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

Print Friendly and PDF