Bava Kamma 46a ~ Injuries from Cows

בבא קמא מו, א

שור שנגח את הפרה ונמצא עוברה בצדה ואין ידוע אם עד שלא נגחה ילדה אם משנגחה ילדה משלם חצי נזק לפרה ורביע נזק לולד וכן פרה שנגחה את השור ונמצא ולדה בצדה ואין ידוע אם עד שלא נגחה ילדה אם משנגחה ילדה משתלם חצי נזק מן הפרה ורביע נזק מן הולד

If a bull gored a cow and its newly-born calf is found dead nearby, and it is not known whether the birth of the calf preceded or followed the goring, half damages are paid for the injuries inflicted upon the cow but only quarter damages are paid for the loss of the calf. If a cow gored a bull and a live calf was found nearby, so that it was unknown whether the birth of the calf preceded or followed the goring, half damages can be recovered out of the value of cow ,and quarter damages out of the  value of her calf. (Bava Kamma 46a.)

BullS vs people: the score so far

The Spanish Matador Victor Barrio was gored to death by a bull in Teruel, Spain last Shabbat. He was buried on Monday.

It's been a tough week for bullfighters. Last week, during the annual festival of running with the bulls in Pamplona, eleven men (including three Americans) were gored.  Meanwhile in the Italian village of Pedreguer near Valencia, a 28-year-old man died after a bull’s horn pierced his lung and heart during a run with the bulls there. Finally, last Shabbat, on the very day that we learned a page of Talmud about bullfighting, Victor Barrio, a 29-year-old professional matador, was killed when a bull’s horn pierced his chest as he competed in a fight in the town of Teruel in the eastern region of Aragon. He was the first matador to die in a bullfight since 1992. As we learned last week, Lorenzo, the 1,000 pound bull would not have been held liable in Jewish law, but this fact didn't help the him. Or his mother.   The killer bull and his mother were slaughtered for meat, because in Spanish tradition, the mother of any bull that kills a human is also destined to be slaughtered, in order to “kill off the bloodline”.  This news seems to make more relevant the talmudic discussions of the liabilities if an ox gores a person. But wait a minute. The opening chapters of Bava Kamma, the tractate currently being studied in the Daf Yomi cycle, focuses heavily on the legal liabilities of an ox that gores. But these were bulls. Is there any difference?

Just what is an ox?

The Hebrew word used in the Talmud is shor - (שור, rhymes with shore). Consider the following verse from Leviticus 22:27:

שור או כשב או עז כי יולד והיה שבעת ימים תחת אמו 

Here are some of the ways it is translated into English:

• When a bull or a goat is born, it shall be seven days under its mother... (Robert Alter. The Five Books of Moses. [Alter seems to have forgotten to translate the word כשב]).

• When an ox or a sheep or a goat is born, it shall be seven days under its mother...(S.R. Hirsch. The Pentateuch, translated into English by Isaac Levy.)

• When any of the herd, or a sheep, or a goat is brought forth, then it shall be seven days under its dam..(The Pentateuch, translated into English by M. Rosenbaum and A.M. Silberman.)

• When an ox or a sheep or a goat is born, it shall stay seven days with its mother...(The JPS Torah Commentary, ed. N. Sarna.)

• When a bullock or a sheep or a goat is brought forth, then it shall be seven days under its dam...(Koren Jerusalem Bible.)

• When a calf, a lamb or a goat is born, it is to remain with its mother for seven days...(New International Version.)

• When a bullock, or a sheep, or a goat, is brought forth, then it shall be seven days under the dam...(King James Bible)

There are more, but you get the point. The word shor (שור) has been translated as a bull, an ox, a calf, a bullock and as a collective, any of the herd.  The Koren Talmud, The ArtScroll Schottenstein Talmud and the Soncino Talmud all translate it as ox.  Confused? Me too.

Here are some of  The Shorter Oxford English Dictionary definitions of an ox:

1. The domestic bovine quadruped (sexually dist. as bull and cow); in common use, applied to the male castrated and used for draught purposes, or reared to serve as food.

2. Zool. Any beast of the bovine family of ruminants, including the domestic European species, the 'wild oxen' preserved in certain parks in Britain, the buffalo, bison, gaur, yak, musk-ox, etc.

In his late nineteenth century translation of the Jerusalem Talmud into French, Moise Schwab translated the word shor as "le bouef" (rather than "le teureau"). De Sola's English translation of the Mishnah, published in 1843, uses the word ox. So does the 1878 compendium by Joseph Barclay, and the first complete English translation of the Talmud, by Michael Rodkinson, published between 1896 and 1903.  The translation of shor as ox is goes back to these early translations, but the suggestion that the meaning of the word is a 'castrated male bovine quadraped' is certainly wrong. Jews are forbidden to castrate their animals, and a castrated bull would have been ineligible to use as a sacrifice. And so we must conclude that the best translation of the word shor (שור) is a bull. 

The delightfully named lecturer Dr. Goodfriend from California State University recently published a lengthy paper (in this book) on the various terms for cattle in the Bible, and the question of whether a castrated bull (a gelding) could have been offered as a sacrifice in the Temple.  The good professor Goodfriend concludes that indeed the prohibition against the castration of animals "would have placed the Israelite farmer at a disadvantage as fewer suitable animals would have been available for his use." One possible way to overcome come this (other than to use cows for ploughing) would have been to import castrated bulls from those who lived outside of Israel.  

“Cow-related trauma is a common among farming communities and is a potentially serious mechanism of injury that appears to be under-reported in a hospital context. Bovine-related head-butt and trampling injuries should be considered akin to high-velocity trauma.”

— Murphy, CG. McGuire, CM. O’Malley, N. Harrington P. Cow-related trauma: A 10-year review of injuries admitted to a single institution. Injury 2010. 41: 548–550.

Injuries from Domestic bulls (and Cows too)

Mechanisms of injury from cows. From Murphy, CG. McGuire, CM. O’Malley, N. Harrington P. Cow-related trauma: A 10-year review of injuries admitted to a single institution. Injury 2010. 41: 548–550.

Injures from bullfighting are hardly surprising, and the Talmud in Bava Kamma does not focus its attention on them. Rather, it addresses injuries from domestic bulls and cows outside of the bull fighting arena. This is made clear in the Mishnah we will learn in the Daf Yomi cycle tomorrow, which discusses injuries caused by a cow. It turns out that these kind of injuries remain common even today. In 2009, orthopedists from Our Lady of Lourdes Hospital in Ireland published a fascinating paper entitled Cow-related trauma: A 10-year review of injuries admitted to a single institution. Over a decade, the hospital admitted 47 people with cow related trauma, most of whom sustained their injuries from kicking (unlike matadors, who suffer from horn related injuries). And next time you feel like walking across a field containing some gentle-looking cows, remember this: one of the patients was admitted with a head injury, a hip fracture and hypothermia after being trampled on by his herd of cattle in a field and found a number of hours later.

“If a bull be a goring bull and it is shown that he is a gorer, and he does not bind his horns, or fasten the bull, and the bull gores a free-born man and kills him, the owner shall pay one-half a mina in money. If he kills a man’s slave, he shall pay one-third of a mina.””

— Code of Hammurabi, Articles 251–252.

In another paper - Blunt Bovine and Equine Trauma - from La Crosse Lutheran Hospital in Wisconsin, researchers provided this illustrative case:

A 57-year-old male was pinned to the ground by a 2,000 pound dairy bull and repeatedly knocked to the ground forcefully at least seven times before he was able to crawl from the pen…Examination revealed the following injuries: bilateral flail chest, 13 rib fractures, bilateral hemopneumothoraces, renal contusion, two forearm fractures, left shoulder dislocation, bilateral scapula fractures, and dental alveolar fractures. The patient was treated by...mechanical ventilation for 15 days…His hospital course was complicated by Klebsiella pneumonia and at 16-month followup he remained severely dyspneic, unable to perform his usual farm work.

Cattle look gentle, and for the most part, they are.  But they are large beasts with incredible strength. Hikers (and farmers) beware.

John Singer Sargent. Shoeing The Ox, 1910. Oil on board. From the collection of the Aberdeen Art Gallery, Aberdeen, Scotland.

Bava Kamma 39a ~ Injuries from Bullfighting

Let's Run with the Bulls

Don't try this at home.  In fact, don't try this anywhere.

As I write these words, the annual Running of the Bulls is taking part in Pamplona, Spain. (According to NPR yesterday, the score was Bulls: 4, People: 0.  The bulls always win, and it's not over yet. There are another seven days of running to go.) Which is a glorious coincidence since we have reached a remarkable passage in the Talmud that addresses the legal liabilities of bulls whose job was to gore people. Here is that passage from a Mishnah which we read in today's Daf Yomi:

 בבא קמא לט, א 

שור האצטדין אינו חייב מיתה שנאמר כי יגח ולא שיגיחוהו

A bull of the arena [that killed a person] is not liable to the death penalty, for the verse states [Ex. 21:28] "If an ox gores" - which implies that an ox that is compelled to gore [is exempt]. (Bava Kamma 39a.)

According to Rashi, bulls were trained to fight against each other (שמיוחד לנגיחות ומלמדין אותו לכך). Tosafot takes it up a notch; back on page 24b Tosafot noted that the bulls were trained to fight people. (.לא דמי לשור האצטדין שהאדם נלחם עמו להורגו) In other words, we are describing a bullfight.

 A Jewish Bullfighter from the Upper West Side

Before we go further, let's frame this liability by watching a video. It is, I am fairly certain, the only video evidence of a lady Jewish bullfighter from New York's Upper West Side. Her name is Rachel Wolf, and her day job is to raise money for Shaare Zedek Hospital in Jerusalem. But here she is, in Peru in 2010, 'fighting' (kinda) a bull (kinda).  Note: No Jews, matadors, or animals were harmed in the making of this video. Listen our for the screams of "Yay Rachel" over the rather cheesy background music.

Now imagine if the still sizable horns on that little bull had met, not the matador's cape, but the matador. Or worse still, Rachel. According to the Mishnah, the bull would not be subject to any penalty, since it was bred to gore, and so did not really do so of its own volition. Which seems rather fair to me. (Sorry, Rachel.)  

Injuries from Bullfighting

Far from a theoretical ruling, the Mishnah addresses a real issue for those countries in which bullfighting is still a national pastime. (I'm talking about you, Spain. And Portugal. And you too, Mexico, Columbia, Ecuador, Venezuela and Peru.)  Not surprisingly, all countries in which bullfighting is practiced continue to see the nasty injuries that result. And I'm not talking about those of the bull. 

In May 2010 Julio Aparicio slipped while fighting this half-ton bull.  The horn of the animal tore into the bullfighter's throat and emerged through his mouth.  Aparicio underwent six hours of surgery; doctors performed an emergency tracheotomy and worked to reconstruct his throat, jaw, tongue and the roof of the mouth. But don't worry. He made a full recovery and returned to the bullfighting arena ten weeks after the goring.  

“A considerable risk of serious, life-threatening injuries is inherent to bullfighting. Penetrating inguinal and perineal trauma with injury to the femoral vessels represents a specific, potentially fatal injury. ”

— Rudloff, U. Gonzalez, V. Fernandez, E. et al. Chirurgica Taurina: A 10-Year Experience of Bullfight Injuries. Journal of Trauma. 2006; 61: 970–974.

In 2005 a group of surgeons published an enticingly titled paper: Chirurgica Taurina: A 10-Year Experience of Bullfight Injuries, based on data collected from the Plaza de Toros Nuevo Progreso, the second-largest bullfighting arena in Mexico. 

Over the ten year study period, 2,328 bullfights  were included. Seven hundred and fifty bull- fighters were identified, of which 68 -that's 9% - required emergency medical care by the surgical trauma service Not surprisingly, the most common site of injury was the lower extremity (55 of 99 injuries), followed by the upper extremity, the groin, the perineum, and the abdomen. And there were some really nasty injuries. "Of the seven perineal injuries" wrote the authors, 

all involved the scrotum with varying degrees of scrotal hematoma and avulsion of the scrotal skin leaving the testicle bare in one case. There was one case of rectal perforation requiring a diverting colostomy. Of the five abdominal injuries, two breached the peritoneum causing bleeding from the small bowel mesentery in one case, and prolapse of the omentum in the other. In two other cases the bullfighters had separate wounds of entry and exit caused by the horn which had passed tangentially through the layers of the abdominal wall...

Another paper, Bullhorn and Bullfighting Injuries, reported on fifteen bullfighting injuries. Here they are:

 From Garcia-Marin, A. Turegano-Fuentes, F.  Sanchez-Artega A et al.  Bullhorn and Bullfighting Injuries.  Eur J Trauma Emerg Surg (2014) 40:687–691. 

A Jewish Bullfighter from the Fifteenth Century

The fact that the Mishnah addresses the liability of a bull that injures or kills in the arena suggests that Jews were indeed involved in the business of bullfighting. But through the centuries this Jewish involvement seems to have been rare.  Evidence for this is found in a manuscript in the British Museum. It was written sometime in the fifteenth century, and it parodies a bullfight in which Jews appear as both spectators and participants.  In a paper analyzing the parody, Elena Lourie notes that the point of the poem was

clearly to ridicule the Jews and their cowardice when confronted by a brave and ferocious bull...Although fourteenth and early fifteenth-century records reveal the presence of three or four Jewish lion tamers in Saragossa and Pamplona, entrusted with the keeping of the king's lions...there can be no doubt that they were oddities and that the very notion of Jews engaged in bullfighting went against the canon of what was considered proper and was intended to strike the reader as a thing, in itself, ridiculous and grotesque.

...And one from the Twentieth Century

Aside from Rachel, I know of only one other Jew who entered the arena - the professional matador Sidney Franklin (1903-1976). Franklin, who wrote an autobiography Bullfighter from Brooklyn, left New York (and his orthodox Jewish upbringing) in 1922, and moved to Mexico City, where he started his career as a professional bullfighter.  Ernest Hemingway was rather impressed with the Jewish matador from Brooklyn; he wrote a chapter about Franklin in Death in the Afternoon, and included pictures of Franklin at work in the arena. Let's end with Hemingway's description of Franklin at work:

Franklin is brave with a cold, serene and intelligent valor but instead of being awkward and ignorant he is one of the most skillful, graceful and slow manipulators of a cape fighting today. His repertoire with the cape is enormous but he does not attempt by a varied repertoire to escape from the performance of the veronica as the base of his cape work and his veronicas are classical, very emotional, and beautifully timed and executed. You will find no Spaniard who ever saw him fight who will deny his artistry and excellence with the cape...He is a better, more scientific, more intelligent, and more finished matador than all but about six of the full matadors in Spain today and the bullfighters know it and have the utmost respect for him.

“שוורים שמשחקין בהן ומלמדין אותן ליגח זה את זה אינם מועדים זה לזה. ואפילו המיתו את האדם אינן חייבין מיתה שנאמר כי יגח לא שיגיחוהו
Bulls that are taught to gore one another and that are used in tournaments are not considered to be ‘warned.’ Even if such a bull kills a person it is not liable to the death penalty...”

— רמב"ם משנה תורה הל׳ נזיקי ממון פרק ו ,ה

Next time on Talmudology: Injuries from Cows.

Bava Kamma 35a ~ Analgesia for Animals

בבא קמא לה, א

ההוא תורא דהוה בי רב פפא דהוה כיבין ליה חינכיה עייל ופתקיה לנזייתא ושתי שיכרא ואיתסי

There was an ox in the house of Rav Pappa that had a toothache. It went inside, pushed the cover off a beer barrel, drank the beer, and was healed.

Descartes on Animal Pain

The silly notion that animals do not feel pain is widely thought to have originated with the French philosopher Rene Descartes (1596-1650). "They eat without pleasure, cry without pain, grow without knowing it; they desire nothing, fear nothing, know nothing". While these words were those a student of Descartes, the contemporary philosopher Peter Harrison notes that they are generally thought to capture the essence of Descartes' view of animals. "The father of modern philosophy" continues Harrison, "is credited with the opinion that animals are non-sentient automata, an opinion for which over the centuries he has been ridiculed and vilified."

“To be able to believe that a dog with a broken paw is not really in pain when it whimpers is a quite extraordinary achievement, even for a philosopher.”

— John Cottingham. "A Brute to the Brutes?' Descartes's Treatment of Animals. Philosophy 1978; 53; 551-559.

Scientists Ignoring Animal Pain

Vivisection of a dog. From J. Walaeus. Epistola Prima de Motu Chyli et Sanguinis (1647).

The debate as to Descartes' true view is fascinating, but need not detain us. What is certain is that the pain that animals undoubtedly feel was either denied as existing, or overlooked for centuries by scientists.  Animals were used for experiments of the most horrendous kind in the names of science, even when the pain was evident to those who were causing it. Here, for example, is the French physiologist Claude Bernard (d. 1878), who felt that without vivisection, 'neither physiology not scientific medicine is possible': 

A physiologist is not a man of fashion, he is a man of science, absorbed by the scientific idea where he pursues: he no-longer hears the cry of animals, he no-longer sees the blood that flows, he sees only his idea...no anatomist feels himself in a horrible slaughter house; under the influence of a scientific idea, he delightfully follows a nervous filament through stinking livid flesh, which to any other man would be an object of disgust and slaughter.

“It is sometimes said that people in the seventeenth century had no motion of cruelty to animals and Descartes even argued that animals are mere machines, incapable of feeling pain. It is also said there was so much cruel treatment of one human being by another in the seventeenth century that what was done by the vivisectionists to animals would scarcely have seemed horrendous. ”

— David Wootton. Bad Medicine. Oxford University Press 2006. 108-109.

Do Fish Feel Pain? - Yes!

The tropical Zebrafish grow to about 2.5 inches in length.  And they don't like pain.

Rav Pappa's ox sought out pain relief from beer, but recent evidence has shown that it's not just oxen who like to have their pain relieved.  So do fish.  In a paper in the The Journal of Consciousness Studies, Lynn Sneddon demonstrated that not only can fish feel pain, but that they are willing to pay a cost to get pain relief. Zebrafish, like humans, prefer an interesting environment to a boring one. When given a choice, these fish swim in an enriched tank with vegetation and objects to explore, rather than in one that is bare. With me so far? OK. Next, Sneddon, from the University of Liverpool in the UK, injected the tails of the zebrafish with acetic acid, which no doubt annoyed them, but did not cause any change in their preference for the interesting tank over the one that was bare.  Finally, she injected the fish with acetic acid, but added a painkiller into the water of the bare tank. This time, the fish chose to swim into the bare but drug filled tank. Fish who were injected with saline as a control remained in the enriched tank and did not swim into the drug enhanced bare tank.  The conclusion: zebrafish are willing to pay a cost in return for getting relief from their pain. Similar observations have been made in rodents too; when in pain, they will self administer analgesics, preferring to drink analgesic dosed water or eat dosed food when presented with a choice. 

Defining Animal Pain

In the scientific world there was  - and perhaps still is -  a debate about the nature of pain that animals may feel.  Sneddon, the fish physiologist, wrote that if we are to conclude that animals experience pain in a way similar to humans, then (1) "animals should have the apparatus to detect and process pain; (2) pain should result in adverse changes in behavior and physiology; and (3) analgesics (painkillers) should reduce these responses..." Thanks to advances in microscopy and physiology, today we know that animals have many of the anatomical features (like nerves that transmit the pain stimulus) needed to process pain.  

The Ox of the House of Rav Pappa

Rav Pappa's ox demonstrated the second and third of Sneddon's features: pain changed the behavior of the ox (off it trotted to find pain relief ), and analgesia, (in this case beer) indeed reduced the pain response.  Of course we are left wondering how it was known that the ox of the house of Rav Pappa specifically had a toothache, (and not say sinusitis or a bad migraine), but based on what we know about the ways in which fish and rodents will seek out an environment in which painkillers are available, the story is no where near as fanciful as we might suspect.  

קיצור שולחן ערוך - קצא

אָסוּר מִן הַתּוֹרָה לְצַעֵר כָּל בַּעַל חָי. וְאַדְּרַבָּא, חַיָב לְהַצִּיל כָּל בַּעַל-חַי מִצַּעַר 

It is forbidden to cause pain to any living creature. In fact a person is required to save any living creature from pain...(Abbreviated Code of Jewish Law by Shlomo Ganzfreid, 1864).

Bava Kamma 32a ~ Liability for Intimate Injuries

בבא קמא לב,א

בעא מיניה רבה בר נתן מרב הונא המזיק את אשתו בתשמיש המטה מהו כיון דברשות קעביד פטור או דלמא איבעי ליה לעיוני

Rabbah bar Nassan asked Rav Huna this question: If a man injured his wife during sexual intercourse, what is the law regarding his liability? Do we say that since he is acting with permission of his wife, he is not liable? Or perhaps we say that he should have been more careful to avoid injuring his wife, and therefore he is liable to pay her damages? (Bava Kama 32a)

In the daf we will learn tomorrow, the Talmud records a series of legal precedents to help decide this perplexing question, and concludes that a wife does not have any legal culpability in causing her injury, however active or passive she may have been. Therefore, the husband is legally deemed responsible for damages and must compensate his wife, which is codified in the authoritative Code of Jewish Law (שולחן ערוך אבן העזר סימן פג ,ב).

Intimate Injures in the Medical Literature

The Talmud’s case discussion is not simply theoretical. Injuries during consensual sexual intercourse are not uncommon, and over the years I’ve treated several in the emergency department. Because of sexual taboos however, the amount of scientific knowledge in this area has been very limited, particularly regarding the female. In one (very small) study, about 5% of women reported an injury after consensual intercourse, compared with 41% of the woman who were forced to have non-consensual intercourse.

A more recent study from the University of Manchester in England evaluated genital injuries in a cohort of 68 women who had recently had consensual penile-vaginal intercourse, and compared them with a group of 500 women who had been victims of non-consensual penile-vaginal intercourse. Of the 68 women, one (1%) had a single injury, and three (4%) had more than one injury.  One woman had a laceration, another had an abrasion, and a third had bruising.  The posterior fourchette was the most commonly injured area both in women who had consensual intercourse and those in whom intercourse was not consensual. 

Another study, from emergency medicine researchers, looked at the rates of genital injury in adolescents (aged 13-17) who had either consensual (51 women) or non-consensual (204 women) sexual intercourse. They found rates far higher than the Manchester study: anogenital trauma was documented in 73% of adolescent females after consensual sexual intercourse (versus 85% of victims of sexual assault). The researchers helpfully add that several predisposing factors have been suggested: “first coitus, rough or hurried coitus, intoxication, variant coital positions, anatomical disproportion, mental factors (fear of discovery), postmenstrual state, and clumsiness.” (Really. Clumsiness.)

Men Too

Rabbah bar Nassan’s legal question concerned only the husband causing damage to his wife, and does not address another kind of coital injury: that caused of husband.  One of these injuries is a penile fracture, and over the last six decades about 1,330 cases have been reported in 183 medical publications. I’ve treated these too. But don’t worry: they are a lot worse than they already sound. Sexual intercourse is the most common cause, and inexplicably, “more than half of the [reported] cases are from Mediterranean countries including Turkey.” Here, for example, is a case in the Asian Journal of Urology published last June:

A 54-year-old male presented to the emergency department with penile injury. The trauma occurred when the patient was having sexual intercourse with his wife at around 2 o’clock in the early morning. His wife kneeled forward and he penetrated from behind. The patient then accidentally collided his penis into his wife’s buttocks. He felt a popping sensation and reported rapid detumescence followed by severe penile pain and hematoma formation.

And here are the causes and complications of a fracture of the penis in 32 unhappy men treated in the Department of Urology in Tehran.

Asgari, MA. Hosseini, SY. Safarinejad, MR. et al. Penile  Fractures: Evaluation, therapeutic approaches and long-term results. The Journal of Urology 1995: 155; 148-149. 

Rabbah bar Nassan asked only about the rights of a wife to claim compensation for intimate injuries from her husband. But he might well have asked the question about compensation for the husband. In this age of equality, it seems only fair.

שולחן ערוך אבן העזר הלכות כתובות סימן פג סעיף ב 

המזיק את אשתו בתשמיש המטה, חייב בנזקיה