By Rabbi Michael Leo Samuel
CHULA VISTA, California –Every custom has a remarkable history and story.
In dealing with someone who has an unusual seminal discharge, the Torah defines that person as being ritually and ceremonially “impure” and is called a “zab” (cf. Lev. 15:8). Historically, such persons often experienced being shunned by the general community—a point that Josephus personally witnessed.[1]
The medieval commentator, Abraham Ibn Ezra, takes a different tact. According to him, if the zäb wants to diminish the severity of his impurity, all he has to do is thoroughly wash his hands. Once he does so, if his hands touch another person’s food, the food does not become ritually impure.[2] The zäb’s hands still convey impurity, but at least the clothes of the person he touches would not require laundering and anyone touching him would only require ritual bathing in a spring of water.
In light of Ibn Ezra’s important insight, let us look at his interpretation through the prism of medical science history.
Many people today understand the importance of hand-washing and how it is especially important for people to wash their hands with a disinfectant whenever one visits or takes care of someone who is ill. Although such protocol is essential for medical hygiene, there was a time when our ancestors undervalued hand-washing—much to their peril.
Once there was a Hungarian obstetrician-gynecologist named Ignaz Phillips Semmelweiss (1818–1865), whose serendipitous medical discovery in a Vienna hospital changed the practice of medicine forever.
Hospitals in the 19th century hospitals barely resembled the kind of hospitals we have today and take for granted. Back in 1846, Dr. Semmelweiss joined one of the most prestigious medical staffs in the European world. When he arrived, he discovered a virulent infection that led to an astounding 45% mortality rate among those who underwent surgery. New mothers were faced with a 25% death rate. Bear in mind, this was before Louis Pasteur discovered the Streptococcus bacteria that was responsible for childbed fever back in 1878. Medical science did not discover penicillin until 1928.
Within a month of his arrival at the famous Viennese hospital, Semmelweiss discovered that 36 out of 208 women died following the delivery of a baby, a mortality rate of 17 percent. One maternity ward in particular, suffered from 451 infectious-related deaths, while a second maternity ward lost only 90 women. He wondered about why was there such a discrepancy.
One day, he came across an expectant mother, who was crying because the Hospital administration assigned her to the medical students’ ward, instead of the midwives’ ward. Everyone knew that the students’ ward had a much higher mortality rate, and to be assigned there was tantamount to a death sentence. Soon, the woman died.
In 1847, a friend of Semmelweiss had a accidentally cut himself with a scalpel while performing an autopsy upon a woman who had died from “childbed fever.” Semmelweiss’s friend soon died shortly afterwards. After personally attending his friend’s autopsy, to Semmelweiss’s surprise, he observed the lesions on his friend’s body were exactly the same as the lesions seen on the women dying from childbed fever.
The pieces of the puzzle finally came together. Semmelweiss realized that the same substance was apparently being introduced into women after childbirth by the hospital physicians and students who examined them with unwashed hands immediately after performing autopsies on the victims of childbed fever. Before then, many causes of the malady were sought, including mother’s milk, foreign doctors, fear, and medical student incompetence.
The notion clicked that maybe the reason the death rate was so high on the students’ ward was that they were participating in autopsies, and not because they were incompetent. The midwives were not studying medicine, so they did not attend the autopsies. Semmelweiss excitedly ordered all the students and doctors to wash their hands thoroughly with a calcium chloride solution and clean sand after each autopsy. The death rate fell from one out of six to one out of 100 within a year.
Shortly thereafter, an outbreak of sepsis occurred on the ward, killing 11 out of 12 women. This outbreak began after a pregnant woman with infected cervical cancer was assigned to the first bed in the row. Realizing that the infective material must have spread from this woman, Semmelweiss insisted that all the physicians and students not only wash their hands after autopsies, but between patients on the ward. Later he also isolated the badly infected cases. By 1848 the mortality rate was so low on these wards that during one month no death from childbed fever was reported.
Throughout these events, Semmelweiss made plenty of enemies. People found his personality to be difficult; he was also moody, unstable, and arrogant. Furthermore he was ordering physicians to perform novel, burdensome sanitary techniques, and there was great opposition. He bluntly called his opponents to these hand-washing techniques “murderers.” Conflicts with his supervisors and peers led to his dismissal in 1850.
Hand washing ceased at the Vienna hospital, and the death rate once again soared. The hospital pressure proved to be too difficult for him to handle. In 1865, at 47 years of age, he entered a mental institution. When he arrived, he noticed he had accidentally cut himself from his most recent obstetrical operation. A few days later he died, ironically, of childbed fever.
The moral of this anecdote is to highlight, that one of the most brilliant intuitions of the Torah, is the laws governing bodily hygiene. With new appreciation, we can say and perhaps understand literally, the oft-cited passage found in the Book of Proverbs: “She is a tree of life to those who grasp her, and he is happy who holds her fast” (Proverbs 3:18).
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Rabbi Samuels is spiritual leader of Temple Beth Sholom in Chula Vista. He may be contacted at michael.samuel@sdjewishworld.com