By Rabbi Yair Hoffman for the Five Towns Jewish Times
Rabbi Rephoel Szmerla’s new Sefer entitled, “Alternative Medicine in Halacha” [Israel Bookshop 198 pages English 398 pages Hebrew 596 total] is divided into two sections – the main part of the Sefer and the in-depth biurim in Hebrew in the back of the work. In the biurim, it is truly groundbreaking in terms of its exhaustive treatment of the aveiros of the occult: specifically, kishuf, doresh el hameisim, nichush and kosaim. It also deals with following the ways of the gentiles (Darchei Amori) and of the Mitzvah of Tamim Tehiyeh. In discussing these aveiros, the author takes us through every opinion of the rishonim.
In the body of the English text the Sefer is near exhaustive in its discussion of alternative forms of healing. In terms of the scholarship – it is quite clear that we are dealing with an extraordinary Talmid Chochom.
The Sefer also has numerous haskamos from leading figures who back up the Torah erudition of the author. There are two underlying ideas that permeate the work. The first is that the multiple modalities of alternative medicines do not in their core violate the aveiros of the occult. The second underlying idea is that these alternative forms of medicine are, in fact, effective. It is this author’s opinion, however, that the author makes a number of fundamental errors in coming to this conclusion, and that this thesis can seriously compromise the physical health of the Torah-observant community with the publication of this Sefer.
And while the author states that it is not his goal to encourage people to discount conventional medicine – the reality is that advocating the efficacy of modalities of treatment that have statistically been proven ineffective actually does the very thing that Rabbi Szmerla claims that he is not doing: His book will perforce encourage people to discount conventional medicine in favor of the forms of medicine that he claims work. One must always keep in mind that Hashem is the ultimate Rofeh Cholim – but one must also utilize and implement the proper Hishtadlus that Hashem put into the world.
THREE MAJOR PROBLEMS WITH THE SEFER
Specifically, it can and does cause family members of those who suffer illness to a] squander much needed and valuable resources on ineffective treatments b] not pursue effective and proven forms of treatment c] cause unnecessary damage to those who are ill. In the overwhelming majority of cases, the moneys spent on pursuing most of these alternative treatments would be far better spent on supporting Torah learning. Rabbi Szmerla ignores the overwhelming medical evidence that these treatments have proven ineffective.
THE HASKAMOS ARE NOT NECESSARILY ENDORSING OF HIS VIEWS
It is clear that Rabbi Szmerla is a scholar of great knowledge and depth, which is perhaps why great Rabbis provided him with approbations. However, a careful reading of a number of the approbations clearly indicate that they do not necessarily agree with his conclusions.
SEFER IS DANGEROUS
It is this author’s view that this second and central thesis of the sefer is dangerous and can seriously undermine the health of many members of Klal Yisroel. People may pick up the sefer, and peruse the haskamos. They may erroneously assume that the information contained in the sefer is correct. If they discontinue their regular course of treatment, which many will do, this can be extremely problematic.
In this reviewer’s view, the thesis flies in the face of basic mathematics. The proper use and understanding of statistics is essential in determining whether a modality of treatment should be used or not. It is the correct hishtadlus – al pi derecho hateva. That is, in fact, what modern medicine is based upon. This sefer, notwithstanding the deep Torah erudition of its author, has the potential to throw us back to the days when families of cancer victims squandered their parents’ life’s savings on the likes of such cures as “shark cartilage.”
FAULTY UNDERSTANDING OF STATISTICS
The vast majority of people that advocate the efficacy of most of the alternative medicines found in the sefer – are not at all proficient in the use of advanced statistical analysis. Because of this flaw, they are unable to differentiate between what constitutes a valid study and an invalid one.
One example of this lies in those who advocate against vaccinations. They claim that they have studied the statistics behind both sides of the vast literature regarding vaccinations. However, when put to the challenge those who argue against vaccinations are fundamentally unable to answer basic questions in simple statistics. Arguing with someone in statistics who has no background in statistics is akin to arguing about translations of sentences in Hebrew with someone who does not understand a word of it.
WHEN AN ERROR IS MADE IN METZIUS
When an error is made in metzius – and we are sure of the error, we do not adhere to that person’s view – no matter how great the individual is. This concept was told to this author by the greatest of Gedolei haPoskim in America as well as in Eretz Yisroel (Rav Dovid Feinstein Shlita, Rav Chaim Kanievsky Shlita, and Rav Elyashiv zt”l). Thus, when the Aruch haShulchan had a fundamental misunderstanding of the dynamics of electricity – the view of Rav Shlomo Zalman Auerbach zt”l and other Gedolei HaPoskim won out. Yet the greatness of the Aruch haShulchan and his vast depth and erudition in dalet chelkei shulchan aruch are there for everyone to see.
Rabbi Szmerla dismisses the view of Rav Dovid Morgenstern Shlita, Rav Elyashiv zt”l and Rav Nissim Karelitz Shlita regarding the definition if what would constitute a refuah bedukah – a tested and certain cure. He writes that Chazal only required a cure having worked three times – as manifest in the Shulchan Aruch’s ruling on Kamiyas. Rav Morgenstern writes that it must be a statistically valid cure and cites these other authorities (See Sefer Piskei Din Vol. X p. 535). Rav Elyashiv zatzal has numerous times praised Rav Morgenstern Shlita as fluent in Kol haTorah Kulah, and the dismissal of his views and quotes of Rishonim by Rabbi Szmerla is unwarranted. But let us now examine the various forms of treatments the Rabbi advocates.
In regard to energy medicine, Rabbi Szmerla ignores the six most recent studies showing that there is absolutely no efficacy to such healing – disproving Richard Gerber’s earlier assertions. Rabbi Szmerla attempts to associate the Gemorah’s discussion of B’boah d’boah with the concept of aura. The association is far from proven. Boah is described by rishonim as a shadow. True, Rav Chaim Vital disagrees with this association, but that does not mean that it means aura. Rabbi Szmerla thus rejects the views of the Rishonim, asher mipihem anu chaim, and adopts a kabbbalistic view which he assumes is synonymous with aura. This is far from conclusive. The fact that the overwhelming scientific evidence has demonstrated that there is a lack of efficacy to this type of healing is also proof that the Boah d’Boah is not, in fact, aura. [See, as just one example, the Medical Journal Pain (91 pp 79-89) Abbot, NC; Harkness, EF; Stevinson, C; Marshall, FP; Conn, DA; Ernst, E (2001). “Spiritual healing as a therapy for chronic pain: a randomized, clinical trial.” There are numerous others.]
As far as Rabbi Szmerla’s identification of qi or chi with an adaptive definition of nefesh – this identification is clearly not the authorial intent of Rashi in Vayikra 17:11.
THERAPEUTIC TOUCH (TT) OR HANDS ON HEALING
Therapeutic touch healing is a pseudo-science which believes that by placing their hands on, or near, a patient, practitioners are able to detect and manipulate what they say is the patient’s energy field. Study after study has shown that this is completely ineffective (See for example, JAMA (279:13 pp 1005-1010)Rosa, Linda; Rosa, E; Sarner, L; Barrett, S (1998-04-01). “A Close Look at Therapeutic Touch.” PMID 9533499. doi:10.1001/jama.279.13.1005.) – including one demonstration by a nine-year old girl that practitioners of it are either charlatans or are fooling themselves. Indeed, the American Cancer Society has remarked, “Available scientific evidence does not support any claims that TT can cure cancer or other diseases.”
Rabbi Szmerla’s impressive halachic arguments that it does not constitute kishuf is irrelevant. It doesn’t work beyond the placebo effect.
This reviewer agrees with Rabbi Szmerla that acupuncture is, for many types of maladies, indeed, effective. However, the theories behind acupuncture – the notion of restoring energy meridians has been summarily rejected by those with a thorough and grounded understanding of the underlying science behind it. Winston Churchill’s life was extended by his regular intake of aspirin – even though the science behind it was not yet understood.
It is this reviewer’s contention that Rabbi Szmerla fails to differentiate between the current state of Kinesiology and the notion of Applied Kinesiology which he mentions on page 81. A.K. is a technique wherein the ability to diagnose illness by practitioners or to choose the required effective treatment. Practitioners claim to do so by testing muscles for strength and weakness. However, once again the vast majority of statistically valid surveys have proven beyond a sliver of a doubt that there is no validity to this method in diagnosing illness. One who is untrained in statistics will not be able to differentiate between a valid study and an invalid one and there are plenty of both. The American Cancer Society has also gone out of its way to state that the scientific evidence does not support the claim that applied kinesiology can diagnose or treat cancer or other illness.
Rabbi Szmerla explains that dowsing is the ability to uncover information through the use of an L shaped rod or a pendulum. He claims that dowsing is not pseudo-science by virtue of the fact that a number of respectable Rabbonim have concluded, through their experience, that dowsing is authentic. The conclusion of the scientific community is that it is no more effective than random chance guessing (see Water Witching U.S.A. (2nd ed.), Vogt, Evon Z.; Ray Hyman (1979), Chicago: Chicago University Press. ISBN 978-0-226-86297-2. via Hines, Terence (2003). Pseudoscience and the Paranormal (Second ed.). Amherst, New York: Prometheus Books. p. 420).
HOMEOPATHY AND FLOWER ESSENCE
Here too, the author seems to be claiming efficacy of a discredited form of therapy. And while it is true that it may be incorrect to forbid the practice of these therapies on account of darchei amori – it may be forbidden on account of wasting time and money. The statistical studies are conclusive in the idea that they do not work (See, as just one example, Bioethics (26:9 pp 508-512) Smith K (2012). “Homeopathy is Unscientific and Unethical.” doi:10.1111/j.1467-8519.2011.01956.x.)
The modern day crystal therapy is compared by the Rabbi to the Even Tekumah discussed in the Gemorah in Sanhedrin (68a). However, not all Rishonim agree with this definition of Even tejumah and it is far from clear that it refers to the same type of stone. Let us also keep in mind that the Baalei haTosfos in Moed Koton 11a (d”h Kavra) write that Nishtaneh hateva and that the medical cures in Chazal may not be effective nowadays. Other Poskim who rule in this manner are cited in the authoritative Nishmas Avrohom 1:4 note 14. See also Rav Akiva Eiger, Yoreh Deah 336:1 (d”h Nitna) that one should not even attempt to use the remedies in the Gemorah due to the fact that we cannot properly identify the various samim discussed nor do we know exactly how to administer the remedies. See also Yam Shel Shlomo Chullin (8:12) that even the effective cures should not be done so that am haartzim not develop kefirah.
The author finds some aspects of Feng Shui as being in violation of the prohibition of Darchei Emori – following the ways of the gentiles. He comes to the conclusion that this form of alternative medicine is forbidden based upon the inability to determine which aspects of it achieve true energy harmonization and which ones stem from superstitious beliefs. This reviewer believes that it the former are completely ineffective and have been proven invalid statistically.
The author’s conclusions on both the effectiveness and the halachic validity of hypnotherapy are both perfectly valid. The effectiveness of hypnotherapy is accepted in the medical and scientific communities. There are issues of undergoing hypno-therapy when issues of gender and Tznius are involved. The author does not mention this and recent events have shown some serious breaches in this regard.
Rabbi Szmerla’s conclusions on Yoga’s effectiveness are not out of the ordinary, and do fall in line with the accepted scientific understanding of it. Halachically, he points to some problems with some aspects of Yoga meditation techniques. He does not mention another halachic problem and that is the use of the mantra perforce has one clearing his mind of all thoughts. This does not fall in line with Mitzvah of always having in mind the shaish zechiros. Anochi Hashem – belief in Hashem; Lo Yih’yeh – there shall be no other gods; Yichud Hashem – belief in the absolute Oneness of Hashem; Ahavas Hashem – loving Hashem; Yiras Hashem – fear of Hashem (or as the Nesivos Shalom understands it – fear of losing one’s kesher with Hashem; and Lo Sasuru – do not stray, following apikorsus and taavah.
The author concludes that Shamanic healing is strictly forbidden.
As stated throughout this review – the halachic views of the Rabbi Szmerla constitute amazing depth and profundity in the Hebrew biurim section. The medical views espoused in the main body of the book are, in this reviewer’s opinion and in the opinion of a number of mathematically trained doctors and scientists, quite dangerous. Traditionally, our abilities in calculating the ibbur and other such areas of Torah thought have been described by the rishonim as “ki hi chachmaschem uvinaschem b’ainai ha’amim.” The rejection of statistics in how medicine is applied is a dangerous trend.
The author can be reached at firstname.lastname@example.org