During this time of the year, when meeting a friend, we automatically wish that person “a healthy and a happy New Year.”  Health is stressed.  There is a bracha specifically designated to thank HaShem for our continued health; that bracha is “asher yatzer.”  Although affectionately known as the “bathroom” bracha, as it is recited upon exiting the lavatory, an analysis of its wording quickly shows that it is a bracha for our overall health, not specifically directed to the excretory system. Rav S. Schwab noted that this bracha is a “universal expression of “shevach v’hodaah” on behalf of all human beings, as we acknowledge the properly functioning, normal healthy human body as a gift from G-d.” The bracha reads as follows:

“Blessed are You, HaShem, our G-d, King of the universe, Who fashioned the man with wisdom and created within him many openings and many cavities. It is obvious and known before Your Throne of Glory that if one of them (which is usually closed) was to be opened or if one of them (which should be open) was to be blocked, it would be impossible to survive and to stand before You. Blessed are you, HaShem, Who heals all flesh and acts wondrously.” This phraseology, from the Talmud (Berachos 60b) and incorporated into the siddur, will be dissected and analyzed.

“Who fashioned the man with wisdom:” To whom does this opening statement refer? One thought is that it refers to HaShem. In His wisdom, HaShem created a perfectly functioning human being, with the precise balance of organs and organ systems needed to maintain a healthy lifestyle. A corollary of this is that HaShem in His wisdom, initially created a world containing all the sustenance needed to support humanity. This explains why Adom HaRishon was the last creation. Or, perhaps, wisdom refers to human beings, that HaShem created humans with a mind capable of thinking and analyzing situations. As the bracha of asher yatzer is on health, the thought is that a human should have the wisdom to develop a lifestyle that promotes good health.  

“and created within him many openings and many cavities.” The “openings” refer to the orifices of the human body, such as the mouth, nostrils, ears, and anus. Also included are the microscopic openings, such as those of the salivary glands and the pores of sebaceous glands, sweat glands, and hair follicles. The “cavities” refer to the internal organs, such as those of the respiratory system (i.e., trachea, bronchi, bronchioles, and alveoli), of the excretory system (e.g., the bladder and urethra), of the reproductive system (e.g., the female oviducts and the male vas deferens), the digestive system (i.e., esophagus, stomach, small intestines, and large intestines), the circulatory system (e.g., veins, venules, capillaries, arterioles, arteries, and heart), and the nervous system (e.g., spinal cord and brain). 

“It is obvious …  that if one of them (which is usually closed) was to be opened or if one of them (which should be open) was to be blocked, it would be impossible to survive.” There are numerous examples of organs that should be open and, when closed, a pathology results. For example, coronary arterial disease is the condition in which the heart muscle receives inadequate oxygen due to blockage of the blood supply. Depending on the extent of blockage, symptoms can range from mild chest pain (angina pectoris) to a full-scale heart attack. One cause of coronary arterial disease is atherosclerosis, due to the accumulation of cholesterol and fatty substances within the walls of arteries. Blockage of the venous system is also problematic. Deep vein thrombosis is the presence of a blood clot usually in the deep veins of the lower limbs. A serious complication is the dislodgement of the clot and its movement, via the circulatory system, to the lungs. Conversely, there are organs that should be closed, with the pathology occurring when they open or rupture. An aneurysm is a thin, weakened section of the wall of an artery or a vein that bulges outward. If the aneurysm goes untreated, it grows larger and larger until the blood vessel becomes so thin that it bursts, resulting in massive hemorrhage.   

There are other organs that, at times, we want them to be opened, and, at other times, to be closed. It is the unexpected closing or the unexpected opening of these organs that creates the health issue. For example, ingested food travels down the esophagus to the stomach. At the base of the esophagus is a sphincter muscle that normally relaxes as food approaches, thereby allowing it to enter the stomach. We want the ingested food to remain in the stomach. If the lower esophageal muscle fails to close adequately after food entered the stomach, the acidic contents of the stomach can enter the lower portion of the esophagus, causing irritation and a burning sensation. A converse example is difficulty in the elimination of fecal material from the colon. Here, the desire is for the waste materials to be eliminated from the body. Constipation is the infrequent or difficult defecation, caused by decreased mobility of the intestines. Because the feces remain in the colon for prolonged periods of time, there is excessive water absorption and this waste material becomes hard and dry.   

“Blessed are You, HaShem, Who heals all flesh ..:” The beginning of the bracha, in which HaShem is praised for providing a perfectly functioning body, seems to contradict the end of the bracha, in which we thank HaShem for healing us. There is a thought that the end of the bracha refers to the everyday healing processes that were built into human physiology and that function, without our knowledge, to protect us from disease. If so, we are now thanking HaShem for our immune system which provides protection against viral, bacterial, fungal, and protozoan infections. There is the biological concept termed the clonal expansion theory. According to this idea, there are millions of clones of lymphocytes (a type of white blood cell) which circulate within our circulatory system, each clone waiting to encounter a specific antigen (e.g., a bacterium). There are millions of such clones of circulating lymphocytes, each specific for a specific antigen (i.e., a foreign invader). Upon encountering the antigen for which they are specific, these lymphocytes proliferate and amplify in numbers to fight that specific invader.  We are unaware of the constant battles waged between our immune system and foreign invaders, capable of causing disease. It is for this that we thank HaShem.

“Blessed are You, HaShem, Who … acts wondrously:” The wondrous acts may refer to the digestive system, in which the complex foods ingested are degraded into simpler nutrients, absorbed into the body, and into extraneous materials, compiled into liquid and solid wastes, excreted from the body.

Most people take the normal functioning of their bodies for granted, unless, one has pain or has received a distressful diagnosis from a physician. Rav Yerucham Levovitz, Mir mashgiach, would humorously tell his students that they should send a telegram to their parents after each use of their bodily functions, to tell them, “Baruch HaShem, they are well.” Rav Yechezkel Levinstein, Ponovezh mashgiach, would comment that reciting the bracha asher yatzer is a segulah for good health!

The sources used in compiling this article are:

Berachos, volume 2, Artscroll edition, Mesorah Publ., Ltd., Brooklyn, NY

Rubin, Y.D., 2005, Talelei Oros, volume 1, Tefillah, Feldheim Publ., NY, NY

Schwab, S., 2009, Schwab on Prayer, Mesorah Publ., Ltd., Brooklyn, NY