Thursday, December 20, 2012

Musings on Metzitzah

In the previous post, I mentioned that I adopted a seemingly anti-rationalist approach regarding metzitzah at my son's bris on Sunday. No, the mohel did not do metzitzah b'peh. But he did perform metzitzah via a tube. And as someone asked me, Why do metzitzah at all?

As explained at length in the seminal article by my friend Shlomo Sprecher, "Mezizah be-Peh: Therapeutic Touch or Hippocratic Vestige?", Chazal clearly instituted the oral suction of blood from the circumcision wound due to their belief that it was medically beneficial - as Chazal themselves stated. Much later, it was realized that it is in fact potentially dangerous rather than beneficial. Halachic authorities such as Chasam Sofer, who analyzed the issue based on solely halachic aspects, thus ruled that oral suction need not be performed. (Those who took a meta-halachic approach, due to perceived threats to traditional Judaism, inflated the role of metzitzah b'peh; see my paper on "The Novelty of Orthodoxy".)

However, the halachic authorities who discounted the need for metzitzah b'peh still ruled that blood must be extracted from the wound via other means, such as with a sponge or via sucking it through a tube. An article in the latest volume of Hakirah by Rav Moshe Tzuriel of Bnei Brak, which stridently argues against performing metzitzah b'peh, still insists that it is unthinkable to do without metzitzah altogether.

But why? If metzitzah b'peh was only instituted in the first place due to a particular medical concern, and we now see that in fact it is of no medical benefit, then why do any form of suction?

The answer is very straightforward. To quote Tevye, "Because it's a tradition!"

Sure, sucking blood from the wound via a sponge or tube is of no apparent medical benefit. But on the other hand, it doesn't do any harm either. And since Jews have been doing this for thousands of years, why tamper with the practice? Judaism, especially Orthodox Judaism, is inherently conservative in nature. It is also in a fragile state due to its confrontation with modernity. Therefore, it should be tampered with as little as possible. (This really needs expanding upon at greater length, but it's difficult to do so with a baby on my lap.)

Before concluding this post, I would like to raise another point on this topic. There is currently a furious reaction by the Charedi community in the US to the proposal that parents must be informed of the medical risks involved with metzitzah b'peh. (I saw a letter from the "International Bris Association" which, demonstrating an astonishing lack of self-awareness, accused the Health Authority of being biased!) I wonder: suppose the requirement was that Mohelim, instead of having to tell the parents that there are medical risks, had to inform parents that Chassam Sofer and many others said that if doctors claim that metzitzah b'peh is potentially dangerous, it need not be done. Would people still object, and if so, on what basis?


  1. There's nothing novel in your post. Any bar da'as understands that Judaism is conservative in nature. You may as well ask why we still keep yom tov sheni, or why we separate meat and fish, or any one of scores and scores of traditions that are outdated. Of course, we came up with the concept of "no court is able to undo a previous court ruling unless greater in size and intelligence" (i.e., an impossible to mmet standard, because orthodoxy holds by definition that succeeding generations cannot be greater than previous ones.) This gives solace to some who can now tell themseles that it's not simple conservatism, its halacha. But in reality everyone knows its because there's no good way to avoid going down the slippery slope of throwing out the baby with the bathwater. And that's the truth.

    Having said that - the mohelim are right to pushback on the attempt of government to regulate the bris. Leaving aside the First Amendment principles which will rightly be raised, the last thing we need is even more government regulation.

  2. Doing something merely out of tradition, would depend if its a minhag shtus or not whether it fits with a rationalist approach. Although I have no problem if someone did not take a rational approach to a harmless action; just like if someone ate a ton of matzah because he felt like doing so.

  3. There's is also the Chasidic angle in which metzizah b'peh is inflated to assume incredible spiritual significance which means if it's not performed the baby's neshama will be damaged forever, or something like that.
    The metzitzah b'tzinor is the best compromise. Metzitzah is performed, the baby is safe, everyone's happy. That's probably why some UO groups are against it. If everyone's happy then something must be wrong!

  4. I wonder: suppose the requirement was that Mohelim, instead of having to tell the parents that there are medical risks, had to inform parents that Chassam Sofer and many others said that if doctors claim that metzitzah b'peh is potentially dangerous, it need not be done. Would people still object, and if so, on what basis?

    They will criticize any attempt by the government to intervene in bris. And the First Amendment concerns, at least with regards to speech, are serious here.

  5. Constitutionally WeakDecember 20, 2012 at 11:55 PM

    It appears that the pro-metzitza constitutional arguments in the case are weak. See

  6. 1) Doesn't the mishnah require metzitza? We can't exactly change a halacha.

    2) I think the state is being extremely lenient. In reality, they could (should?) easily prosecute a mohel who kills a baby with metzitza b'peh for murder.

  7. I don't believe that any tradition based argument can justify doing metzitza on Shabbos, although I'm sure you disagree.

  8. At the very least, let metzitza on Shabbos be done with a shinui significant enough to take the practice out of a deoraisa. One can then argue on the drabonon aspect that Chazal never made the gzeira by a bris. And metzitza done with a qualifying shinui would fully comport with tradition no less than metzitza with a straw.

    1. Check shulchan shlomo on hilchos Shabbos siman 331 where RSZA grapples with this issue of mitzitza on Shabbos.
      He too is bothered why we don't follow the doctors current medical expertise just like we do with washing the baby after the milah, a practice we abandoned due to modern science or at least because of nishtana hateva and therefore don't heat up water for this purpose.
      He does suggest that it is already a derabanan by mItzitza because based on what the doctors say that it is not beneficial it is considered mikalkel.
      But he actually concludes that it might be considered an integral part of the mitzvah and not just medicinal because otherwise we would have a gentile do it on Shabbos.

  9. Your post was so good, that the only thing I could find wrong was the fact that you spelled R' Sofer's name both Chasam and Chassam.

  10. I don't understand the invocation of First Amendment rights here. Would you say it is the violation of a doctor's free speech to give his patient a full warning of the effects a procedure may have on him? It's his duty to make sure the patient is making a well-informed decision. A mohel should be no different.

  11. The latest volume of Dialogue, has many articles devoted to this topic, explaining legal and halakhik implications of MbP. Also, they explain in detail the danger of having secular regulation.

    Does anyone know if it is available online?

  12. Mezizah be-Peh is a perfect example of the ignorance of it's advocates.

    When tradition turns out to be a health risk, it can no longer be considered Halacha.

    Mezizah be-Peh can, and has caused death.

    Then by all means it clearly violates the Torah's commandment, 'Ye shall live by my Torah laws,' i.e. not die by them.

  13. Nephtuli, it's a matter of well-established Law. The First Amendment is not absolute. When religious practices constitute a clear danger there is no obstacle to regulating them. MBP is a clear danger. It is septic. It causes horrible lifetime disabilities kills through herpes transmission. It is a health hazard.

    My father, a distinguished urologist and sometime mohel summed up his professional opinion on the matter in one word "Gaaaaahhhhh!"

    From a medical and public health viewpoint it should be completely illegal. The fact that there is a namby-pamby overly-sensitive proposal to require informed consent is a testament to the bloc-voting power of the Charedim in the greater NYC area.

  14. I'm in favor of reading the word "metziza" as "whatever contemporary medicine judges to be appropriate health protections." Of course, every mohel out there practices those (washing hands, antiseptic, antibiotics, etc.).

    Again I ask: Is metziza performed on stillbirths or deceased infants? If not, that pretty much settles it, no?

  15. Well, can you imagine what would happen were we to start taking suggestions, swaying to demands, and buckling to Treyfeh, 'biased', shoulder-chipped reform jews like Bloomberg, who suggest you must sign a waiver before infecting a newborn with Khassidish'e brand STDs? חלילא וחס! Whats next, trying Tayereh Rabbonim, Helige Mechanchim, Mosrei Nefesh and transmitters of the Mesorah (assuming they teach in Torah Umesora approved schools, otherwise they are automatically teaching counter the Mesorah) for mishkav Zochar on Yeladim, for being Me'anes the Far'dreckine'h Zoineh who talks to boys >while in Bais Yankev<!!! Challilah!


    This blog post has contact information for Dialogue.

  17. @NACHUM
    Metzitza is not performed on deceased infants, but that does not settle the question at all, since circumcising a deceased infant is a mere custom and not an halachic obligation.

  18. Sorry, the Mesora is to follow the best practices of Medicine!

    Mazel Tov to your wife, from her distant cousins in Melbourne Australia

  19. Thanks Yeedle- I was figuring that not doing it proves it's only a health issue, but you have a point.


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