Hygiene

Bava Kamma 81a ~ Open Defecation

On today’s page of Talmud we read about ten conditions which Joshua stipulated when he divided up the Land of Israel between the tribes. These include the right of all to pasture animals in a privately owned forest, the right of all to fish from the Kinneret (called then the “Tiberias”) using hooks, and the right to draw water from a new privately owned spring. But today we will discuss another of these conditions. The right to defecate in public.

בבא קמא פא, א

וְנִפְנִין לַאֲחוֹרֵי הַגָּדֵר, וַאֲפִילּוּ בְּשָׂדֶה מְלֵיאָה כַּרְכּוֹם

And people shall have the right to relieve themselves outdoors behind a fence, even in a field that is full of saffron [karkom].

The Talmud then outlines the details of this public right:

בבא קמא פא, ב

אָמַר רַב אַחָא בַּר יַעֲקֹב לֹא נִצְרְכָה אֶלָּא לִיטּוֹל הֵימֶנּוּ צְרוֹר. אָמַר רַב חִסְדָּא: וַאֲפִילּוּ בְּשַׁבָּת. מָר זוּטְרָא חֲסִידָא שָׁקֵיל וּמַהְדַּר, וַאֲמַר לֵיהּ לְשַׁמָּעֵיהּ (לִמְחַר): זִיל שִׁירְקֵיה

Rav Aḥa bar Ya’akov said: It goes without saying that one may relieve himself when necessary; this stipulation is necessary only to permit the one relieving himself to take a stone out of a wall in the field with which to clean himself. Rav Chisda said: And it is permitted to remove a stone from a wall for this purpose even on Shabbat. Mar Zutra the Pious would take a stone in this manner on Shabbat and replace it in the wall, and say to his attendant after Shabbat: Go and plaster it over, so that it would fit securely back in the wall.

So the right even extended to using the stones from another person’s wall to as toilet paper, though for extra credit it should be replaced and plastered over. Thankfully, in rich, modern, liberal western democracies, open defecation is not something most of us need to think about. But it remains a reality for much of the world's population, even here in the US.

Elsewhere in the Talmud, open defecation is discussed, well, openly:

ברכות סב, ב

וְכֵן אָמַר לֵיהּ רַבִּי זֵירָא לְשַׁמָּעֵיהּ: חֲזִי מַאן דְּאִיכָּא אֲחוֹרֵי בֵּית חֶבְרַיָּא, דְּבָעֵינָא לְמִפְנֵי

Rabbi Zeira told his servant: See who is behind the study hall, as I need to defecate…

אָמַר עוּלָּא: אֲחוֹרֵי הַגָּדֵר — נִפְנֶה מִיָּד. וּבַבִּקְעָה, כל זְמַן שֶׁמִּתְעַטֵּשׁ וְאֵין חֲבֵרוֹ שׁוֹמֵעַ. אִיסִי בַּר נָתָן מַתְנֵי הָכִי: אֲחוֹרֵי הַגָּדֵר,כל זְמַן שֶׁמִּתְעַטֵּשׁ וְאֵין חֲבֵרוֹ שׁוֹמֵעַ, וּבַבִּקְעָה — כל זְמַן שֶׁאֵין חֲבֵרוֹ רוֹאֵהוּ 

With regard to where one may or may not go to defecate, Ulla said: Behind a fence, one need not distance himself from people and may defecate immediately. In a valley or open field, one must distance himself sufficiently so that if he passes wind, no one will hear him. Isi bar Natan taught as follows: Behind a fence one must distance himself sufficiently so that if he passes wind another does not hear him, and in a valley, one must distance himself sufficiently so that no one can see him.

During Talmudic times nearly everyone defecated outside. So let’s discuss…open defecation.

Open Defecation - a Worldwide Problem

In 2018 a small team of public health and civil engineering experts conducted a survey of open defecation in the American city of Atlanta. Yes. Atlanta. America’s 37th most populous city, and home to the busiest airport in the world. They identified and mapped thirty-nine open defecation sites, the majority of which were located within just 400 meters of a soup kitchen. San Fransisco has also been challenged with open defecation on its streets. An NBC report last year found more than “300 piles of feces” throughout the downtown area, leading Dr. Lee Riley, an infectious disease expert at the University of California to conclude that areas of the city are even dirtier than the slums in some developing countries.

Image+Stop+Open+Defecation.jpg

As its name implies open defecation is the practice of defecating in the open environment rather than using any kind of toilet. Although great progress has been made in reducing the practice, it still remains a serious challenge to public health. India is likely to be the country that comes to mind in association with open defecation, but that country has in fact made tremendous strides. “Sanitation is more important than independence,” Mahatma Gandhi remarked at a time when more than three-quarters of the population defecated in the open. Just two weeks ago, on the 150th anniversary of Gandhi’s birth, the Prime Minister Narendra Modi declared India free of open defecation. India launched its Swachh Bharat (Clean India) campaign in 2014, and Modi claimed that since then “toilets have been provided to more than 600 million people in 60 months, building more than 110 million toilets…No one was ready to believe earlier that India will become open defecation-free in such a short period of time. Now, it is a reality.” Critics are not convinced that the rates of open defecation have fallen as rapidly as Modi claimed, but there is no doubt the country has made a remarkable effort to improve the situation. According to the World Health Organization, the campaign saved as many as 300,000 deaths.

Defecating in the open is as old as humankind. As long as population densities were low and the earth could safely absorb human wastes, it caused few problems. But as more people gathered in towns and cities, we gradually learned the link between hygiene and health and, in particular, the importance of avoiding contact with feces. Today open defecation is on the decline worldwide, but nearly 950 million people still routinely practice it. Some 569 million of them live in India. Walk along its train tracks or rural roads, and you will readily encounter the evidence.
— National Geographic Magazine, August 2017
The percentage of people defecating in the open air declined worldwide from 1990 to 2015, with the most dramatic reductions in some of the least developed countries. Yet nearly 950 million people still practice this public health hazard. From Nation…

The percentage of people defecating in the open air declined worldwide from 1990 to 2015, with the most dramatic reductions in some of the least developed countries. Yet nearly 950 million people still practice this public health hazard. From National Geographic Magazine, August 2017.

Open defecation, as strange as this may sound to Westerners, offers young women a welcome break from their domestic confines and the oversight of in-laws and husbands
— National Geographic Magazine August 2017.

Bathrooms with locks - a Jewish gift to humanity

Here is a Mishnah that introduces a rather radical notion for the time: lockable latrine stalls:

משנה תמיד כו,א

ומדורה היתה שם ובית הכסא של כבוד זה היה כבודו מצאו נעול יודע שיש שם אדם פתוח בידוע שאין שם אדם

And a fire was burning there [in a tunnel off of the the side of the Temple in Jerusalem]…and there was a bathroom of honor in the Chamber of Immersion. This was its honor: If one found the door closed, he would know that there was a person there, and he would wait for him to exit before entering.

Restored view of Ithidiki’s lavatory on Amorgos, built in the mid-4th century BCE. From G.P. Antoniou, Lavatories in Ancient Greece. Water Science and Technology, Water Supply 7:1; 156-164.

Restored view of Ithidiki’s lavatory on Amorgos, built in the mid-4th century BCE. From G.P. Antoniou, Lavatories in Ancient Greece. Water Science and Technology, Water Supply 7:1; 156-164.

This notion of privacy was not always shared. Prof Ann Olga Kolowki-Ostrow of Brandeis University is the world’s expert about Roman toilets, and author of the fascinating Archaeology of Sanitation in Roman Italy: Toilets, Sewers, and Water Systems. Virtually every home excavated in Pompeii and Herculaneum has its own private toilet she notes, but the Romans used two terms for their toilets, latrina and forica. The latrina was found in a home or private space and was not publicly accessible, whereas the forica was an open plan multi-seat facility. In contrast, the Mishnah and this passage of Talmud remind us that for Jews, the toilet was supposed to be a very private space.

More Advice on Hygiene

The Talmud has with more advice about what today we would call hygiene:

שטוף ושתי [שטוף] ואחית וכשאתה שותה מים שפוך מהן ואח"כ תן לתלמידך 

When you drink wine, rinse the cup first and only then drink from it; after you drink, rinse the cup and only then set it back in its place. But when you drink water, it is not necessary to rinse the cup afterward; rather, pour out some of the water to rinse the rim of the cup, and afterward you may give the cup to your student, if he wants to drink.

The Essenes and Hygiene

Although ancient Judaism often encouraged frequent bathing and the washing of shared utensils, some sects really emphasized it. One of the most well known was the Essenes, a sect that broke away from Jerusalem and whose members lived around the Dead Sea from the second century BCE to the first century CE. It was this sect that gave us the Dead Sea Scrolls, and in the these scrolls are strict rules for where the Essenes were allowed to defecate. According to a report published in Nature, these places had to be “far enough away from the camp not to be visible, sometimes as much as 3,000 cubits (1.4 kilometres) away in a northwesterly direction. They also had to bury their feces and perform a ritual all-over wash in the local waters afterwards.” The report continues:

At Qumran, following such instructions would take the Essene men to a nicely secluded spot behind a mound. And … the soil there bears the hallmarks of a latrine — and one not used by the healthiest of people.

Dead eggs from intestinal parasites, including roundworm (Ascaris), whipworm (Trichuris), tapeworm (Taenia) and pinworm (Enterobius vermicularis), were preserved in the soil. "If you look at a latrine from the past you will always find these parasites," comments Piers Mitchell, a medical practitioner and archaeologist at Imperial College London, UK.

It seems a pretty ordinary picture of ancient ill health, says Mike Turner, a parasitologist at the University of Glasgow, UK. He describes the pinworm rather aptly as "common as muck", adding that to use its presence to argue that the Essenes wrote the Dead Sea Scrolls is "an interesting bit of lateral thinking…”

[One researcher, J. Zias] is certain that the toilet was used by the scrolls' authors. He was already convinced that the Essenes lived at Qumran from previous studies of the local graveyard, which contains remains of almost exclusively men, which fits with the fact that the Essenes were a monastic sect.

What's more, the men buried there had an average age at death of 34, making them a sickly bunch. But it wasn't the toilet parasites that finished them off, Zias suggests, but their ritual of post-poo bathing in a stagnant pool.

Geography worked against the Essenes because the pool in which they cleansed themselves was filled with run-off collected during the winter months. "Had they been living in Jericho 14 kilometers to the north, where one finds fresh spring water, or in other sites whereby one has an oasis, they would have lived quite well," Zias says.

What rotten luck: a religious code that emphasized bathing, but not the cleanliness of the water itself.

Although it lacked any idea about the causes of communicable diseases, the Talmud sometimes contained what we now understand to be very good public health advice. And the requirement to remove human waste far from habitation predates the Talmud. It is found in the text of the Torah itself:

דברים 23:10

וְיָד֙ תִּהְיֶ֣ה לְךָ֔ מִח֖וּץ לַֽמַּחֲנֶ֑ה וְיָצָ֥אתָ שָׁ֖מָּה חֽוּץ׃ 

וְיָתֵ֛ד תִּהְיֶ֥ה לְךָ֖ עַל־אֲזֵנֶ֑ךָ וְהָיָה֙ בְּשִׁבְתְּךָ֣ ח֔וּץ וְחָפַרְתָּ֣ה בָ֔הּ וְשַׁבְתָּ֖ וְכִסִּ֥יתָ אֶת־צֵאָתֶֽךָ׃ 

כִּי֩ יְה-וָ֨ה אֱלֹקיךָ מִתְהַלֵּ֣ךְ ׀ בְּקֶ֣רֶב מַחֲנֶ֗ךָ לְהַצִּֽילְךָ֙ וְלָתֵ֤ת אֹיְבֶ֙יךָ֙ לְפָנֶ֔יךָ וְהָיָ֥ה מַחֲנֶ֖יךָ קָד֑וֹשׁ וְלֹֽא־יִרְאֶ֤ה

בְךָ֙ עֶרְוַ֣ת דָּבָ֔ר וְשָׁ֖ב מֵאַחֲרֶֽיךָ׃

Further, there shall be an area for you outside the camp, where you may relieve yourself. With your gear you shall have a shovel, and when you have squatted you shall dig a hole with it and cover up your excrement. Since the Lord your God moves about in your camp to protect you and to deliver your enemies to you, let your camp be holy; let Him not find anything unseemly among you and turn away from you.

How fortunate we are that we no-longer have to dig our own outside latrines, or hop behind a fence and use a stone for cleanliness. But much of the world is not as fortunate. The Gates Foundation has donated at least $200 million to fix the problem, and if you want to help, click here to donate to the World Toilet Organization. Tell them it’s in honor of Mar Zutra the Pious.

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Nedarim 80~ Rabbi Yossi on Bathing and Laundry

Today, we take a deep dive into baths.

נדרים דף עט, א - פא, א 

ואלו נדרים שהוא מפר, דברים שיש בהן ענוי נפש: אם ארחץ ואם לא ארחץ ...אלא דאמרה הנאת רחיצה עלי לעולם אם ארחץ היום, ורבי יוסי סבר: ניוול דחד יומא לא שמיה ניוול

מעיין של בני העיר, חייהן וחיי אחרים - חייהן קודמין לחיי אחרים, בהמתם ובהמת אחרים  בהמתם קודמת לבהמת אחרים, כביסתן וכביסת אחרים - כביסתן קודמת לכביסת אחרים, חיי אחרים וכביסתן - חיי אחרים קודמין לכביסתן, רבי יוסי אומר: כביסתן קודמת לחיי אחרים

כביסה אלימא לר' יוסי, דאמר שמואל: האי ערבוביתא דרישא מתיא לידי עוירא, ערבוביתא דמאני מתיא לידי שעמומיתא, ערבוביתא דגופא מתיא לידי שיחני וכיבי

 

These are the vows [made by a wife] that a husband may revoke: matters that involve self-afflction. For example [a wife made a vow] "If I bathe and if I do not bathe..."

What could this mean? She said The pleasure of bathing is forbidden to me forever if I bathe today. And Rabbi Yossi believes that not bathing for one day is not called repugnance...

If a spring belonged to townspeople, [but it does not supply the needs of everyone, whose needs take precedence?] When it is a question of their own lives or the lives of strangers, their own lives take precedence;  the lives of their cattle or the cattle of strangers - their cattle take precedence over those of strangers; their laundering or that of strangers - their laundering takes precedence over that of strangers. But if the choice lies between the lives of strangers and their own laundering, the lives of the strangers take precedence over their own laundering. R. Yossi ruled: Their laundering takes precedence over the lives of strangers...

[The discomfort of not laundering clothes is greater than that of not bathing] according to Rabbi Yossi, as Shmuel taught: filth on the head leads to blindness, dirty clothes leads to dementia, not bathing leads to boils and sores...

Clean Body, Clean Clothes

The passage on today's page in the Talmud seeks to understand the Mishnah (learned yesterday) which taught that a husband may annul his wife's vow if it would interfere with her bathing regime and hence cause her to become, well, smelly and unattractive.  In contrast to this, Rabbi Yossi (a student of Rabbi Akivah and who lived in Israel in the second century CE.) taught that this vow cannot be annulled since he understands that it only prevents her from bathing for a single day - and this brief abstinence does not cause her to become repugnant in her husband's eyes.  In tomorrow's daf the analysis is completed when it is discovered that Rabbi Yossi, while not seeming to be bothered by a lack of one day of bathing, was indeed very bothered by a lack of clean laundry.  How bothered? Well, if it's your water and you only have enough to clean your own laundry or to give an outsider a life sustaining drink, guess who is going to be wearing some clean clothes! Rabbi Yossi was so bothered by dirty clothes that he valued them over life itself (so long as that life was not your own). It seems rather odd, does it not, for Rabbi Yossi to allow a wife to do without bathing for a day and yet hold clean clothing to be really important? To answer this, we need to dive in to the history of bathing.

Jewish, Roman and Early Christian Bathing Habits

The Talmud is replete with statements that emphasize the importance of daily bathing.  A תלמיד חכם (scholar) is forbidden to live in a town that does not have at least one bathhouse, and Hillel the Elder taught his students that going to wash in the bathhouse was a מצוה, since there was a responsibility to care for the human body, created as it was in the very image of God. Hillel seems to have left a cleanliness legacy in his family: his grandson, Rabban Gamliel (who lived in the early part of the first century CE.) was so in need of bathing that he allowed himself to wash on the first night after his wife died - an act that was understood to be forbidden.  In the Jerusalem Talmud, the precedent of Rabban Gamliel is further analyzed. When a rabbi developed boils during his period of mourning (which the Talmud assumes was due to a lack of washing) a certain Rabbi Yassa allowed him to wash immediately - "for otherwise he could die." Rabbi Yassa extended his ruling to allow bathing on (wait for it...) Tisha Be'Av and Yom Kippur - so long as the bathing was to alleviate discomfort rather than for pleasure.   

The famous Greek physician Hippocrates, (died c. 370 BC) wrote about the healing power of warm (and very cold) baths.  But as Katherine Ashenburg wrote in The Dirt on Clean, her definitive (and very readable) history of bathing, "...while the Greeks appreciated water...the Romans adored it."  The Roman desire of cleanliness and their culture of bathing is of course well known to anyone who has visited a Roman ruin in Israel, Italy or elsewhere. The focus on bathing seems to have changed with the fall of the Roman empire and the rise of Christianity. Ashenburg explains that since the first Christians were Jews, a way of distinguishing themselves was to ignore the Jewish laws of ritual purity, which involved so much hand washing and body dipping.  Although ritual purity is not the same as cleanliness, the two became linked, and with the opposition to the Jewish rules of ritual cleanliness, there rose a Christian opposition to bathing.  In the middle ages, some monastic orders allowed only three baths a year, "but monks whose holiness trumped cleanliness could decline any or all baths."

Jesus’ indifference to ritual purity accorded with what later became a wider Christian distrust or neglect of the body.
— Katherine Ashenburg. The Dirt on Clean (North Point Press 2007) p 54.

What few bathhouses there were in medieval Europe were closed during the years of the Great Plague, since the best science of the day taught that heat and water created openings on the skin, through which the plague would enter. Here, for example is Ambroise Pare (c. 1510- 1590) who served as surgeon to four French kings: 

They must close the public hot baths, because on leaving them the muscles and the general tone of the body are relaxed, and the pores are open, and so the vapour of the plague can readily enter the body and cause death at once; there are many cases of this kind.

 "Sadly,” noted Ashenburg “the best medical advice of the day probably doomed many people, for the dirtier people were, the more likely they were to harbor Pulex irritants, the flea now believed to have carried the plague bacillus from rats to humans."

As I point out in my new book on Jews and pandemics, bathing was also frowned upon by eastern European Jews in the 1900s.

According to a Jewish doctor from Wolozyn (now Valozhyn, Belarus), who collected folk curios in the course of his work in the field, it was common practice to avoid changing a patient’s sheets, underwear, and clothing; and washing them with clean water (even wiping their face), and even the use of a cold compresses, would be forbidden. There was no question of opening a window or giving the patient a bath . . . Similar precautions were taken in the room where a woman lay in confinement; moreover, her bed linen would not be changed for four weeks (until her next ritual immersion). The foul air in such rooms was thought to be evidence of the presence of the forces of evil and the struggle against sickness as a demonic being.

Eilizabeth I of England bathed once a month, as she said, “whether I need it or not.” But the seventeenth century raised the bar: it was spectacularly, even defiantly dirty. Elizabeth’s successor, James I, reportedly washed only his fingers, The body odor of Henri IV of France (1553-1610) was notorious, as was that of this son Louis XIII. He boasted, “I take after my father, I smell of armpits”.
— Ashenburg. The Dirt on Clean. p99.

Clean Linens and Rabbi Yossi

While washing the body was generally avoided in seventeenth century Europe, clean clothes were most certainly demanded, especially among the middle and upper classes.  "Clean linen" writes Ashenburg, "was not a substitute for washing the body with water - it was better than that, safer, more reliable and based on scientific principles." And here perhaps is an echo of the position of Rabbi Yossi in today's page of Talmud.  To be clear: Rabbi Yossi was not arguing that bathing was not important - rather he argued about the length of time a person could forgo a bath and not become "repulsive" to a spouse.  But his emphasis on the need for laundered and clean clothes is striking.  The Talmud (Nedarim 81a) relates Rabbi Yossi's concerns to a teaching of the physician ShmuelFilth on the head leads to blindness, dirty clothes leads to dementia, and not bathing leads to boils and sores..." According to Rabbenu Nissim, (a fourteenth century commentator known by his acronym as the Ran), the first and third of these conditions may be cured - but not the dementia caused by dirty clothes. That's why Rabbi Yossi claimed that the water needed to do the laundry was so important.  Here's the text of the Ran:

כשגופו מזוהם שאינו רוחץ תמיד מביאו לידי שיחנא וכיבי אבעבועות המכאיבות ולאלו יש רפואות אבל שעמום קשה מהן אלמא כביסה אלימא מרחיצה

Bathing and Healing

In a 2002 a review of the history of spa therapies was published in Annals of the Rheumatic Diseasesthe authors noted that several randomised controlled trials had studied the effects of spa therapy in rheumatoid arthritis and osteoarthritis but that "definite judgment about its efficacy is impossible because of methodological flaws in these studies." However, "...overall, the results showed positive effects lasting for three to nine months. Recently, a randomised controlled trial has shown that spa therapy is clearly effective in ankylosing spondylitis. Two intervention groups followed a three week course of spa therapy at two different spa resorts, and were compared with a control group who stayed at home and continued standard treatment consisting of anti-inflammatory drugs and weekly group physical therapy. Significant improvements in function, pain, global wellbeing, and morning stiffness were found for both intervention groups until nine months after spa therapy." 

Bathing - and clean clothes - are social customs that have changed and changed again over time. We  know of no evidence to support Rabbi Yossi's link between dementia and clean clothes, but at other times and on other cultures clean clothes were indeed valued far beyond a clean body.  And today, bathing and doing the laundry still seem like rather good ideas.

Throughout the ages the interest in the use of water in medicine has fluctuated from century to century and from nation to nation. The (medical) world has viewed it with different opinions, from very enthusiastic to extremely critical, and from beneficial to harmful. Today, spa therapy is receiving renewed attention from many medical specialties and health tourists, and having a revival. However, the exact therapeutic potential of spa therapy still remains largely unknown. Better and more profound scientific evidence for its efficacy is therefore warranted, in particular for its effects on the musculo-skeletal system.
— van Tubergen and van der Linden. A Brief History of Spa Therapy. Ann Rheum Dis 2002;61:275
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Shabbat 81 ~ A History of Toilet Paper

First patent for Toilet paper.jpg

Toilet paper has been in short supply recently. But it was non-existent in talmudic times. People used stones instead. Today’s page of Talmud gets into the details of personal hygiene, and discusses how the stones used to clean oneself after defecation may be prepared and used on Shabbat:

שבת פא,א

זוּנִין עַל לְבֵי מִדְרְשָׁא, אֲמַר לְהוּ: רַבּוֹתַי, אֲבָנִים שֶׁל בֵּית הַכִּסֵּא שִׁיעוּרָן בְּכַמָּה? אָמְרוּ לוֹ: כְּזַיִת כֶּאֱגוֹז וּכְבֵיצָה. אֲמַר לְהוּ: וְכִי טוּרְטָנֵי יַכְנִיס? נִמְנוּ וְגָמְרוּ מְלֹא הַיָּד. תַּנְיָא, רַבִּי יוֹסֵי אוֹמֵר: כְּזַיִת כֶּאֱגוֹז וּכְבֵיצָה. רַבִּי שִׁמְעוֹן בְּרַבִּי יוֹסֵי אוֹמֵר מִשּׁוּם אָבִיו: מְלֹא הַיָּד

Examples of terracotta pessoi found in Roman latrines dating from the 2nd century AD. The one on the left comes from Utica (Sicily). The one the right was found in Crete. From Charlier, P. Brun L. Prêtre C. Huynh-Charler I. Toilet Hygiene in the Cla…

Examples of terracotta pessoi found in Roman latrines dating from the 2nd century AD. The one on the left comes from Utica (Sicily). The one the right was found in Crete. From Charlier, P. Brun L. Prêtre C. Huynh-Charler I. Toilet Hygiene in the Classical era. British Medical Journal. 2012; 345; e8287.

The Gemara relates: Zunin entered the study hall and said to the Sages: My teachers, with regard to stones that may be moved on Shabbat for wiping in the bathroom, how much is their measure? They said to him: Stones of only three sizes may be moved for that purpose: An olive-bulk, a nut-bulk, and an egg-bulk. He said to them: And will he take scales [turtani] into the bathroom to weigh each stone? They were counted and the Sages concluded that one need not measure the stones. He simply takes a handful of stones. It was taught in a baraita: Rabbi Yosei says the measure of bathroom stones is an olive-bulk, a nut-bulk, and an egg-bulk. Rabbi Shimon, son of Rabbi Yosei, says in the name of his father: One need not measure the stones. He simply takes a handful of stones.

Roman Toilet HygiEne

Museum of Fine Arts Boston. Drinking Cup (kylix) c. 500 BCE. From Orvieto Greece. A gift of Edward Perry Warren to MFA; accessioned 1910. Accession # RES.08.31b

Museum of Fine Arts Boston. Drinking Cup (kylix) c. 500 BCE. From Orvieto Greece. A gift of Edward Perry Warren to MFA; accessioned 1910. Accession # RES.08.31b

In a helpful paper titled Toilet hygiene in the classical era, the authors explain that in the Roman world there was no toilet paper. After defecation, the Roman rear end would be cleaned with a natural sponge attached to a stick called a tersorium. This sponge was then rinsed off in water or vinegar and thoughtfully left for the next person to use. They also used small stones or ceramic fragments called pessoi in place of a sponge, much like those described in today’s page of Talmud. These pessoi have been uncovered in ancient latrines all around the Mediterranean.

The next time you have a chance to visit the Museum of Fine Arts in Boston, have a look at their Greek drinking cup or kylix dated around 500 BCE (accession number RES.08.31b.) It demonstrates (as if you needed an explanation) how these pessoi were used. A man is shown semi-squatting with his clothing raised. While he maintains his balance with a cane in his right hand he is clearly wiping his buttocks using a pessos with his left hand. So now you know.

Early Toilet Paper

I remember waxed toilet paper, rather like baking paper (yes, it was once a thing) from my grandparents homes in north London in the 1960s and 70s. Rather inexplicably, the British once liked their paper to be hard and impervious to absorbing anything, and had to be persuaded to try a softer approach.

Toilet paper was used in China as early as the sixth century CE. In fact the scholar Ten Chih-Thui (531-91 CE) wrote that “paper on which there are quotations or commentaries from Five Classics or the names of sages, I dare not use for toilet purposes.” All this was a bit much for an Arab traveller through China in 851. He was horrified at the practice of using toilet paper: “They are not careful about cleanliness, and they do not wash themselves with water when they have done their necessities; but they only wipe themselves with paper.” One can only wonder what the traveller would have thought of the English and their waxed shiny toilet paper.

Ad for soft TP.jpg

Toilet Paper and Human Dignity

Later in today’s page of Talmud, Rav Chisdah was asked if it would be permitted to carry the pessoi up to a rooftop latrine on Shabbat. The concern here is that this would involve additional exertion, which is forbidden. Rav Chisdah ruled that it was certainly permissible, because “human dignity is so important that it suspends a prohibition of the Torah” (גָּדוֹל כְּבוֹד הַבְּרִיּוֹת שֶׁדּוֹחֶה אֶת ״לֹא תַעֲשֶׂה״ שֶׁבַּתּוֹרָה).

This lofty principal has many disparate applications; it has been cited in modern responsa literature as the driving force behind allowing the deaf to wear hearing aids on Shabbat, or allowing women to be called to read from the Torah. But from today’s page of Talmud we are reminded that, for the rabbis of the Talmud, the principal of human dignity operates in our most private and intimate spaces.

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Shabbat 50a ~ Cleanliness is next to Godliness

שבת נ, ב

דְּתַנְיָא: רוֹחֵץ אָדָם פָּנָיו יָדָיו וְרַגְלָיו בְּכׇל יוֹם בִּשְׁבִיל קוֹנוֹ, מִשּׁוּם שֶׁנֶּאֱמַר: ״כֹּל פָּעַל ה׳ לַמַּעֲנֵהוּ״

It was taught in a baraita: A person must wash his face, his hands, and his feet every day for the sake of his Maker, as it is stated: “The Lord has made everything for His own purpose” (Proverbs 16:4).

Cleanliness, it is said, is next to Godliness. Its is an odd phrase, suggesting that being clean is an attribute of divinity. Today’s passage in the Talmud suggests that cleanliness is a feature of a God-fearing person. Here is how Rashi, the eleventh-century exegete, explains it:

בשביל קונהו - לכבוד קונהו דכתיב (בראשית ט׳:ו׳) כי בצלם אלהים עשה וגו' ועוד דהרואה בריות נאות אומר ברוך שככה לו בעולמו

For the sake of his Maker: to honor his maker, as it is written (Gen. 9:6) “For he was made in the image of God.” In addition, when others see a clean person they will say “Blessed Be He who created this in His world.

As we will see, it wan’t just the face hands and feet that should be washed daily.

Early Christianity and its rejection of Hand washing

Washing and bathing rituals have been a part of Judaism since its inception, and it was over some of these rituals that the early Christians broke away from Judaism. Jesus spent much of his time among the ritually impure, which annoyed the rabbinate of the day. In the Gospel of Mark (7:1-23) we read that Jesus’ disciples ate bread with out having washed their hands. This was a remarkable rebellion, “For the Pharisees, and all the Jews do not eat unless they give their hands a ceremonial washing, holding to the tradition of the elders.” When criticized for this, Jesus belittled the practices and accused those who followed it of hypocracy: “Isaiah was right when he prophesied about you hypocrites; as it is written: “‘These people honor me with their lips, but their hearts are far from me. They worship me in vain; their teachings are merely human rules.’” From then on, Judaism and Christianity adopted very different attitudes towards personal hygiene and cleanliness.

Jesus’ indifference to ritual purity accorded with what later became a wider Christian distrust or neglect of the body.
— Katherine Ashenburg. The Dirt on Clean (North Point Press 2007) p 54.

Clean Body, Clean Clothes

Elsewhere, there Talmud outlines the importance of bathing in a discussion about vows:


נדרים דף עט, א - פא, א 

ואלו נדרים שהוא מפר, דברים שיש בהן ענוי נפש: אם ארחץ ואם לא ארחץ ...אלא דאמרה הנאת רחיצה עלי לעולם אם ארחץ היום, ורבי יוסי סבר: ניוול דחד יומא לא שמיה ניוול

מעיין של בני העיר, חייהן וחיי אחרים - חייהן קודמין לחיי אחרים, בהמתם ובהמת אחרים  בהמתם קודמת לבהמת אחרים, כביסתן וכביסת אחרים - כביסתן קודמת לכביסת אחרים, חיי אחרים וכביסתן - חיי אחרים קודמין לכביסתן, רבי יוסי אומר: כביסתן קודמת לחיי אחרים

כביסה אלימא לר' יוסי, דאמר שמואל: האי ערבוביתא דרישא מתיא לידי עוירא, ערבוביתא דמאני מתיא לידי שעמומיתא, ערבוביתא דגופא מתיא לידי שיחני וכיבי

 

These are the vows [made by a wife] that a husband may revoke: matters that involve self-afflction. For example [a wife made a vow] "If I bathe and if I do not bathe..."

What could this mean? She said The pleasure of bathing is forbidden to me forever if I bathe today. And Rabbi Yossi believes that not bathing for one day is not called repugnance...

If a spring belonged to townspeople, [but it does not supply the needs of everyone, whose needs take precedence?] When it is a question of their own lives or the lives of strangers, their own lives take precedence;  the lives of their cattle or the cattle of strangers - their cattle take precedence over those of strangers; their laundering or that of strangers - their laundering takes precedence over that of strangers. But if the choice lies between the lives of strangers and their own laundering, the lives of the strangers take precedence over their own laundering. R. Yossi ruled: Their laundering takes precedence over the lives of strangers...

[The discomfort of not laundering clothes is greater than that of not bathing] according to Rabbi Yossi, as Shmuel taught: filth on the head leads to blindness, dirty clothes leads to dementia, not bathing leads to boils and sores...

This passage seeks to understand a Mishnah which taught that a husband may annul his wife's vow if it would interfere with her bathing regime and hence cause her to become, well, smelly and unattractive.  In contrast to this, Rabbi Yossi (a student of Rabbi Akivah and who lived in Israel in the second century C.E.) taught that this vow cannot be annulled, since he understands that it only prevents her from bathing for a single day - and this brief abstinence does not cause her to become repugnant in her husband's eyes.  The analysis is completed when it is discovered that Rabbi Yossi, while not seeming to be bothered by a lack of one day of bathing, was indeed very bothered by a lack of clean laundry.  How bothered? Well, if it's your water and you only have enough to clean your own laundry or to give an outsider a life sustaining drink, guess who is going to be wearing some clean clothes! Rabbi Yossi was so bothered by dirty clothes that he valued them over life itself (so long as that life was not your own). It seems rather odd, does it not, for Rabbi Yossi to allow a wife to do without bathing for a day and yet hold clean clothing to be really important? To answer this, we need to dive in to the history of bathing.

Jewish, Roman and Early Christian Bathing Habits

The Talmud is replete with statements that emphasize the importance of daily bathing.  A scholar (תלמיד חכם) is forbidden to live in a town that does not have at least one bathhouse, and Hillel the Elder taught his students that going to wash in the bathhouse was a mitzvah, since there was a responsibility to care for the human body, created as it was in the very image of God. Hillel seems to have left a cleanliness legacy in his family: his grandson, Rabban Gamliel (who lived in the early part of the first century CE.) was so in need of bathing that he allowed himself to wash on the first night after his wife died - an act that was forbidden.

In the Jerusalem Talmud, the precedent of Rabban Gamliel is further analyzed. When a rabbi developed boils during his period of mourning (which the Talmud assumes was due to a lack of washing) a certain Rabbi Yassa allowed him to wash immediately - "for otherwise he could die." Rabbi Yassa extended his ruling to allow bathing on (wait for it...) Tisha Be'Av and Yom Kippur - so long as the bathing was to alleviate discomfort rather than for pleasure. The famous Greek physician Hippocrates, (died c. 370 BC) wrote about the healing power of warm (and very cold) baths.  But as Katherine Ashenburg wrote in The Dirt on Clean, her definitive (and very readable) history of bathing, "...while the Greeks appreciated water...the Romans adored it."  The Roman desire of cleanliness and their culture of bathing is of course well known to anyone who has visited a Roman ruin in Israel, Italy or elsewhere.

The focus on bathing seems to have changed with the fall of the Roman empire and the rise of Christianity. Ashenburg explains that since the first Christians were Jews, a way of distinguishing themselves - as we have noted - was to ignore the Jewish laws of ritual purity, which involved so much hand washing and body dipping.  Although ritual purity is not the same as cleanliness, the two became linked, and with the opposition to the Jewish rules of ritual cleanliness, there rose a Christian opposition to bathing.  In the middle ages, some monastic orders allowed only three baths a year, "but monks whose holiness trumped cleanliness could decline any or all baths." What few bathhouses there were in medieval Europe were closed during the years of the Great Plague, since the best science of the day taught that heat and water created openings on the skin, through which the plague would enter.  "Sadly, the best medical advice of the day probably doomed many people, for the dirtier people were, the more likely they were to harbor Pulex irritants, the flea now believed to have carried the plague bacillus from rats to humans."

Eilizabeth I of England bathed once a month, as she said, “whether I need it or not.” But the seventeenth century raised the bar: it was spectacularly, even defiantly dirty. Elizabeth’s successor, James I, reportedly washed only his fingers, The body odor of Henri IV of France (1553-1610) was notorious, as was that of this son Louis XIII. He boasted, “I take after my father, I smell of armpits”.
— Ashenburg. The Dirt on Clean. p99.

Clean Linens and Rabbi Yossi

While washing the body was generally avoided in seventeenth century Europe, clean clothes were most certainly demanded, especially among the middle and upper classes.  "Clean linen" writes Ashenburg, "was not a substitute for washing the body with water - it was better than that, safer, more reliable and based on scientific principles." And here perhaps is an echo of the position of Rabbi Yossi in Nedarim.  To be clear: Rabbi Yossi was not arguing that bathing was not important - rather he argued about the length of time a person could forgo a bath and not become "repulsive" to a spouse.  But his emphasis on the need for laundered and clean clothes is striking.  As we noted, the Talmud (Nedarim 81a) relates Rabbi Yossi's concerns to a teaching of the physician ShmuelFilth on the head leads to blindness, dirty clothes leads to dementia, and not bathing leads to boils and sores..." According to Rabbenu Nissim, (a fourteenth century commentator known by his acronym as the Ran, but pronounced Run), the first and third of these conditions may be cured - but not the dementia caused by dirty clothes. That's why Rabbi Yossi claimed that the water needed to do the laundry was so important.  Here's the text of the Ran:

כשגופו מזוהם שאינו רוחץ תמיד מביאו לידי שיחנא וכיבי אבעבועות המכאיבות ולאלו יש רפואות אבל שעמום קשה מהן אלמא כביסה אלימא מרחיצה

Bathing and Healing

In a 2002 a review of the history of spa therapies was published in Annals of the Rheumatic Diseasesthe authors noted that several randomised controlled trials had studied the effects of spa therapy in rheumatoid arthritis and osteoarthritis but that "definite judgment about its efficacy is impossible because of methodological flaws in these studies." However, "...overall, the results showed positive effects lasting for three to nine months. Recently, a randomised controlled trial has shown that spa therapy is clearly effective in ankylosing spondylitis. Two intervention groups followed a three week course of spa therapy at two different spa resorts, and were compared with a control group who stayed at home and continued standard treatment consisting of anti-inflammatory drugs and weekly group physical therapy. Significant improvements in function, pain, global wellbeing, and morning stiffness were found for both intervention groups until nine months after spa therapy." 

Bathing - and clean clothes - are social customs that have changed and changed again over time. We  know of no evidence to support Rabbi Yossi's link between dementia and clean clothes, but at other times and in other cultures clean clothes were indeed valued far beyond a clean body.  And today, in the midst of the COVID pandemic, bathing, laundry and above all hand-washing still seem like rather good ideas.

Avraham HaCohen. Millel LeAvraham. Bnei Brak 1980. 145.

Avraham HaCohen. Millel LeAvraham. Bnei Brak 1980. 145.

Furthermore, during the enormous [influenza] pandemic after the First World War which killed many from across all nations, very few Jews died…There are a number of practices over the generations that prove that our Torah is a Torah of Life. Even now, during the cholera, may we be spared, the Ministry of Health has declared that everyone must wash their hands prior to eating, and must wash all fruit and edibles very well. Blessed be He who has chosen us and given us the Torah of Truth. Thus is what is meant when they said how great is the Torah which instills life into those who follow it both in this world and how much more in the world to come, the Eternal World!

[A partial repost from here.]

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