Sotah 42~ Goliath, Polydactyly and Hereditary Gigantism

 

On today’s long page of Talmud, we read how the rabbinic imagination described the giant Goliath. It was Goliath who, you will recall, was smitten by a slingshot from David, the future King of Israel. The rabbis of the Talmud painted quite the picture of this not so gentle giant. While Goliath himself was “unblemished”, his mother cohabited with one-hundred men (plus one dog) or possibly even more, and when doing so she engaged in all manner of sexual positions.

סוטה מב, ב

״וַיֵּצֵא אִישׁ הַבֵּינַיִם מִמַּחֲנוֹת פְּלִשְׁתִּים וְגוֹ׳״. מַאי ״בֵּינַיִם״? אָמַר רַב: שֶׁמְּבוּנֶּה מִכל מוּם. וּשְׁמוּאֵל אָמַר: בֵּינוֹנִי שֶׁבְּאֶחָיו. דְּבֵי רַבִּי שֵׁילָא אָמַר: שֶׁהוּא עָשׂוּי כְּבִנְיַן. רַבִּי יוֹחָנָן אָמַר: בַּר מְאָה פָּפֵי וַחֲדָא נָאנָאי.

The verse introduces Goliath: “And a champion [ish habeinayim] went out from the camp of the Philistines, named Goliath” (I Samuel 17:4). The Gemara asks: What is indicated by the term beinayim? Rav said: The word is related to the root beit, nun, heh, meaning build, and means that he is built [muvneh] perfectly and free of any blemish. And Shmuel said: The word is related to the word bein, meaning between, and means that he was the middle [beinoni] among his brothers. A Sage from the school of Rabbi Sheila said: The word is related to the root beit, nun, heh, meaning build, and means that he was made strong as a building [binyan]. Rabbi Yochanan said: The word is related to the word bein, meaning between, and means that he was born from among many, as follows: He was the son of one hundred fathers [pappi] and one dog [nanai], as his mother engaged in sexual intercourse with one hundred men and a dog, and he was fathered from among them.

״וְגלְיָת שְׁמוֹ מִגַּת״. תָּנֵי רַב יוֹסֵף: שֶׁהַכֹּל דָּשִׁין אֶת אִמּוֹ כְּגַת. כְּתִיב ״מַעֲרוֹת״, וְקָרֵינַן ״מַעַרְכוֹת״. תָּנֵי רַב יוֹסֵף: שֶׁהַכֹּל הֶעֱרוּ בְּאִמּוֹ

The verse recounts that he was “named Goliath, of Gath” (I Samuel 17:4). Rav Yosef taught: This is because everyone would thresh his mother by cohabiting with her like people do in a winepress [gat], where everyone tramples. It is written that Goliath came from “the caves [me’arot] of the Philistines” (I Samuel 17:23), but we read, according to the Masoretic text: He came from among “the ranks [ma’arkhot] of the Philistines.” What is meant by the written term me’arot? Rav Yosef taught: The word is related to the word he’era, meaning penetrated, and implies that everyone penetrated [he’eru], i.e., engaged in sexual intercourse with, his mother.

כְּתִיב ״הָרָפָה״, וּכְתִיב ״ערְפָּה״, רַב וּשְׁמוּאֵל חַד אָמַר: ״הָרָפָה״ שְׁמָהּ, וְלָמָּה נִקְרָא שְׁמָהּ ״ערְפָּה״ — שֶׁהַכֹּל עוֹרְפִין אוֹתָהּ מֵאַחֲרֶיהָ, וְחַד אָמַר: ״ערְפָּה״ שְׁמָהּ, וְלָמָּה נִקְרָא שְׁמָהּ ״הָרָפָה״ — שֶׁהַכֹּל דָּשִׁין אוֹתָהּ כְּהָרִיפוֹת, וְכֵן הוּא אוֹמֵר: ״וַתִּקַּח הָאִשָּׁה וְתִפְרֹשׁ הַמָּסָךְ עַל פְּנֵי הַבְּאֵר וַתִּשְׁטַח עָלָיו הָרִפוֹת״. וְאִי בָּעֵית אֵימָא מֵהָכָא: ״אִם תִּכְתּוֹשׁ אֶת הָאֱוִיל בַּמַּכְתֵּשׁ בְּתוֹךְ הָרִיפוֹת בַּעֱלִי״.

It is written that Goliath’s mother was: “Harafa” (II Samuel 21:16), and in another place it is written: “Orpah” (Ruth 1:4), and the Gemara will soon explain that this was the same woman. Rav and Shmuel engaged in a dispute concerning this matter. One of them said: Her name was Harafa, and why is she called by the name Orpah? It is because everyone came at her from behind [orfin] her, i.e., sodomized her. And one of them said: Her name was Orpah, and why is she called by the name Harafa? It is because everyone threshed her like groats [harifot], i.e., engaged in sexual intercourse with her, and so it says that this word means groats: “And the woman took and spread the covering over the well’s mouth, and strewed groats [harifot] thereon” (II Samuel 17:19). And if you wish, you can say from here: “Though you should crush a fool in a mortar with a pestle among groats [harifot], yet will not his foolishness depart from him” (Proverbs 27:22).

״וְאֶת אַרְבַּעַת אֵלֶּה יֻלְּדוּ לְהָרָפָה בְּגַת וַיִּפְּלוּ בְיַד דָּוִד וּבְיַד עֲבָדָיו״. מַאי נִינְהוּ? אָמַר רַב חִסְדָּא: סַף וּמָדוֹן גלְיָת וְיִשְׁבִּי בְּנוֹב.

The Gemara continues its discussion of the battle of David and Goliath. “These four were born to Harafa in Gath; and they fell by the hand of David, and by the hand of his servants” (II Samuel 21:22). The Gemara asks: What are the names of the four siblings mentioned here? Rav Chisdah said: They are Saph, and Madon, Goliath, and Ishbi in Nob (see II Samuel 21:16–20).

״וַיִּפְּלוּ בְיַד דָּוִד וּבְיַד עֲבָדָיו״, דִּכְתִיב: ״וַתִּשַּׁק ערְפָּה לַחֲמוֹתָהּ וְרוּת דָּבְקָה בָּהּ״. אָמַר רַבִּי יִצְחָק, אָמַר הַקָּדוֹשׁ בָּרוּךְ הוּא: יָבוֹאוּ בְּנֵי הַנְּשׁוּקָה, וְיִפְּלוּ בְּיַד בְּנֵי הַדְּבוּקָה. דָּרֵשׁ רָבָא: בִּשְׂכַר אַרְבַּע דְּמָעוֹת שֶׁהוֹרִידָה ערְפָּה עַל חֲמוֹתָהּ — זָכְתָה וְיָצְאוּ מִמֶּנָּה אַרְבָּעָה גִּבּוֹרִים, שֶׁנֶּאֱמַר: ״וַתִּשֶּׂנָה קוֹלָן וַתִּבְכֶּינָה עוֹד״,

It says: “And they fell into the hands of David and his servants.” Why? It is because of the acts of their forebears, as it is written: “And Orpah kissed her mother-in-law, and Ruth cleaved to her” (Ruth 1:14). Rabbi Yitzchak says: The Holy One, Blessed be He, said: The children of the one who kissed, referring to the four giants descended from Orpah, will come and fall into the hand of the children of the one who cleaved, referring to David, who was descended from Ruth. Rava taught: As a reward for the four tears that Orpah shed in sadness over her mother-in-law, she merited four mighty warriors descended from her, as it is stated: “And they lifted up their voice and wept again” (Ruth 1:14).

כְּתִיב: ״חֵץ חֲנִיתוֹ״, וְקָרֵינַן ״עֵץ חֲנִיתוֹ״. אָמַר רַבִּי אֶלְעָזָר: עֲדַיִין לֹא הִגִּיעָנוּ לַחֲצִי שִׁבְחוֹ שֶׁל אוֹתוֹ רָשָׁע. מִכָּאן שֶׁאָסוּר לְסַפֵּר בְּשִׁבְחָן שֶׁל רְשָׁעִים. וְלָא לִפְתַּח בֵּיהּ כְּלָל! לְאוֹדוֹעֵי שְׁבָחֵיהּ דְּדָוִד.

It is written about Goliath: “And the half [chetz] of his spear was like a weaver’s beam” (I Samuel 17:7), and we read, according to the Masoretic tradition: “And the shaft [etz] of his spear.” Rabbi Elazar says: The written version of the text demonstrates that we have not yet reached half [chrtzi] of the praise of that wicked man. Only half of his spear was as long as a weaver’s beam, but the Masoretic reading offers a less impressive description. It is learned from here that it is prohibited to relate the praise of wicked people. The Gemara asks: If so, then the verse should not begin by praising him at all. The Gemara answers: It was necessary in this case in order to relate the praise of David, who defeated Goliath.

Let’s leave these imaginative rabbinic interpretations and read what the Bible itself has to say. In the Book of Samuel, the height of Goliath is described “six cubits and a span.” He was covered with armor, and his appearance was so awesome that none of the Israelites dared to fight against him. Until David showed up:

וַיֹּאמֶר֮ דָּוִד֒ יְהֹוָ֗ה אֲשֶׁ֨ר הִצִּלַ֜נִי מִיַּ֤ד הָֽאֲרִי֙ וּמִיַּ֣ד הַדֹּ֔ב ה֣וּא יַצִּילֵ֔נִי מִיַּ֥ד הַפְּלִשְׁתִּ֖י הַזֶּ֑ה {ס} וַיֹּ֨אמֶר שָׁא֤וּל אֶל־דָּוִד֙ לֵ֔ךְ וַיהֹוָ֖ה יִהְיֶ֥ה עִמָּֽךְ׃

The Lord,” David went on, “who saved me from lion and bear will also save me from that Philistine.” “Then go,” Saul said to David, “and may the Lord be with you!”

And you probably already know the end of the story:

וַיֶּחֱזַ֨ק דָּוִ֤ד מִן־הַפְּלִשְׁתִּי֙ בַּקֶּ֣לַע וּבָאֶ֔בֶן וַיַּ֥ךְ אֶת־הַפְּלִשְׁתִּ֖י וַיְמִתֵ֑הוּ וְחֶ֖רֶב אֵ֥ין בְּיַד־דָּוִֽד׃

Thus David bested the Philistine with sling and stone; he struck him down and killed him. David had no sword;

וַיָּ֣רץ דָּ֠וִ֠ד וַיַּעֲמֹ֨ד אֶל־הַפְּלִשְׁתִּ֜י וַיִּקַּ֣ח אֶת־חַ֠רְבּ֠וֹ וַֽיִּשְׁלְפָ֤הּ מִתַּעְרָהּ֙ וַיְמֹ֣תְתֵ֔הוּ וַיִּכְרת־בָּ֖הּ אֶת־רֹאשׁ֑וֹ וַיִּרְא֧וּ הַפְּלִשְׁתִּ֛ים כִּי־מֵ֥ת גִּבּוֹרָ֖ם וַיָּנֻֽסוּ׃

So David ran up and stood over the Philistine, grasped his sword and pulled it from its sheath; and with it he dispatched him and cut off his head. When the Philistines saw that their warrior was dead, they ran.

Pierre Puget (1620-1694). David Gazing at Goliath's Head. From the collection of  the Museum of Civilization, Quebec City, Canada. 

Goliath certainly stuck fear into all he met. But why was he so tall, and did this have anything to do with David’s ability to knock him out with his slingshot? Today, Talmudology answers these pressing questions.

Other Giants in the Bible

Before we proceed, we should note that Goliath’s gigantism was not the only example of its kind in the Bible. Giants first appear in Bereshit, as a sort of super-hero:

בראשית 6:4

הַנְּפִלִ֞ים הָי֣וּ בָאָ֘רֶץ֮ בַּיָּמִ֣ים הָהֵם֒ וְגַ֣ם אַֽחֲרֵי־כֵ֗ן אֲשֶׁ֨ר יָבֹ֜אוּ בְּנֵ֤י הָֽאֱלֹהִים֙ אֶל־בְּנ֣וֹת הָֽאָדָ֔ם וְיָלְד֖וּ לָהֶ֑ם הֵ֧מָּה הַגִּבֹּרִ֛ים אֲשֶׁ֥ר מֵעוֹלָ֖ם אַנְשֵׁ֥י הַשֵּֽׁם׃ {פ}

It was then, and later too, that the Nephilim appeared on earth—when divine beings cohabited with the human women, who bore them offspring. Such were the heroes of old, the men of renown.

The exact relationship between the various races of biblical giants is a little hard to follow. The Nephilim (Numbers 13:32-33), are found before and after the flood. The Emites, the Ammonites (or Anakites) and the Rephaim (Deuteronomy 2:10-11), existed only after the Flood, and they appear to be separate entities. Here is a quick recap:

The Anakim seem to be derived from the Nephilim. The Rephaim although similar to the Nephilim, appear to be distinct from them with respect to family lineage. Deuteronomy 2.21 states the Rephaim were largely subdued by the Ammonites which ‘dwelt in their stead’ One of the most prominent Rephaim was Og, King of Bashan, who slept in ‘a bedstead of iron; nine cubits was the length, and four cubits the breadth of it’ (Deuteronomy 3:11). A cubit was the distance from the elbow to the fingertips. He appears to be one of the last survivors of the Rephaim.

Now if there is a race of giants, then we are dealing with some hereditary element. Some believe that the cause of this gigantism was “hyperthyroidism, possibly due to underlying pituitary gland, or other endocrine, dysfunction.”

In 2014, two medical geneticists suggested that Goliath and his close kin likely had a hereditary autosomal dominant pituitary gene. First, they reconstructed Goliath’s family tree, based on the descriptions given in both the Book of Samuel and Divrie Hayomim, the Book of Chronicles:

 

From Donnelly and Morrison. Hereditary Gigantism – the biblical giant Goliath and his brothers. Ulster Med J 2014;83(2):86-8.

 
 

From Donnelly and Morrison. Hereditary Gigantism – the biblical giant Goliath and his brothers. Ulster Med J 2014;83(2):86-88.

 

Not all of the sons of Goliath are identified. His third son is not named, and so in the family tree above, the geneticists called him Exadactylus because “he had on every hand six fingers, and on every foot six toes. (Samuel II, 21:20-21). This family tree suggests an inherited cause, or in medicalese, “a hereditary autosomal dominant pituitary gene, such as AIP,” where AIP is the gene for aryl hydrocarbon receptor-interacting protein. Other studies have shown that a mutation in this gene causes familial isolated pituitary adenoma (FIPA). Normally, the pituitary gland makes and then stops making growth hormone (GH). FIPA is a non-cancerous growth in the pituitary gland that causes it to make way too much GH. As a result, the bones and organs keep receiving the signal to grow and grow more. Hence gigantism, or in medicalese, acromegaly.

Sultan Kösen in 2010.

And here is a fun fact about acromegally. A Kurdish farmer named Sultan Kösen who was born in 1982 is the current Guinness World Record holder for tallest living male. He is 251 cm tall (and for you non-metric folks, that’s 8 feet 2.82 in). He had a pituitary tumor, and in 2010 doctors at the University of Virginia zapped the tumor in Kosen's pituitary gland to stop its excess production of growth hormone.

Now back to our medical geneticists, with their helpful explanation:

Pituitary adenomas can be present in a number of genetic conditions, such as multiple endocrine neoplasia type 1, Carney complex, and Familial Isolated Pituitary Adenoma (FIPA). FIPA is an autosomal dominant condition with incomplete penetrance, caused by germline mutations of the aryl hydrocarbon receptor interacting protein (AIP) gene4. Patients with AIP mutations have an earlier mean age at diagnosis than AIP mutation-negative patients. The age of Goliath is not clear, but early onset of pituitary tumours is typical of hereditary gigantism and limitation of lateral vision is common. Goliath himself had a shield bearer precede him, possibly to indicate to Goliath the direction of the approaching foe.

And this condition also explains why Goliath didn’t see that sling shot coming:

Goliath was killed by David who threw a stone at his forehead (Samuel 17:49). This gives further evidence that he suffered from pituitary gland dysfunction; a pituitary tumour pressing on his optic chiasm, and consequent visual disturbance due to pressure on his optic nerve, would have made it difficult for him to see the stone in his lateral vision. Pituitary giants look impressive in terms of stature, but may not have speed and agility to match their perceived strength.

In conclusion, Goliath may have had an AIP mutation causing early onset autosomal dominant pituitary gigantism and one of his sons may have had a syndrome involving both AIP and BBS1, which could some way account for the physical characteristics of his family and their good success rate on the battle field until they met David.
— From Donnelly and Morrison, op cit.

And what about the six fingers and six toes of Goliath’s unnamed son? We have discussed polydactyly before, when we noted Rav Hiyyah bar Ashi’s helpful ruling that “if a slave had an extra finger and his master cut it off, the slave is freed on account of this act. Rav Huna said this only applies if the extra finger is in line with the others [lit. counted alongside the hand],” but in Goliath’s family the polydactyly is a bit of a mystery:

Polydactyly has not been described in association with FIPA. The AIP gene lies on chromosome 11q13.3. The Bardet-Biedl gene, BBS1, is located close by on chromosome 11q13.2. Bardet-Biedl syndrome type I is characterized by rod-cone dystrophy, truncal obesity, cognitive impairment and postaxial polydactyly. The protein encoded by BBS1 is thought to play a role in limb development. It is unlikely that Goliath’s family had FIPA caused by a microdeletion which also involved BBS1, as the genetic distance between the BBS1 and AIP genes is separated by a 1 Mb gene- packed region. Such a gap makes an inherited contiguous gene syndrome unlikely as there would have been too many other features. Very rarely BBS1 patients have symmetric exadactyly; most commonly it is present in one or two extremities, upper and lower - not in all four.

We are not given much other detail about Exadactylus so a new BBS1 mutation due to some complex rearrangement is unlikely – a new mutation in an autosomal dominant polydactyly gene might explain his symmetrical phenotype. If he had pituitary disease and six digits – he may have looked an intimidating foe - but he may not have been a great warrior in action.

Roman Acromegally

Hereditary acromegaly. It’s not just for the Philistines. It can be found in the family of the Roman Emperor Maximinus Thrax (173-238). [Really. That is his name. He’s not a character from Asterix and Obelisk.] In a 2019 paper an international medical team suggested that the emperor (who was assassinated by his own troops during the siege of Aquileia in May 238) had “an endocrine disorder caused by a tumour in the anterior pituitary gland secreting an excess of growth hormone (GH) causing elevated insulin-like growth factor (IGF-1) levels before puberty (prepubertal gigantism).” And it wasn’t only the emperor. The authors believe that his son Gaius Iulius Verus Maximus (217/220-238), was affected by the same disorder. This suggestion is supported by a passage in the Historia Augusta [XXVII.2] which describes Gaius in this way:

He gave such promise of height, moreover, that he might have reached his father’s stature [proceritatis videbatur posse illius esse, ut ad paternam staturam perveniret] had he not perished in his twenty-first year, in the very flower of his youth, or, as some say, in his eighteenth.”

The medical team continued:

“Even though concise, the source reveals two decisive elements: firstly, the emperor’s son was much taller than average and, secondly, he was still growing despite having already reached the postpubertal age. If he had not perished prematurely, he would have most likely reached his father’s stature. Besides the phenotypical descriptions provided by this classical source, Gaius Iulius Verus Maximus’ facial morphology, as can be appreciated on minted coins does reinforce the hypothesis that he also suffered from acromegalic gigantism, potentially of a hereditary nature. This is characterized by early-onset excessive acceleration of linear growth and body size caused by a pituitary somatotroph or lactosomatotroph adenoma. Patients who present with acromegalic gigantism show such phenotypical characteristics as coarse facial features, frontal bossing, prognathism, increased interdental space, diastema, as well as marked enlargement of hands and feet, soft tissue swelling and increased appetite. Insufficiency of other pituitary hormones, because of the presence of a pituitary macroadenoma compressing normal anterior pituitary structures, may result in central hypogonadism, hypothyroidism and hypocortisolism. The epiphysial growth plates will not close due to untreated hypogonadism leading to continuous growth, even after the age at which normal persons reach puberty. Mutations of the aryl hydrocarbon receptor interacting protein (AIP) are at present the most frequent mutations causing pituitary gigantism.

Gaius Iulius Verus Maximus denarius, son of Maximinus.

So there it is. From a couple of biblical verses and a brief excerpt from a Roman history book we can learn so much about the natural causes of Goliath’s height.

Had enough acromegaly for now? OK. Next time, in our last post of this most fascinating masechet , we will discuss talmudic embryology.

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Sotah 40a ~ Gratitude is Good for You

סוטה מ, א

בזמן ששליח צבור אומר מודים העם מה הם אומרים אמר רב מודים אנחנו לך ה' אלהינו על שאנו מודים לך 

When the chazzan says Modim, what does the congregation say? Rav said “we are grateful for the fact that that we are able to give thanks” (Sotah 40a)

Detail of cover from Thanks! How the new science of gratitude can maker you happier.  By Robert Emmons.  Houghton Mifflin Harcourt, 2007.

Detail of cover from Thanks! How the new science of gratitude can maker you happier.  By Robert Emmons.  Houghton Mifflin Harcourt, 2007.

Much has been written in the social sciences about the effects of gratitude on a person’s physical and mental health. In the page of Talmud that we are studying today, Rav expressed a rather odd idea- that of all the things for which one could be grateful, the simple ability to be grateful was the most important of all.  Let’s turn to some of that scientific literature and evaluate Rav’s statement.

Gratitude Journals

In a review of the psychotherapeutic effects of gratitude, Robert Emmons from UC Davis and Robin Stern from the Center for Emotional Intelligence at Yale suggest that gratitude involves (a) affirming the “good things” in one’s life and (b) the recognition that the sources of this goodness lie at least partially outside the self. They note that in experimental studies, persons who were randomly assigned to keep gratitude journals on a weekly basis exercised more regularly, reported fewer physical symptoms, felt better about their lives as a whole, and were more optimistic about the upcoming week compared with those who "recorded hassles or neutral life events.” Rather than focus on complaints, they wrote, “an effective strategy for producing reliably higher levels of pleasant affect is to lead people to reflect, on a daily basis, on those aspects of their lives for which they are grateful.” The authors believe that gratitude is an effective psychotherapeutic intervention, which may "spontaneously catalyze the healing process.” 

Clinical trials indicate that the practice of gratitude can have dramatic and lasting positive effects in a person’s life. It can lower blood pressure, improve immune function, promote happiness and well-being, and spur acts of helpfulness, generosity, and cooperation.
— Emmons and Stern. Gratitude as a Psychotherapeutic Intervention. J. Clin. Psychol. 2013. 69:846– 855

Letters of Gratitude

Keeping  a record of things for which you are grateful seems to have  psychological benefits. So does expressing that gratitude to others. Researchers from Kent State University studied the effects of writing letters of gratitude on three qualities of well-being: happiness, life satisfaction and depression.  They followed 219 people who agreed to write letters of gratitude for three weeks.  “Participants were…instructed to write non-trivial letters of gratitude to an individual to express appreciation for them. Participants were asked to be reflective, write expressively, and compose letters from a positive orientation while avoiding ‘‘thank you notes’’ for material gifts.  The researchers reviewed the letters “to insure the basic guidelines were followed”, and found that those in the letter-writing group had a significant improvement in their levels of happiness, which included feelings of gladness, satisfaction and fulfillment.  Compared to the non-writers, the letter writing group also showed and increased life satisfaction.  

Gratitude appears to be a powerful and preexisting resource that when utilized can produce positive effects upon well-being.
— Toepfer et al. Letters of Gratitude: Further Evidence for Author Benefits. J Happiness Stud (2012) 13:187–201

Finally, those in the writing group showed significant decreases in symptoms of depression over time, compared to non-writers. The authors concluded that “…writing letters of gratitude may have potential for alleviating depressive symptoms prior to more severe clinical depression. Further investigation is required before such claims can be made but the results are promising.” The study was published in the Journal of Happiness Studies. (Perhaps a subscription to this delightfully titled journal would make a good antidote to news in the papers lately.)

Effect of writing letters of gratitude - means for experimental and control groups on well-being variables and depressive symptoms. From Toepfer et al. Letters of Gratitude: Further Evidence for Author Benefits. J Happiness Stud (2012) 13:187–20.&nb…

Effect of writing letters of gratitude - means for experimental and control groups on well-being variables and depressive symptoms. From Toepfer et al. Letters of Gratitude: Further Evidence for Author Benefits. J Happiness Stud (2012) 13:187–20. 

If you are looking for an entire book of the psychology of gratitude and appreciation, then you might consider reading Gratitude and the Good Life by Philip Watkins. In his review of the health benefits of gratitude, Watkins notes that “grateful people tend to be religious people.” Watkins emphasizes that religiosity is not a requirement for gratitude, and that there are many non-religious people who are very grateful. Nevertheless, “a number of religious variables show moderate to strong correlations with trait gratitude.” Which leads us to...

Gratitude to God

While there are health benefits to anyone who expresses gratitude, one study looked at the effects of expressing that gratitude to God, rather than to a person, in a paper published in the Journal for the Scientific Study of Religion. There were four authors: two from the University of Michigan and two from the Research Services arm of the Presbyterian Church. (Interestingly no conflict of interest was declared by any of the authors. Should being a member of a Church count as a conflict?) The authors of the paper, Gratitude to God, Self-Rated Health, and Depressive Symptoms, analyzed data from the US Congregational Life Survey and wrote:

 There are three reasons why feelings of gratitude to God may affect physical and mental health. First… gratitude is a positive emotion that arises from the pleasant feelings that are associated with receiving a benefit. Viewing gratitude as a positive emotion is important because a rapidly growing body of research indicates that positive emotions are associated with a range of beneficial physiological effects, including a lower heart rate, lower blood pressure, and improved immune functioning… Second, research… reveals that positive emotions, such as gratitude, are associated with the adoption of a range of beneficial health behaviors, including exercise and medication compliance…Third, research…indicates that people who feel more grateful to God are able to cope more effectively with the deleterious effects of stress....Consistent with earlier research, the results indicate that individuals who feel more grateful to God are more likely to rate their health in a favorable manner…and they are less likely to experience symptoms of depression.

The authorship of מודים דרבנן - A meditation on Gratitude

Today’s page of Talmud cites five different versions of what should be said when the chazzan recites the Modim prayer in the repition of the Amidah. Here they are:

סוטה מ, א

אמר רב מודים אנחנו לך ה' אלהינו על שאנו מודים לך

ושמואל אמר אלהי כל בשר על שאנו מודים לך

רבי סימאי אומר יוצרנו יוצר בראשית על שאנו מודים לך

נהרדעי אמרי משמיה דרבי סימאי ברכות והודאות לשמך הגדול על שהחייתנו וקיימתנו על שאנו מודים לך

רב אחא בר יעקב מסיים בה הכי כן תחיינו ותחננו ותקבצנו ותאסוף גליותינו לחצרות קדשך לשמור חוקיך ולעשות רצונך בלבב שלם על שאנו מודים לך

  1. Rav: We are grateful to you Lord our God, for the fact that that we are able to give you thanks.

  2. Shmuel: The God of all flesh, for the fact that we are able to give you thanks.

  3. Rav Simai: Our creator, and the one who formed creation, for the fact that we are able to give you thanks.

  4. The Nehardeans say in the name of Rav Simai: Blessings and praises to your great name for your having given us life and sustained us, and for the fact that we are able to give you thanks.

  5. Rav Acha bar Yaakov: So may you continue to keep us alive and find favor in us and may you bring us together and gather our exiles to the courtyards of your sanctuary to observe your decrees and to do your will with a whole heart, for the fact that we are able to give you thanks.

Unable to decide between them, (and not wanting to hurt anyone's feelings,) Rav Pappa ruled that all should be said, (אמר רב פפא הילכך נימרינהו לכולהו)  which is what is done to this day. And this is one explanation of why this prayer is called מודים דרבנן  - it is a prayer of thanks of several rabbis.

As you no doubt will have noted, the one common thread in the five versions is that they all end with the phrase “for the fact that we are able to give you thanks.” As we have seen, evidence from the social sciences suggests that there are numerous health benefits associated with expressing gratitude. Perhaps then, acknowledging the ability to express gratitude is acknowledging that on top of everything else, we are thankful for a way of improving our well-being. Expressing gratitude isn’t just a good idea; it might also improve your mental and physical health. That sounds like something worth doing twice a day.

I would maintain that thanks are the highest form of thought; and that gratitude is happiness doubled by wonder.
— G.K. Chesterton. A Short History of England, chapter 6.
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Sotah 31a ~ What Can a Fetus See?

In tomorrow’s post we will study an aggadic statement, that is to say, a homiletic teaching, that is not to be taken literally - or so one would think.  In that daf the Talmud discusses the miracles which occurred as the Children of Israel crossed through the parted waters of the Red Sea. Rabbi Meir taught that even a fetus in its mother's womb praised God, saying "This is my God and I will glorify him." Now we might have considered this a homiletic teaching that is meant to simply express a degree of amazement and thanks.  But the Talmud then asks a question that suggests Rabbi Meir meant what he said more literally:

סוטה לא, א

והא לא חזו! אמר רבי תנחום כרס נעשה להן כאספקלריא המאירה וראו

These fetuses in the womb could not see the Divine presence, so how could they sing praise? Rabbi Tanchum said: Their mother's abdomen became as clear as glass for them and they were able to see.

While Rabbi Tanchum suggested that it takes physical sight rather than emotional insight to see the divine, it turns out that the fetus can see - and hear, while still in the womb.

Increased Fetal Heart Rate in Response to Light

In 1980, two Israelis published a preliminary report on the response to light of ten fetuses between 38 and 43 weeks' gestation. They inserted an amnioscope through the cervix and shone a light into the womb for thirty seconds while monitoring the heart rate of the little fetus. They found that eight of the ten little fetuses had an acceleration of their heartbeat in response to the light. That's interesting you say, but hardly what Rabbi Tanchum was describing. And you'd be correct.  So let's turn to some other studies.

Increased Fetal Brain Activity in Response to Light

A review in the European Journal of Obstetrics and Gynecology and Reproductive Biology published in 1996 was sceptical that the fetus could see much of anything while inside the womb: 

In utero visual stimulation appears to be very limited...in a dark room the amniotic cavity may be candled with a torch light, especially in the case of a polyhydramnios [an excess of amniotic fluid]. Measurements performed during rat and guinea-pig gestation have demonstrated that if only 2% of incoming light was transmitted in utero below 550 nm, this value increases with wavelength of the signal to reach 10% around 650 nm. Thus, a limited portion of external light may reach the human fetal retina when eyelids are open (this behavior starts at 20 weeks) or through the eyelids. 

But in 2003 a group of researchers from the United Kingdom (with apparently nothing else to do for amusement) built a light source from a "cardboard tube lined with non-conducting aluminised plastic, resulting in a light intensity of 1,100–1,200 Lux at the maternal abdomen as measured with a hand-held light meter." After an ultra-sound confirmed that the fetus was looking forward (really, they did this too) they turned the light on and off. And all this took place while the mother and her in-utero child were lying in a functional MRI scanner, which was used to look for activation of the little fetal brain in response to the light. Of the nine subjects they tortured in this way, one could not be analyzed due to motion, three did not show any significant activation, and five showed significant activation. Oddly, none of the fetal brains that responded showed any activation of the occipital lobe, that part of the brain in which the primary visual cortex is located and which responds to light.  Instead, it was the fetal frontal cortex showed a response to the light being shone.  Hmmm.

The Fetal Response to Sound

So much for vision. Researchers have also studied what - if anything - a fetus may be able to hear.  A group from Rambam Hospital and the Technion in Haifa studied the effect of music on fetal activity. Back in 1982 they took twenty pregnant women and played them either 25 minutes of nothing, or 25 minutes of classical or pop music through headphones. If you are wondering, the music was either a canon and songs composed by Pachelbel, or "the pop-hits of the [sic] Boney-M." (Give yourself an extra point if you can recall any of the pop hits of the Boney M.) Anyway, they played the music in random sequence and monitored the fetus for breathing and body movements.  They found that compared to no music, when music was piped into the mothers' ears there was a significant increase in the breathing movements of the fetus, but there was no difference between classical and pop music.  

..it seems that the fetus moves into a more active state when music is played to the mother.
— Zimmer, EZ. et al. Maternal Exposure to music and fetal activity. Europ. J. Obstet. Gyec. Reprod. Biol. 1982 (13) 210.

And remember the experiments with cardboard tubes shining light into the womb of forward facing fetuses? Well that same group also performed functional MRI scanning of the brains of a group of fetuses but this time they strapped "an MRI compatible headphone" to the maternal abdomen (or the maternal ears, as a control) and played 15 seconds of music. (The paper does not specify the kind of music that was chosen. I do hope it wasn't the Boney-M.) Five of the twelve fetuses that had music piped into their mother's abdomen showed activation of the temporal lobes, but despite this low number the authors enthusiastically concluded that their study showed "...that brain activity can be detected in response to stimulation prenatally..." 

A ray of hope flitters in the sky
A tiny star lights up way up high
All across the land dawns a brand new morn
This comes to pass when a child is born
— Boney M. When a Child is Born, 1981.

Giving Thanks - Thanksgiving

The Talmud describes how the Crossing of the Red Sea was a miracle of such extraordinary nature that even in-utero fetuses joined in singing a prayer of thanks with the Children of Israel. In his famous introduction to the tenth chapter of Sanhedrin, Maimonides describes how aggadah should not be taken literally. Instead, a deeper message should be sought. And so, over Shabbat, perhaps you can discuss what you are thankful for. For what blessings in your life might a fetus open its eyes and see, or say thanks while still in its mother's  womb? Now that I think of it, that's a question that everyone should answer.

Human fetuses are, to a certain extent, able to memorize certain sensory properties...Despite the fact that they have only very short periods of wakefulness and that their brain is not mature enough to integrate sensory experiences, several experiments suggest that this does not prevent pre- and perinatal learning.
— Lecanuet, J, Schaal B. Fetal Sensory Competencies. European Jopurnal of Obstetrics and Gynecology and Reproductive Biology 1996. 68: 1-23
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The Nobel Prize, the Paratrooper, and the Maimonides Rule

Last year, we celebrated Yom Ha’atzmaut (Israel Independence Day) with a discussion of Israel’s many winners of the Nobel Prize. This year we will focus on just one of them, the economist Joshua Angrist.

Joshua Angrist.

Angrist was born in 1960, grew up in Pittsburgh, and from 1982-1985 he served in the Israel Defence Forces as a paratrooper. He then came back to the US where he earned a PhD from Princeton. (His thesis was on the Vietnam Draft Lottery.) He returned to Israel as a lecturer at the Hebrew University, and in 1996 he was appointed MIT's Ford Professor of Economics. He holds dual US-Israeli nationality, and has spent most of his career analyzing the economics of schooling and the effect of class size on academic achievement. One of his papers looks at the “Maimonides Rule,” named for, well, Maimonides, who apparently noted a correlation between class size and student achievement.

The Maimonides Rule

Angrist noted that the Talmudic sage Rava limited the size of a class of students to twenty-five. Any more than that, and the school must provide a second teacher:

בבא בתרא כא, א

וְאָמַר רָבָא סַךְ מַקְרֵי דַרְדְּקֵי עֶשְׂרִין וְחַמְשָׁה יָנוֹקֵי וְאִי אִיכָּא חַמְשִׁין מוֹתְבִינַן תְּרֵי וְאִי אִיכָּא אַרְבְּעִין מוֹקְמִינַן רֵישׁ דּוּכְנָא וּמְסַיְּיעִין לֵיהּ מִמָּתָא

Rava said: The maximum number of students for one teacher of children is twenty-five children. And if there are fifty children in a single place, one establishes two teachers, so that each one teaches twenty-five students. And if there are forty children, one establishes an assistant, and the teacher receives help from the residents of the town to pay the salary of the assistant.

This ruling was later codified by Maimonides:

משנה תורה, הלכות תלמוד תורה 2:5

עֶשְׂרִים וַחֲמִשָּׁה תִּינוֹקוֹת לְמֵדִים אֵצֶל מְלַמֵּד אֶחָד. הָיוּ יוֹתֵר עַל עֶשְׂרִים וַחֲמִשָּׁה עַד אַרְבָּעִים מוֹשִׁיבִין עִמּוֹ אַחֵר לְסַיְּעוֹ בְּלִמּוּדָם. הָיוּ יוֹתֵר עַל אַרְבָּעִים מַעֲמִידִין לָהֶם שְׁנֵי מְלַמְּדֵי תִּינוֹקוֹת

[A maximum of] 25 students should study under one teacher. If there are more than 25, but fewer than 40, an assistant should be appointed to help him in their instruction. If there are more than forty students, two teachers should be appointed.

Angrist noted that Maimonides’ ruling leads to smaller class sizes and a lower student-teacher ratio, and that “this rule induces a nonlinear and non-monotonic relationship between enrollment size and class size.” Angrist used this rule as a basis for an investigation between the class size of fourth and fifth graders in Israel and the scores of their tests in math and reading. His work which you can read here, showed that reductions in class size induced a significant and substantial increase in reading and math scores.

Besides being of methodological interest and providing new evidence on the class size question, these findings are of immediate policy interest in Israel where legislation to reduce the maximum class size is pending.
— Angrist, J. D.; Lavy, V. (1999). "Using Maimonides' Rule to Estimate the Effect of Class Size on Scholastic Achievement". Quarterly Journal of Economics. 114 (2): 533–575.

Who would have thought that the Rava’s ruling as codified by Maimonides would play a role in the awarding of a Nobel prize to an Israeli ex-paratrooper?

Happy Yom Ha’atzmaut from Talmudology

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