Tuesday, August 22, 2023

Ramban doctors are only a minhag

Ibn Ezra[(Shemos 23:25): … a person who observes the Torah has no need for a doctor other than G‑d…

Avnei Nezer[C.M. 193): [Written by the father of the Avnei Nezer] … According to the Ramban who says that the ideal is not to use doctors at all... he would also permit the sick person to refuse treatment.... However according to the Bach it would be prohibited for a person to refuse medical treatment. Nevertheless it would appear if the sick person is really a tzadik then he can rely on the Ibn Ezra and the Ramban since relative to them the Bach is the minority opinion.... Furthermore it would appear to me that in this matter everyone would be considered a tzadik since he wants to be strict with himself with prohibited food and he has trust in G‑d even in the face of death. Therefore even a person who is not considered a tzadik would be permitted to refuse the doctors’ orders to be cured by eating unkosher food. .....
Derashos HaRan#6): I have absolutely no doubt that spiritual sickness is the cause for physical sickness. In fact there is no cure of the body without cure of the soul. … spiritual illness is the cause of physical illness and that a totally healthy soul can ward off all deadly influences…... 
Chazon IshLetters 1:136): While it is true that there is a path in serving G‑d which totally transcends nature and the need for great effort to obtain something, nevertheless [for most people] there is a need for each person to evaluate very carefully the relationship of effort and bitachon for himself. Deviating in either direction from the precise true path is not correct i.e.,. to act in accord with greater bitachon than the level the person has reached or to rely too much on his own efforts [rather than having bitachon].
Beis HaLevi(Bereishis 41:1): …The fundamental principle is that one should not worry but should have complete trust in G‑d. However the permission to exert oneself to achieve a particular goal is because not everyone is able to reach the level of total trust in G‑d. Therefore it is permitted to exert effort so as to be able to achieve the proper level of trust. Every person needs to obtain work and activity so that it will be easy for him to have trust in G‑d. It is not unusual that the Torah will permit something in order to make it easier to achieve the desired higher level. For example One should always be involved in Torah and Mitzvos even for ulterior motives because eventually one’s motives will be pure. Thus the development of pure motivation can proceed initially through ulterior motivation. Based on this understanding the degree of desirable effort is not equal for everyone but rather depends on the nature of the individual. One who can achieve total trust with little effort is considered to be sinning if he exerts more effort. Thus there is an inverse relationship between actual level of trust and the amount of personal effort which is permitted. The main point is to achieve trust and tranquility by relying entirely on what G‑d provides. One who exerts himself more than he needs to achieve that state is punished from Heaven and is required to exert himself more. In fact he will not attain what he needs except from personal effort - which is what he has chosen for himself…

Shemos (15:26): If you will strongly obey G d and do you do that which is upright in His eyes and pay attention to His commandments and keep His statutes - I will not put any of the diseases on you that I put on the Egyptians. That is because I am G d who heals you.


Shir HaShirim Rabbah (6:17): The door that is not open for mitzvos will be open for the doctor.

 Rabbeinu Bachyei(Shemos 23:25):… There are certain internal sicknesses that occur because of certain food and drink and there are sicknesses which are external that result of such things as change in climate and alterations of the stars. Therefore this verse promises that when Jews serve G‑d, He will bless man’s food and water so they will have the strength to not to become ill. Therefore the righteous who fulfill the Torah will have no need for a doctor...

Chazon Ish(Emuna and Bitachon 5:5): Pesachim (56a) states that Chezkiyahu concealed the Book of Cures. Rashi explains that it was concealed because people were not being humbled by their illness because they were being cured immediately - therefore they derived no spiritual benefit from their illness. The Rambam in his commentary to this mishna cites and interpretation that Shlomo had composed the Book of Cures to cure any sickness and that when Chezkiyahu saw that people were no longer relying on G‑d he concealed it. The Rambam rejects this interpretation saying that it makes no sense for a person to be denied a cure just as it is wrong to deny a hunger person of food…. However the Rambam’s explanation that medicinal cure is just as natural as eating - is problematic. First of all Bava Kama (85a) says that the Torah had to give permission to cure illness [apparently otherwise it would be forbidden]. Secondly we see stated in Berachos (60a) that according to R’ Eliezar that it is not natural for a person to be cured through medicine. Rashi explains R’ Eliezar to mean that a person should ideally not use medicine but should pray instead. Abaye disagrees with R’ Eliezar and says that a person should not prohibit the use of medicine since the Torah has already given permission to utilize medicines. From these sources it is quite clear that medicine does not have the status of food because there is no need to utilize a Torah verse to permit one to eat. In fact hunger is not viewed as punishment and eating is considered a way of serving G‑d - the table of a tzadik is considered as a holy altar (Avos 3:3). Sickness - contrary to the Rambam - is a punishment and should motivate a person to repent and to pray. Nevertheless a doctor has permission to cure because there are very few genuinely spiritual people who can follow this approach. The generation of Chezkiyahu was unique. Sanhedrin 94b) states that they searched the entire land of Israel and could not find an ignorant person… Such spiritual giants needed to rely entirely on their faith and trust in G‑d and not utilize medicine. The Ramban (Vayikra 26:11): writes the minority who are totally sanctified to serving G‑d do not in fact utilize medicine. However this approach is reserved only from people on the level of the R’ Shimon bar Yochai.

MaharaNetzach Yisroel): Even though the Sages said (Bava Kama 85a) that doctors are permitted to cure illness, nevertheless the main thing is to have trust in G‑d and want that He be his doctor in nature. However in the time of Chezkiyahu they only wanted a cure from nature and they paid no attention at all to the cure that comes from G‑d in a manner which transcends nature. Therefore he concealed the Book of Cures which is itself totally in nature and it was good that he removed this exclusive focus on the material aspects of cure.
Rambam(Commentary to Pesachim 4:10): Chezkiah hid the Book of Cures The only reason I have gone into detail in this matter is because there are those who mistakenly claim that Shlomo composed the Book of Cures [Ramban Introduction to Torah Commentary] so that if someone was sick he could readily find the treatment and be cured. The further claim that because Chezkiah saw that people were not relying on G‑d to be cured he concealed the book. Besides being utterly nonsensical, it ascribes to Chezkiyahu and his peers who agreed with him such tremendous stupidity that is only found amongst the lowest of the masses. According to their mistaken idiotic fantasy if a person is hungry and he takes food to eat to be obviously cured from the tremendous pains of hunger - would we say that such a person is lacking in bitachon? Woe are the fools!. Just as I thank G‑d when I eat that He provided me with something to remove my hunger and to rejuvenate and sustain me, I similarly thank Him that He produced medicines that cure my illnesses when I use them. There was no need to refute such this disgusting explanation except for the fact that it is so widespread



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רמב"ן על ויקרא פרק כו פסוק יא 
 אבל הדורש השם בנביא לא ידרוש ברופאים - ומה חלק לרופאים בבית עושי רצון השם, אחר שהבטיח וברך את לחמך ואת מימיך והסירותי מחלה מקרבך, והרופאים אין מעשיהם רק על המאכל והמשקה להזהיר ממנו ולצוות עליו:
 וכך אמרו (ברכות סד -) כל עשרין ותרתין שנין דמלך רבה רב יוסף אפילו אומנא לביתיה לא קרא, והמשל להם (במדב"ר ט ג) תרעא דלא פתיח למצותא פתיח לאסיא והוא מאמרם (ברכות ס) שאין דרכם של בני אדם ברפואות אלא שנהגו, אילו לא היה דרכם ברפואות יחלה האדם כפי אשר יהיה עליו עונש חטאו ויתרפא ברצון ה', אבל הם נהגו ברפואות והשם הניחם למקרי הטבעים:
 וזו היא כונתם באמרם (שם) ורפא ירפא מכאן שנתנה רשות לרופא לרפאות, לא אמרו שנתנה רשות לחולה להתרפאות, אלא כיון שחלה החולה ובא להתרפאות כי נהג ברפואות והוא לא היה מעדת השם שחלקם בחיים, אין לרופא לאסור עצמו מרפואתו, לא מפני חשש שמא ימות בידו, אחרי שהוא בקי במלאכה ההיא, ולא בעבור שיאמר כי השם לבדו הוא רופא כל בשר, שכבר נהגו ועל כן האנשים הנצים שהכו זה את זה באבן או באגרוף (שמות כא יח) יש על המכה תשלומי הרפואה, כי התורה לא תסמוך דיניה על הנסים, כאשר אמרה (דברים טו יא) כי לא יחדל אביון מקרב הארץ, מדעתו שכן יהיה אבל ברצות השם דרכי איש אין לו עסק ברופאים:
(49) רמב"ן על ויקרא פרק כו פסוק יא
 אין מעשיהם רק על המאכל והמשקה להזהיר ממנו ולצוות עליו:
 וכך אמרו (ברכות סד -) כל עשרין ותרתין שנין דמלך רבה רב יוסף אפילו אומנא לביתיה לא קרא, והמשל להם (במדב"ר ט ג) תרעא דלא פתיח למצותא פתיח לאסיא והוא מאמרם (ברכות ס) שאין דרכם של בני אדם ברפואות אלא שנהגו, אילו לא היה דרכם ברפואות יחלה האדם כפי אשר יהיה עליו עונש חטאו ויתרפא ברצון ה', אבל הם נהגו ברפואות והשם הניחם למקרי הטבעים:
 וזו היא כונתם באמרם (שם) ורפא ירפא מכאן שנתנה רשות לרופא לרפאות, לא אמרו שנתנה רשות לחולה להתרפאות, אלא כיון שחלה החולה ובא להתרפאות כי נהג ברפואות והוא לא היה מעדת השם שחלקם בחיים, אין לרופא לאסור עצמו מרפואתו, לא מפני חשש שמא ימות בידו, אחרי שהוא בקי במלאכה ההיא, ולא בעבור שיאמר כי השם לבדו הוא רופא כל בשר, שכבר נהגו ועל כן האנשים הנצים שהכו זה את זה באבן או באגרוף (שמות כא יח) יש על המכה תשלומי הרפואה, כי התורה לא תסמוך דיניה על הנסים, כאשר אמרה (דברים טו יא) כי לא יחדל אביון מקרב הארץ, מדעתו שכן יהיה אבל ברצות השם דרכי איש אין לו עסק ברופאים

2 comments:

  1. The Chazon Ish is a rational or pragmatist in his approach -

    In Biblical times it was a different world from today. Just as we had Neviim, also there was more of a direct relation between our sins and punishments.

    In Rambam's times, it was the precursor of modern science. Professor Rabbi Maimonides was a leading scientist and doctor of his time - he was the Gadol haDor in every field , including Astronomy, medicine, philosophy - of course it doesn't need saying he was the Gadol hador and for every generation a Torah leader. So obviously he would differ from others. Rambam wrote a treatise on asthma, but in those days they did not have inhalers and modern treatments.

    There are a lot of diseases which are being treated by modern science, so it is difficult to rely on views of ancient times. All Gedolei hador have their own doctors, Rav Shach ztl had a special doctor, so it is again not something that applies today.


    This isn't even a debate between MO and Hareidi or Chassidim. It is also true what Chazal say, even the best doctors are butchers - ie they can often cause more harm than good, and they treat people like rats.

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  2. I commented about 5 years ago on this. My views have developed. A lot of disease is influenced by genes, and mutations - which can be random or inherited. Genetics is a bit like gilgul, but on a more molecular scale.
    So why do some people get disease, and others not.? Is it the aveirot I did that led to my genetic makeup, which in turn causes disease? Did the mutations occur from the X ray machine in the airport, the agrochemicals in Israeli salads, or from my ling list of aveirot? Does teshuva change disease, or is it part of the deal, and kapara process?
    Why are there rashaim who live to 100?
    Is being Jewish a liability, because any aveira can cause severe punishment? What about the inherited diseases, is that punishment for grandparents sins? Or gilgul?

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