One who is slightly ill and makes an effort [and manages] to get around like a well person, is forbidden to be medically treated in any way, even in a way that no melachah is involved.1The Sages prohibited taking cures lest one come to grind medicines. Grinding is one of the thirty nine major melachos (prohibited labors). This prohibition applies only to things done exclusively by and for the sick. Thus, walking for health reasons would be permitted since it is also done by persons who are well. [This applies] even to applying oil,2If this is done only by and for the sick. See footnote 1. [Rema 327: 1; Mishnah Berurah ibid.] whether this is done by himself or by someone else or even by a non-Jew.3A non-Jew may be asked to do even a melachah d’oraisa for one who is ill enough to be confined to bed. [Rambam; Mishnah Berurah 326: 46] For one who is less ill, some permit asking a non-Jew to do a melachah d’rabanan. [Magein Avraham 328: 12; Shulchan Aruch Harav, etc.] Others prohibit this. [Chayei Adam 69: 1]
All foods and beverages which are consumed by people who are well may be eaten and drunk as a cure, even if they have some bad side effects, and it is [therefore] obvious that it is being done for medicinal reasons, nevertheless, it is permitted. Anything that is not eaten or drunk by well people, is forbidden to be eaten or drunk as a cure.4Unless you are ill enough to be confined to bed. You may consume herbal juices, or drink a raw egg to make your voice more pleasant.5Products consumed solely to improve your health are not permitted. [Mishnah Berurah 328: 120] There is, however, disagreement among contemporary poskim regarding vitamins. This is not considered medicinal since your throat is not sore.
If you have a slight toothache but are not in great pain, do not rinse them (the teeth) with vinegar, or other liquid for medicinal purposes and then expectorate the liquid.6It is obvious that you are taking a cure. Rather, you should rinse and swallow it, or dip some bread into it and eat it as usual. Similarly, if you have a sore throat do not gargle with some liquid,7Gargling with mouthwash is permitted even for relief of a sore throat. [Biur Halacha 302: 10] but, instead, swallow it and, if as a result, you feel better, then so be it.8For severe pain you may ask a non-Jew to do even a melachah d’oraisa or even a Jew to do a d’rabanan with a shinuy (doing the act in an atypical fashion). [Minchas Shabbos]
If you have abdominal pains and the like, or if you have a rash on your scalp, since in our society we do not usually apply oil except for medical purposes, it is forbidden to apply oil, because it is obvious that you are doing this as a cure.
One who suffers from angina, and relieves his pain by sucking [milk] directly from a goat, may do so on Shabbos (because sucking milk is [considered] mefarek9Mefarek = lit. separating, the name of the category of melachos which includes milking. Sucking the milk directly from the goat is an unusual way of milking which is only a d’rabanan prohibition. In case of pain the Sages removed their prohibition. in an unusual manner, and due to the pain of the illness the Sages did not forbid it.)
If you have a stomach ache [and would feel relieved by heat] you may place on your stomach a cup from which hot water was emptied, although it still contains warm vapor.10See Chapter 33 paragraph 12 where the author rules that placing the cup while still containing the hot water is prohibited due to the danger of scalding. A “hot water bottle” is allowed if there is a real need. [Mishnah Berurah 326: 19] Similarly, you may warm up some clothes and put them on your abdomen.
If you have injured your hand or foot, you may soak11צָמַת = lit. contract or shrink i.e. the wine has a contracting effect which aids in halting the bleeding. it in wine to halt the bleeding, but not in vinegar12Or whisky. [Mishnah Berurah 328: 92] because it is [more] potent, and is [therefore] obviously medicinal. For a delicate person, wine is the same as vinegar and is forbidden. If [the wound] is on the back of the hand or the back of the foot or was caused by a metal object you may do anything at all for a remedy. [For the significance of these wounds see later, Chapter 92, paragraph 5.]
For a slight pain of the eyes do not apply undiluted saliva (i.e. saliva that is in one's mouth before having eaten anything) because it is obvious that you are doing this as a remedy.13[Shulchan Aruch 328: 20] For severe pain or infection you may use eye drops or ointments. However, if you are unable to open your eyes, you may moisten them with undiluted saliva, because this is not applied as a remedy but rather to enable you to open your eyes.
A wound which is not critical may not be bandaged with a dressing even if it was prepared the day before. Nor [may you apply] anything that acts as a remedy, even a leaf or an old dry rag, since it too serves as a remedy. However, you may apply something to prevent it from being scratched [or irritated]. If it was already bandaged the day before, you may open one end [of the dressing] slightly and cleanse the wound opening, and then open the other end and cleanse it. Do not wipe the dressing itself because you would be "smearing."14מְמַרֵחַ = spreading or smoothing whatever may be on the bandage—a forbidden melachah. If the bandage fell off the wound onto the floor you may not restore it.15Lest you are מְמַרֵחַ—see above footnote. If it fell on any object, you may restore it. If you are suffering great pain you may tell a non-Jew to restore it. However, you may not ask a non-Jew to prepare a dressing on Shabbos, because smearing the dressing is a d'oraiso prohibition and is prohibited even through a non-Jew, unless you take completely ill16Or the possibility exists that you might become so ill. [Sefer Hachaim] (as [is discussed] later, paragraph 16).
You may not place a cloth on a bleeding wound because the blood dyes the cloth;17Magein Avraham 320: 24. The poskim are in disagreement because it is of questionable benefit for a cloth to be dyed in this manner. The Mishnah Berurah, (328: 146) therefore rules that when the need is great, this is permitted. and certainly [not] a red cloth because it is improved by this. It is also forbidden to squeeze the wound in order to extract blood.18According to some it is the melachah d’oraisa—chovel (causing a wound). [Magein Avraham] Others say it is only d’rabanan. [Chayei Adam] But, what may you do? You may bathe it in water or wine to remove the blood, and then wrap it in a cloth. If bathing does not stop the bleeding, you may apply a spider web19Though a spider-web is muktzeh, nevertheless, it may be handled for the benefit of one who is ill. [Mor Uktziya; Yeshuos Yaakov 309; Kikeles Shabbos] Others, however, disagree and prohibit handling muktzeh for this purpose. [Chayei Adam] Therefore, the Mishnah Berurah (328: 58) rules that for the benefit of an ill person, muktzeh should be handled with a shinuy—i.e. in a manner that is unusual. and then tie a cloth around it. However, some have misgivings about this because spider webs are curative. Therefore, if possible, this should be done by a non-Jew.
One who punctures an abscess in order to enlarge the opening of the wound, in the manner of physicians when they attempt to facilitate healing by enlarging the opening of the wound,20This allows the abscess to drain and the wound to be exposed to the air which quickens the healing process. is guilty of a Shabbos violation,21He is liable for the melachah—מַכֶּה בְּפַּטִישׁ (lit. hammer—blow) i.e. the final act of a craftsman’s work, since this requires a degree of skill. [Shulchan Aruch 328: 28] Others hold him liable for the melachah—בּוֹנֶה (building). The creation of the opening is somewhat akin to building. [Rashi] for this requires a doctor's skill. If his [purpose in] opening it the abscess is only to drain the pus, which is causing him pain, and he is unconcerned if the [opening] closes up again immediately, this is permitted due to his pain.22This requires some clarification. The melachah of this paragraph (be it makeh bepatish or boneh, see footnote 21) requires that the wound be opened and remain open. Where the opening is not made for its own sake but only temporarily to drain the wound then it is “not a melachah for its own sake” i.e. a מְלָאכָה שֶׁאֵינָה צְרִיכָה לְגוּפָה, which according to all poskim except the Rambam is only d’rabanan and where pain is involved such an act is permitted. The Rambam rules that מְלָאכָה שֶׁאֵינָה צְרִיכָה לְגוּפָה is d’oraisa. Nevertheless, he allows the temporary opening of a wound because in his opinion this cannot be construed as a melachah in any manner whatsoever. [Shaar Hatziyun 328: 65] [This is permitted] only when he punctures it with a needle or something similar.23Squeezing the wound is not permitted lest you cause bleeding. However, the blood already accumulated in the abscess may be cleaned out. [Mishnah Berurah 328: 89] But, [he may not do so] with his nails because he then tears some of the skin of the abscess, which makes him liable [for doing a melachah].24Others (Taz 328: 23 and Magein Avraham 301: 7) disagree and prefer using a fingernail to a needle in order to avoid the usual method of puncturing a wound provided care is taken not to tear any of the skin. [Biur Halachah] Even by means of a needle or something similar, there is concern that he may want the wound to remain open, so that the pus will continue to drain, therefore, wherever possible this should be done by a non-Jew.25Mishnah Berurah, ibid.
If you have an incision on the arm, commonly referred to as "aftora" aperture26Fistula. and the opening has closed slightly, you may not insert a legume [for the purpose] of reopening it, because it is your intention that it remain open.27Which has a curative effect. A dressing (that was prepared yesterday) may be applied to the incision, because it is only to protect [the wound].28Shulchan Aruch Harav disallows applying any dressing. See Aruch Hashulchan 328: 37. However, if you know that the dressing draws pus or blood, it is forbidden. Similarly, if you intend to wipe it [and] you know that [as a result] of wiping, blood or pus will be drawn out it is forbidden to wipe it. (This is not comparable to puncturing an abscess, because where the abscess is concerned, the pus and blood have accumulated in one spot and exist separately, and draining them is not considered making a wound, whereas in this situation where the pus and blood are still absorbed throughout the flesh, if you drain them you are [in effect] making a wound.)29Magein Avraham.
If the wound has healed you may apply a dressing that you prepared yesterday, since it is only for protection. It is permitted to remove the crust around the wound.30Shulchan Aruch 328: 22.
If you were stuck by a splinter, you may remove it with a needle, provided you take care not to extract blood, for that would be making a wound.31If you cannot avoid causing it to bleed but are in pain you may go ahead and remove it. [Mishnah Berurah 328: 88; Shaar Hatziyun 328: 63]
A sick person who is confined to bed, but is not critical, or he has an ailment which causes his entire body to feel pain, whereby, although he gets around, is considered as someone who is bed-ridden; you may tell a non-Jew to do [anything required] for his cure,32Shulchan Aruch, Rema 328: 17. and to cook food for him.33Rambam. He may, eat on Shabbos that which the non-Jew cooked,34See Chapter 38, paragraph 9. since, today [Shabbos], cooking for him is permitted through a non-Jew.
He may also take any medications or do anything necessary for his cure, whether by himself or through someone else, provided that it does not involve any forbidden melachah, even if only a d'rabanan prohibition. But, if it involves even a d'rabanan prohibition, it must be done only by a non-Jew. If a non-Jew is unavailable, a Jew may do a d'rabanan prohibition by altering [the usual manner of doing it].35Other poskim prefer a Jew doing a d’rabanan in an altered manner rather than a non-Jew doing it in the usual way. [Mishnah Berurah from Taz; Magein Avraham; Gra; 328: 17] Some go so far as to permit a Jew to do a d’oraisa in an altered manner for a sick person. [Shulchan Aruch Harav 328: 19; Eglei Tal; Tehilla Ledavid 328: 22] Where danger of a loss of a limb is involved one may rely on this last opinion. [R’ S. Z. Auerbach, zatzal] Mishnah Berurah (328: 85) implies that a d’rabanan in an altered manner may be done even for one who is only slightly ill.
When a non-Jewish doctor comes to vaccinate children against smallpox, if the Jew can offer him compensation to postpone the vaccination till after Shabbos, he should do so. If not [i.e. the doctor adamantly refuses] and it must be done on Shabbos, in that case, the Jew should not hold the child, but let a non-Jew hold him.36Teshuva Mei’ahava 134–135. He adds that if a non-Jew is unavailable, a Jew may hold the child.
מִי שֶׁיֵּשׁ לוֹ מֵחוּשׁ בְּעָלְמָא וְהוּא מִתְחַזֵּק וְהוֹלֵךְ כְּמוֹ בָרִיא, אָסוּר לַעֲשׂוֹת לוֹ שׁוּם רְפוּאָה, אֲפִלּוּ בְּדָבָר שֶׁאֵין בּוֹ מִשּׁוּם מְלָאכָה, וַאֲפִלּוּ לָסוּךְ בְּשֶּׁמֶן, בֵּין בְּעַצְמוֹ בֵּין עַל יְדֵי אֲחֵרִים, וַאֲפִלּוּ עַל יְדֵי אֵינוֹ יְהוּדִי.
One who is slightly ill and makes an effort [and manages] to get around like a well person, is forbidden to be medically treated in any way, even in a way that no melachah is involved.1The Sages prohibited taking cures lest one come to grind medicines. Grinding is one of the thirty nine major melachos (prohibited labors). This prohibition applies only to things done exclusively by and for the sick. Thus, walking for health reasons would be permitted since it is also done by persons who are well. [This applies] even to applying oil,2If this is done only by and for the sick. See footnote 1. [Rema 327: 1; Mishnah Berurah ibid.] whether this is done by himself or by someone else or even by a non-Jew.3A non-Jew may be asked to do even a melachah d’oraisa for one who is ill enough to be confined to bed. [Rambam; Mishnah Berurah 326: 46] For one who is less ill, some permit asking a non-Jew to do a melachah d’rabanan. [Magein Avraham 328: 12; Shulchan Aruch Harav, etc.] Others prohibit this. [Chayei Adam 69: 1]
כָּל אֳכָלִים וּמַשְׁקִין שֶׁהֵם מַאֲכַל בְּרִיאִים, מֻתָּר לְאָכְלָן וְלִשְׁתּוֹתָן לִרְפוּאָה, אַף עַל פִּי שֶׁהֵם קָשִׁים לִקְצָת דְּבָרִים וּמוּכָחָא מִלְתָא דִּלִרְפוּאָה עָבֵיד, אֲפִלּוּ הָכִי שָׁרִי. וְכֹל שֶׁאֵינוֹ מַאֲכַל וּמַשְׁקֶה בְּרִיאִים, אָסוּר לְאָכְלוֹ וְלִשְׁתּוֹתוֹ לִרְפוּאָה. מֻתָּר לֶאֱכוֹל שְׂרָפִים מְתוּקִּים (מיצים סמיכים) (זעפטל) וְלִגְמוֹעַ בֵּיצָה חַיָּה כְּדֵי לְהַנְעִים אֶת הַקּוֹל, וְאֵין בּוֹ מִשּׁוּם רְפוּאָה, כֵּיוָן שֶׁאֵין לוֹ מַכָּה בִּגְרוֹנוֹ.
All foods and beverages which are consumed by people who are well may be eaten and drunk as a cure, even if they have some bad side effects, and it is [therefore] obvious that it is being done for medicinal reasons, nevertheless, it is permitted. Anything that is not eaten or drunk by well people, is forbidden to be eaten or drunk as a cure.4Unless you are ill enough to be confined to bed. You may consume herbal juices, or drink a raw egg to make your voice more pleasant.5Products consumed solely to improve your health are not permitted. [Mishnah Berurah 328: 120] There is, however, disagreement among contemporary poskim regarding vitamins. This is not considered medicinal since your throat is not sore.
הַחוֹשֵׁשׁ בְּשִׁנָיו בְּמֵחוּשׁ בְּעָלְמָא וְאֵין לוֹ צַעַר גָּדוֹל (וְעַיֵּן בְּסִימָן שֶׁאַחַר זֶה סָעִיף ד) לֹא יִגְמַע בָּהֶן חֹמֶץ אוֹ שְׁאָר מַשְׁקֶה לִרְפוּאָה וְיִפְלוֹט אֶת הַמַּשְׁקֶה, אֶלָּא מְגַמֵּעַ וּבוֹלֵעַ אוֹ טוֹבֵל בּוֹ פַּת וְאוֹכְלוֹ כְּדַרְכּוֹ. וְכֵן הַחוֹשֵׁשׁ בִּגְרוֹנוֹ לֹא יְעַרְעֲרֶנּוּ בְּאֵיזֶה מַשְׁקֶה, אֶלָּא בּוֹלֵעַ. וְאִם נִתְרַפֵּא, נִתְרַפֵּא (שכ"ח).
If you have a slight toothache but are not in great pain, do not rinse them (the teeth) with vinegar, or other liquid for medicinal purposes and then expectorate the liquid.6It is obvious that you are taking a cure. Rather, you should rinse and swallow it, or dip some bread into it and eat it as usual. Similarly, if you have a sore throat do not gargle with some liquid,7Gargling with mouthwash is permitted even for relief of a sore throat. [Biur Halacha 302: 10] but, instead, swallow it and, if as a result, you feel better, then so be it.8For severe pain you may ask a non-Jew to do even a melachah d’oraisa or even a Jew to do a d’rabanan with a shinuy (doing the act in an atypical fashion). [Minchas Shabbos]
הַחוֹשֵׁשׁ בְּמָתְנָיו וְכַדּוֹמֶה, וְכֵן מִי שֶׁיֵּשׁ לוֹ חֲטָטִין בְּרֹאשׁוֹ, בִּמְדִינוֹת אֵלּוּ, כֵּיוָן שֶׁאֵין נוֹהֲגִין לָסוּךְ בְּשֶּׁמֶן, כִּי אִם לִרְפוּאָה, אָסוּר לָסוּךְ בַּשַׁבָּת, מִשּׁוּם דְּמוּכָחָא מִלְתָא דְּלִרְפוּאָה קָעָבֵיד.
If you have abdominal pains and the like, or if you have a rash on your scalp, since in our society we do not usually apply oil except for medical purposes, it is forbidden to apply oil, because it is obvious that you are doing this as a cure.
הַגּוֹנֵחַ מִכְּאֵב לֵב שֶׁרְפוּאָתוֹ לִינוֹק בְּפִיו מִן הָעֵז, מֻתָּר לוֹ לִינוֹק בְּשַׁבָּת, (מִשּׁוּם דִּינִיקָה, הֲוֵי מְפָרֵק כִּלְאַחַר יָד, וּמִשּׁוּם צַעְרָא דְּחֹלִי, לֹא גָּזְרוּ רַבָּנָן) (שכח).
One who suffers from angina, and relieves his pain by sucking [milk] directly from a goat, may do so on Shabbos (because sucking milk is [considered] mefarek9Mefarek = lit. separating, the name of the category of melachos which includes milking. Sucking the milk directly from the goat is an unusual way of milking which is only a d’rabanan prohibition. In case of pain the Sages removed their prohibition. in an unusual manner, and due to the pain of the illness the Sages did not forbid it.)
הַחוֹשֵׁשׁ בְּמֵעָיו, מֻתָּר לִתֵּן עֲלֵיהֶם כּוֹס שֶׁעֵרוּ מִמֶּנּוּ חַמִּין, אַף עַל פִּי שֶׁעֲדַיִן יֵשׁ בּוֹ הֶבֶל (וְעַיֵּן לְעֵיל סִימָן לג סָעִיף יב). וְכֵן מֻתָּר לְהָחֵם בְּגָדִים וּלְהַנִּיחַ עָלָיו.
If you have a stomach ache [and would feel relieved by heat] you may place on your stomach a cup from which hot water was emptied, although it still contains warm vapor.10See Chapter 33 paragraph 12 where the author rules that placing the cup while still containing the hot water is prohibited due to the danger of scalding. A “hot water bottle” is allowed if there is a real need. [Mishnah Berurah 326: 19] Similarly, you may warm up some clothes and put them on your abdomen.
מִי שֶׁנִּגְפָה יָדוֹ אוֹ רַגְלוֹ, צוֹמְתָהּ בְּיַיִן כְּדֵי לְהַעֲמִיד הַדָּם, אֲבָל לֹא בְּחֹמֶץ, מִפְּנֵי שֶׁהוּא חָזָק וְיֵשׁ בּוֹ מִשּׁוּם רְפוּאָה. וְאִם הוּא מְעֻנָּג, אַף הַיַּיִן לוֹ כְּמוֹ הַחֹמֶץ, וְאָסוּר. וְאִם הוּא עַל גַּב הַיָּד אוֹ גַּב הָרֶגֶל אוֹ שֶׁנַּעֲשָׂה עַל יְדֵי בַּרְזֶל, מֻתָּר לְרַפֹּאת בְּכָל דָּבָר, כְּדִלְקַמָּן סִימָן צ"ב סָעִיף ה'.
If you have injured your hand or foot, you may soak11צָמַת = lit. contract or shrink i.e. the wine has a contracting effect which aids in halting the bleeding. it in wine to halt the bleeding, but not in vinegar12Or whisky. [Mishnah Berurah 328: 92] because it is [more] potent, and is [therefore] obviously medicinal. For a delicate person, wine is the same as vinegar and is forbidden. If [the wound] is on the back of the hand or the back of the foot or was caused by a metal object you may do anything at all for a remedy. [For the significance of these wounds see later, Chapter 92, paragraph 5.]
יֵשׁ לוֹ אֵיזֶה מֵחוּשׁ בְּעֵינָיו, לֹא יִתֵּן עֲלֵיהֶם רֹק תָּפֵל. (פֵּרוּשׁ רֹק שֶׁבְּפִיו בְּעוֹד שֶׁלֹּא טָעַם כְּלוּם) דְּמוּכְחָא מִלְּתָא דְּלִרְפוּאָה, אֲבָל מִי שֶׁאֵינוֹ יָכוֹל לִפְתֹּח עֵינָיו, מֻתָּר לְלַחְלְחָן בְּרֹק תָּפֵל, כִּי אֵין זֹאת לִרְפוּאָה, אֶלָּא לִפְתֹּחַ הָעֵינַיִם קָמְכַוֵּן.
For a slight pain of the eyes do not apply undiluted saliva (i.e. saliva that is in one's mouth before having eaten anything) because it is obvious that you are doing this as a remedy.13[Shulchan Aruch 328: 20] For severe pain or infection you may use eye drops or ointments. However, if you are unable to open your eyes, you may moisten them with undiluted saliva, because this is not applied as a remedy but rather to enable you to open your eyes.
מִי שֶׁמִּצְטַעֵר מֵרֹב הַמַּאֲכָל שֶׁאָכַל, מֻתָּר לִתְחֹב אֶצְבָּעוֹ לְתוֹךְ גְּרוֹנוֹ כְּדֵי שֶׁיָּקִיא.
If you are suffering from overeating, you may insert your finger into your throat in order to regurgitate.
מַכָּה שֶׁאֵין בָּהּ סַכָּנָה, לֹא יַנִּיחַ עָלֶיהָ רְטִיָּה, אֲפִלּוּ עֲשָׂאָהּ מֵאֶתְמוֹל, וְלֹא כָּל דָּבָר שֶׁהוּא מִשּׁוּם רְפוּאָה, אֲפִלּוּ עָלֶה אם חֲתִיכָת בֶּגֶד יָבֵשׁ וְיָשָׁן, שֶׁהוּא מְרַפֵּא גַּם כֵּן. אֲבָל נוֹתֵן עָלֶיהָ אֵיזֶה דָּבָר לְשָׁמְרָהּ שֶׁלֹּא תִּסָּרֵט. הָיְתָה עָלֶיהָ רְטִיָּה מֵאֶתְמוֹל, מְגַלֶּה קְצָתָהּ וּמְקַנֵּחַ פִּי הַמַּכָּה וְחוֹזֵר וּמְגַלֶּה קְצָתָהּ הַשְׁנִיָה וּמְקַנְּחָהּ, וּרְטִיָּה עַצְמָהּ לֹא יְקַנֵּחַ, מִפְּנֵי שֶׁהוּא מְמָרֵחַ. נָפְלָה הָרְטִיָּה מֵעַל גַּבֵּי הַמַּכָּה עַל גַּבֵּי הַקַּרְקַע לֹא יַחְזִירֶנָה. נָפְלָה עַל גַּבֵּי כְּלִי, יַחְזִירֶנָה. וְאִם מִצְטַעֵר הַרְבֵּה, מֻתָּר לוֹמַר לְאֵינוֹ יְהוּדִי לְהַחְזִירָהּ. אֲבָל אָסוּר לוֹמַר לְאֵינוֹ יְהוּדִי לַעֲשׂוֹת רְטִיָּה בַּשַׁבָּת, כִּי מֵרוּחַ הָרְטִיָּה הוּא אִסּוּר דְּאוֹרַיְתָא וְאָסוּר אֲפִלּוּ עַל יְדֵי אֵינוֹ יְהוּדִי, אִם לֹא כְּשֶׁחָלָה כָּל גּוּפוֹ. (כְּדִלְקַמָּן סָעִיף ט"ז)
A wound which is not critical may not be bandaged with a dressing even if it was prepared the day before. Nor [may you apply] anything that acts as a remedy, even a leaf or an old dry rag, since it too serves as a remedy. However, you may apply something to prevent it from being scratched [or irritated]. If it was already bandaged the day before, you may open one end [of the dressing] slightly and cleanse the wound opening, and then open the other end and cleanse it. Do not wipe the dressing itself because you would be "smearing."14מְמַרֵחַ = spreading or smoothing whatever may be on the bandage—a forbidden melachah. If the bandage fell off the wound onto the floor you may not restore it.15Lest you are מְמַרֵחַ—see above footnote. If it fell on any object, you may restore it. If you are suffering great pain you may tell a non-Jew to restore it. However, you may not ask a non-Jew to prepare a dressing on Shabbos, because smearing the dressing is a d'oraiso prohibition and is prohibited even through a non-Jew, unless you take completely ill16Or the possibility exists that you might become so ill. [Sefer Hachaim] (as [is discussed] later, paragraph 16).
אָסוּר לְהַנִּיחַ בֶּגֶד עַל מַכָּה שֶׁיּוֹצֵא מִמֶּנָּהּ דָּם, מִפְּנֵי שֶׁהַדָּם יִצְבַּע אוֹתוֹ, וּמִכָּל שֶׁכֵּן בֶּגֶד אָדֹם, שֶׁהוּא מְתַקְּנוֹ. וְגַם אָסוּר לִדְחוֹק בַּמַכָּה לְהוֹצִיא אֶת הַדָּם. אֶלָּא כֵּיצַד עוֹשֶׂה. רוֹחֵץ בְּמַיִם אוֹ בְּיַיִן לְהַעֲבִיר הַדָּם, וְאַחַר כָּךְ יִכְרֹךְ עָלֶיהָ סְמַרְטוּט. וְאִם אֵין הַדָּם פּוֹסֵק עַל יְדֵי רְחִיצָה, יַנִּיחַ שָׁמָּה קוּרֵי עַכָּבִישׁ וְיִכְרֹךְ עָלֶיהָ סְמַרְטוּט. אַךְ יֵשׁ מְפַקְפְקִים בָּזֶה, מִשּׁוּם דְּקוּרֵי עַכָּבִישׁ מְרַפְּאִים, עַל כֵּן אִם אֶפְשָׁר, יֵשׁ לַעֲשׂוֹת עַל יְדֵי אֵינוֹ יְהוּדִי (שכ"ח).
You may not place a cloth on a bleeding wound because the blood dyes the cloth;17Magein Avraham 320: 24. The poskim are in disagreement because it is of questionable benefit for a cloth to be dyed in this manner. The Mishnah Berurah, (328: 146) therefore rules that when the need is great, this is permitted. and certainly [not] a red cloth because it is improved by this. It is also forbidden to squeeze the wound in order to extract blood.18According to some it is the melachah d’oraisa—chovel (causing a wound). [Magein Avraham] Others say it is only d’rabanan. [Chayei Adam] But, what may you do? You may bathe it in water or wine to remove the blood, and then wrap it in a cloth. If bathing does not stop the bleeding, you may apply a spider web19Though a spider-web is muktzeh, nevertheless, it may be handled for the benefit of one who is ill. [Mor Uktziya; Yeshuos Yaakov 309; Kikeles Shabbos] Others, however, disagree and prohibit handling muktzeh for this purpose. [Chayei Adam] Therefore, the Mishnah Berurah (328: 58) rules that for the benefit of an ill person, muktzeh should be handled with a shinuy—i.e. in a manner that is unusual. and then tie a cloth around it. However, some have misgivings about this because spider webs are curative. Therefore, if possible, this should be done by a non-Jew.
הַפּוֹתֵחַ מֻרְסָא כְּדֵי לְהַרְחִיב פִּי הַמַּכָּה, כְּדֶרֶךְ שֶׁהָרוֹפְאִים עוֹשִׂים, שֶׁהֵם מִתְכַּוְנִים לִרְפוּאָה לְהַרְחִיב פִּי הַמַּכָּה, הֲרֵי זֶה חַיָּב, שֶׁזּוֹ הִיא מְלֶאכֶת הָרוֹפֵא. וְאִם פְּתָחָהּ רַק כְּדֵי לְהוֹצִיא מִמֶּנָּהּ אֶת הַלֵּחָה שֶׁמְצַעַרְתּוֹ, וְאֵינוֹ חוֹשֵׁשׁ אִם תַּחֲזוֹר וְתִסָּתֵם מִיָּד, הֲרֵי זֶה מֻתָּר מִשּׁוּם צַעְרוֹ. וְדַוְקָא לְנָקְּבָהּ עַל יְדֵי מַחַט וְכַדּוֹמֶה אֲבָל לֹא בְצִפָּרְנָיו, מִשׁוּם דְּתוֹלֵשׁ קְצָת מֵעוֹר הַמֻּרְסָא, וְיֵש בָּזֶה חִיוּב. וְגַם עַל יְדֵי מַחַט וְכַדּוֹמֶה, כֵּיוָן שֶׁיֵּשׁ לָחוּשׁ, שֶׁמָּא יִתְכַּוֵּן שֶׁתִּשָׁאֵר פְּתוּחָה, כְּדֵי שֶׁתּוֹצִיא לֵחָה גַּם אַחַר כָּךְ עַל כֵּן אִם אֶפְשָׁר יֵשׁ לַעֲשׂוֹת עַל יְדֵי נָכְרִי.
One who punctures an abscess in order to enlarge the opening of the wound, in the manner of physicians when they attempt to facilitate healing by enlarging the opening of the wound,20This allows the abscess to drain and the wound to be exposed to the air which quickens the healing process. is guilty of a Shabbos violation,21He is liable for the melachah—מַכֶּה בְּפַּטִישׁ (lit. hammer—blow) i.e. the final act of a craftsman’s work, since this requires a degree of skill. [Shulchan Aruch 328: 28] Others hold him liable for the melachah—בּוֹנֶה (building). The creation of the opening is somewhat akin to building. [Rashi] for this requires a doctor's skill. If his [purpose in] opening it the abscess is only to drain the pus, which is causing him pain, and he is unconcerned if the [opening] closes up again immediately, this is permitted due to his pain.22This requires some clarification. The melachah of this paragraph (be it makeh bepatish or boneh, see footnote 21) requires that the wound be opened and remain open. Where the opening is not made for its own sake but only temporarily to drain the wound then it is “not a melachah for its own sake” i.e. a מְלָאכָה שֶׁאֵינָה צְרִיכָה לְגוּפָה, which according to all poskim except the Rambam is only d’rabanan and where pain is involved such an act is permitted.
The Rambam rules that מְלָאכָה שֶׁאֵינָה צְרִיכָה לְגוּפָה is d’oraisa. Nevertheless, he allows the temporary opening of a wound because in his opinion this cannot be construed as a melachah in any manner whatsoever. [Shaar Hatziyun 328: 65] [This is permitted] only when he punctures it with a needle or something similar.23Squeezing the wound is not permitted lest you cause bleeding. However, the blood already accumulated in the abscess may be cleaned out. [Mishnah Berurah 328: 89] But, [he may not do so] with his nails because he then tears some of the skin of the abscess, which makes him liable [for doing a melachah].24Others (Taz 328: 23 and Magein Avraham 301: 7) disagree and prefer using a fingernail to a needle in order to avoid the usual method of puncturing a wound provided care is taken not to tear any of the skin. [Biur Halachah] Even by means of a needle or something similar, there is concern that he may want the wound to remain open, so that the pus will continue to drain, therefore, wherever possible this should be done by a non-Jew.25Mishnah Berurah, ibid.
מִי שֶׁיֵּשׁ לוֹ נֶקֶב בַּזְּרוֹעַ שֶׁקּוֹרִין "אַפְטוֹרָא" (פונטינעללע, אימפעראטור), אִם נִסְתַּם הַנֶּקֶב קְצָת, אָסוּר לִתֵּן לְתוֹכוֹ קִטְנִית שֶׁיִּפָּתֵח, דְּהָא כַּוָּנָתוֹ שֶׁיִּשָׁאֵר פָּתוּחַ. וּרְטִיָּה (שֶׁנַּעֲשֵׂית מֵאֶתְמוֹל) מֻתָּר לִתֵּן עַל הָאַפְטוֹרָא שֶׁהִיא רַק לְשָׁמְרוֹ. אַךְ אִם יוֹדֵעַ שֶׁהָרְטִיָּה מוֹצִיאָה לֵחָה אוֹ דָּם, אָסוּר. וְכֵן אִם בָּא לְקַנְּחָהּ, אִם יוֹדֵעַ שֶׁעַל יְדֵי הַקִּנּוּחַ יֵצֵא דָם אוֹ לֵחָה, אָסוּר לְקַנְּחָהּ, (וְלֹא דָּמִי לְפוֹתֵחַ מֻרְסָא, דְּהָתָם בְּמֻרְסָא, הַלֵּחָה וְהַדָּם כָּנוּס וְעוֹמֵד בִּפְנֵי עַצְמוֹ וְאֵינוֹ עוֹשֶׂה חַבּוּרָה. אֲבָל כָּאן שֶׁהַלֵּחָה וְהַדָּם מֻבְלָעִים בַּבָּשָׂר, אִם מוֹצִיאָם עוֹשֶׂה חַבּוּרָה).
If you have an incision on the arm, commonly referred to as "aftora" aperture26Fistula. and the opening has closed slightly, you may not insert a legume [for the purpose] of reopening it, because it is your intention that it remain open.27Which has a curative effect. A dressing (that was prepared yesterday) may be applied to the incision, because it is only to protect [the wound].28Shulchan Aruch Harav disallows applying any dressing. See Aruch Hashulchan 328: 37. However, if you know that the dressing draws pus or blood, it is forbidden. Similarly, if you intend to wipe it [and] you know that [as a result] of wiping, blood or pus will be drawn out it is forbidden to wipe it. (This is not comparable to puncturing an abscess, because where the abscess is concerned, the pus and blood have accumulated in one spot and exist separately, and draining them is not considered making a wound, whereas in this situation where the pus and blood are still absorbed throughout the flesh, if you drain them you are [in effect] making a wound.)29Magein Avraham.
מַכָּה שֶׁנִּתְרַפְּאָה, נוֹתְנִין עָלֶיהָ רְטִיָּה שֶׁעֲשָׂאָה מֵאֶתְמוֹל, שֶׁאֵינָהּ אֶלָּא לְשָׁמְרָהּ. וּמֻתָּר לְהָסִיר גִּלְדֵי מַכָּה.
If the wound has healed you may apply a dressing that you prepared yesterday, since it is only for protection. It is permitted to remove the crust around the wound.30Shulchan Aruch 328: 22.
נִתְחַב לוֹ קוֹץ, מֻתָּר לְהוֹצִיאוֹ בְּמַחַט, וּבִלְבַד שֶׁיִּזָּהֵר שֶׁלֹּא יוֹצִיא דָּם, דְּעָבֵיד חַבּוּרָה.
If you were stuck by a splinter, you may remove it with a needle, provided you take care not to extract blood, for that would be making a wound.31If you cannot avoid causing it to bleed but are in pain you may go ahead and remove it. [Mishnah Berurah 328: 88; Shaar Hatziyun 328: 63]
חוֹלֶה שֶׁנָּפַל מֵחֲמַת חָלְיוֹ לְמִשְׁכָּב וְאֵין בּוֹ סַכָּנָה, אוֹ שֶׁיֵּשׁ לוֹ מֵחוּשׁ שֶׁמִּצְטַעֵר וְחָלָה מִמֶּנּוּ כָּל גּוּפוֹ, שֶׁאָז אַף עַל פִּי שֶׁהוּא הוֹלֵךְ, כְּנָפַל לְמִשְׁכָּב דָּמִי, אוֹמְרִים לְאֵינוֹ יְהוּדִי לַעֲשׂוֹת לוֹ רְפוּאָה וּלְבַשֵּׁל בִּשְׁבִילוֹ. וּמֻתָּר לוֹ לֶאֱכוֹל בַּשַׁבָּת בִּשּׁוּלֵי אֵינוֹ יְהוּדִי, כֵּיוָן שֶׁהֻתַּר לוֹ הַיּוֹם הַבִּשּׁוּל עַל יְדֵי אֵינוֹ יְהוּדִי (וְעַיֵּן לְעֵיל סִימָן ל"ח סָעִיף ט').
A sick person who is confined to bed, but is not critical, or he has an ailment which causes his entire body to feel pain, whereby, although he gets around, is considered as someone who is bed-ridden; you may tell a non-Jew to do [anything required] for his cure,32Shulchan Aruch, Rema 328: 17. and to cook food for him.33Rambam. He may, eat on Shabbos that which the non-Jew cooked,34See Chapter 38, paragraph 9. since, today [Shabbos], cooking for him is permitted through a non-Jew.
וּמֻתָּר לוֹ לֶאֱכֹל וְלִשְׁתּוֹת סַמֵּי רְפוּאָה, וְכֵן לַעֲשׂוֹת לוֹ אֵיזֹה רְפוּאָה, בֵּין הוּא בְּעַצְמוֹ בֵּין אֲחֵרִים, וּבִלְבַד שֶׁלֹּא יְהֵא בַּדָּבָר אֵיזֶה אִסּוּר מְלָאכָה, אֲפִלּוּ אִסּוּר דְּרַבָּנָן. אֲבָל כָּל שֶׁיֵּשׁ בּוֹ אֲפִלּוּ אִסּוּר דְּרַבָּנָן, אָסוּר לַעֲשׂוֹתוֹ כִּי אִם עַל יְדֵי אֵינוֹ יְהוּדִי. וְאִם אֵין אֵינוֹ יְהוּדִי, יֵשׁ לְהַתִּיר לַעֲשׂוֹת עַל יְדֵי יִשְֹרָאֵל אִסּור דְּרַבָּנָן עַל יְדֵי שִׁנּוּי (שכ"ח).
He may also take any medications or do anything necessary for his cure, whether by himself or through someone else, provided that it does not involve any forbidden melachah, even if only a d'rabanan prohibition. But, if it involves even a d'rabanan prohibition, it must be done only by a non-Jew. If a non-Jew is unavailable, a Jew may do a d'rabanan prohibition by altering [the usual manner of doing it].35Other poskim prefer a Jew doing a d’rabanan in an altered manner rather than a non-Jew doing it in the usual way. [Mishnah Berurah from Taz; Magein Avraham; Gra; 328: 17]
Some go so far as to permit a Jew to do a d’oraisa in an altered manner for a sick person. [Shulchan Aruch Harav 328: 19; Eglei Tal; Tehilla Ledavid 328: 22]
Where danger of a loss of a limb is involved one may rely on this last opinion. [R’ S. Z. Auerbach, zatzal]
Mishnah Berurah (328: 85) implies that a d’rabanan in an altered manner may be done even for one who is only slightly ill.
רוֹפֵא אֵינוֹ יְהוּדִי שֶׁהוּא מַצְמִיחַ [מַרְכִּיב] אַבַעְבּוּעוֹת (בלאטרן אומפפען) לִילָדִים אִם יָכוֹל הַיִשְֹרָאֵל לְפַיְסוֹ בְּמָמוֹן שֶׁיַּעֲשֶׂה לְאַחַר הַשַׁבָּת יַעֲשֶׂה כֵּן. וְאִם לָאו, וּצְרִיכִין לַעֲשׂוֹת בַּשַׁבָּת, אַל יַחְזִיק יִשְֹרָאֵל אָז אֶת הַיֶּלֶד, אֶלָּא אֵינוֹ יְהוּדִי יַחְזִיקוֹ (כֵּן כָתוּב בְּסֵפֶר תְּשׁוּבָה מֵאַהֲבָה).
When a non-Jewish doctor comes to vaccinate children against smallpox, if the Jew can offer him compensation to postpone the vaccination till after Shabbos, he should do so. If not [i.e. the doctor adamantly refuses] and it must be done on Shabbos, in that case, the Jew should not hold the child, but let a non-Jew hold him.36Teshuva Mei’ahava 134–135. He adds that if a non-Jew is unavailable, a Jew may hold the child.