Part of what leads people to forget or deny Hashem’s continuing role in the world is that Hashem doesn’t openly run the world, day to day. For various reasons, including leaving room for freewill, we are able, if we choose, to experience a “natural” world, even to discern ways of the world running that might seem independent of Hashem. Those are what give rise to the various forms of alien worship that we are sharply proscribed from engaging.
In some ways, the world of healing presents an even harder challenge, because that’s an area where we take advantage of the natural world, seemingly without Hashem at all. Can that be the Jewish view?
A Prayer Before Bloodletting
In Berachot 60a, R. Acha records a prayer to say before bloodletting, asking Hashem to make this act be for healing, that Hashem should heal him or her, since Hashem is the true Healer. Abbaye disagrees, but halachah records the prayer, meaning we walk two paths—we go for whatever contemporary wisdom identifies as effective medical treatment, but also pray. Magen Avraham 230;6 says to recite the prayer even before taking a pill, and Chayye Adam 1;65 before eating medicinal foods, like chicken soup. Even as we use Hashem’s world, we emphasize His continuing role in it.
What Kind of Balance Between Hashem and Doctors?
Tsits Eliezer draws our attention to the difficulty of asserting both positions fully, when he complains about a formulation of the Aruch haShulchan Note, in preparation, that R. Waldenberg was the rabbi of Shaarei Zedek for decades, and in responsum 18;62, he obligates undergoing any well-recognized and necessary medical intervention, including amputation. There are nuances to that discussion not relevant here, but it shows he was not someone who doubted the efficacy, value, or importance of medicine.
Yet he objects to Aruch haShulchan Yoreh De’ah 335, which warns readers not to rely on doctors alone, the error of Asa, the king of Judea, who is described by Scripture as consulting only doctors in his time of illness.
In the first chapter of Ramat Rachel (a small book on the laws of visiting the sick that he wrote to commemorate his mother’s passing, found in volume 5), Tsits Eliezer argues that that sounds like we may rely on both together, when—as we have seen—we are not allowed to pair anything with Hashem! Tsits Eliezer says we have to think of it as all coming from Hashem, with the doctors the vehicle for Divine Providence to provide the healing we need.
Your View of Nature and Your View of Medicine
He has lit upon a point we glide over often: if Hashem is actively involved in the world, particularly in Jewish lives, what does that say about Nature? As I’ve shown over the course of this series, Jewish thinkers including Ramban and Tsits Eliezer argue that the regularity of Nature can be misleading. It can look like there’s a Nature independent of Hashem, but it’s all from Him.
Aruch haShulchan may have disagreed—he may have thought (as Rambam might have, as well) that if we think of Nature as without any sort of consciousness, without angels running it, the problems of alien worship are less prominent, so that there is no problem in relying on doctors and Hashem. Especially if we think we have to earn Providence, medicine alone might have been what those without full Providence need. However we work it, we have to be sure not to leave Hashem too far out of the picture.
What Is a Medicine?
Shabbat 67a records a debate between R. Meir and the Sages as to whether one can wear certain chains or charms on Shabbat. The Sages reject all the items on that list—a fox’s tooth, the nail from a cross—even for weekday wear, terming them darchei haEmori, the ways of the Emorites.
Abbaye and Rava explain that anything that has actual medicinal value cannot be a problem of darchei haEmori; the Sages of the Mishnah thought these items didn’t rise to that level, and therefore not only couldn’t be worn on Shabbat, they couldn’t be worn during the week.
Rambam, Laws of Shabbat 19;13, allows wearing these items, adding that anything that doctors say works would be allowed as well. He may have had some kind of placebo effect in mind, but that would mean he would apply it to whatever contemporary medical knowledge believed—we can do whatever doctors tell us, not because they’re necessarily right, but because our acceptance of their expertise makes it medicinal. But there’s another way to read it, as shown by the discussion of amulets.
Amulets and Evidence-Based Medicine
Whether or not we believe in amulets today, the halachic discussion of them teaches us about what qualifies as medicine in halachah. Aruch haShulchan Orach Chayim 301;27 notes that amulets have to be “expert” before they are certified as medicinal.
One way to be certified was that the person writing it had previously written three amulets that healed three different sick people, or that a particular inscription in three different amulets had been effective. But if that streak was broken, Aruch haShulchan notes, the writer or the inscription would lose their status and become an untested medication. In paragraph 80, Aruch haShulchan expands the discussion to any medication that works in some well-understood way.
Then he writes, “but if one does an act with no natural mechanism of healing, and no experience to prove it works, even during the week it is prohibited as the ways of the Emorites.” That does imply that if a medication does not have a clear mechanism, and hasn’t been established as effective, there would be some question of whether we could take it—it might be a violation of “ways of the Emorites.” Just because a lot of people swear by something, in other words, doesn’t make it medicine, and if it’s not, our right to use it is questionable.
Aruch haShulchan summarizes by echoing Rambam, that we may do whatever the doctors say works, and that seems like a good place to leave the conversation. What I hope I’ve shown these past five weeks is that we can fail to notice when we stray into the ways of the Emorites, or even alien worship. We are well-advised to watch ourselves, to be sure that, in medicine and other areas, we never lose sight of proper faith as defined for us by the Torah and halachah.