine for him on Thursday and Friday. Rabbi Yoḥanan said to her: What shall I do tomorrow, on Shabbat, when I cannot come to collect the medicine from you? She said to him: You will not need it. Rabbi Yoḥanan asked her: If I do need it, what shall I do? She said to him: Take an oath to me that you will not reveal the remedy, and I will tell you, so that you can prepare it yourself should you need it. Rabbi Yoḥanan took an oath to her: To the God of the Jews, I will not reveal it. She revealed the remedy to him. On the following day Rabbi Yoḥanan went out and taught it publicly, revealing the secret of the remedy.

והא אישתבע לה לאלהא דישראל לא מגלינא אבל לעמיה ישראל מגלינא והאיכא חילול השם דגלי לה מעיקרא

The Gemara challenges: But Rabbi Yoḥanan took an oath to her that he would not reveal her secret. The Gemara explains that his vow meant: I will not reveal it to the God of the Jews, which indicates: But I will reveal it to His people, the Jews. The Gemara challenges: But even so, isn’t there a desecration of God’s name, as the matron now thinks that a great man of Rabbi Yoḥanan’s stature violated his vow? The Gemara answers that he revealed it to her at the outset. As soon as she disclosed the remedy to him, he informed her that his vow would not prevent him from publicizing it.

אלמא כמכה של חלל דמיא אמר רב נחמן בר יצחק שאני צפדינא הואיל ומתחיל בפה וגומר בבני מעיים

With regard to the issue at hand, the Gemara infers: Apparently, an affliction that affects the gums is similar to an internal injury, as it was permitted for Rabbi Yoḥanan to prepare the remedy on Shabbat. Rav Naḥman bar Yitzḥak said: Tzafdina is different, since it begins in the mouth, and ends in the intestines, i.e., the disease spreads until it infects one’s intestines, and therefore it is considered an internal affliction even while it is only in the mouth. Consequently, the incident involving Rabbi Yoḥanan affords no proof, and Rabbi Eliezer’s dilemma remains unresolved.

מאי סימניה רמי מידי בי ככי ומייתי דמא מבי דרי ממאי הוי מקרירי קרירי דחיטי ומחמימי חמימי דשערי ומשיורי כסא דהרסנא מאי עבדא ליה אמר רבי אחא בריה דרבא מי שאור ושמן זית ומלח ומר בר רב אשי אמר משחא דאווזא בגדפא דאווזא

The Gemara inquires: What are the symptoms of tzafdina? If one places an item between his teeth, blood flows from the rows of teeth. From what does it result? It results from the consumption of very cold wheat foods, and from very hot barley foods, and from remains of fried fish [kasa deharsena]. With what remedy did the gentile matron treat Rabbi Yoḥanan? Rabbi Aḥa, son of Rava, said: It was water in which leaven was steeped, olive oil, and salt. And Mar bar Rav Ashi said: She smeared goose fat over his gums with a goose feather.

אמר אביי אנא עבדי כולהו ולא איתסאי עד דאמר לי ההוא טייעא אייתי קשייתא דזיתא דלא מלו תילתא וקלנהו אמרא חדתא ודביק ביה דדרי עבדי הכי ואיתסאי

Abaye said: I prepared all of these medicines and was not cured from this ailment until a certain Arab told me the remedy for it: Take olive seeds that are less than one-third ripe, and burn them in a fire on top of a new hoe, and stick them along the row of gums. I did this and was cured.

ורבי יוחנן היכי עביד הכי והאמר רבה בר בר חנה אמר רבי יוחנן כל מכה שמחללין עליה את השבת אין מתרפאין מהן אדם חשוב שאני

§ It was stated above that Rabbi Yoḥanan sought the medical attention of a gentile. The Gemara asks: And how could Rabbi Yoḥanan do so? But doesn’t Rabba bar bar Ḥana say that Rabbi Yoḥanan says: With regard to any injury for which Shabbat is desecrated, one may not be treated by gentiles. Tzafdina is a disease for which Shabbat is desecrated, and yet Rabbi Yoḥanan was treated by a gentile. The Gemara answers: An important person such as Rabbi Yoḥanan is different, as gentiles would not dare to kill him.

והא רבי אבהו דאדם חשוב הוה ורמא ליה יעקב מינאה סמא אשקיה ואי לא רבי אמי ורבי אסי דלחכוהו לשקיה פסקיה לשקיה

The Gemara questions this: But Rabbi Abbahu was an important person, and yet Ya’akov the heretic placed upon his leg a salve that was actually a poison. And if it were not for Rabbi Ami and Rabbi Asi, who licked his leg to remove the poison, his leg would have had to be amputated. Apparently, Ya’akov the heretic attempted to kill Rabbi Abbahu despite the fact that Rabbi Abbahu was an important person.

דרבי יוחנן רופא מומחה הוה דרבי אבהו נמי רופא מומחה הוה שאני רבי אבהו דמוקמי ביה מיני בנפשייהו תמת נפשי עם פלשתים

The Gemara explains: The healer of Rabbi Yoḥanan was an expert physician who would not jeopardize her reputation by harming him. The Gemara rejects this explanation: But the healer of Rabbi Abbahu was also an expert physician. The Gemara answers: The case involving Rabbi Abbahu is different, as heretics establish within themselves the attitude of: “Let me die with the Philistines” (Judges 16:30), i.e., heretics are willing to risk their lives in order to hurt Jews, due to their religious disputes. By contrast, gentiles will not jeopardize their own reputation for this purpose, and therefore it was permitted for Rabbi Yoḥanan to be treated by the matron.

אמר שמואל האי פדעתא סכנתא היא ומחללין עליה את השבת מאי אסותא למיפסק דמא תחלי בחלא לאסוקי גרדא דיבלא וגירדא דאסנא או ניקרא מקילקלתא

§ The Gemara lists a series of afflictions and their remedies. Shmuel said: This gash caused by a sword is considered a danger to one’s life, and one may desecrate Shabbat for its treatment. The Gemara asks: What is the remedy for this wound? To stop the blood flow one should consume cress soaked in vinegar. To cause flesh to emerge over the gash, one applies a salve made of yavla scrapings and thornbush scrapings, or a salve made from the worms of the trash.

אמר רב ספרא האי עינבתא פרוונקא דמלאכא דמותא היא מאי אסותא טיגנא בדובשא או כרפסא בטילייא אדהכי והכי ליתי עינבתא בת מינא וניגנדר עילוי חיורתי לחיורתי ואוכמתי לאוכמתי

Rav Safra said: These grapelike boils are the forerunners [parvanka] of the Angel of Death, i.e., they often precede one’s death. The Gemara asks: What is the remedy? The remedy is either a tigna plant soaked in honey or parsley soaked in wine. In the meantime, while the plants are soaking, one should bring a grape of the same size and rub it on the boil, a white grape for a white boil, and a black grape for a black boil.

אמר רבא האי סימטא פרוונקא דאשתא היא מאי אסותא למחייה שיתין איתקוטלי וליקרעיה שתי וערב והני מילי דלא חיור רישיה אבל חיור רישיה לית לן בה

Rava said: This abscess [simta] is the forerunner of fever. The Gemara asks: What is the remedy? One should snap [itkutlei] the boil sixty times with his fingers, i.e., click one’s fingers on the boil, and then he should tear it vertically and horizontally. The Gemara comments: And this statement applies only in a case where the head of the abscess has not whitened, but if its head has whitened, we have no problem with it, i.e., it is in the process of healing, and it does not pose any danger.

רבי יעקב חש

Rabbi Ya’akov suffered

בפיקעא אורי ליה רבי אמי ואמרי לה רבי אסי אורי ליה ליתי שב ביני אהלא תולנא וצייר ליה בחללא דבי צוארא וליכריך עילויה נירא ברקא וטמיש ליה בנטפא חיורא וליקליה ובדר ליה עילויה אדהכי והכי ליתי קשיתא דאסנא לינח פיקעא להדי פיקעא

from hemorrhoids. Rabbi Ami instructed him, and some say that Rabbi Asi instructed him that he should bring seven seeds of ice plant that are red like a worm and bind them in the collar of a shirt, and then he should wrap a strip of hair around it, and dip the bundle in white naphtha and he should burn it and spread the ashes upon the sores. In the meantime, he should bring the kernel of a bramble [asna] fruit and place its crevice against his own crevice, i.e., the anus.

והני מילי פיקעא עילאה פיקעא תתאה מאי לייתי תרבא דצפירתא דלא אפתח וליפשר ולישדי ביה

The Gemara remarks: And this matter applies only to the upper crevice, which is located at the outer edge of the anus and can be treated with bramble fruit. What should one do if he is experiencing pain in the lower crevice, located deeper within the rectum? He should bring the fat of a goat that has not yet opened, i.e., given birth, and he should melt it and then he should apply it to the irritated area.

ואי לא לייתי תלת טרפא קרא דמייבשי בטולא וליקלי וליבדר עילויה ואי לא לייתי משקדי חלזוני ואי לא מייתי משח קירא ולינקוט בשחקי דכיתנא בקייטא ודעמר גופנא בסיתווא

And if this is not possible, he should bring three pumpkin leaves that were dried in the shade and he should burn them, and then he should spread the ashes upon the irritated area. And if this is not possible, he should bring snail shells instead. And if this is also not possible, he should bring oil mixed with wax [kira] and he should smear it upon worn flax clothing in summer, or worn cotton clothing in winter, and place it upon the irritated area.

רבי אבהו חש באודניה אורי ליה רבי יוחנן ואמרי ליה בי מדרשא מאי אורי ליה כי הא דאמר אביי אמרה לי אם לא איברי כולייתא אלא לאודנא ואמר רבא אמר לי מניומי אסיא כולהו שקיינו קשו לאודנא לבר ממיא דכולייתא לייתי כולייתא דברחא קרחא וליקרעיה שתי וערב ולינח אמללא דנורא והנהו מיא דנפקי מיניה לישדינהו באודניא לא קרירי ולא חמימי אלא פשורי

Rabbi Abbahu suffered from pain in his ear. Rabbi Yoḥanan instructed him, and some say that other Sages from the study hall instructed him, how to heal it. The Gemara asks: What did they instruct him? They told him to act in a fashion similar to that which Abaye said: My mother told me that the kidney was created only for the ear, i.e., it can be extremely beneficial to the ear. And Rava said: Minyumi the physician said to me: All liquids are harmful to the ear except for the fluid of the kidneys. Therefore, Rabbi Abbahu should bring the kidney of a bald goat [barḥa] and tear it vertically and horizontally and then place it upon dimming coals. And as for those fluids that issue from it, he should apply them to his ear while they are neither cold nor hot, but tepid.

ואי לא לייתי תרבא דחיפושתא גמלניתא וליפשר ולישדי ביה ואי לא למלייה לאודניה מישחא וליעבד שב פתילתא דאספסתא וליתי שופתא דתומא וליתוב ברקא בחד רישא וליתלי בהו נורא ואידך רישא מותבא באודנא וליתוב אודניה להדא נורא ויזדהר מזיקא ונישקול חדא וננח חדא

The Gemara adds: And if this is not possible, he should bring the fat of a large beetle and melt it and apply it to the ear. And if not, he should fill his ear with oil and prepare seven wicks made of alfalfa [aspasta] and bring dried garlic ends, and tie the ends to the wicks with a strip of hair at one end, and set the wicks aflame. And he should place the other end of each wick in his ear one at a time, and place his ear opposite the flame. Parenthetically, the Gemara notes: And he should be cautious of drafts and avoid them, as they will harm his ear. The Gemara continues: And he should take one wick and remove one wick, i.e., replace each wick as it is consumed until all seven have been used.

לישנא אחרינא ואי לא לייתי שב פתילתא ביקרא ושייף ליה מישחא דאספסתא ונייתי חד רישא בנורא וחד רישא באודניה ונשקול חדא וננח חדא ויזדהר מזיקא

The Gemara presents another version of this remedy: And if not, he should bring seven wicks of wax tapers and smear them with alfalfa oil, and place one end of each wick in the flame and one end in his ear, and take one wick and remove one wick. And again he should be cautious of drafts.

ואי לא לייתי אודרא דנדא דלא משקיף וננח בה ולתלייה לאודניה להדי נורא ומזדהר מזיקא ואי לא לייתי גובתא דקניא עתיקא בר מאה שנין ולימלחיה מילחא גללניתא ולקלי ולידבק וסימנך רטיבא ליבשתא ויבשתא לרטיבא

And if this is not possible, he should bring fiber that was dried but not combed and place it in his ear, and then bring his ear opposite the flame. And he should be cautious of drafts. And if not, he should bring the tube of an aged reed that is one hundred years old, i.e., that has been detached from the ground for a century, and salt it with rock salt and then burn it and stick it in his ear. The Gemara adds: And your mnemonic to remember these remedies is this: Moist cures are prescribed for dry afflictions, and dry cures are prescribed for moist afflictions.

אמר רבה בר זוטרא אמר רבי חנינא מעלין אזנים בשבת תני רב שמואל בר יהודה ביד אבל לא בסם איכא דאמרי בסם אבל לא ביד מאי טעמא מזריף זריף

§ The Gemara returns to the issue of medical treatment on Shabbat. Rabba bar Zutra says that Rabbi Ḥanina says: One may raise his ears to their appropriate position, i.e., set his dislocated jaw, on Shabbat. Rav Shmuel bar Yehuda teaches: This applies only if one raises it by hand, but not by means of medicine. There are those who say the opposite: One may raise his ears by means of medicine, but not by hand. What is the reason that one may not manually raise the ear? It is because doing so might injure [zareif ] the ear, which would constitute a violation of Torah law, whereas applying medicine is a violation of rabbinic law.

אמר רב זוטרא בר טוביה אמר רב עין שמרדה מותר לכוחלה בשבת סבור מיניה הני מילי הוא דשחקי סמנין מאתמול אבל משחק בשבת ואתויי דרך רשות הרבים לא אמר ליה ההוא מרבנן ורבי יעקב שמיה לדידי מיפרשא מיניה דרב יהודה אפילו מישחק בשבת ואתויי דרך רשות הרבים מותר

Rav Zutra bar Toviyya says that Rav says: With regard to an eye that rebelled, i.e., which is apt to pop out of its socket, it is permitted to apply blue eye shadow to it on Shabbat. The Sages initially concluded from this that this statement applies only where one had already ground the ingredients yesterday, i.e., on Shabbat eve, but if he planned to grind them on Shabbat, or to bring them through a public domain, it would not be permitted, as this would constitute a desecration of Shabbat by Torah law. To dispel this notion, one of the Sages, named Rabbi Ya’akov, said to them: This matter was explained to me by Rav Yehuda, who said that even if he plans to grind the ingredients on Shabbat and bring it through a public domain, it is permitted.

רב יהודה שרא למיכחל עינא בשבת אמר להו רב שמואל בר יהודה מאן ציית ליהודה מחיל שבי לסוף חש בעיניה שלח ליה שרי או אסיר שלח ליה לכולי עלמא שרי לדידך אסיר

The Gemara relates that Rav Yehuda permitted someone to apply blue eye shadow to the eye on Shabbat. Rav Shmuel bar Yehuda said to the Sages: One who adheres to the ruling of Yehuda desecrates Shabbat. Ultimately, Rav Shmuel bar Yehuda himself suffered pain in his eye. He sent a message to Rav Yehuda, asking: Is it permitted or prohibited for me to treat my eye on Shabbat? Rav Yehuda sent back to him: For everyone else, it is permitted; for you, it is prohibited, as you treated my lenient ruling with disdain.

וכי מדידי הוא דמר שמואל היא ההיא אמתא דהואי בי מר שמואל דקדחא לה עינא בשבתא צווחא וליכא דאשגח בה פקעא עינא למחר נפק מר שמואל ודרש עין שמרדה מותר לכוחלה בשבת מאי טעמא דשורייני דעינא באובנתא דליבא תלו

Rav Yehuda continues: But was it of my own accord that I issued this ruling? It is the ruling of Mar Shmuel, as demonstrated in the following incident: There was a certain maidservant who was in the house of Mar Shmuel whose eye became infected on Shabbat. She screamed in pain, but there was no one who attended to her. Eventually, her eye popped out of its socket. The next day, Mar Shmuel went out and taught: With regard to an eye that rebelled, it is permitted to apply blue eye shadow to it on Shabbat. What is the reason for this leniency, seeing as one may desecrate Shabbat only to treat life-threatening afflictions? The reason is that the tendons [shuraynei] of the eye are dependent upon the valves of the heart.

כגון מאי אמר רב יהודה כגון רירא דיצא דמא דימעתא וקידחא ותחלת אוכלא לאפוקי סוף אוכלא ופצוחי עינא דלא

The Gemara asks: What ailment of the eye, for example, is considered life-threatening? Rav Yehuda said: For example, any of the following: Abnormal discharge; the sensation of pricking; blood flow from the eye; excessive tearing; and inflammation; and the onset of infection. This list serves to exclude the final stages of a waning infection that is mostly healed, and the opening of the eye, i.e., treatment administered to improve one’s eyesight, which are not life-threatening and therefore one is not permitted to treat them on Shabbat.

אמר רב יהודה זיבורא ודחרזיה סילוא וסמטא ודכאיב ליה עינא ואתי עילויה אישתא כולהו בי בני סכנתא חמה לחמה וסילקא לצינא וחילופא סכנתא חמימי לעקרבא וקרירי לזיבורא וחילופא סכנתא חמימי לסילוא וקרירי

Rav Yehuda says: With regard to one who suffers from the sting of a hornet, or the prick of a thorn [silva], or an abscess, or one whose eye pains him, or one overcome by a fever, bathing in a bathhouse is a life-threatening danger for all of these. Additionally, eating radish [ḥamma] is good for a fever [ḥamma], and eating beets [silka] is good for chills [tzina], but the reverse, i.e., eating radish when one has chills or beets when one has a fever, poses a danger. Similarly, eating hot foods is good for the sting of a scorpion, and cold foods are good for a hornet sting, but the reverse poses a danger. Hot water is good for a thorn embedded in one’s skin, and cold water is good