Gittin 86b ~ How do Pigeons Drink?

In a brief digression from the rules of gittin, the Talmud digresses into ornithology. If a bird sips water in which ashes of the red heifer have been placed (known as מי חטאת) the water can no longer be used. This applies to all birds except for the pigeon, because it sips the water from the container and presumably none falls back into the water from its mouth. The source for this is a Mishnah from masechet (tractate) Parah (9:3).

כל הָעוֹפוֹת פּוֹסְלִין בְּמֵי חַטָּאת, חוּץ מִן הַיּוֹנָה – מִפְּנֵי שֶׁמּוֹצֶצֶת.

All birds disqualify water of purification by drinking from it, (because some of the water spills from the bird’s beak back into the basin after being disqualified by having been in the bird’s mouth.) This is the halakha with regard to all birds except for the pigeon, because it sucks the water, (which prevents it from spilling back).

HOW PIGEONS DRINK

We are most fortunate that back in 1982 Professor G.A. Zweers from the zoological laboratory at the University of Leiden published what is surely the definitive paper on the topic, Drinking of the Pigeon (Columba Livia L.). Zweers opens his 43 page gem by noting that birds drink in many different ways. “Most of them drink like waterfowl; they walk to or through the water, move their beak open and close their beak several times, take some water, tip head and let the water run down by gravity.” However the way in which pigeons drink had for many years been a source of academic debate, and it was time to clear this up once and for all. So Zweers decided to “formulate a mechanical model for the drinking of pigeons….” and film them merrily drinking using high speed cameras. Now Talmudology readers are the lucky beneficiaries of these herculean efforts.

Using a frame by frame analysis of high speed films and X-ray motion pictures, Zweers figured out that thirsty pigeons use “a double-suction or vacuum-pump model” to drink. Here is how it works:

Consummatory drinking is a series of similar movement cycles, each transporting one dose of water into the oesophagus. The swallowing movement cycle shows five phases:

1, capillary action of the beak tips;

2, lingual suction

3, pharyngeal preparation

4, pharyngeal suction;

and 5, oesophageal collection.

A double build up of an area of low air pressure occurs. As a result of the retraction of the tongue in the mouth (acting as a piston in a cylinder) low air pressure develops in the buccal cavity and water is sucked into the mouth. Secondly, a lower air pressure area develops in the pharynx as a result of a depression of its floor, so that the water in the mouth is given a momentum caudad, by which it is forced over the larynx into the oesophagus.

It’s not only pigeons who suck…

The Mishnah rules that other than the pigeon any bird that drinks the waters of purification renders it unusable, because it is only the pigeon that sucks in water through its beak. All other birds drink using different mechanisms, during which time drops of water may fall back into the water, and render it unfit. But this isn’t quite the case. Some parrots like the parakeet (known in the United Kingdom and many parts of the Commonwealth as budgerigar) and the fig parrots also use a sucking mechanism to swallow, though they are native to Oceania and the islands of south-east Asia, so the rabbis of the Talmud could not have known this. The African fork-tailed drongo (Dicrurus adsimilis) sucks in water like pigeons, but then tip their heads back to swallow it. And finally, the common sandgrouse drinks using a very similar mechanism to pigeons.

To conclude: the pigeon is not the only bird that uses suction to drink, but it is certainly one of the few species that do so. We had the benefit of high-speed photography and a determined German professor, but the rabbis of the Mishnah had only their daily observations to guide them, and most of the time that was good enough.

“Pigeons and doves are among the few birds that can suck water while their head is down. They don’t need to look skyward to swallow.”

— Bird Watchers Digest

Gittin 71~ The Relationship between Hearing and Intelligence

Not too far from where I live is Gallaudet University. It was founded in 1864 with a Charter signed by Abraham Lincoln. (And here’s a fun fact: to this day the diplomas of all Gallaudet graduates are signed by the presiding U.S. president.) Among its alumni are the actress Shoshanah Stern, the poet Dorothy Miles and Wilma Newhoudt-Druchen, a member of South Africa’s Parliament. Oh, I forgot to tell you. Gallaudet is a university for the deaf and hard-of-hearing. Which brings us to today’s daf.

In a discussion of whether and how a deaf man may divorce his wife, we read the following:

גיטין עא, א

אָמַר רַב כָּהֲנָא אָמַר רַב: חֵרֵשׁ שֶׁיָּכוֹל לְדַבֵּר מִתּוֹךְ הַכְּתָב, כּוֹתְבִין וְנוֹתְנִין גֵּט לְאִשְׁתּוֹ. אָמַר רַב יוֹסֵף: מַאי קָא מַשְׁמַע לַן? תְּנֵינָא: נִשְׁתַּתֵּק, וְאָמְרוּ לוֹ: ״נִכְתּוֹב גֵּט לְאִשְׁתְּךָ?״ וְהִרְכִּין בְּרֹאשׁוֹ, בּוֹדְקִין אוֹתוֹ שְׁלֹשָׁה פְּעָמִים, אִם אָמַר עַל לָאו – ״לָאו״, וְעַל הֵן – ״הֵן״, הֲרֵי אֵלּוּ יִכְתְּבוּ וְיִתְּנוּ

Rav Kahana says that Rav says: With regard to a deaf-mute who can express himself through writing, the judges of the court may write and give a bill of divorce to his wife based on his written instructions.

Rav’s teaching here is that a deaf person needs to demonstrate the ability to communicate in order to be able to issue a get, the Jewish bill of divorce. A few lines later this ruling is further delineated:

תַּנָּאֵי הִיא – דְּתַנְיָא, אָמַר רַבָּן שִׁמְעוֹן בֶּן גַּמְלִיאֵל: בַּמֶּה דְּבָרִים אֲמוּרִים – בְּחֵרֵשׁ מֵעִיקָּרוֹ, אֲבָל פִּיקֵּחַ וְנִתְחָרֵשׁ – הוּא כּוֹתֵב וְהֵן חוֹתְמִין

Rabban Shimon ben Gamliel said: In what case is this statement that the court may not rely on the written testimony of a deaf-mute with regard to a bill of divorce said? Only in the case of a deaf-mute who was deaf from the outset, i.e., from birth. But if he had been halakhically competent, i.e., he could previously hear, but became a deaf-mute later, then he may write instructions to give his wife a bill of divorce and they, the witnesses, should sign, in accordance with the opinion of Rav Kahana.

There are several other legal constraints placed on a deaf person:

In a discussion of who may perform the ritual act of semicha - laying hands on an animal before its sacrifice, the Mishnah lays down the following rules:

מנחות צג, א

הכל סומכין חוץ מחרש שוטה וקטן וסומא ועובד כוכבים והעבד והשליח והאשה

Everyone [who brings an animal offering] places their hands upon its head, except for a deaf-mute, an deranged person, a minor, a blind person, a gentile, a Canaanite slave, the agent of the owner of the offering who brings the offering on the owner’s behalf, and a woman.

The Talmud explains why the deaf are excluded: חרש שוטה וקטן דלאו בני דעה “a deaf -mute, a deranged person and and a minor are not mentally competent.”

This is a widespread legal principle that appears often in the Talmud. For example, this group of three are not required to appear in Jerusalem three times a year, they may not write a get, (bill of divorce) and they may not serve as a ritual slaughterer unless properly supervised.

Which raises the question - what have we learned about the relationship between intelligence and hearing?

The Rabbinic and the Roman

American Sign Language: “Deaf.” Touch your finger on your cheek near your ear, then move your finger in a small arch and touch it near the mouth. Start and end the sign on the cheek.

To better understand the rabbinic rulings about the deaf, we must put them into a historical context. “In the early law of Rome” wrote the historian Albert Gaw (from Gallaudet) over a century ago, “the deaf-mute from birth was considered incapable; he was classed with the madman and the infant; he was unable to perform without assistance any legal act in his own behalf.” Hmm. Sounds familiar? Gaw continues:

It is evident that the deaf and dumb would naturally be debarred from engaging in such formal and solemn acts as the making of stipulations, testaments, codicils, executory trusts, and donations mortis causa, at least so long as the ability to spéak or to understand speech was requisite for the performance of these acts. In like manner, the deaf and dumb would be unable to take part in adoptions, emancipations, solemn manumissions, and would be excused from the duties of guardianship as long as verbal formalities were required to give validity to these acts. Also because of their inability to speak and hear they would not be chosen to act as judges, arbiters, witnesses, or procurators. They would also be barred from solemn entrance upon an inheritance because of the necessity of repeating the prescribed formula at the time of entry, which for a person both deaf and dumb would be physically impossible. Even for persons adventitiously deaf who retained their speech some of the above named acts were prohibited, as a person who could not hear was held to be unable to carry out the letter of the law as to the repetition of the formula made imperative on pain of nullity. The solemn forms of marriage, confarreatio et coemptio, could not be complied with by persons who were deaf and dumb; neither could a deaf-mute buy and sell by the formal emptio venditio or mancipatio.

“...the Romans did not consider deafness a separate phenomenon from mutism and... consequently, many believed all deaf people were incapable of being educated. Ancient Roman law, in fact, classified deaf people as ‘mentecatti furiosi’ which may be translated roughly as raving maniacs and claimed them uneducable.”

— Elana Radutsky. The Education of Deaf People in Italy and the Use of Italian Sign Language. In Van Cleve (ed) Deaf History Unveiled. Gallaudet University Press 2002.p 239

Things got (a little) better under Emperor Justinian (527-565 CE). His code recognized different types of deafness and distinguished between them in law. Those deaf people who could write enough to conduct their daily affairs were granted legal rights.

Into the (Not so) Modern Age

The rights of the hard-of-hearing remained mired due to a lack of understanding about the nature of deafness, and an aversion to understanding their sign language. In fact, so strong was this aversion that at the infamous Milan conference of 1880, sign language instruction was banned. Banned. Instead, the members of the Second International Congress on the Education of the Deaf declared that oral instruction (lip-reading and speech) was to be used exclusively. Ignorance reigned supreme.

Alexander Graham Bell, (yes, he of the telephone) was one of those behind the Milan declaration. He later wrote a treatise “Upon the Formation of a Deaf Variety of the Human Race” in which he noted that many deaf people marry other deaf people. Sometimes these marriages produced children who were hard-of-hearing. Bell, the card-carrying eugenicist, found this unacceptable. And so in his paper (published by the National Academy of Sciences no less) he suggested outlawing the marriage of two deaf people. It’s enough to make you throw your phone across the room.

Research on the intelligence of the hard of hearing

In 1968 the psychologist McCay Vernon published a now classic paper “Fifty Years of Research on the Intelligence of Deaf and Hard-of-Hearing Children.” He pointed out the biases in IQ assessment of deaf children resulting from improper testing methods, research participant sampling, and even the experience level of the evaluators themselves. He reviewed 37 studies that measured the intelligence of samples of deaf and hard-of-hearing children performed between 1930 and 1965. Here are some of Vernon’s conclusions (but keep in mind that he was writing this in the 1960s, and our notions of the utility of standardized IQ tests as a measure of anything have evolved considerably since then.)

• The communication problems of profound hearing loss, the attentive set of deaf children toward psychological examination, and other aspects of test administration rule out the validity of group intelligence testing.

• Almost all of the investigations involved only samples of deaf children who were in school programs for the hearing impaired. This approach involved incomplete sampling and left unanswered the question of the intelligence of deaf children not in these schools.

• The work done by investigators who were experienced in the psychological testing of deaf children at the time they did their work (see the notations in this table) yielded results showing the deaf and the hearing more nearly equal in intelligence. As the experience of the examiner has strong direct bearing on the validity of test results, these studies must be given special emphasis in any consideration of the relative intelligence of deaf and hearing children on IQ measures.

• Based on an understanding of the disease conditions causing deafness, it is apparent that many of the etiologies of profound hearing loss are also responsible for other neurological impairment which frequently results in lower intelligence. “The point to be made is that the relationship, if any, between developmental delays and deafness is not causal but is due to the common etiology which brought about both the deafness and the developmental delay.”

• These studies indicate that there is no relationship between degree of hearing loss and IQ or the age of onset of deafness and IQ.

“In sum, the implication of the research of the last fifty years which compared the IQ of the deaf with the hearing and of subgroups of deaf children indicates that when there are no complicating multiple handicaps, the deaf and hard-of-hearing function at approximately the same IQ level on performance intelligence tests as do the hearing.”

— McCay Vernon. Fifty Years of Research on the Intelligence of Deaf and Hard-of-Hearing Children: A Review of Literature and Discussion of Implications. Journal of Rehabilitation of the Deaf 1968: 1; 1–11,

On one of the most thorough reviews of the literature since the publication of Vernon’s paper is found in a book called “Deafness, Deprivation and IQ,” by Jeffrey Braden from the University of Wisconsin. It is a deep dive into the methodologies of intelligence tests, what they measure and what they don’t. Braden found that deafness has very little impact on non-verbal intelligence; the impact of deafness is simply to lower verbal IQs and not affect non-verbal IQs. Which is what you would expect. His analysis of all the data also revealed that deaf children with deaf parents have performance IQs that are above the mean for hearing people. Above it. (Alexander Graham Bell, did you get that message?)

In her 2003 paper What the Rabbis Heard: Deafness in the Mishnah Bonnie Gracer noted that

The ancient Jews did live amongst the ancient Greeks and Romans. It is therefore not surprising that the rabbis, as evidenced in the Mishnaic canon, incorporated into Jewish law Greco Roman beliefs linking hearing, speech, intelligence, and morality. It is clear, however, that the rabbis viewed all people, including deaf people, as unique individuals. The Mishnaic delineation of multiple categories of deafness resulted in not every deaf person being "categorically" disqualified or exempt from the performance of specific mitzvot. The rabbis observed deaf people, paid enough attention to notice detail, and deemed deaf people worthy of life, legal rulings, and protections. From the standpoint of deaf history, these are all extremely positive developments.

They are. But still not good enough.

On the Role of Science

In 1971 Rabbi Moshe Feinstein ruled that hearing aids would give a congenitally deaf person all the rights and obligations of one who hears normally. But five years earlier, in 1966, the great Torah scholar Yaakov Yechiel Weinberg published an article in the journal Hechal Shlomo about the religious rights and duties of a deaf Jew. He concluded by explaining that there were two approaches to this issue. Some rabbis believed deafness to be an organic deficit in the brain that also caused a degree of “mental handicap” (חסרון דעת) that remained despite any degree of education. Others believe that any degree of developmental delay was entirely due to a lack of adequate education. Consequently, once educated in school, the deaf were to be treated like any other Jew. Then he continued:

But we are not to rely on physicians or scientists to answer this question for us. For the measure of understanding required for a person to uphold mitzvot is entirely different for the rabbis than it is for scientists.

“הרב י.י. וינברג "חרש שלמד לדבר לחיוב מצוות. היכל שלמה שנה בשנה תשכ׳ה. 128

Rav Weinberg was of course correct: what is reality in halakha and what is reality in reality are often two very different things. But still, this was an unusual position to take, for as Marc Shapiro noted in his excellent intellectual biography of R. Weinberg, “the tendency to take into account modern social and educational issues is constantly present in his responsa.”Surely the religious status of a deaf person would be a test case for just that approach.

The halakhic status of the deaf should make us uncomfortable. It raises many difficulties and challenges about the way Judaism once viewed - and often still does view - those with disabilities and people who were not free agents of their own time. The sages of the Mishnah and Talmud, influenced by cultural norms like those in ancient Rome, deemed the deaf not “mentally competent.” Two thousand years later, with the march of science we know that that this is factually incorrect. But you don’t need the science to tell you that. You just need to be lucky enough to know a deaf person.

Talmudology for Tisha B'Av: Titus and Tinnitus

Francesco Hayez (1791-1882): The destruction of the Temple of Jerusalem.

“My purpose in this discussion is to review briefly the ancient evidence for the death of Titus, to consider some of the recent ideas about the circumstances of the event and, finally, to suggest that, from an examination of evidence in our sources which has so far gone virtually unnoticed, one of the most intractable-seeming of the ancient sources may just possibly contain the truth.”

— Murison, C.L The Death of Titus; A reconsideration. Ancient History Bulletin 1995: 9, 3-4. 135-142.

Tisha B’Av, the Fast of the Ninth of the month of Av, is a day that traditionally commemorates the destruction of the First and Second Temples that once stood in Jerusalem. Over the centuries however, Tisha B’Av took on an expanded role as a time to commemorate the collective tragedies of the Jewish People, from the Crusades to the Holocaust, and all tragedies in between.

שולחן ערוך אורח חיים תקנ’ד ומשנה ברורה שם

ומותר ללמוד מדרש איכה ופרק אלו מגלחין וכן ללמוד פירוש איכה ופירוש איוב

איכה - וכן אגדת החורבן בפרק הניזקין ובפרק חלק ולקרות בחורבן הנזכר ביוסיפון מותר

Because of the sad nature of the day, the rabbis forbade the study of Torah on it. Such study brings joy, and this is an emotion that is out of keeping with Tisha B’Av (שֶׁנֶּאֱמַר: ״פִּקּוּדֵי ה׳ יְשָׁרִים מְשַׂמְּחֵי לֵב״). However, it is permitted to study certain passages that are sad or depressing (preferably both). One of these passages is from our current tractate Gittin, and we studied it a few days ago.

גיטין נו, ב

מָה עָשָׂה? תָּפַשׂ זוֹנָה בְּיָדוֹ וְנִכְנַס לְבֵית קדְשֵׁי הַקֳּדָשִׁים, וְהִצִּיעַ סֵפֶר תּוֹרָה וְעָבַר עָלֶיהָ עֲבֵירָה. וְנָטַל סַיִיף וְגִידֵּר אֶת הַפָּרוֹכֶת, וְנַעֲשָׂה נֵס וְהָיָה דָּם מְבַצְבֵּץ וְיוֹצֵא, וּכְסָבוּר הָרַג אֶת עַצְמו,

What did Titus do when he conquered the Temple? He took a prostitute with his hand, and entered the Holy of Holies with her. He then spread out a Torah scroll underneath him and committed a sin, i.e., engaged in sexual intercourse, on it. Afterward he took a sword and cut into the curtain separating between the Sanctuary and the Holy of Holies. And a miracle was performed and blood spurted forth. Seeing the blood, he thought that he had killed God.

ּEventually Titus was punished and died at the age of 41. The cause? A gnat:

בְּרִיָּה קַלָּה יֵשׁ לִי בְּעוֹלָמִי, וְיַתּוּשׁ שְׁמָהּ עֲלֵה לַיַּבָּשָׁה וְתַעֲשֶׂה עִמָּהּ מִלְחָמָה. עָלָה לַיַּבָּשָׁה, בָּא יַתּוּשׁ וְנִכְנַס בְּחוֹטְמוֹ, וְנִקֵּר בְּמוֹחוֹ שֶׁבַע שָׁנִים. יוֹמָא חַד הֲוָה קָא חָלֵיף אַבָּבָא דְּבֵי נַפָּחָא, שְׁמַע קָל אַרְזַפְתָּא, אִישְׁתִּיק; אֲמַר: אִיכָּא תַּקַּנְתָּא. כֹּל יוֹמָא מַיְיתוּ נַפָּחָא וּמָחוּ קַמֵּיה. לְגוֹי – יָהֵיב לֵיהּ אַרְבַּע זוּזֵי, יִשְׂרָאֵל – אֲמַר לֵיהּ: מִיסָּתְיָיךְ דְּקָא חָזֵית בְּסָנְאָךְ. עַד תְּלָתִין יוֹמִין עֲבַד הָכִי; מִכָּאן וְאֵילָךְ, כֵּיוָן דְּדָשׁ, דָּשׁ.

… a gnat came, and entered the nostril of Titus, and picked at his brain for seven years. Titus suffered greatly from this until one day he passed by the gate of a blacksmith’s shop. The gnat heard the sound of a hammer and was silent and still. Titus said: I see that there is a remedy for my pain. Every day they would bring a blacksmith who hammered before him. He would give four dinars as payment to a gentile blacksmith, and to a Jew he would simply say: It is enough for you that you see your enemy in so much pain. He did this for thirty days and it was effective until then. From that point forward, since the gnat became accustomed to the hammering, it became accustomed to it, and once again it began to pick away at Titus’s brain.

תַּנְיָא, אָמַר רַבִּי פִּנְחָס בֶּן עֲרוּבָא: אֲנִי הָיִיתִי בֵּין גְּדוֹלֵי רוֹמִי, וּכְשֶׁמֵּת פָּצְעוּ אֶת מוֹחוֹ, וּמָצְאוּ בּוֹ כְּצִפּוֹר דְּרוֹר מִשְׁקַל שְׁנֵי סְלָעִים. בְּמַתְנִיתָא תָּנָא: כְּגוֹזָל בֶּן שָׁנָה – מִשְׁקַל שְׁנֵי לִיטְרִין.

It is taught in a baraita that Rabbi Pineḥas ben Arova said: I was at that time among the noblemen of Rome, and when Titus died they split open his head and found that the gnat had grown to the size of a sparrow weighing two sela. It was taught in another baraita: It was like a one-year-old pigeon weighing two litra.

Might there be a medical explanation for this story?

Titus and a Brain Tumor

In 1995 Charles Murison published a suggestion in the Ancient History Bulletin. After reviewing contemporary Roman accounts of the death of Titus, he concluded that

Titus was believed to have died of a fever, perhaps exacerbated by cold bathing or harsh medical treatment; furthermore, Domitian was suspected of some involvement in hastening his end, but actual accusations of poisoning were not, apparently, contemporary.

He then turned to our passage of Talmud, and suggested that it described the death of Titus from a brain tumor, and that this was more likely than the fever hypothesis.

All in all, then, while certainty is obviously not attainable, I would argue that the Talmudic suggestion that Titus died of a brain tumour fits the facts, known and deducible, of the last fourteen months of his life better than any other hypothesis.

Titus and Tinnitis

According to ENT surgeon extraordinaire (and Talmudology neighbor) David Eisenman, this story “mixed with both plausible and fanciful elements” is “one of the earliest detailed case reports of PT [pulsatile tinnitus] in the classical literature.” Tinnitus is a buzzing like sound in the ear without any external auditory stimulus, or, in medicalese “the abnormal self- perception of an internally generated vascular somatosound.” In his 2018 paper on Pulsatile Tinnitus Associated With Sigmoid Sinus Wall Anomalies (now a classic work on the topic) he noted that some historians have suggested that the story of the gnat in the ear can best be explained as Titus having died from complications related to a cerebellopontine angle tumor. However, Eisenman believes that this was a misidentification of “the presumed histopathology as an acoustic neuroma or meningioma rather than as the far more likely jugular foramen paraganglioma with both intracranial and middle ear involvement, a well-known neoplastic cause of PT.” And that banging of the anvil? “It masked the sound, after which he [Titus] hired such a workman to sit before him, banging continuously to mask his self-perception of the somatosound. This provided transient relief for 30 days, after which the masking was no longer effective.” And that sparrow or pigeon sized gnat they found in the head of the departed Titus? It was “an intracranial mass with the appearance of a small bird.”

And what if it was really a gnat?

Dr. Eisenman the ENT surgeon has also encountered an actual “gnat in the brain,” or at least a version of it. In 2010 he published a paper titled Myiasis of the External and Middle Ear, where myiasis is “the infestation of human tissue by fly larvae that feed on the host's dead or living tissue and cause disease.” The case describes a

44-year-old woman [who] presented with 6 days of progressive left-sided ear pain aural fullness, and tinnitus… The symptoms began shortly after she disembarked from an airplane on vacation in the Dominican Republic. She felt something fly into her left ear. A bug was removed by the treating physician, but 24 to 48 hours later she began to hear the tinnitus and felt pressure in the ear. She returned to the United States and sought consultation.

When he took a look, Dr Eisenman found “live insect larvae filling the external auditory canal,” (where the external auditory canal is the tube into which you pop your ear buds). Here are some pictures (you are welcome):

(A) Endoscopic view of right external auditory canal, with maggots burrowing under skin and through tympanic membrane. B) View of single maggot after extraction. From Hatten et al. Myiasis of the External and Middle Ear. Annals of Otology, Rhinology & Laryngology 119(7):436-438.

The only way to get all those maggots out of the ear was to anesthetize the patient in the operating room and dig them out.

So Titus went mad from tinnitus. It has a certain poetic ring to it. And may your Tisha B’Av be a meaningful one.

כל הַמִּתְאַבֵּל עַל יְרוּשָׁלַיִם — זוֹכֶה וְרוֹאֶה בְּשִׂמְחָתָהּ

Gittin 67b~ Might Talmudic Medicines Really Work?

For the next three days, those who study the Talmud following the one-page-a-day Daf Yomi cycle will spend some time reading about cutting edge medical practices.  In Babylon. About 1,500 years ago. Here's a smattering of some of those practices:

For  sun-stroke

• the remedy is on the first day to take a jug of water, [if it lasts] two days to let blood, [if] three days to take red meat broiled on the coals and highly diluted wine. For a chronic heat stroke, he should bring a black hen and tear it lengthwise and crosswise and shave the middle of his head and put the bird on it and leave it there till it sticks fast, and then he should go down [to the river] and stand in water up to his neck till he is quite faint, and then he should swim out and sit down. If he cannot do this, he should eat leeks and go down and stand in water up to his neck till he is faint and then swim out and sit down. (Gittin 67b).

For blood rushing to the head

• take shurbina [a kind of cedar] and willow and moist myrtle and olive leaves and poplar and rosemary and yabla [a herb] and boil them all together. The sufferer should then place three hundred cups on one side of his head and three hundred on the other. Otherwise he should take white roses with all the leaves on one side and boil them and pour sixty cups over each side of his head. (Gittin 68b.)

For migraine

• take a woodcock and cut its throat with a white zuz over the side of his head on which he has pain, taking care that the blood does not blind him, and he should hang the bird on his doorpost so that he should rub against it when he goes in and out. (Gittin 68b.)

For a cataract

• take a scorpion with stripes of seven colors and dry it out of the sun and mix it with stibium in the proportion of one to two and drop three paint-brushfuls into each eye — not more, lest he should put out his eye. (Gittin 69a.)

For night blindness

• take a string made of white hair and with it tie one of his own legs to the leg of a dog, and children should rattle potsherds behind him saying 'Old dog, stupid cock'. He should also take seven pieces of raw meat from seven houses and put them on the doorpost and [let the dog] eat them on the ashpit of the town. After that he should untie the string and they should say, 'Blindness of A, son of the woman B, leave A, son of the woman B,' and they should blow into the dog's eye. (Gittin 69a.)

For catarrh [or a lung infection?] 

• take about the size of a pistachio of gum-ammoniac and about the size of a nut of sweet galbanum and a spoonful of white honey and a Mahuzan natla of clear wine and boil them up together...He can also take the excrement of a white dog and knead it with balsam, but if he can possibly avoid it he should not eat the dog's excrement as it loosens the limbs. (Gittin 69a-b.)

For swelling of the spleen

• take the spleen of a she-goat which has not yet had young, and stick it inside the oven and stand by it and say, 'As this spleen dries, so let the spleen of So-and-so son of So-and-so' dry up'. (Gittin 69b.)

For a stone in the bladder

• take three drops of tar and three drops of leek juice and three drops of clear wine and pour it on the penis of a man or on the corresponding place [i.e. the urethra] in a woman. Alternatively he can take the ear of a bottle and hang it on the penis of a man or on the breasts of a woman. Or he can take a purple thread which has been spun by a woman of ill repute or the daughter of a woman of ill repute and hang it on the penis of a man or the breasts of a woman. Or again he can take a louse from a man and a woman and hang it on... (Gittin 69b.)

We could go on but no doubt you've got the idea.  I doubt there are many of us eager to eat balsam mixed with dog excrement to ease our winter coughs (For those who are, remember: the Talmud tells us to go easy on the excrement.) But I will share with you the remarkable healing properties of two ancient remedies. To be sure, neither is a talmudic concoction, but their stories have implications for those too. 

“ A rich source of new antimicrobials potentially resides in medieval and early modern medical texts”

— Harrison F, Roberts AEL, Gabrilska R, Rumbaugh KP, Lee C, Diggle SP. 2015. A 1,000-year-old antimicrobial remedy with antistaphylococcal activity. mBio 6(4):e01129- 15.

A 1,000-Year-Old Antimicrobial Remedy

Bald’seyesalve.A facsimile of the recipe, taken from the manuscript known as Bald’s Leechbook (London, British Library, Royal 12, D xvii).

I am not aware of any published descriptions of attempts to test these talmudic remedies. But a 2015 paper described something close. It was an attempt to reproduce a remedy described in Bald's Leechbook, an English medical text written in the tenth century. This text, which exists as a single copy in the British Library in London, contains a number of remedies, including those for what appear to be microbial infections.  Here's one of them:  

Make an eyesalve against a wen [a lump in the eye]: take equal amounts of cropleac [an Allium species] and garlic, pound well together, take equal amounts of wine and oxgall, mix with the alliums, put this in a brass vessel, let [the mixture] stand for nine nights in the brass vessel, wring through a cloth and clarify well, put in a horn and at night apply to the eye with a feather; the best medicine.

The most likely clinical condition that correlates with a wen is a hordeolum, or, in non-medical language, a sty. It's a bacterial infection of an eyelash follicle, caused by a common bacterium called Staph. Aureus. They are easily treated with antibiotic cream and warm compresses. A group of medical researchers (with the help of a historian from the School of English and Centre for the Study of the Viking Age at the University of Nottingham) tested the effect of Bald’s eyesalve on Staph. aureus. They wanted to to determine if it worked at all.  If it did, they wanted to see if its efficacy could be attributed to a single ingredient, or whether it only worked when all the ingredients were combined according to the instructions laid down by Bald.  

Of course the first thing the scientists needed to do was to figure out what some of ingredients were. For example, copleac might be an onion, or a leek. (Actually, they couldn't figure out which of the two it was, so they made two variants of the recipe.) Next, they took both the recipe, and controls, which were the individual ingredients alone, and after leaving them to stand for "nine nights" as the Leechbook requires (læt standan nion niht) they applied them to colonies of Staph Aureus. Then they counted the number of colonies of the bacteria that remained.

Two hundred microliters of ES-Onion or ES-Leek (batch A, filled circles, and batch B, open circles) or of each individual ingredient preparation was added to five 1-day-old cultures of S. aureus growing at 37°C in a synthetic wound. After 24 h of further incubation, the collagen was dissolved to recover cells for agar plate counts. The control treatment was sterile distilled water left to stand for 9 days in the presence of brass, which was also present in all other preparations, to simulate the presence of a copper alloy vessel Asterisks denote treatments whose results were significantly different from those of the control. From Harrison F, Roberts AEL, Gabrilska R, Rumbaugh KP, Lee C, Diggle SP. 2015. A 1,000-year-old antimicrobial remedy with antistaphylococcal activity. mBio 6(4):e01129-15.

To their great delight they found the recipe was only effective when all the ingredients were present. They even tested whether it was necessary to wait for nine days and reported that "the number of viable cells left after treatment with either version...was [significantly] lower when the eyesalve had been left to stand for 9 days prior to use." In other words, the potion concocted only worked when the recipe was followed in its entirety; skipping any part decreased the efficacy.    

“What is the remedy for a boil? — Abaye said: [A mixture of] ginger and silver dross and sulphur and vinegar of wine and olive oil and white naphtha laid on with a goose’s quill.”

— Gittin 86a

But the next experiments were no less remarkable. The researchers tested the potion on methicillin-resistant Staph. Aureus (MRSA) which is an entirely modern "superbug". Through the indiscriminate and widespread use of antiobiotics, this strain of Staph. Aureus has grown resistant to the usual antibiotics, and is very real health problem.  The researchers tested the onion (ES-O) and leek (ES-L) versions against a standard antibiotic used to treat MRSA, called vancomycin, using mice that had been infected with the superbug. Vancomycin, the standard modern therapy, did not cause significant reductions in viable bacteria, but "ES-O and ES-L caused statistically significant drops in the numbers of viable cells recovered from wounds." In fact when compared to our modern vancomycis, the Leechbook potions caused a ten-fold reduction in the number of viable MRSA cells recovered. Of course there's a long way between a single small study done on cell cultures and mice, and a drug that is safe and effective in humans. But this story reveals how come very old medical texts may contain treatments that work. 

For more on the the story of the discovery of Bald'eye remedy, listen to this wonderful podcast:

“If medieval physicians really did use observation and experience to design effective antimicrobial
medicines, then this predates the generally accepted date for the adoption of a rational scientific method (the formation of the Royal Society in the mid-17th century) and the modern age of antibacterial medicine (Lister’s use of carbolic acid in the late 19th century) by several hundred years.”

— Harrison F, Roberts AEL, Gabrilska R, Rumbaugh KP, Lee C, Diggle SP. 2015. A 1,000-year-old antimicrobial remedy with antistaphylococcal activity. mBio 6(4):e01129-15

The 2015 Nobel Prize for an Ancient Remedy

“ ...take one bunch of Qinghao, soak in two sheng of water, wring it out to obtain the juice and ingest it in its entirety”

— Extract from The Handbook of Prescriptions for Emergency Treatments by Ge Hong (283–343 CE).

Another example of the medical wisdom of some ancient texts was acknowledged by the Nobel Prize Committee, no less. Last year, the Nobel Prize in Medicine was shared by the Chinese physician Youyou Tu "for her discoveries concerning a novel therapy against Malaria." Professor Tu led a team that screened more than 2,000 traditional Chinese medical herbs for antimalarial activity. Extracts from a herb known locally as Qinghao, (Artemisia annua) inhibited the malarial parasite and was successfully tested on mice in 1971. Clinical studies in the 1980s established the efficacy of artemicinin (as it came to be called). This drug is now part of the standard treatment for malaria worldwide.  Yet it was first identified in a Chinese medical text from the third century CE. - the era of the Mishnah and early Talmud.

Ancient texts certainly may contain efficacious treatment, though the odds are stacked against them. Today only a very tiny number of compounds that are screened for possible medical benefit ever make it to early trials, and of those most fail. It would take a lot of convincing to get Pfizer to test a "woodcock with its throat cut with a coin" for headache.  Until then, it is best to follow the words of another very old source of wisdom, Rav Sherira Gaon, who died around the year 1000 CE. (and so lived around the time of the composition of Bald's Leechbook). 

אוצר הגאונים, חלק התשובות, גיטין דף ס"ח ע"ב, סימן שע

צריכין אנן למימר לכון, דרבנן לאו אסותא אינון, ומילין בעלמא דחזונין בזמניהון...אמרונין, ולאו דברי מצוה אינון. הלכך לא תסמכון על אלין אסותא, וליכא דעביד מינהון מידעם, אלא בתר דמיבדיק וידע בודאי מחמת רופאים בקיאים, דההיא מילתא לא מעיקא לה וליכא דליתיה נפשיה לידי סכנה. והכין אגמרו יתנא ואמרו לנא אבות וסבי דילנא, דלא למעבד מן אילין אסותא אלא מאי דאיתיה

We must tell you that the rabbis were not physicians. Whatever they saw in their day, they addressed, but these matters are not mitzvot. Therefore, do not rely on these remedies. They must not be applied until they have been tested by expert physicians, who can be sure that the remedy will not cause harm or danger. This is what our ancestors have taught us. We should not apply these remedies unless they have been tested...

2023 UPDATE:

This post was originally published in 2015. Here is what has happened since.

In 2020, Harrison and her colleagues tested the ability of Bald’s eyesalve against a particularly nasty bacterial infection of the eye. (The salve “was “prepared using a standard method as previously reported with garlic, onions, bovine bile and white wine”.) They found it was active against Neisseria Gonorhoeae, a sexually transmitted disease that can cause conjunctivitis in infants and adults alike:

Here, we show that Bald’s eyesalve is also effective against a multidrug-resistant N. gonorrhoeae strain. N. gonorrhoeae is a common cause of ophthalmia neonatorum or neonatal conjunctivitis acquired during delivery from an infected mother. If left untreated, it can lead to corneal perforation and blindness, with neonatal conjunctivitis being a major cause of childhood corneal blindness in developing countries. With the increasing occurrence of multidrug-resistant strains of bacteria, an alternative treatment for N. gonorrhoeae is very valuable and these experiments show that Bald’s eyesalve has the potential to be developed into a viable alternative.

In 2022 the salve was the topic of a PhD dissertation (supervised by Dr. Harrison), and was the subject of an early safety study in 109 healthy volunteers. “The reconstructed medieval ancientbiotic” wrote the authors, coining a clever new word while doing so “was well tolerated and had a good safety profile when applied to healthy human skin over a 48-h exposure period. There were no serious adverse events amongst our sample of healthy volunteers. Our findings suggest that further molecular investigation and testing of Bald’s eyesalve is worthwhile….We believe this is the first time that a medieval “ancientbiotic” comprising multiple ingredients has been assessed in a Phase I trial with healthy volunteers.” Harrison and Connelly have also published a 22-page review of the topic, which you can find here, in a terrifically titled compendium Making the Medieval Relevant.