Introduction

The Mishna (Shabbat 109b and 111a) presents the prohibition against taking medicine on Shabbat. The Gemara (Shabbat 53b) explains that Chazal prohibited us to take medicine on Shabbat lest one grind the medicine on Shabbat. Grinding (Tochen) is one of the thirty-nine categories of forbidden labor on Shabbat and is biblically prohibited.

In the next two issues, we will explore this rabbinical prohibition. We will focus primarily on the exceptions to the rule articulated by classic and contemporary rabbinical authorities. There is a large body of contemporary responsa literature on this topic since a great variety of medicines have been recently developed. Moreover, new types of medicines that do not cure maladies (such as sleeping pills) have been subject of Halachic debate.

Why Does This Prohibition Still Apply?

People commonly ask why this rabbinical prohibition still applies if its reason is no longer relevant. The answer is that rabbinical prohibitions remain even if their reasons no longer apply. The Gemara (Beitzah 5a) articulates the rule that Kol Davar B'minyan Tzarich Minyan Acher L'hatiro, "once the rabbis issue a decree only a rabbinical assemblage of equivalent stature can overturn it." The Gemara cites a biblical precedent for this rule. Today there is no rabbinical assemblage of equivalent stature to the rabbis of the Gemara. Hence, Chazal's decrees still apply even if their reasons are no longer relevant.

Rav Yosef Dov Soloveitchik (Nefesh Harav p.173) specifically invoked this principle when he ruled that even today we are prohibited from taking medicine on Shabbat. Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 8:15:15:4) adds that the reason for this decree is still relevant, as even today many people grind medicines when preparing home remedies.

Ma'achal Bri'im

The aforementioned Mishnayot note an important exception to the prohibition. The Mishnayot state that if healthy people commonly consume the medicine (Ma'achal Bri'im), then it is permitted to take that medicine on Shabbat. Thus, one who has a cold on Shabbat is permitted to drink chicken soup or tea for relief.

Aspirin

Rav Yosef Adler cites Rav Yosef Dov Soloveitchik as ruling that one may take aspirin on Shabbat because it is considered Ma'achal Bri'im. The Rav explains that some healthy people take aspirin as a preventative for heart attacks. Shemirat Shabbat Kehilchata (34:3, citing Teshuvot Minchat Yitzchak 3:35) disagrees, defining Ma'achal Bri'im in a narrower manner. According to this source, this category applies only to something consumed by healthy people for non-medicinal purposes.

All authorities agree, however, that if the individual is suffering from an intense headache to the extent that he is bedridden or cannot function properly, he is permitted to take aspirin (Mishna Berura 328:1). The rabbinical decree to refrain from taking medicine on Shabbat applies only to someone suffering from mere discomfort (Michush Bialma). Rav Shlomo Zalman Auerbach (cited in Nishmat Avraham 1:164) and Rav Yehoshua Neuwirth (Shemirat Shabbat Kehilchata 34:16) rule that one who is suffering from a mild headache may take aspirin if this will avoid his developing a severe headache. Rav Shlomo Zalman argues that one is not required to wait until he is very sick to take the medicine.

One may ask why this rabbinical decree applies even if the person is experiencing mild discomfort. Does not Rav Akiva Eiger posit (in his commentary to Orach Chaim 307:5) that rabbinical decrees do not apply in cases of suffering? Rav Shlomo Zalman Auerbach (cited in Shemirat Shabbat Kehilchata 34:note 7) explains that this decree to refrain from taking medicine on Shabbat was specifically instituted to apply in cases of (mild) suffering. Rav Neuwirth (cited in Nishmat Avraham 1:163) notes that this also applies to the rabbinically ordained fast days. Only if one is suffering significantly more than most people suffer on fast days may he break his fast.

Vitamins

There are three major opinions regarding the question of whether one is permitted to take vitamins on Shabbat. Rav Yosef Adler cites Rav Yosef Dov Soloveitchik who permits taking vitamins on Shabbat because they are Ma'achal Bri'im. Shemirat Shabbat Kehilchata (34:20) forbids one to take vitamins in ordinary circumstances. Rav Moshe Feinstein (Teshuvot Igrot Moshe 3:54) adopts a compromise approach. He rules that if a weak person wishes to take vitamins to strengthen himself, then it is forbidden. However, Rav Moshe believes that it is permissible for a healthy individual to take vitamins in order to prevent illness.

These opinions stem from a dispute between the Bait Yosef and the Magen Avraham regarding how to interpret a passage in the Tur. The Tur (O.C. 328) writes that "if a healthy individual eats or drinks the medicine to satisfy his hunger or thirst and he is not ill, then it is permitted." The Bait Yosef (ibid. s.v. Kol Ochlin) writes that the rabbinical decree to refrain from taking medicine on Shabbat does not apply to a healthy person. The Magen Avraham (328:43), however, limits the Tur to a case where the person is taking the medicine purely to satisfy his hunger or thirst. It is forbidden, though, if he is taking the medicine because of health considerations.

Rav Soloveitchik appears to follow the ruling of the Bait Yosef, which Rav Yosef Karo seems to follow in the Shulchan Aruch (O.C.328:37). On the other hand, the Mishna Berura (328:120) and the Aruch Hashulchan (O.C.328:48) rule in accordance with the Magen Avraham. Rav Moshe also rules in accordance with the Magen Avraham, but he limits the Magen Avraham to a case where one takes the medicine to improve his health. Rav Moshe argues that the Magen Avraham's ruling does not apply when a healthy person takes medicine merely as a preventative measure. Shemirat Shabbat Kehilchata rules that the Magen Avraham's ruling applies even to medicine taken as a preventative measure.

Rav Shlomo Zalman Auerbach (cited in Nishmat Avraham 1:164) permits taking vitamins to prevent becoming ill to the point that one is permitted to take medicine. Rav Shlomo Zalman (cited in Shemirat Shabbat Kehilchata 34:note 85) permits taking vitamins if one takes them in place of food. One might be permitted to drink "Ensure" (or a similar product) on Shabbat based on this ruling.

Conclusion

Next week, God willing and Bli Neder, we will complete our discussion of the topic of medicine on Shabbat. We will survey a wide range of medicines and discuss if it is permissible for healthy people to take them on Shabbat.