Behold your father is ill (48:1)
The following is a discussion of Halachic topics related to the Parsha of the week. For final rulings, consult your Rav.
Until Yaakov fell ill, no one was sick…(Bava Metzia 87a)
One of several Rabbinical decrees that our Sages enacted in order to guard the sanctity of Shabbos concerns the use of medications. In the opinion and experience of the Rabbis, easy access to medicine may lead to the transgression of Shabbos Labors such as “grinding” (when preparing certain medications) or “smoothing” (when applying certain medications). While issuing the decree, however, the Rabbis were bound by the halachic principle of being as lenient as possible with those suffering pain or distress. Thus, they established guidelines for determining when it is permitted to take medication on Shabbos and when it is not. In the following discussion, we will list several common conditions which normally require medication and how they are dealt with on Shabbos.
HOW TO USE THIS LIST:
Our discussion is limited to non-life threatening situations. When in doubt whether or not a situation is life-threatening, consult a rav and/or a doctor.
Whenever we mention that an act may be done “with a shinui”, it means that the act may be done in a manner different from the normal and usual. For example, dialing a telephone with the knuckles instead of the fingers is considered a shinui.
Our discussion applies to healthy adults and children over three(1). Children under three, and certainly infants and babies, are treated (for the most part) as “patients not dangerously ill”, and will be discussed elsewhere.
A separate area of discussion concerns a healthy person who takes medication for preventive purposes or in order to strengthen himself. Those laws are not discussed here.
LIST OF AILMENTS AND CONDITIONS:
ABSCESS – may be opened to relieve pressure from pus, even if some blood is secreted in the process(2).
ALLERGIES (mild) – medication may not be taken.
ANGINA – all medications are permitted.
ASTHMA – all oral and/or breathing medications may be taken(3).
ATHLETE’S FOOT – all medications are prohibited.
BACK OR NECK BRACE – may be put on or removed(4).
BEDRIDDEN(5) DUE TO PAIN – ALL ORAL MEDICATIONS MAY BE TAKEN.
BEE STING – the stinger may be removed and the area may be washed with ice water, lemon juice or vinegar, etc. The area may not be soaked, however, in those liquids(6).
BLEEDING (SLOW) – pressure may be applied to a cut to stop bleeding. Sucking or squeezing out blood is prohibited(7).
BROKEN BONE – a non-Jew may be asked to do anything necessary, e.g., make a phone call, drive a car, take x-rays or put on a cast. [If a non-Jew is not available, some poskim permit a Jew to do these actions with a shinui(8).]
COLD (RUNNING NOSE) – medication may not be taken.
COUGH – medication may not be taken. If the cough may be an indication of pneumonia or asthma, medication is permitted.
CUTS AND ABRASION (minor wounds) – may be washed or soaked in water. Hydrogen peroxide may be poured over a cut. It is not permitted, however, to soak absorbent cotton or paper in such a solution and then wash the wound with it. The wound may be covered with a non-medicated band-aid(9).
DIABETES– all oral medications may be taken.
DRIED (OR CRACKED) LIPS– It is prohibited to apply chapstick or any other medication, liquid or otherwise.
DRIED (OR CHAPPED) HANDS – It is prohibited to rub them with either oil, ointment (vaseline) or lotion. One who regularly uses a pourable, liquid lotion or oil on his hands (whether they are chapped or not) may do so on Shabbos, too, even if his hands are chapped(10).
EAR INFECTION – all medications are permitted. Cotton balls may be inserted(11). Even if the infection is no longer present, the prescription begun during the week must be continued until finished in order to avoid a relapse
EYE INFLAMMATION – eye drops (or ointment) may be instilled in the eye. If the eye is not inflamed but merely irritated, no medication is permitted(12).
FEVER – all oral medications may be taken. A conventional thermometer may be used(13). If a person is suffering from high-grade fever, a non-Jew may be asked to do whatever the patient needs in order to feel better(14). If the cause of the fever is unknown, a doctor should be consulted.
HEADACHE – medication may not be taken. If the headache is severe enough so that one feels weak all over or is forced to go to bed, medication may be taken. One who is unsure if he has reached that stage of illness may be lenient and take pain relieving medication(15).
HEARTBURN – Foods which will have a soothing effect may be eaten. Some poskim permit taking anti-acid medication while others are more hesitant. In a severe case, one may be lenient(16).
INSECT REPELLENT – liquid or spray repellents may be used(17).
MIGRAINE HEADACHE – all oral medications may be taken.
NOSEBLEED – the bleeding may be stopped with a tissue or a napkin. If none is available, a cloth napkin may be used(18).
RETAINER – may be inserted and removed(19).
RHEUMATISM – It is prohibited to bathe in therapeutic hot springs(20).
SCAB – it is permitted to remove a scab as long as blood is not drawn from the wound(21).
SORE THROAT – medication may not be taken. Gargling is prohibited(22). Drinking tea or any other hot drink, or sucking a candy, is permitted even if the intention is for medicinal purposes(23). See also ‘strep throat’.
SLEEP DISORDER – There are conflicting views among contemporary poskim whether it is permitted to take sleeping pills or no-doze pills(24). One who is weak all over or is bedridden may take these pills. Cotton balls may be used as ear plugs. It is questionable if it is permitted to use pliable ear plugs, which are made from a wax-like material thst must be spread to fill the cavity of the ear(25).
SPRAINS – If the patient is not experiencing severe pain, nothing may be done. If the patient is experiencing severe pain, medication may be taken and a massage may be given. A makeshift splint may be applied, provided that no Shabbos Labors are transgressed.
SPLINTER UNDER THE SKIN(26) – May be extracted with the fingers, or with tweezers or a needle. If, unavoidably, a little blood is secreted in the process it is of no consequence(27).
STITCHES a non-Jew is allowed to stitch any wound(28), even if the stitching is done only for cosmetic reasons(29).
STOMACH CRAMPS – Unless one is in severe pain, it is prohibited to take a laxative or castor oil. Prune juice or any other food or drink is permitted. A hot water bottle is permitted when one experiences strong pains(30).
STREP THROAT-all oral medications may be taken. Even if the infection is no longer present, the prescription begun during the week must be continued until finished in order to avoid a relapse.
SUNBURN (ORDINARY) – medications are not permitted.
SWEATING – it is permitted to sprinkle baby powder on those parts of the body which are perspiring(31).
SWELLING – It is permitted to press a knife, etc. against the skin to prevent or minimize swelling(32). It is permitted to wash or soak the swollen area in water(33). It is permitted to place a compress(34), ice (placed in plastic bag) or any frozen item over a swollen area(35).
TOOTHACHE – a slight toothache may not be treated with painkillers, but one is permitted to drink whiskey, etc., provided that it is swallowed immediately(36). A severe toothache (to the point where one feels weak all over) or gum infection may be treated with oral medication. If the tooth needs to be extracted, a non-Jew may be asked to do so(37).
WEAK ALL OVER -all oral medications are permitted to be taken.
It is commonly accepted among the majority of poskim that the Rabbinical restriction against taking medications on Shabbos applies to Yom Tov as well(38). The poskim agree, however, that on the second day of Yom Tov(39) and on Chol ha-Moed(40) it is permitted to swallow any medication, even for the most minor of ailments. No shinui is required.
On Shabbos, a pill may be split in half(41) (even on a dotted line(42)) ground into small pieces(43) or dissolved in a cup of liquid(44).
One who suffers from two conditions – one for which he may take medication on Shabbos and another for which he may not – may take medication only for the former(45).
Sometimes (as described above) a medication may not be taken on Shabbos, but not taking it could lead to aggravating a condition to the point where the medication would become necessary and permitted. In such a case, one is allowed to take the medication in order to avoid this eventuality. For example, one who has a headache which, if untreated, tends to escalate to a migraine, may take medication before the migraine sets in(46).
When ointment needs to be applied on Shabbos, it should, preferably, be prepared before Shabbos on a gauze square and then placed on the skin on Shabbos. If this was not done, the ointment may be squeezed directly from the tube on to the wound and a bandage placed over it. Whatever shinui can be made should be employed, so as to serve as a reminder not to inadvertently spread ointment on the skin (“smoothing”), which is prohibited. If this is impractical, there are sometimes other methods that may be followed. Consult a rav.
1. There are different opinions as to when a child is no longer treated as a “patient not dangerously ill”. Some (Chazon Ish O.C. 59:4; Harav S.Z. Auerbach in Nishmas Avrohom 328:54; Harav S.Y. Elyashiv in Eis la-Ledes, pg. 57) quote the age of 2-3; others (Tzitz Eliezer 8:15-12) say six, while yet others (Minchas Yitzchak 1:78) are lenient till the age of nine. The poskim agree, however, that in the last analysis, it all depends on the strength and maturity of the child.
2. O.C. 328:28.
3. See The Journal of Halacha and Contemporary Society # 6, pg. 47 for a full discussion of how to treat asthma on Shabbos.
4. Based on ruling of Harav S.Z. Auerbach in Tikunim u’Miluim 34, note 111.
5. Even if he is capable of getting out of bed and walking around, but presently he is in bed due to his pain, he is considered as bedridden – Aruch ha-Shulchan 328:19.
6. See Mishnah Berurah 328:141,142. Obviously, one is allergic to a bee sting must do everything necessary to avert danger.
7. Mishnah Berurah 328:147.
8. This is the view of Shulchan Aruch Harav 328:19 and Eglei Tal (Tochen 18). Some poskim (Harav S.Z. Auerbach, quoted in Shemiras Shabbos K’hilchasah 33, note *17) rule that one may rely on this view, especially when there is “danger to a limb”. Note, however, that Mishnah Berurah and Aruch ha-Shulchan and the majority of the poskim do not agree with this leniency.
9. Some poskim (oral ruling by Harav M. Feinstein, Harav S.Z. Auerbach in Tikunim u’Miluim, pg. 58; Harav C.P. Scheinberg, quoted in Children in Halachah, pg. 88; Az Nidberu 7:34,35) permit removing the protective tabs from a band-aid, while other poksim (Minchas Yitzchak 5:39-2; Harav S.Y. Elyashiv, quoted in Machazeh Eliyahu 70) are stringent. It is proper to prepare band-aids for Shabbos use by peeling off their protective tabs and re-sealing them before Shabbos. Once they have prepared in this fashion, they may be used on Shabbos (Tzitz Eliezer 16:6-5).
10. Based on O.C. 327:1.
11. It is prohibited to tear cotton balling on Shabbos – Shemiras Shabbos K’hilchasah 35:19 and Tikunim u’Miluim; Minchas Yitzchak 4:45.
12. O.C. 328:20. See also Eglei Tal (Tochen 17).
13. O.C. 306:7. Before using it, the mercury may be shaken down.
14. Mishnah Berurah 328:46, 47.
15. See Ketzos ha-Shulchan 138, pg. 100; Minchas Yitzchak 3:35; Be’er Moshe 1:33; 2:32.
16. See Ketzos ha-Shulchan 138, pg. 98; Tzitz Eliezer 8:15 (15-21); Az Nidberu 1:31; Shemiras Shabbos K’hilchasah 34:4.
17. Shemiras Shabbos K’hilchasah 14:31; Shalmei Yehudah, pg. 179.
18. Mishnah Berurah 328:146.
19. Harav S.Z. Auerbach, quoted in Shemiras Shabbos K’hilchasah 34:29. See Tikunim u’Miluim for the reason that it is not considered mesaken.
20. Mishnah Berurah 328:137.
21. O.C. 328:22 and Mishnah Berurah 90.
22. O.C. 328:32.
23. O.C. 328:37.
24. See Minchas Yitzchak 3:21, Tzitz Eliezer 9:17, Be’er Moshe 1:33 and Shalmei Yehudah, pg. 176 for the various views.
25. Harav S.Z. Auerbach (Tikunim u’Miluim 14:39) permits their usage while Harav S.Y. Elyashiv (Shalmei Yehudah, pg. 179) and Az Nidberu 3:21 do not.
26. If the thorn or splinter is under a fingernail, it may be considered dangerous.
27. Mishnah Berurah 328:88 and Sha’ar ha-Tziyun 63.
28. See Nishmas Avrohom, vol. 4, O.C. 340 who quotes Harav S.Z. Auerbach and Harav S. Y. Elyashiv as ruling that stitching a wound may be a Biblically prohibited activity. Accordingly, only a non-Jew may do it, unless it is a life threatening situation.
29. Ibid. See also Shemiras Shabbos K’hilchasah 33, note 23 and 35, note 62.
30. Mishnah Berurah 326:19.
31. Shemiras Shabbos K’hilchasah 34:12.
32. Mishnah Berurah 328:124.
33. Tzitz Eliezer 8:15 (15-12).
34. In order to avoid several possible prohibitions, only paper towels or napkins should be used and care should be taken not to squeeze them.
35. Harav S.Z. Auerbach (Tikunim u’Miluim 34, note 87); Be’er Moshe 1:33-18.
36. O.C. 328:32. It may not be retained in the mouth longer than usual, nor may one rinse his mouth with it and then spit it out.
37. Rama O.C. 328:3. See Tzitz Eliezer 9:17 (2-11).
38. Mishnah Berurah 532:5. There is a minority opinion that permits taking medications on Yom Tov, see Tzitz Eliezer 8:15 (16) who quotes their opinion and rules that when in distress one may rely on this view.
39. Mishnah Berurah 496:5.
40. O.C. 532:2.
41. Harav S.Z. Auerbach, quoted in Shemiras Shabbos K’hilchasah 33:4.
42. Harav S.Z. Auerbach, quoted in Nishmas Avraham, vol. 5, pg. 225.
43. Rama O.C. 321:12.
44. See Mishnah Berurah 320:34,35.
45. Igros Moshe O.C. 3:53.
46. Shemiras Shabbos K’hilchasah 34:16.
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