Avodah Zara 23b ~ Caesarean Section in Cows and Ewes

In this page of Talmud there is a discussion about the blemishes that might render the rare red heifer - parah aduma - unfit to be sacrificed. According to Rabbi Shimon, a parah aduma born via caesarian section may indeed be offered as a sacrifice, while his colleagues disagreed.

עבודה זרה כג, ב

הִקְדִּישָׁהּ בְּיוֹצֵא דּוֹפֶן — פְּסוּלָה, וְרַבִּי שִׁמְעוֹן מַכְשִׁיר

If one consecrated a red heifer despite the fact that it was born by caesarean section, it is disqualified for use as a red heifer, and Rabbi Shimon deems the heifer fit for use.

Elsewhere, the Talmud raises the question about cesarian sections in cows again, this time when it discusses sacrifices offered outside of the Temple. This act is usually prohibited, and is accompanied with a punishment, but there is one exception: an animal that was born by caesarean section:

זבחים קיב, א

ויוצא דופן שהקריבן בחוץ פטור

One who sacrifices an animal born by caesarian section, outside of the Temple, is exempt from punishment.

The term יוצא דופן literally means "brought out through the wall," the wall in question being the abdomen. Animals born by c-section may not be used as sacrifices in the Temple. There is something different, not quire right, perhaps not normal, about them. That's why these same c-sectioned animals may be offered outside of the Temple without penalty. 

The indications for a caesarean section in a cow

Before we go further, a clarification. The surgical procedure about which we are discussing can be spelled in various ways: caesarean, Caesarean, cesarean or just plain "c." Take your pick. Anyway, according to the American College of Veterinary Surgeons, there are several indications for performing a c-section in a cow:

• Inadequate cervical dilation (not enough relaxation of the cervix muscles)

• Abnormal pelvic bone conformation (shape) in the cow

• Rupture of the cow's abdominal musculature

• Problems with uterine position or uterine function

• Abnormalities of the cow's uterus or vagina

• Abnormal calf position that is not correctable through the vagina

• Fetal monsters (congenital defects)

• Presence of a dead fetus

Standing left oblique celiotomy approach. The placement of the incision is indicated by the dashed line. From Schultz L.G. et al. Surgical approaches for cesarean section in cattle. Can Vet J 2008;49:565–568

Having decided that your cow needs a c-section, there are no fewer that eight different ways you could operate on her to pull this off. Eight! Here they are: (The positions described are that of the cow, not that of the surgeon.)

1. standing left paralumbar celiotomy,

2. standing right paralumbar celiotomy,

3. recumbent left paralumbar celiotomy,

4. recumbent right paralumbar celiotomy,

5. recumbent ventral midline celiotomy,

6. recumbent ventral paramedian celiotomy,

7. ventrolateral celiotomy,

8. standing left oblique celiotomy

According to this helpful paper published in the Canadian Medical Journal, it is the left oblique approach that is preferable under most circumstances. This is because the uterus is readily removed from the abdominal cavity limiting contamination of the abdominal cavity.  

...and in sheep

In sheep, things are only slightly different. The most common cause for performing a c-section is a fetal lamb in the wrong position, one which cannot be safely corrected by manipulation. This is the cause of about 50% of all sheep c-sections.  The cause of about another third is incomplete or non-dilation of the cervix which has failed to respond to medical treatment.  Feto-pelvic disproportion, in which a single large lamb is too big to pass through the maternal pelvis account for another 5%.  There are generally three approaches to the c-section: through the flank, through the midline, and through an incision parallel to the midline, which is called the paramedian approach. Today the midline approach is not recommended, because it requires a general anesthetic, as opposed to a local injection. (You can read more about c-sections in the ewe in this helpful article.)

Exceptional animals with exceptional births

In modern Hebrew the phrase meaning a caesarean section, יוצא דופן, has another meaning: exceptional. Which certainly describes these animals born by c-section. In the pre-modern era, when there were neither local anesthetics nor antibiotics, there would have been only one survivor of a c-section if you were lucky, and it wasn't the mother. (We will have more to say about the c-section survival rate in women when we learn Bechorot 47 on November 4, 2026.)  For these animals who, but for the intervention of a skilled vet would otherwise have died in-utero, perhaps being spared from sacrifice was rather fitting.  If their birth was abrupt, bloody and at the hands of a human, perhaps their deaths could be different.  

“בהמה המקשה ללדת ויש סכנה לחייה, כי הוולד מת, והרפתנים קובעים שצריכים לחתוך את הוולד ולהוציאו דבלי זה הפרה תמות. אם מותר לעשות זה בשבת. אם צער בע”ח דוחה איסור מוקצה. הב”ח בסימן שח סעיף כג, מדבריו משמע דמשום צער בע”ח שרי טלטול מוקצה. וכנראה שהמחמירים לא ראו דברי הב”ח ולכן יש להתיר וכדאי הוא הב”ח לסמוך עליו 

The question of performing an emergency caesarean section on animal on Shabbat: 

...Does the prohibition of not causing pain to animals override the prohibition of מוקצה muktzeh [not touching certain items on Shabbat]?...Those who are strict in this matter [and prohibit the c-section] have not seen the words of the Bach [R. Yoel Sirkis 1561-1640]. It is permissible [to perform the surgery] and appropriate to rely on the opinion of the Bach”

— Rabbi Tzvi Pesach Frank [1874-1960]. Har Tzvi Tal Harim Shvut 3.

Talmudology Bonus Post: Avodah Zara 12b ~ Abracadabra and Talmudic Demonology

Last week we studied Avodah Zara 12b which included a passage about the dangers of drinking water at night. Here is a bonus post on the topic, in which we learn about the intersection of Abracadabra and talmudic demonology. Enjoy.

עבודה זרה יב, ב

תָּנוּ רַבָּנַן: לֹא יִשְׁתֶּה אָדָם מַיִם בַּלַּיְלָה, וְאִם שָׁתָה — דָּמוֹ בְּרֹאשׁוֹ, מִפְּנֵי הַסַּכָּנָה. מַאי סַכָּנָה? סַכָּנַת שַׁבְרִירֵי. וְאִם צָחֵי, מַאי תַּקַּנְתֵּיהּ? אִי אִיכָּא אַחֲרִינָא בַּהֲדֵיהּ — לִיתְרְיֵיהּ וְלֵימָא לֵיהּ: ״צָחֵינָא מַיָּא״, וְאִי לָא — נְקַרְקֵשׁ בְּנִכְתְּמָא אַחַצְבָּא, וְנֵימָא אִיהוּ לְנַפְשֵׁיהּ: ״פְּלָנְיָא בַּר פְּלָנִיתָא, אָמְרָה לָךְ אִימָּךְ אִזְדְּהַר מִשַּׁבְרִירֵי בְּרִירֵי רִירֵי יְרֵי רֵי בְּכָסֵי חִיוָּרֵי״

The Sages taught: A person should not drink water at night. And if he drank, his blood is upon his own head, due to the danger. The Gemara asks: What is this danger? The Gemara answers: The danger of the shavrirei, an evil spirit that rules over water. And if he is thirsty, what is his remedy? If there is another person with him, he should wake him and say to him: I thirst for water, and then he may drink. And if there is no other person with him, he should knock with the lid on the jug and say to himself: So-and-so, son of so-and-so, your mother said to you to beware of the shavrirei verirei rirei yirei rei, found in white cups. This is an incantation against the evil spirit.

Rashi explains that by diminishing the name of the demon responsible for the danger, it is weakened, until it ceases to exist altogether.

רש׳י שם

איזדהר משברירי שברירי ברירי רירי ירי רי בכסי חיורי - לחש הוא ומתמעט והולך משם השד כאשר הוא שומע מיעוט תיבות אות אחר אות עד רי וכן הוא הלחש להבריחו משם

He whispers and reduces the number of letters of the name of the demon. When the demon hears his name losing letter after letter, until all that is left are the letters “rei” [he vanishes] and the whispering expels him from there . . .

Medieval amulet to protect mother and child against attack from the demon Lilith during childbirth. From Sefer Raziel, Amsterdam 1701.

abracadabra against malaria

The belief in the power of amulets is a powerful one. Some of the beliefs of the rabbis might feel strange to our modern minds, but they reflected what everyone believed back then. Galen, the second century Roman physician wrote that assertion that a peony root hung about the neck was effective against epilepsy and that stones of green jasper worn over the stomach cured stomach complaints. And here, as another example, is an amulet against the disease we call malaria, written in the third century by Quintus Serenus Sammonicus (d. 212 CE) who was the physician to the Roman emperor Caracalla.

Inscribis chartae, quod dicitur Abracadabra, Saepius: et subter repetas, sed detrahe summae, Et magis atque magis desint elementa figuris Singula, quae semper rapies et coetera figes, Donec in angustam redigatur litera conum. His lino nexis collum redimire memento.

Write several times on a piece of paper the word ‘Abracadabra,’ and repeat the word in the lines below, but take away letters from the complete word and let the letters fall away one at a time in each succeeding line. Take these away ever, but keep the rest until the writing is reduced to a narrow cone. Remember to tie these papers with flax and bind them round the neck.

After wearing the talisman for nine days, it was to be thrown over the shoulder into an eastward-running stream. Should this treatment fail, Sammonicus recommended the application of lion’s fat, or the wearing of cat’s skin tied with yellow coral and green emeralds around the neck.

Abracadabra written as an amulet remained popular for more than 1,500 years after it was mentioned by Sammonicus. In fact it was widely used during the outbreaks of bubonic plague in London in the seventeenth century, as Daniel Defoe recorded in his book Journal of a Plague Year.

But there was still another madness beyond all this, which may serve to give an idea of the distracted humour of the poor people at that time: and this was their following a worse sort of deceivers than any of these; for these petty thieves only deluded them to pick their pockets and get their money, in which their wickedness, whatever it was, lay chiefly on the side of the deceivers, not upon the deceived. But in this part I am going to mention, it lay chiefly in the people deceived, or equally in both; and this was in wearing charms, philtres, exorcisms, amulets, and I know not what preparations, to fortify the body with them against the plague; as if the plague was not the hand of God, but a kind of possession of an evil spirit, and that it was to be kept off with crossings, signs of the zodiac, papers tied up with so many knots, and certain words or figures written on them, as particularly the word Abracadabra, formed in triangle or pyramid, thus:—

ABRACADABRA

ABRACADABR

ABRACADAB

ABRACADA

ABRACAD

ABRACA

ABRAC

ABRA

ABR

AB

A

I might spend a great deal of time in my exclamations against the follies, and indeed the wickedness, of those things, in a time of such danger, in a matter of such consequences as this, of a national infection. But my memorandums of these things relate rather to take notice only of the fact, and mention only that it was so. How the poor people found the insufficiency of those things, and how many of them were afterwards carried away in the dead-carts and thrown into the common graves of every parish with these hellish charms and trumpery hanging about their necks, remains to be spoken of as we go along.

Talmudic demonology might make some uncomfortable- why on earth did the rabbis of the Talmud believe in such things? But they believed what everyone believed- that demons were real and that they can be controlled with magic incantations Just ask Daniel Defoe.

(Want more on amulets? See the post here.)

Avodah Zarah 17b ~ What Gender is that Bee?

This post is for the page of Talmud to be studied tomorrow, Shabbat.

Print it up now and enjoy.

From here.

Rabbi Elazar ben Perata was in trouble. When the  Romans heard him being called him by the title "Rabbi" they arrested him.Teaching Torah was banned, and to be identified as a Rabbi, a teacher of Torah, invoked the death penalty. To save his life, Rabbi Elazar denied the charge. Instead, he claimed, he was simply a teacher (rabban) of weavers.  So the Roman authorities tested him on his knowledge of weaving:

עבודה זרה יז, ב

 אייתו ליה תרי קיבורי אמרו ליה הי דשתיא והי דערבא איתרחיש ליה ניסא אתיא זיבוריתא אותיבא על דשתיא ואתאי זיבורא ויתיב על דערבא אמר להו האי דשתיא והאי דערבא

They brought him two coils of wool and said to him: Which is the warp, and which is the woof?  A miracle occurred, as a female bee came and sat on the warp, and a male bee came and sat on the woof. Rabbi Elazar ben Perata said to them: This is the warp, and that is woof.

Rabbi Elazar understood the message the two bees were sending. The male was sitting on the woof, which is threaded into the warp. The female bee was on the warp, which is fixed in the loom and receives the woof. 

What is going on here?  Is it in fact the case that male and female bees are distinguishable? It turns out that they are. Sort of.

Queens, Drones, and Workers

A hive contains three kinds of bees. First, there are thousands of worker bees. These are the ones that you see flying around collecting nectar from flowers, or annoying you in the Sukkah.  All worker bees are female. The hive also has one Queen, whose sole task is to lay eggs.  Obviously, the queen is female. She stays in the hive and is attended to by special worker bees who become nurse bees.  And then there are the male drone bees, whose only job is to mate with a virgin queen. They leave the hive and fly to drone congregation areas, where, in midair, they mate (or attempt to mate) with a virgin queen.  Then they fall to the ground and die.

 The male drones are about twice the size of the female worker bees.  According to a helpful article (Differences in drone and worker physiology in honeybees) published in 2005, the weight of an emerging worker is 70-100mg.  In contrast, the weight of an emerging drone is around 260mg - over two-and-a-half times heavier. Drones also have bigger eyes and rounded, more stocky bodies. 

“Drone bees are the hapless males within a colony. They seemingly have little or no purpose within the colony: they take no part in hive building or maintenance; they don’t defend the colony (drones do not possess a sting); they don’t gather food or nurture the larvae.”

— Barnsley Beekeepers Association

A typical hive contains one queen, about 60,000 worker bees, and a few hundred drones.  You are likely to have seen hundreds of worker bees over the years.  You are, however, far less likely to have seen a drone.  In fact, you may never have seen one. But they are out there.

Rashi vs. Tosafot

According to Rashi, Rabbi Elazar was able to distinguish between a smaller female worker (זיבוריתא) and a larger male drone (זיבורא). The worker sat on the warp, and the drone sat on the woof. Since the woof is inserted into the warp, Rav Elazar deduced that the woof was indicated by the male drone. Because there is indeed a difference in size and gross morphology between the workers and the drones, it is entirely possible that Rav Elazar could identify each. Assuming that he had great eyesight and was an experienced apiarist.

Drone Bee Phallus. From here.

Tosafot disagrees.  There is no way, claims Tosafot, that Rabbi Elazar's eyesight was that good. Now not knowing anything about bees, you might agree. After all, the penis of a drone bee is very, very small. But as we have seen, to determine the gender of a bee you don't have to get that close.  You just have know what you're looking for in terms of the body size and morphology.   

Tosafot therefore suggests that the Talmudic words זיבוריתא and זיבורא do not refer to a female and a male of the same species. Instead, the words refer to two different species, which Rabbi Elazar could identify from a distance. The species זיבוריתא, written in a female form, was sitting on the warp. The species זיבורא, written in a male form, was sitting on the woof, since the woof goes into the warp.

There are thousands of species of bees and their larger cousins, the hornets.  It is entirely possible that Rabbi Elazar noted that the two insects on the loom were two different species called by two similar but distinct names. Tosafot is incorrect to claim that the gender of a bee cannot be determined from a distance.  But the alternative theory is also scientifically plausible.

We have already learned that honey has some amazing medicinal properties.  Today we learn that bees too, can save a life.  So next time you are bothered by bees, act kindly. After all, they saved Rabbi Elazar's life.

Avodah Zarah 12b ~ Vinegar, Leeches and Rav Huna

עבודה זרה יב ,ב

ת"ר לא ישתה אדם מים לא מן הנהרות ולא מן האגמים לא בפיו ולא בידו אחת ואם שתה דמו בראשו מפני הסכנה מאי סכנה סכנת עלוקה

The Sages taught: A person should not drink water from rivers or from ponds either by drinking from the water directly with his mouth, or by collecting the water with one hand alone. And if he drank in this manner, his blood is upon his own head, due to the danger. What is this danger? It is the danger of swallowing a leech.

There are about 680 identified species of leeches (so far). Most are found in freshwater, and are found on every continent except Antarctica. You should stay away from them.

In western developed countries, our drinking supplies are safe to drink (mostly). But around the world leeches are still found in water that is used for human (and animal) consumption.  Today's page of Talmud reminds us of the danger that leeches once imposed. That danger is still very much present.

The Nile Leech. And others

The Koren Talmud notes that one species of leech, the Nile leech (Limnatis nilotica) can still be found in bodies of water in Israel.  Indeed, leeches are found across the Middle East. Ten years ago, a case report was published in the Turkish Journal of Parasitology which described what happened when Limnatis nilotica  got into the nose of a poor five year-old girl in Turkey.

“ The doctor who was trying to aspirate the blood in the patient’s mouth noticed the bloody formation moving slightly. This formation was removed by an otolaryngologist under local anesthesia and was brought to the parasitology laboratory and identified as a leech.”

— Agin, H. et al. Türkiye Parazitoloji Dergisi, 32 (3): 247 - 248, 2008

The girl had nose bleeds and had vomited blood over three days.  She required an urgent blood transfusion, and while trying to remove blood from the girl's nose the doctor "noticed the bloody formation moving slightly." The bloody moving formation was carefully removed and sent to the pathology laboratory where it was identified. It was a leech. Here is a picture of the villain:

Leech obtained from the case. From Agin, H. et al. Severe Anemia Due to the Pharyngeal Leech Limnatis nilotica in a Child. Türkiye Parazitoloji Dergisi, 32 (3): 247 - 248, 2008

This is certainly not an isolated incident.  In fact, there are so many reports of leeches in the medical literature, that an Iranian group published a meta-analysis of leeches "as a live foreign body." 

Selection of published literature on leech infestations. From Saki, N. et al. Meta Analysis of the Leech as a Live Foreign Body: Detection, Precaution and Treatment. Pakistan Journal of Biological Sciences 2009: 12 (24); 1556-1563

The more you read, the more the meta-analysis gets scary. Here is another table, detailing the 28 patients the Iranians had seen at their hospital in Ahwaz, Iran. (Fun fact about Ahwaz: in 2011 the World Health Organization declared it to be the most air-polluted city in the world. Ahwaz: If our leeches don't kill you, our air will.)

Detail of 28 leech infested patients seen over a ten year period at Ahwaz Jondishapour University of Medical Science, Ahwaz, Iran. From Saki, N. et al. Meta Analysis of the Leech as a Live Foreign Body: Detection, Precaution and Treatment. Pakistan Journal of Biological Sciences 2009: 12 (24); 1556-1563

The longest leech they found was a whopping 10 cm (over 4 inches) that had taken up residence in the back of the mouth. Why didn't the patient feel that massive creature? Well, leeches are crafty; they secrete an analgesic so the victim doesn't feel the bite. At most, you might feel a little wiggling.  

Vinegar. Really?

Today's page of Talmud not only cautions us to be careful when drinking from a spring or river. It also suggests a treatment for leech attachment: 

אמר רבי חנינא הבולע נימא של מים מותר להחם לו חמין בשבת ומעשה באחד שבלע נימא של מים והתיר רבי נחמיה להחם לו חמין בשבת אדהכי והכי אמר רב הונא בריה דרב יהושע ליגמע חלא

 Rabbi Hanina says: In the case of one who swallows a water leech [nima], it is permitted to perform labor on Shabbat and heat water for him to drink on Shabbat, as his life is in danger. And in fact there was an incident involving one who swallowed a water leech, and Rabbi Neḥemya permitted them to heat water for him on Shabbat. In the meantime, until the water is ready, what should he do? Rav Huna, son of Rav Yehoshua, said: He should swallow vinegar.

As it turns out, Rav Huna's advice to drink vinegar can be found in today's medical literature. The Ahwaz team offers this suggestion:

If the leech is in the nares or upper pharynx, it be detached by applying 30% cocaine, 1:10,000 adrenalin or dimethyl phthalate to it. Another method is irrigation with strong saline, vinegar, turpentine or alcohol.

Rav Huna's treatment with vinegar seems to be supported in the medical literature. So next time you travel to Ahwaz, take some along with you.