Rav Chaim:

I seem to remember my teacher telling me that Rambam said we ignore pronouncements regarding medicine and physiology in the Talmud when they are in clear contradiction to well-established science. Of course, I cannot now find such a reference. Irregardless, one of the aspects of Talmud which bothers me is the occasional comment on medicine or physiology which, while based in the understanding of the time, is contrary to what I understand as a physician and scientist.

TB Shabbath 147b: One may not induce vomiting on the Shabbath. (Medicine not OK, hand OK? R. Nehemiah said: Neither.) In the case of poisons, it is imperative to save a life, and we use syrup of ipecac.

One may not set a broken bone. But one may reset a fracture? Fractures of longbones especially require relatively swift treatment because they are prone to causing (clot-related) thrombo-embolism to the lungs.

If one's hand is dislocated etc... Possibly this could wait, but rapid treatment before edema occurs will prevent further injury.

TB Berakoth 61a/b:
"our rabbis taught: man has two kidneys, one of which prompts him to do good, the other to evil; and it is natural to assume that the good one is on his right side and the bad one on his left, as it is written, 'A wise man's understanding is at his right hand, but a fool's understanding is at his left.'
Our rabbis taught: The kidneys prompt, the heart discerns, the tongue shapes, the mouth articulates, the gullet takes in and lets out all kinds of food, the windpipe produces the voice, the lungs absorb all kinds of liquids, the liver is the seat of anger, the gall lets a drop fall into it and allays it, the milt produces laughter, the large intestine grinds, the maw brings sleep and the nose awakens."

I think it is obvious to those who have lost a kidney that they are neither more good or evil, and indeed we can see this also with those who have lost their kidneys or have had transplants.
The heart 'discerns' nothing: it is a pump, plain and simple. We feel distress in our chests, but as a physiologic response, NOT from 'the heart'. MOST ESPECIALLY, the lungs DO NOT absorb all kinds of liquids. They can absorb small amounts of water, but that is NOT their purpose: 'all kinds of fluids' destroy the lungs. The liver produces bile (gall), not vice versa, and it is certainly not the seat of anger. That is well-established to be in the amygdala of the brain. The large intestine is a storage organ and is responsible for resorption of water and some nutrients, but it does not 'grind food'.

This to me seems sufficient for your comment. Some of these are simply wrong, though commonly believed for millinia before the modern age. Others have serious impact on my profession of medicine, since I am an anesthesiologist. If 'the rabbis taught' that a particular intervention was not allowed on Shabbath, should I then not participate? Or should I use the knowledge now available to do what is appropriate to save human life? And if these are wrong ( and some undoubtedly are), then where is the oral message from Sinai? I know HaShem knows the uses of our organs!

On a second note, in Rambam's "Guide", in the second part, on Propositions of the philosophers, he lists those in order. Physics since Newton recognizes that almost all of these are errors, in particular, 1, 2, 6, 7, 8 and all subsequent. For this reason, almost all arguments/discussions by Rambam subsequent are incorrect, especially 4 and 5. There are NO spheres, and thus they can have no 'intelligence or soul'. The scripture that RamBam quotes is certainly not to be taken literally! It seems we were better off before we tried to adopt our beliefs to those of Aristotle and the other heathens.

These are the two areas I referred to in my comments. I always believed RamBam's comments in this area were his own and did not have any standing as a part of halachah (as opposed to those decisions he recorded that were subsequently accepted). The quotes from the gemorah and mishnah are more troubling. I accepted my teacher's comment before, but I would appreciate your explaation now.

1) The first Gemarah in Shabbos about vomiting seems to be talking about when one is doing it for a non life threatning illness, most probably to be able to eat a second time after being full the first time, as it ends "even during the week it's prohibited due to the loss of food" (that you ate 2 times when only once was necessary, hence it's Baal Tashchis.)

2) All the rest, I don't know where that Rambam would be, but I remember reading an article from Rabbi S.R. Hirsch that wrote something to that effect, that Chazal where not zooligist etc. but they took the science and information that was believed in their time and applied it to Halacha. (If there was reports in those days that there were half man creatures or other oddities, which are found in works around that time, so Chazal had to judge them if they are K'laiyim with man or not, but not that they independitly held such views.) Of corse, the lessons Chazal teaches us from them (it wasn't the actual science that Chazal wanted to inpart with us) are still applical.

3) About the rambam's Moreh N'vuchim, I'm not such an expert in it (to be honest I never even read it) so I can't comment on it. Of course, you need not to take it as from Moshe from Sainai. One thing I do know that a physics proffeser that had a seat in MI state, said there were things he read in the Moreh N'vuchim that seemed to agree with advanced sciences, which what made him frum (but for myself I don't have too much knoledge in modern science or Moreh N'vuchim, to comment.)

Berakoth 61a/b
Quote: I think it is obvious to those who have lost a kidney that they are neither more good or evil, and indeed we can see this also with those who have lost their kidneys or have had transplants.

Once a persons nature is set by his upbringing or training the losing of a kidney may not necessarily determine how a person acts in the future

Quote: The heart 'discerns' nothing: it is a pump, plain and simple. We feel distress in our chests, but as a physiologic response, NOT from 'the heart'.

The proper translation is "the heart considers" Does the brain think? Where is the point that the soul "connects" to the body?

Quote: MOST ESPECIALLY, the lungs DO NOT absorb all kinds of liquids. They can absorb small amounts of water, but that is NOT their purpose: 'all kinds of fluids' destroy the lungs

Rashi explains that the lungs absorb the liquids while they are still in the walls of the stomach not before that.

Quote: The liver produces bile (gall), not vice versa,

The Gemara does not say that the gall produces the bile it says that it injects a drop into the liver. That would make sense because this is where the bile is stored.

Quote: and it is certainly not the seat of anger. That is well-established to be in the amygdala of the brain

How do we know where the anger starts. It may be that the liver sends a message to the amygdala of the brain.

Quote: The large intestine is a storage organ and is responsible for resorption of water and some nutrients, but it does not 'grind food'.

Rashi there says it is referring to the stomach of a bird which corresponds the the omasum in animals.(the third stomach)

With all due respect, these answers are simply inadequate.

Kidneys: "Once a person's nature is set by upbringing or training, the losing of a kidneymay not necessarily determine how a person acts in the future." The simple fact is that the kidneys do NOT have any function in how we act. There is NO feedback mechanism from the kidney to the brain. The kidney filters and eliminates: that is its function. To be clear, however, there are people who are born with one kidney (either side) due to problems in utero. None of these are either particularily good or evil. This is the mos extreme example refuting your proposition, but there are also children who at very early ages have lost a kidney due to trauma or cancer who also have not any change from the median of response. The rabbis were, in this case, simply wrong in their assertion of the function of the kidney.

HEART: "The proper translation is 'the heart considers'. Does the brain think? Where is the point the soul connects o the body?"

The heart does NOT consider. It pumps. There have been people with mechanical hearts implanted. Their ability to 'consider' or feel emotions was never compromised. The seat of the emotions is in the brain. This has been well-documented, including very specific lesions which would consistently eliminate certain emotional responses. The amygdala is one such: lesions therein produce anger-free individuals. It should be obvious from people with strokes that intact hearts and livers are insufficient for the expression of love or anger. Destroy the brain and the person is gone. The heart and liver can be transplanted and even when severely damaged have NO effect on emotional status.

LUNGS: "Rashi explains that the lungs absorb the liquids while they are still in the walls of the stomach not before that."

And Rashi is still WRONG. The lungs no more absorb liquids (per se) than the brain or the eyes and ears. The stomach and bowels are responsible for absorption of nutritive materials. After absorption, utilization is determined by the liver and pancreas and all end-organs share as needed in the materials provided.

LIVER: Gall and bile are the same. There is NO organ (which you would identify as 'gall') which secretes into the liver. The liver extracts potential poisons from the blood and THE LIVER excretes the bile/gall into the small bowel/duodenum.

'LARGE Intestine': If Rashi says this corresponds to the stomach of a bird, then that makes sense.

There is still a large problem. All of this is in contradiction to not some theoretic science, but well-established and obvious conclusions developed over the past 200 years. And as I said before, using these ideas to determine what is appropriate treatment (on Shabbat, for example) would lead to fatalities. We could argue that HaShem could intervene, but then thee is the counter-argument that we are not allowed to 'rely on miracles'.

In the book The Ways of the Talmud by Rabbi Yitzchak Canpanton (around the 15th century)it states in the first chapter on the General Rules for Talmud study thus "At the beginning of your inquiry into the Talmud, let the Talmud itself establish the proper premises and mode of thinking. Thus we assume that each and every speaker in the Talmud, whether he asks or answers a question, is extremely intelligent. All their words are full of wisdom, understanding and knowledge; they contain nothing crooked or twisted. This premise is found in the Talmud itself, in the words of our Rabbis of blessed memory: "Do you mean to suggest that we are dealing with fools?!" (Shevuoth 48b). Accordingly, you must look deeply into all their words and discern if they are reasonable, powerful, and sound like a polished mirror, or pointless and weak like a tasteless paste? Are their words readily acceptable or far fetched? It is then the task of the student to justify every statement and refine its meaning in such a way that the intended thought becomes pleasing, acceptable and reasonable to the mind. Do not err or stray from this path by attributing faulty or frail meanings to their words for not one word can fall by the wayside, and all of their words are the words of the living G-d. If their words are empty, the emptiness is ours. Even when one of the Rabbis changes his opinion, the Talmud asks for a sound and reasonable understanding of his thoughts, "How did he reason at first, and at the end, what is his reasoning that he should change his opinion?" (Katuboth 86a, etc.)"

The foundation of learning Gemara, Rashi and Tosofoes is based on this premise "If their words are empty, the emptiness is ours". We are the ones who do not understand. They are never "wrong". For us, their words are like nature to a scientist. If a scientist was to find a new species of plant which did not fit into any of our previous understating of plants, the plant would not be wrong! It would be our job to understand it.

I spoke with several major Talmidai Chachomim (including Rav Moshe Shapiro) here in Bayit Vegan over the chag. The conclusion that I heard from them was that when our rabbis refer to the heart (or other organs) in such a context it means the heart of the spiritual form of man. Man was created in the image (form) of Hashem. This spiritual form is tied to the body but not limited to it.



Translated of The Ways of the Talmud by Rabbi David Sackton and Rabbi Chaim Tscholkowsky (not yet published)

This message has been edited. Last edited by: Rabbi Mitterhoff,

I would like to add that this is the attitude we have to have when we approach the Talmud and it is this attitude that gives us the power to hear the depths of the words of the holy Rabbis. Your difficulties are real difficulties. If you do not ask your questions it means you did not really think about the text! The first approach to the text always has to be the literal understanding of the text and must be understood to apply to in all places, all times, and in all aspects. This is what the Ramchal calls a "stam" (simple) statement. When there are difficulties with the text we are pressed to give a "forced explanation" (perush dochek) ,which is what we must do here, and say that the heart does not mean the "literal" heart but rather is a reference the "spiritual form" of man. This perspective is called "Covod Chachmim" (Honor to the Rabbis)and without you cant even start to learn Gemara. Even if in the end we are left with difficulties that is also OK. Many Rabbis have had difficulties that took them 30 years to solve. There is also nothing wrong with explaining the text to be a "drush" (midrush) like we did here since we are forced to do so. The main thing is that you don't want to throw out the baby with the bath water and not give Hashem's Torah the proper honor.

I also think this is more in the spiritual sense then the Physical sense. Where the parts of the soul rest.
You are right that all the functions of the body are controlled physically by the brain (which I was reading a book over the summer "A case for a Creator, that claims a proof for G-d is our conciousness, that we must have souls and our brain is not just a biodegradable computer, because you'll never make a computer with conciousness, so even if this conciousness works through the brain, where is it located?), but the action of these organs are more astute in there behavior than can be measured by brainwaves.

I.e. emotions can be more measured (without any machines), by the heart rate than any other part of the body. The kidneys are organs that filter and separate the bad and the good, so that's the organ that would have the attribute of Eitzeh, having counsel to separate what is good for you and what is not good for you. (I'm still working on the case for the liver and lungs, maybe someone else out there can come up with an explanation along these lines.) I also wonder if Artscroll has an explanation on this (sometimes they have to explain these Gemarras) the copy in the Kollel was "borrowed" by someone and is considered a MIA)

I never learned to much of anatomy, but isn't there a gall bladder next to the liver or something like that?

quote:

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Originally posted by Rabbi Mitterhoff:

How do we know where the anger starts. It may be that the liver sends a message to the amygdala of the brain.

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I agree with that one, from a different perspective, too. According to traditional Chinese medicine, too, emotion of anger starts with what they call "excessive heat in the liver" - excessive Yang (similar to Gevurah) energy along the liver meridian, suppressing the Yin (similar to Chesed) along same meridian . I hope nobody is offended by me quoting unusual medical textbooks.

From my humble understanding of the western biology point of view, we know that adrenalin is secreted by adrenal glands on command from the same region of our brain when we are angry as when we are displeased, or being attacked, or just have had too much coffee.

Frankly, I think our Nefesh (animal soul) is trained to force the brain to generate anger-like response when in a fight-or-flight situation, which is why the outcome is the same: adrenalin. But do we know where it comes from? (I am not asking a rhetorical question; I really would like to know... )

(edited for misspellings - Alex)

This message has been edited. Last edited by: Alex,

Welcome to the Global Yeshiva! I am happy that you are enjoying the forums. Can you clarify your question? Where does it come from physically or emotionally?

Thank you for the warm welcome. My question was related to where anger comes from physically: what gives the signal for the brain to send the signal to the rest of the body? Why is it that in some cases we are really angry and in others we are calm and relaxed, even when facing the same set of stimuli? Our body and soul are a unit; I understand that, but Hashem does not have an attribute of anger; therefore, it must be a human emotion, and then it must be related to the body, but which organ sends the initial command that it is time to get angry - that's my question.