MDG –
It seems to me that since the Efer Mikla is normally placed for health reasons…
True – but so what if it is normally placed there for health reasons? Not that that isn’t a good reason, but you have to follow through with something. It’s normally placed there for health reasons and therefore ______? You are saying it’s normally placed there for health reasons and therefore it is permitted for another, added reason; that it only discolors. That can’t be pashut pshat because you are adding a reason that it doesn’t say. I am not adding anything, because the Shach himself follows through: It’s normally done for health reasons and therefore it is permitted because the wound is an indication that the mark is not idolatrous in nature. This seems to me to be pashut pshat.