Medication & Vitamins-the halachos of Refuah on Shabbos

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Medication & Vitamins-the halachos of Refuah on Shabbos

Chazal instituted many Shabbos prohibitions in order to safeguard the halachos and sanctity of Shabbos. One of the prohibitions which Chazal enacted is the prohibition of Refuah – taking medication on Shabbos. In the following paragraphs we will discuss why Chazal instituted the prohibition against using medication on Shabbos, the halachos of this prohibition, and how it relates to taking vitamins on Shabbos. [Note: We will attempt to discuss the basic halachos of Refuah; however these halachos are very broad. Since there are many different types of medications, all of which serve different purposes, one must consult one’s Rav regarding taking a specific medication on Shabbos.]

 

The reason behind the prohibition of Refuah: Safeguarding the melacha of Tochain (Grinding)

One of the thirty-nine melachos of Shabbos is the melacha of Tochain – Grinding1. The melacha of grinding was performed in the Mishkan when producing the Lechem ha’Panim (Showbread). In order to produce the flour necessary for the Lechem ha’Panim, grain kernels were ground into flour2. Therefore any act of grinding an object into small pieces on Shabbos violates the melacha of Tochain.

 

In the times of the Talmud, most medications were made from herbs; in order to produce these medications, herbs had to first be ground into small pieces and then made into medication. If it would be permitted to use medication on Shabbos, someone who is in the need of medication may, in their haste, grind herbs and violate the melacha of Tochain3. Therefore, in order to prevent this unintentional desecration of Shabbos from occurring Chazal prohibited using all forms of medication on Shabbos4. For example the following methods of medication are prohibited on Shabbos5:

 

  •    Ingesting pills or liquid medications
  •   Smearing medicated creams, lotions or oils
  •  Applying medicated powder

 

Since using these and any other forms of medication on Shabbos may lead to inadvertently violating the melacha of Tochain, they may not be used on Shabbos.

 

The applicability of the prohibition of Refuah nowadays

Someone taking medication nowadays generally does not grind herbs to produce medication, and one may argue that the original concerns of Chazal do not apply. However, the prohibition of Refuah which Chazal enacted is still effective even nowadays for a few different reasons.

 

1) Once Chazal institute a prohibition, the restriction remains perpetually, even if the original concerns which prompted Chazal to institute this prohibition does not exist anymore8.

 

2) There are still some homeopathic remedies which are still made by grinding herbs and spices9. Similarly, there are still some places in the world where people make their own homemade medication by grinding herbs10. Since there are instances where the concerns of Chazal still apply, we cannot assume that the original prohibition of Refuah should be abolished.

Exemptions to the prohibitions of Refuah

There are a number of important leniencies which Chazal included when they instituted the prohibition of Refuah. Based on these leniencies there may be many circumstances and methods that medication may be taken on Shabbos.

1) Choleh sh’ein bo sakanah – Treating a sickness which is not serious or life threatening

The prohibition of Refuah applies to someone who has a minor discomfort or pain11. For example:

 

  • Taking Advil or Tylenol for a headache12
  • Using medicated creams to relieve chapped skin13
  • Using creams to relieve minor muscle pains, or toothaches14
[Note: Using creams on Shabbos is also prohibited under the melacha of Memachaik (Smoothing) 14a.]

lUsing medicated powders to relieve mild rashes, or burns15

 

 

The prohibition of Refuah on Shabbos applies to someone who has a minor discomfort or pain. However, someone who has an illness or is suffering from a lot of pain may take medication on Shabbos. Chazal did not restrict someone who is “sick” from using medications on Shabbos16. There are two ways which we can use to define someone who is “sick” enough that he may use medication on Shabbos:

 

1) Choleh Kol Gufo – One’s entire body feels sick: Someone whose entire body feels sick may use medication on Shabbos17. For example, someone who has a fever may use medication to relieve his pain18.

 

2) Nofel l’mishkav – One feels the need to go into bed: Someone who feels so that he can no longer function normally and must lie down in bed, may take medication on Shabbos19. For example, someone who is suffering from:

 

  • A severe headache or flu20
  • A severe headache21, allergies or cramps22

 

In these examples, one generally feels so sick that he cannot function properly, and would go into bed; therefore Chazal allowed such an individual to use medication on Shabbos. These are just examples of some illness which will cause someone entire body to feel sick, or would cause him to go into bed. In truth every person must be his own judge whether or not he feels “dysfunctional” or not24. If someone is in doubt whether he has reached the point that he is considered “sick”, he may be lenient and take medication25.

 

The Poskim rule26 that this leniency applies even if someone strengthens himself to get out of bed and go to shul and daven, or eat at the Shabbos seudah; since his natural inclination is to go lie down in bed, even if he strengthens himself to get up he is considered “sick” and may use medication on Shabbos.

 

Young children: The Ramah rules27 that a young child has a status of a Choleh sh’ein bo sakanah (a non-serious illness). Since the health of young children is very delicate, if neglected it can worsen and become dangerous; therefore a young child has the same leniencies as a Choleh sh’ein bo sakanah (someone who is ill), and may be given medication on Shabbos for any slight discomfort he is experiencing28.

 

However, until what age a child retains this status is unclear; some Poskim rule29 that a child up to 3 years old has the status of a Choleh sh’ein bo sakanah, while others rule30 that children up to 9 years old may be considered a Choleh sh’ein bo sakanah. *

 

2) Derech B’riyim: Something used by healthy people

The Shulchan Aruch rules31 that someone who is suffering from minor pain or discomfort to take an food item which is used even by someone who is healthy. Since these items are “food” items they are not classified as “medication” and are not prohibited under the prohibition of Refuah. Furthermore, these items are used even by healthy people, using them on Shabbos does not give off the appearance of Refuah and is therefore permitted32. For example:

 

  • Someone who has a cold may drink a hot bowl of chicken soup33.
  • Someone who has a sore throat may drink a cup of hot tea34.
  • One may use drink prune juice or eat Bran cereal in order to relieve mild constipation36.

 

In these examples even healthy people would take these “food” items, therefore when these items are used it does not give off the appearance of taking medication, and is therefore permitted on Shabbos.

 

3) Preventive medication

Any medication which is taken to prevent a sickness is permitted to be used on Shabbos37. Someone who is not suffering from pain or discomfort and is not anxious to take medication, is less likely to forget himself and grind herbs on Shabbos. Therefore, Chazal only prohibited the positive treatment of a sickness on Shabbos; they did not restrict someone from preventing a sickness from occurring. For example:

 

  • One may take antacid in order to prevent heartburn38
  • Advil or Tylenol in order to prevent a migraine headache from occurring39

 

4) Protracted medication

Some Poskim40 permit taking medication which has been prescribed to be taken for many consecutive days. Since if these medications are not taken consecutively their effectiveness will be lost one may continue using them on Shabbos. For example according to these opinions ; someone who suffers from mild acne or eczema may take a ten-day medication to cure these ailments; since if these medications are not taken consecutively their entire effectiveness will be lost they may be taken on Shabbos.

 

However, R’ Moshe Feinstein40a disagrees with this leniency. Accordingly, one may only take such medication if not taking it will result in a relapse of one’s health and cause him to become ill. For example, one may take antibiotic medication on Shabbos, because if one were to neglect taking these medications, it may lead to him becoming sick40b.

 

5) Taking vitamins on Shabbos

There is much debate amongst the Poskim whether taking vitamins on Shabbos violates the prohibition of Refuah on Shabbos. On the one hand vitamins can be classified as a form of medications, as they benefit a person’s health; on the other hand the person taking it is healthy, and perhaps we cannot consider something which a healthy person ingests as medication. There are a number of opinions in the Poskim regarding taking vitamins on Shabbos; we will discuss the opinion of R’ Moshe Feinstein41:

 

The halacha regarding taking vitimins on Shabbos depends on the reason why the vitamins are being used. There are really two reasons why people take vitamins:

 

 

1) As a daily vitamin supplement: Some people use vitamins in order to supplement certain vitamins. When vitamins are used to supplement one’s diet, they are not being used as a medication and may be taken on Shabbos. When vitamins are taken as a daily supplement they are not considered medication, rather they can be viewed as a food giving a person the necessary vitamins he is lacking. Just as one may eat a banana in order to increase his potassium intake, one may ingest a vitamin on Shabbos. Even if the vitamin is taken to give a little energy boost, we do not consider it to be a medication, but a food, and may be taken on Shabbos.

 

2) Instead of a medication: Some people use vitamins instead of medications in order to treat inflammation and pain. Since the vitamins are being used as a medication they may not be taken on Shabbos.

 

Since there are Poskim42 who disagree with the ruling of Rav Moshe, one should consult a Rav on this matter. Furthermore, as we mentioned earlier there are many types of medications nowadays which are used to serve different purposes (i.e. pills taken for sleeping, calming, lactose intolerance, iron deficiency, etc.) someone taking these medications must consult a Rav regarding using these medications on Shabbos.

 

6) Taking medication on Yom Tov

The prohibition of Refuah applies to Yom Tov as well, and therefore medication may not be taken on Yom Tov. However, one is permitted to take medication on the second day of Yom Tov; since it is only observed as a s’fikah d’yomah (observed due to uncertainty as to which day is really Yom Tov) one is permitted to take medication on the second day of Yom Tov. Similarly, one may take medication on Chol Ha’moed.

 

but first let us preface with an important machlokes between the Bais Yosef and the Magen Avraham:

The Bais Yosef rules that a healthy person may use any form of medication on Shabbos; since he is healthy we cannot consider the item which he is using as a medication, and therefore using it on Shabbos does not violate the prohibition of Refuah. However the Magen Avraham rules that even a healthy person may not use items which are specifically intended to be used as medication on Shabbos. Since these items are meant to be used as medication, they are included in the prohibition of Refuah and are therefore prohibited on Shabbos. The opinion of the Magen Avrham is cited in the Mishnah Berurah.

R’ Moshe Feinstein writes that one should follow the more stringent opinion of the Magen Avraham; this would seemingly create a halachic issue with taking vitamins on Shabbos. Although the person is healthy, since vitamins are a form of medication, one may not take them on Shabbos. However, R’ Moshe rules that in the majority of cases vitamins may be taken on Shabbos – the reason for this is as follows.

 

* Note: We have discussed that someone who is classified as a Choleh sh’ein bo sakanah (someone who is ill) may take medication on Shabbos. Additionally, a non-Jew may be asked to perform any melacha [even a d’oraysa] anyone who is considered a Choleh sh’ein bo sakanah30a. However, all other activities which are prohibited on Shabbos (even m’drabanan) may not be performed on Shabbos for a Choleh sh’ein bo sakanah30a

 

1Mishnsh Shabbos 73a       2Based on the opinion of Rav Hai Goan (quoted in introduction to sefer Iglei Tal)       3M.B. 327,1     4S.A. 328,1                 5Not only is ingesting medication prohibited but all forms of medication is prohibited on Shabbos such as using creams on ones body [S.A. 328,20-25] see R’ Bodner pg 16 39 melachos pg 475   8Rambam Mamrim 2,2 see sefer Ketzos ha’ShulchanVol7 pg 19-20     9R’ Neustadt Monthly halachos pg 92           10 Ketzos ha’Shulchan ibid       11S.A. 328,1     1239 melachos pg 487, R’ Bodner pg 16.     1339 melacos pg 487       1439 melachos pg 487,490       15ibid     16M.B. 328,1     17M.B. ibid     18Tzitz Eliezer 4,50,6     19M.B. 328,1       2039 melachos pg 492     21 ibid           22ibid     24R’ Neustadt ibid pg 91       25Ketzos ha’Shulchan ibid pg 20         26Chut Shani 4 pg 197     27328,17; The Rama writes that a child has the halachic status of a Choleh, regarding the halachos of asking a non-Jew to perform a melacha for the needs of the child; similarly a child has a halachic status of a Choleh regarding taking medication [R’ Neustadt ibid pg 91 R’ Bodner pg 46]     28R’ Bodner pg 46       29Chazon Ish O.C. Shabbos 59,2 R’ Shlomo Zalman Aurbach [quoted in Nishmas Avraham 328 note 54       30 Minchas Yitzchak 1,78; however the Tzitz Eliezer [8,15,9] argues and rules that one should only use this leniency for child up to 6 yrs. old up            30aShulchan Shlomo 328 haarah 2 R’ Bodner pg 46 note 12     30bS.A. 328,17; a melacha m’drabanan may however be performed by using a Shinui (irregular manner) 31S.A. 328,37     32see 39 melachos pg 480     33R’ Bodner pg20     3439 melachos pg 481        3639 melachos pg 489     37M.B. 328,86 [39 melachos pg 483]     3839 melachos pg 484       3939 melachos ibid       40SSk”h 34,18     40aIgrm”o O.C. 3,53     40bSSk”h 34,18       41 Igm”o O.C. 3,54,4     42See Chut Shani vol 4 pg 151 [see R’ Bodner pg 18]       43M.B. 496,5 & 532,5     44M.B. 496,5       45Shulchn Aruch 532,2

By: Rabbi Shmuel Stein

Weekly Shabbos Shiur by Avreich of the Miami Beach Community Kollel. Shiur is Wednesday nights at the kollel at 8:15 

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