4862 —שאלות ברפואה: רפואה מונעת, זריקות מדברים אסורים, חיסון סאלק ועירוי דם; וסדר לימוד החסידות

B"H, 24 Marcheshvan, 5717

Brooklyn.

The veteran Chassid, G‑d-fearing man, distinguished and honored, etc., our teacher Rabbi Yitzchak, may he live

Shalom u'Vrachah!

In reply to your letter of 14 Cheshvan (and the one before it), in which you ask:

a) Whether it is permitted to engage in medical treatment only for someone who is ill, or whether it is also permitted to use those medicines that prevent illness — that is, that strengthen the health so that one does not fall ill.

Now, it is an everyday occurrence that the great ones and leaders of Israel do so as well; and see also the Rambam, Hilchos De'os, chapter 4^[1]. And a verse states it explicitly: כל המחלה גו' לא אשים עליך, כי אני ה' רופאך, "All the illness… I will not place upon you, for I am Hashem your Healer" (Shemos 15:26) — so this too is included in healing^[2].

b) Whether it is permitted to use those substances that are injected into the body; apparently your question concerns those made from non-kosher materials.

Here too it is an everyday occurrence that G‑d-fearing and devout people act this way without any hesitation; and it is permitted to derive benefit from things that are forbidden to eat but permitted for benefit^[3].

c) How to act regarding the Salk vaccine^[4], which they are now beginning to inject into children.

It has been the practice here for a number of months already, as above, also in the most devout circles; that is to say, there is no question here as to kashrus and the like. But of course one should make sure that the vaccine comes from a good, reliable laboratory.

Surely you keep fixed times for study in the revealed Torah and in Chassidus, and add to them from time to time, according to the well-known directive, "one ascends in holiness" (Berachos 28a).

Of course, a question in its own right is blood transfusion, which has become customary of late, and the practice keeps spreading more and more, with no attention at all paid to who the blood donor is. Logically, this dulls [the heart] even more than what is written in the Shulchan Aruch, Yoreh De'ah, end of section 81, paragraph 7, in the gloss^[5]. Perhaps the reason no attention is paid to this is that transfusion is often used in a life-threatening illness, or at any rate a serious one; and further, it is a one-time matter — which is not so in the case in Yoreh De'ah there.

— To note: the bloodletting mentioned in the Talmud^[6] refers in most cases to a healthy person who lets blood.

The laws of medicine — see Shulchan Aruch, Yoreh De'ah, sections 155 and 336.

The study of the inner dimension of the Torah in our time is, as explained at length elsewhere, the study of the teachings of Chassidus. It is right that you begin with Tanya, part 3, then part 2 there^[7], and then Kuntres uMaayan and Derech Mitzvosecha by the Tzemach Tzedek, etc.

As for what you write — who are you to influence your surroundings, etc. — the law is explicit in the Shulchan Aruch that even a poor man in Israel is obligated in the mitzvah of tzedakah^[8], and so it is also with spiritual tzedakah.

The task of each person is, as the words of the Mishnah, "I was created to serve my Maker" (Kiddushin 82a); the manner of this service is set out in the Shulchan Aruch. And see the Shulchan Aruch, Orach Chaim, section 231^[9]. And of course it must suit one's talents and surroundings.

With blessing,

On behalf of the Rebbe, shlita

Secretary

Publisher's notes

Rabbi Yitzchak: Weil, Sde Eliyahu. Another letter to him — above, vol. 13, letter 4334.

Salk: see on this also above, vol. 12, letter 4034; below, 4998, 5115, 5131, 5203.

Notes

[1] Hilchos De'os, chapter 4 (הלכות דיעות להרמב"ם פרק ד'): "Since keeping the body healthy and whole is among the ways of Hashem… a person must distance himself from things that destroy the body and accustom himself to things that make it healthy." The Rambam there sets out at length a regimen for preserving health — preventive medicine.

[2] This too is included in healing (שגם זה בכלל הרפואות): Hashem is called "your Healer" even when He keeps the illness from coming at all; hence preventing illness is also a form of healing.

[3] Forbidden to eat but permitted for benefit (האסורים באכילה ומותרים בהנאה): an injection is not eating, and most non-kosher substances are forbidden only to eat, not to derive benefit from.

[4] The Salk vaccine (תרכיב של סאלק): the polio vaccine developed by Dr. Jonas Salk, given to children on a wide scale from 5715–5717 (1955–1957).

[5] Yoreh De'ah, end of 81:7, in the gloss (שו"ע יו"ד ספ"א ס"ז בהגהה): the Rema rules that an infant should not be nursed by a non-Jewish woman when a Jewish one is available, "for the milk of an idolater dulls the heart and produces a bad nature." If this was said of milk, blood entering the body directly would logically dull it even more; hence there is room to be careful about who the donor is.

[6] The bloodletting mentioned in the Talmud (הקזה המוזכרת בש"ס): letting blood for health, common in the times of the Sages. Although it is a medical procedure, it was mostly done by healthy people — so this too is preventive medicine.

[7] Tanya, part 3, then part 2 (תניא ח"ג אח"כ שם ח"ב): part 3 is Iggeres HaTeshuvah; part 2 is Shaar HaYichud veHaEmunah.

[8] Even a poor man is obligated in tzedakah (אפילו עני בישראל מחויב במצות הצדקה): Shulchan Aruch, Yoreh De'ah 248:1: "Every person is obligated to give tzedakah; even a poor man supported by tzedakah must give from what he is given." Likewise someone who feels unable to influence others is still obligated in spiritual tzedakah — to influence his surroundings.

[9] Orach Chaim, section 231 (או"ח סרל"א): "In whatever he enjoys in this world, he should not intend his own pleasure but the service of the Creator… and all his deeds should be for the sake of Heaven."

Summary

This letter answers medical questions: preventive treatment is permitted, as Hashem promises to keep illness away; injections from non-kosher substances are a permitted benefit; the Salk vaccine is used by the most observant, if from a reliable laboratory. It raises the question of blood donors and advises a course of Chassidus study.