Bava Kamma 115b ~ Drinking Snake Venom

בבא קמא קטו, ב

והתניא מים שנתגלו הרי זה לא ישפכם ברשות הרבים ולא יגבל בהן את הטיט ולא ירבץ בהן את הבית ולא ישקה מהם את בהמתו ולא בהמת חבירו

It was taught in a Baraisa: water that was left uncovered should not be spilled out in a public area, nor should one knead clay with it, nor should one lay in the dust with it, nor should one give it to his animal, nor the animal of his friend, to drink. (Bava Kamma 115b)

Don't Drink That Water!

The rabbis of the Talmud were very worried indeed about the health effects of water that had been left uncovered.  This concern was codified by Maimonides, and later by Ya'akov ben Asher (d. 1340) in his famous halakhic work called the Arba'ah Turim. 

טור יורה דעה הלכות מאכלי עובדי כוכבים סימן קטז 

דברים האסורים משום סכנה
  יש דברים שאסרום חכמים משום סכנה כגון משקין שנתגלו שיש לחוש שמא שתה מהן נחש והטיל בהן ארס אפי' אם שתו מהן אחרים ולא הוזקו אין לשתות מהן  שיש נחש שהארס צף למעלה ויש שארס שלו מפעפע עד אמצעית המשקה  ויש שהארס שלו שוקע לשולי הכלי לפיכך אפי' שתו ממנו אחרים ולא הוזקו אין לשתות מהן דשמא ארס של הנחש ששתה מהן שוקע ואלו המשקין שיש בהן משום גילוי מים יין חלב ודבש ושום כתוש 

Tur, Yoreh De'ah 116. Things that are Prohibited Because they are Dangerous

There are things that the rabbis of the Talmud prohibited because they are dangerous. For example, liquids that were left uncovered, because of the possibility that a snake drank from the water and expelled some of its poison into them. Even if others had drunk from the liquid, and not been injured, one should not drink from them.  For some snake venom floats on the surface, and some sinks to the middle and some moves to the edges of the vessel. Therefore, even if others had drunk and had suffered no harm, one should not drink from them, for perhaps the venom from the snake that had drunk the water had sunk to the bottom. The following liquids should not be drunk if they were left overnight in an uncovered vessel: water, wine, milk, honey, and crushed garlic...

The normative Code of Jewish Law, the שולחן ערוך agreed, but added an important caveat:

שולחן ערוך יורה דעה הלכות מאכלי עובדי כוכבים סימן קטז סעיף א 

משקים שנתגלו, אסרום חכמים דחיישינן שמא שתה נחש מהם והטיל בהם ארס. ועכשיו שאין נחשים מצויים בינינו, מותר

The rabbis forbade drinking from liquids that were left uncovered,. They were concerned that a snake may have drunk from them and expelled some of its poison into them. But now that snakes are not commonly encountered, this is permitted. (Shulchan Aruch Yoreh De'ah 116:1)

So today it is permitted for us to drink from an uncovered pot, but only in a place that does not have a problem with poisonous snakes.  Which is not helpful. There are poisonous snakes in nearly every state in the US, resulting in about 2,000 human envenomations each year, and we have noted before that Israel has its own problem with snakes, including the Palestinian Viper.  The World Health Organization estimates that snakes kill between 20,000 and 94,000 people per year. So exactly where this leniency of the Shulchan Aruch might apply is not clear.

But is drinking snake venom indeed dangerous? Maybe not. In 2012 India Today reported that police in New Delhi had seized about half a liter of snake venom to be used "in high-end raves planned for Valentine's Day in and around the national capital." Apparently the venom, when ingested, produces a euphoric state. Who knew?

Video evidence - Drinking Cobra Venom

It is really hard to find any peer-reviewed scientific studies about people drinking snake venom, because, um, it's a silly thing to do.  But that doesn't mean it hasn't been done. So where could we turn to find people doing silly things? YouTube of course. This video involves drinking the venom directly from spitting snake. Apparently, these kind of human interest stories are popular in India. 

Why it is safe to drink snake venom

If you are a diabetic and take insulin, or know someone who does, you may have wondered why the drug has to be injected. It would, after all, be much less bothersome to swallow an insulin pill than to inject insulin several times a day.  The reason is that insulin is a protein, and like all proteins, it is easily broken down by heat and, more importantly, by the acid environment in the stomach.  Our gastrointestinal tracts evolved to break down proteins into their building blocks - and they perform a wonderful job doing precisely that.

Like insulin, snake venom is a complex protein. And so, like insulin, it too is easily broken down in the very acidic environment of your stomach.  Of course, if intact venom gets into your bloodstream, it could kill you. But if you drink venom, then the intact protein never does get into your bloodstream. You don't need to be an Indian snake charmer to safely drink snake venom. You just need a working digestive system.

HOW SNAKES DRINK

 In case you were wondering how we know how snakes drink, here is a diagrammatic view of the apparatus used to record the kinematics and water transport during drinking. The video camera was placed to the left. LED, light-emitting diode. From Cundall, D. Drinking in snakes: kinematic cycling and water transport. The Journal of Experimental Biology. 2000; 203, 2171–2185.

The Talmud was concerned that snakes leave venom in water from which they drank, and that a person drinking from that water would then suffer from envenomation. As we have seen, this concern has no biological basis, although theoretically, if there was an open cut or ulcer in the mouth, ingested venom could get into the bloodstream and then cause its havoc.  But there is another reason why the talmudic concern is overstated.  Snakes, you see, don't leave any venom when they drink water.  As you may have noted from watching the first video, it takes a lot to get a snake to expel its venom - like sticking a blue pen in its mouth.  Venom is a snake's most precious commodity, and it has evolved to protect that commodity. Snakes only release venom when they are in danger, or ready to strike their prey, and not otherwise. Want a great example? The venomous rattlesnake. That species has evolved a warning rattle to tell would-be predators that if they get any closer, they will be bitten. This only makes evolutionary sense if it was in the snake's best interest to do everything possible to conserve its venom.

In a fascinating article on how snakes drink published in The Journal of Experimental Biology, David Cundall notes that a snake's tongue does not carry or move water, and that "in many snakes, the tongue does not visibly move during drinking." That leads to the conclusion that snakes are suction drinkers. And that makes them even less likely to leave any venom behind in the water.

“As far as is known, all snakes are suction drinkers, and the only critical structural variations that might be predicted to influence drinking performance are the relative dimensions and shapes of the mandibles and their suspensorial elements and the arrangements of intermandibular muscles and connective tissues.”

— Cundall, D. Drinking in snakes: kinematic cycling and water transport. The Journal of Experimental Biology. 2000; 203, 2171–2185.

So let's put this all together:

1. Snakes don't release their venom unless they are threatened or hunting. 

2. Snakes use suction when they drink water. Their mouths are not open, which is needed when they are expelling venom.

3. Snake venom is not dangerous when drunk.

4. (If somehow venom did get into the water, it would be greatly diluted.)

So there is no danger if you were to drink from water from which a venomous snake had drunk. None.

Rashi's Two Explanations of Today's Passage

In today's page of Talmud, we are warned not to drink water left standing, because of the danger of a venomous snake having drunk from it.  That danger, as we have seen, does not exist.  But the Talmud also warns us not to use this water to sprinkle on a dirt floor to keep the dust down. According to Rashi, the concern is that a person might cut her foot on a sharp stone left on the floor, which would then allow the venom that was in the water that was sprinkled on that floor to enter the bloodstream. Now that is an incredibly unlikely event, but it is certainly possible, and Rashi's point is absolutely correct. The danger is only if there is an open wound that would allow the venom to enter the blood stream. (שלא יעבור עליהם אדם יחף ויכנס ארס של נחש ברגלו ע"י מכת צרור וימות.)  It is fascinating to compare Rashi's explanation here with his explanation of the the identical passage found in Avodah Zarah (30b).  

 לא ישפכם: שמא יעבור אדם יחף ויעמוד הארס בין קשרי אצבעותיו וכיון שנכנס מעט ונוקב   בבשר שוב אין לו רפואה. רשי, עבודה זרה ל, ב

There, Rashi notes that if "venomous" water was sprinkled on the floor, a person might step on it and absorb the venom through the skin of his toe joints. Once that happens, "שוב אין לו רפואה" - there is no medical treatment. What Rashi may not have known is that snake venom is not dangerous if it gets on your skin, because it is not absorbed from there into the bloodstream.  So his explanation in Avodah Zara is not correct, unlike his explanation of the passage in today's daf.

Bye Bye Bava Kamma

And that brings us to the end of Talmudology on Bava Kamma, which we will finish learning this Thursday. We've discussed all kinds of topics:

Whether wolves can be tamed

Whether donkeys could break pottery with their braying

The talmudic and legal liability for dog bites

Whether a man is liable for injuring his wife during intercourse

How animals feel pain

Liability in bullfighting

Deaths from falling

Whether a goose has a scrotum

Whether kosher and non-kosher animals might cross-breed

Whether garlic is good for you

Whether honey is bad for you

How animals faced trial

And more besides.  Now it is time to turn to the next tractate. I'll see you on the opening page of Bava Metziah,  when we will discuss game theory and the work of the Israeli Nobel prize winner Robert Aumann.

Bava Kamma 15b ~ Where the Wild Things Are

 בבא קמא טו,ב

הזאב והארי והדוב והנמר והברדלס והנחש הרי אלו מועדין רבי אלעזר אומר בזמן שהן בני תרבות אינן מועדין והנחש מועד לעולם

The the wolf, the lion, the bear, the leopard, the bardalis and the snake are considered to be forewarned [so that if they cause damage their owner must pay in full].  R. Eleazar says: if they have been tamed, they are not forewarned; the snake, however, is always forwarned.

Wild Animals gone...Wild

In July 2012, while touring a hospital in Johannesburg, I was given a brutal reminder of the dangers posed by the wild animals were were about to see on safari. In the Intensive Care unit and fighting for his life was a young American named Andrew Oberle, who had come to South Africa to study the chimps. Oberle, a twenty-six year old student, had left the group he was guiding and entered a 'no-go' zone. Two chimps interpreted this as an act of aggression, grabbed the young American, and dragged him into their enclosure. By the time he was finally rescued, Oberline had suffered these injuries: 

The chimps tore away his scalp down to the skull. His ears and nose are gone, and he can’t close his right eye. He has wounds on his trunk and all four limbs. He’s lost most of his fingers, and his right forearm has been eaten, the tendons gone. He’s lost parts of his feet, and his right ankle is destroyed.

(Oberle survived his attack, and in December 2017 he talked about it on podcast which you can listen to here.)

Then there was bear enthusiast Timothy Treadwell (who later became the subject of an excellent 2005 documentary by Werner Herzog).  Treadwell was a self-described bear conservationist, although he lacked any formal training in the field and was frequently at odds with the Park Service. In October 2003, Treadwell and his girlfriend were mauled and eaten by a Grizzly bear in Alaska's Katmai National Park. Thus far, two examples of wild animals acting, well, wild.  

What about training these wild animals to perform tricks?  Well, there's a cautionary tale in that too. Do you recall the great illusionists Siegfried Fischbacher and Roy Horn, the pair of magicians who became world famous for their performances with white lions? For over thirteen years Siegfried and Roy performed at the Mirage Hotel in Las Vegas, until um, they stopped. On October 3, 2003 Roy was bitten in the neck by a seven year old tiger named Manticore, who dragged him off the stage "like a ragdoll." He almost bled to death, and remains partially paralyzed as a result of the attack.  So how could Rabbi Eleazar possibly claim that animals as wild as a lion or a bear ever be considered tame or domesticated? Well, read on...

Domestication

The Encyclopaedia Britannica defines domestication as

the process of hereditary reorganization of wild animals and plants into domestic and cultivated forms according to the interests of people. In its strictest sense, it refers to the initial stage of human mastery of wild animals and plants. The fundamental distinction of domesticated animals and plants from their wild ancestors is that they are created by human labour to meet specific requirements or whims and are adapted to the conditions of continuous care and solicitude people maintain for them.

Thus we speak of domesticated horses and wild horses, domesticated bees and wild bees, and domesticated plants -(think tobacco, and corn)- and wild plants. What turns a species from a wild to a domesticated form is human patience and careful breeding. But the late professor of anthropology Charles Reed (d. 2000) wrote that many animals are naturally tame - or at least not afraid of human contact:

Among these are manatees, who may not even move aside as one swim among them; sea-otters, from whom one can take the young without any defense by the mother; various basking seals, elephant-seals and sea-lions, among who (other than the males in breeding season) one can walk unconcerned, and whose young, if they've lost their mothers, will follow any human hoping to be fed; various of the porpoises and dolphins, who seem to have no fear of man, and even the great whales.

Can Wolves be Tamed?

The Mishnah on today's page of Talmud stated that six species of animal can never be relied upon to have been domesticated. One of these is the wolf, which seems kind of reasonable, even allowing for the fact that our dogs are descended from them.  But wolves have also been successfully raised as family pets, (though you should probably check with your spouse before bringing home a wolf cub for the family). "Actually" wrote Charles Reed, "wolf pups reared as a group in Alaskan isolation or a single pup brought up with children and dogs in an urban family are wonderfully affectionate, social, dynamic, interesting, and of course intelligent fellow citizens." Which sounds rather like the opinion of Rabbi Eleazar, who believed that wolves, (and bears, lions and leopards) may be tamed so successfully that they end up about as aggressive as domestic goats.

“Wild animals ain’t so wild, as shown again by a wild-caught penned wolverine in Alaska, which, within a few days of capture, was taking food from the hand...when the hand was empty, the wolverine gently, with its incisor teeth, held the lady’s fingertips without braking the skin.”

— Charles A. Reed. Wild Animals Ain't So Wild, Domesticating Them Not So Difficult. Expedition 1986. 28 (2) 8-15.

A Pet Grizzly Bear called ben franklin

In the Mishnah, Rabbi Eleazar spoke not only of a tame wolf - but of a tame bear.  While our modern sensibilities would be outraged at the notion of raising a wild bear as a pet, these sensibilities are, to be sure, modern indeed. In a charming article published in the American Naturalist in 1886, John Caton described the domestication of the grizzly bear. Just to remind you- a small grizzly bear weights 400 pounds and stands about six and a half feet tall. Now read on:

Among others he [a certain James Adams] fairly domesticated quite a number of the grizzly bear (Ursus ferox Lewis and Clark) with complete success. This is the largest and fiercest known of all the species, and it might be expected the most intractable or unsubmissive to human control, yet such appears not to have been the case.

The first specimens experimented with were two cubs, over a year old when caught, taken in Washington Territory, between Lewis and Clark's fork of the Columbia. They were brother and sister; the latter was retained by Adams, and his experiments were principally conducted on her, which he called " Lady Washington." She seems to have been the more tractable and submissive. The male he parted with to a friend, after he had received but the rudiments of his education. At first they were chained to trees near the camp-fire, and resisted all attempts at familiarity and kindness; then severity was adopted, until they finally submitted.

Soon after the male was parted with, and we have no account of his subsequent career. The female was always after treated with the utmost kindness, and in a few months became as tractable as a dog. She followed her master in his hunting excursions, fought for him with other grizzlies, and saved him from the greatest perils.

She slept at his feet around the camp-fire, and took the place of a most vigilant watch-dog. He taught her to carry burdens with the docility of a mule, and as she grew up her great strength enabled her to render him great assistance in this way.

Another bear of the same species he captured in the Sierras in California before its eyes were open, and raised it on a greyhound bitch in company with her own pup. This he called Ben Franklin, and proved more docile even than the first. He never found it necessary to confine in any way this specimen, but he was allowed to roam and hunt with his foster brother, the grayhound [sic]. They were inseparable companions, and seemed to have as much affection for each other as if they had been of the same species, Before he was full-grown, when his master was attacked by a wounded grizzly, he joined in the fight with such ferocity as to save his master's life, and though he was severely wounded in this contest, with careful nursing he survived, and ever after showed as much courage in attacking his own species as if he had not met with this severe punishment.

I know what you are thinking: grizzly bears are found only in North America, but bears in Israel were a species of the brown bear called Ursus arctos syriacus, or the Syrian Brown Bear. Well that's true, but it's not only grizzly bears that make cuddly pets; the same owner of Ben Franklin, the pet grizzly, also kept black bears (and who knows, perhaps brown ones too):

He found the black bear, when raised in camp, as readily domesticated as the grizzly, and as fond of his society, following him about the camp and through the woods with fidelity and attachment.

So there we have it. Evidence to support Rabbi Eleazar's dissenting opinion that many wild animals may become as domesticated as a dog or cat.  Still, best to stick with dogs and cats as pets.  They take up far less space than the enormous, though very cute, grizzly bear.

Yevamot 116b~ Of Snake Bites, Palestinian and Israeli

The Palestinian Viper צפע ארצישראלי. Vipera palaestinae

יבמות קטז, ב

דאמר רב יהודה אמר שמואל שילפי קציר חטין היו והלכו עשרה בני אדם לקצור חטין נשכו נחש לאחד מהן ומת

Rav Yehudah said in the name of Shmuel: It was the end of the harvest when ten men went to reap their wheat; a snake bit one of them and he died

Snake bites were a widespread fear in ancient Israel. The Talmud warns that snakes can be found in houses and records a snake attack that occurred in the toilet, so going to the bathroom was a risk to one’s life. (Snakes still appear  to make relieving oneself in the Holy Land a dangerous enterprise, if this report is to be believed.)  And because of the possibility that a snake had discharged its venom into a standing bucket of liquids, the Talmud ruled that it is forbidden to drink from a liquid that had been left uncovered [Terumot 8:4] – a ruling codified, (with some changes) into normative Jewish law.

שולחן ערוך יורה דעה קטז

  משקים שנתגלו, אסרום חכמים דחיישינן שמא שתה נחש מהם והטיל בהם ארס. ועכשיו   שאין נחשים מצויים בינינו, מותר

Liquids that have been left uncovered [overnight] were forbidden by the rabbis, because of the concern that a snake may have drank from them and left its venom in them. Today, when snakes are less prevalent in society, it is permitted [to drink]

Actually, there is no danger in drinking at all, even in places where snakes are found. Snakes only discharge their venom when they intend to bite, not when stopping for a drink. And even if there was venom in the liquid, snake venom is not absorbed by the human gastrointestinal tract, so it would have absolutely no effect. Still, this shows how dangerous snakes were thought to be, and so when they did not bite, it was considered to be miraculous. Hence the Mishnah (Avot 5:5) records that one of the ten miracles that occurred during the time of the Second Temple was that no person was ever injured by a snake.

snake bites in Israel and around the world

Snake bites remain a threat in Israel and beyond (though in my six years of working in Jerusalem as an emergency physician I recall treating only one victim; he was a handler at a private snake collection- who should have known better.) In the US, venomous snakes are found in every state except Maine, Alaska and Hawaii, and each year in the US there are about 2,000 recorded venomous snake bites that result in about 6 deaths. The World Health Organization estimates that snakes kill between 20,000 and 94,000 people per year.

Kastururante A. et al. The Global Burden of Snakebite. PLOS Medicine 2008. 5:1591-1604

Snakes are such a problem for Israel and its neighbors that in 1998 the Israel Defense Forces (IDF) and the Jordanian Armed Forces held a joint conference on the topic. Since snakes are cold blooded, they are virtually inactive in the winter months, and summer time can be too hot for them; hence they are most active in the spring and fall. Like the report in today’s page of Talmud, the IDF found that the peak incidence for snakebites is May (that is, harvest time). 

Snakebites in the IDF. Average incidence per month, 1993-1997. From Haviv, J, et al. Field treatment of snakebites in the Israel Defense Forces. Public Health Rev 1988; 26:24-256.

There are at least eight species of poisonous snake found in Israel, of which the most common is the Palestine Viper, (shown in the photo above,) which is found in all regions north of Be’er Sheva. It is this snake that is responsible for all the fatal snake bites in Israel, though the IDF reported not one fatality during its five year study period.

sidebar: palestinian or israel viper?

Let's re-read that last paragraph:

“There are at least eight other species of poisonous snake found in Israel, of which the most common is the Palestine Viper”

Is that its real name? Well, it depends who you ask, or perhaps, in what language you ask. The snake's Latin name is Vipera palaestinae, and its Hebrew name is...צפע ארצישראלי! The snake could have been given a Hebrew name that was transliterated from the Latin, i.e. צפע פלסטיני – but that's not what whoever chose the name decided on.  Outside the case of the viper in the Jerusalem Zoo, this multiple naming is evident:

(It's not only snakes that have may have a crisis of identity. The chamomile flower, common in Israel, is called by its scientific name Anthemis palaestina, and in Hebrew it is קחוון ארצישראלי. Similarly the Terebinth; it is known to the scientific community as Pistacia palaestina, and in Hebrew as אלה ארץ-ישראלית. I could go on, but the point is made.)

One snake living happily, called two names by two peoples. There's a lesson there somewhere. But I digress.

the treatment of snake bites in the Talmud - and today

The Talmud offers a remedy for the unfortunate person bitten by a snake (of either the Palestinian or Israeli variety. Not the person. The snake.)

If one is bitten by a snake, he should take an embryo of a white donkey, tear it open, and sit on it (Shabbat 109b)

How does this advice compare with the IDF field manual? Not very well, as you can see from this list of the field treatment do's and dont's from the Medical Corps of the IDF.  Embryos of white donkeys do not make it. (Donkey embryos as a therapy also fail to make a fascinating 1953 report of 65 cases of viper bite in Israel.)

Haviv, J, et al. Field treatment of snakebites in the Israel Defense Forces. Public Health Rev 1988; 26:24-256.

Snake venom produces its deadly effects by causing a coagulopathy, which is the general name for a breakdown in the normal way the blood clots.  When things get really bad, snake venom causes a consumption coagulopathy, in which (as its name implies), all the vital bits that are needed for blood to clot are consumed, leaving the poor victim susceptible to life-threatening uncontrollable bleeding. Here's a chart of the clotting pathways that medical students have to learn (a process only slightly less painful than a snake bite itself,) with the bits that venom attacks shown in green.

Diagram of the clotting pathway showing the major clotting factors (blue) and their role in the activation of the pathway and clot formation. The four major groups of snake toxins that activated the clotting pathway are in green and the intermediate or incomplete products they form are indicated in dark red. There are four major types of prothrombin activators, which either convert thrombin to form the catalytically active meizothrombin (Group A and B) or to thrombin (Group C and D). From Maduwage K, Isbister GK. Current Treatment for Venom-Induced Consumption Coagulopathy Resulting from Snakebite. PLoS Negl Trop Dis 2014. 8(10): 1-13.

The standard treatment for snake envenomation is antivenom. (This is a technical term for something that is anti the venom.) In the 1950s  antivenom was already part of the standard  treatment of viper bites in Israel, though apparently it was then called by the far fancier name of "serum antivenimeux."  (If chemistry or immunology is your thing, you can read more about how viper antivenom was made in Israel here.) These antivenoms work in a number of ways, one of which is by blocking the toxin and preventing it from binding to its target (i.e. those green diamonds in the diagram above).

It was these ten vials of antivenom that saved the life of the brave Jewish lady preparing for her son's Bar Mitzvah back in 2011. You can read all about that episode here. (Spoiler alert - the mom won.)

snakes that heal

Snakes aren't only associated with coma, convulsions and death.  They are - paradoxically -  often associated with those who heal.  Here is the cover of Fred Rosner's book; notice what looks like two snakes wrapped around a winged pole.  Compare that image with the insignia of the US Army Medical Corps below.

The image you see is the caduceus, the rod carried by the Greek god Hermes (known as Mercury when in Rome). But in fact this double-snake flying-rod has nothing to do with healing, and is erroneously -though very widely- used as a medical emblem.  But as an article in the Journal of the American Medical Association points out, the adoption of the double-snaked caduceus of Hermes - at least in the US - is likely due to its having been used as a watermark by the prolific medical publisher John Churchill.   

The correct mythological association is with the Staff  of Asklepios, the ancient Greco-Roman god of medicine. In one legend, a snake placed some herbs into the mouth of another serpent that Asklepios had killed, and the dead snake was restored to life.  As a mark of respect, Asklepios adopted as his emblem  a snake coiled around his staff.  While the US Army Medical Corps uses the caducues as its badge, on its regimental flag the US Army Medical Command uses the more appropriate single snaked staff. Oh, and a rooster.  

U.S. Army Medical Command Regimental Flag. Don't ask about the rooster...

Fortunately, the Israel Defense Forces clearly know a caduceus from an Asklepios. They adopted the correct Greco-Roman mythological symbol for the medical unit of the first Jewish army in 2,000 years.

The Greeks may have had their tradition, but we have ours. And in ours, it is never the snake that heals.

“עשה לך שרף ושים אותו על נס, והיה כל הנשוך וראה אותו וחי. וכי נחש ממית או נחש מחיה? אלא בזמן שישראל מסתכלין כלפי מעלה ומשעבדין את לבם לאביהן שבשמים היו מתרפאים, ואם לאו היו נימוקים...

”Make a fiery snake and place it on a pole, and it will be that anyone who is bitten will look at it and live” [Numbers 21:8] But is a snake the source of life and death? Rather, the verse means that when Israel looked up and submitted their heart to their Father in Heaven, they were healed, but if they did not do so, they perished.”

— Mishnah Rosh Hashanah 3:8

Pesachim 56a~ The Snake as a Symbol of Healing

In much of the Talmud snakes are associated with coma, convulsions and death.  But occasionally - and paradoxically -  they are sometimes associated with those healing, and those who heal. Let’s begin with this page of Talmud.

פסחים נו, א

תָּנוּ רַבָּנַן: שִׁשָּׁה דְבָרִים עָשָׂה חִזְקִיָּהוּ הַמֶּלֶךְ, עַל שְׁלֹשָׁה הוֹדוּ לוֹ, וְעַל שְׁלֹשָׁה לֹא הוֹדוּ לוֹ. 

עַל שְׁלֹשָׁה הוֹדוּ לוֹ: גָּנַז סֵפֶר רְפוּאוֹת — וְהוֹדוּ לוֹ. כִּתֵּת נְחַשׁ הַנְּחשֶׁת — וְהוֹדוּ לוֹ. גֵּירַר עַצְמוֹת אָבִיו עַל מִטָּה שֶׁל חֲבָלִים — וְהוֹדוּ לוֹ

The Sages taught: King Hezekiah performed six innovative actions. With regard to three the Sages agreed with him, and with regard to three they did not agree with him.

With regard to three actions the Sages agreed with him:  He suppressed the Book of Remedies, and they agreed with him.  He ground the copper snake through which miracles were performed for Israel (Numbers 21:9), destroying it because it had been used in idol worship (II Kings 18:4), and they agreed with him…

You might have heard that the symbol for healing, that snake (or is it two snakes?) wrapped around a central pole, came from the episode to which today’s page of Talmud is referring. In Numbers 21 the Children of Israel complain that “there is no bread and no water, and we have come to loathe this miserable food.” So God sends fiery snakes “that bit the people and many of the Israelites died.” Let’s let the Good Book tell the rest:

7-10 :במדבר כא

וַיָּבֹא הָעָם אֶל־מֹשֶׁה וַיֹּאמְרוּ חָטָאנוּ כִּי־דִבַּרְנוּ בַיהוָה וָבָךְ הִתְפַּלֵּל אֶל־יְהוָה וְיָסֵר מֵעָלֵינוּ אֶת־הַנָּחָשׁ וַיִּתְפַּלֵּל מֹשֶׁה בְּעַד הָעָם׃

וַיֹּאמֶר יְהוָה אֶל־מֹשֶׁה עֲשֵׂה לְךָ שָׂרָף וְשִׂים אֹתוֹ עַל־נֵס וְהָיָה כָּל־הַנָּשׁוּךְ וְרָאָה אֹתוֹ וָחָי׃

וַיַּעַשׂ מֹשֶׁה נְחַשׁ נְחֹשֶׁת וַיְשִׂמֵהוּ עַל־הַנֵּס וְהָיָה אִם־נָשַׁךְ הַנָּחָשׁ אֶת־אִישׁ וְהִבִּיט אֶל־נְחַשׁ הַנְּחֹשֶׁת וָחָי׃

וַיִּסְעוּ בְּנֵי יִשְׂרָאֵל וַיַּחֲנוּ בְּאֹבֹת׃ 

The people came to Moses and said, “We sinned by speaking against the LORD and against you. Intercede with the LORD to take away the serpents from us!” And Moses interceded for the people.

Then the LORD said to Moses, “Make a seraph figure and mount it on a standard. And if anyone who is bitten looks at it, he shall recover.” 

Moses made a copper serpent and mounted it on a standard; and when anyone was bitten by a serpent, he would look at the copper serpent and recover.

The Israelites marched on and encamped at Oboth.

But you’d be wrong. In fact the episode in the Bible and the fiery snakes that cured has nothing to do with this medical symbol of healing.

“From the beginning of the 17th century, the figure of Asklepios began appearing on medical medals and calling cards. The same pattern seen in antiquity emerged: The symbol was used only in a medical context, whereas the caduceus, although used by some medical organizations, was associated with other fields, especially commerce, communications, chemistry, and pharmacy”

— Robert A. Wilcox. Emma M. Whitham. The Symbol of Modern Medicine: Why One Snake Is More Than Two. Ann Intern Med. 2003;138:673-677.

snakes that heal

Here is the cover of Fred Rosner's book; notice what looks like two snakes wrapped around a winged pole.  Compare that image with the insignia of the US Army Medical Corps below.

The image you see is the caduceus, the rod carried by the Greek god Hermes (known as Mercury when he was in Rome). But in fact this double-snake flying-rod has nothing to do with healing, and is erroneously -though very widely- used as a medical emblem.  As an article in the Annals of Internal Medicine points out, the adoption of the double-snaked caduceus of Hermes - at least in the US - is likely due to its having been used as a watermark by the prolific medical publisher John Churchill.   

The correct mythological association is with the Staff  of Asklepios, the ancient Greco-Roman god of medicine. The opening lines of the Hippocratic Oath clearly reveal the central role occupied by Asklepios (and his mythologic daughters, Hygieia and Panakeia,) in the hearts and minds of the ancients: “I swear by Apollo Physician and Asklepios and Hygieia and Panakeia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgement this oath and this covenant . . .”

In one legend, a snake placed some herbs into the mouth of another serpent that Asklepios had killed, and the dead snake was restored to life.  As a mark of respect, Asklepios adopted as his emblem a snake coiled around his staff.  While the US Army Medical Corps uses the caducues as its badge, on its regimental flag the US Army Medical Command uses the more appropriate single snaked staff. Oh, and a rooster.  

U.S. Army Medical Command Regimental Flag. Don't ask about the rooster...

Fortunately, the Israel Defense Forces clearly know a caduceus from an Asklepios. They adopted the correct Greco-Roman mythological symbol for the medical unit of the first Jewish army in 2,000 years.

The Greeks may have had their tradition, but we have ours. And as the Midrash notes, in ours, it is never the snake that heals.

“עשה לך שרף ושים אותו על נס, והיה כל הנשוך וראה אותו וחי. וכי נחש ממית או נחש מחיה? אלא בזמן שישראל מסתכלין כלפי מעלה ומשעבדין את לבם לאביהן שבשמים היו מתרפאים, ואם לאו היו נימוקים...

”Make a fiery snake and place it on a pole, and it will be that anyone who is bitten will look at it and live” [Numbers 21:8] But is a snake the source of life and death? Rather, the verse means that when Israel looked up and submitted their heart to their Father in Heaven, they were healed, but if they did not do so, they perished.”

— Mishnah Rosh Hashanah 3:8

[An encore post from here.]