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Rabbi Billet Op-Ed: Metzitzah B’peh Should Only Be Done By Father & Not Mohel

bris.jpgThe following opinon article was written by Rabbi Avi Billet, and appears in this weeks Jewish Star: 

Relative to other surgeries, bris milah is a simple procedure, with a surprisingly low risk rate. At the same time, an incision, an open wound and the removal of skin tissue necessitate precautions which will minimize danger to the child. The parents and the mohel must be on the same page on this latter point.

In an operating room, a surgeon takes many precautions to minimize the chance of bacterial infection reaching the patient. Mohels should be held to these same standards when operating on infant boys. It is understood, of course, that the public nature of the ceremony makes complete sterility an impossibility. Nonetheless, we are a far cry from where standards should be.

The sterility litmus test can be broken down to five components: how instruments are sterilized, how they are laid out for bris use, how the mohel cleans his hands, whether sterile gloves are worn when dealing with the open wound and how metzitzah is done.

Surgeons sterilize packaged instruments in a machine at 273° Fahrenheit, and avoid opening the “sterility guaranteed” package until surgery time. Mohels should do the same. Cold sterilization in a solution or in rubbing alcohol is less than ideal, and the five minute soaking some mohels employ before the bris is substandard. It may produce a nice alcohol aroma, but real cold sterilization requires hours of soaking to be completely effective.
Instruments laid out on a freshly laundered diaper cloth may be quite comfortable, but they have lost any claim of sterility. A pre-packaged sterile drape is easily accessible and should be standard for every mohel to use.

A mohel who washes his hands and is careful not to shake others’ hands should be commended. But when he adjusts his pants, head-covering, lab coat or tallis, not to mention his instrument bag or a bottle of wine while laying out instruments, he has negated any previous hand washing.

Some mohels will operate with bare hands “sterilized” by alcohol or Purell. Nice as this is, touching the pillow, baby, sandak, and baby’s diaper make previous efforts meaningless. Additionally, it is virtually impossible to completely clean under the fingernails, unless (with a big ‘perhaps’) the mohel soaks in a chlorinated pool for 20 minutes immediately before the bris. This is an uncommon practice.

Mohels should be required to wear sterile gloves, donned immediately before touching sterile instruments and the sterile field of the bris. If it is time consuming, he can wear two pairs, removing the outer pair immediately prior to beginning. Non-sterile gloves are a step up from “no gloves,” but they are still less than ideal.

“Metzitzah” is defined as drawing “deeper” blood from the circumcision spot, which some view as a medical necessity while others view it, based on modern medical knowledge, as a ritualistic remnant of what may have once been deemed a medical requirement (Shabbat 133a-b).

Over time the idea of doing metzitzah with the power of the mouth was introduced, which is defined in two ways: either put a mouth directly on the wound, or use the power of the mouth through a sterile pipette. The latter avoids direct contact and the sharing of body fluids between mohel and baby.

Both are halachically sanctioned, while only one meets the approval of any unbiased modern medical sensibility. Arguments such as “saliva heals” and “one’s first instinct is to suck a cut on your finger” are irrelevant to the case of a mohel’s mouth touching a fresh wound in a newborn.

Any parent who insists that metzitzah be done with direct oral contact should do the metzitzah himself.

Maimonides writes, “It is impossible to restore the lost life of a Jewish child” (Milah 1:18). While he says this to allow delaying a bris on a child who is not physically ready, certainly the same dictum should be followed when circumcising a child: no step in the bris procedure should allow the slightest possibility that its inclusion can open the door to giving the baby an infection.

It is our responsibility and right to demand the best for our children. For the sake of the health of our children, let us begin with insistence that the bris maintains the highest standards of sterility.

High standards of sterility for a bris:

When the following precautions are taken, the possibility of infection is reduced to the smallest percentage.

*All instruments, drapes and bandages are completely sterile
*The sandak, who holds the baby during the bris, does not touch the baby directly. Baby’s legs are covered with a blanket or wrapped with a conform bandage.
*Mohel wears sterile gloves for the bris and every time he touches the baby’s open wound thereafter
*When metzitzah is done, there is no direct bodily contact between mohel and baby
*No one who is ill participates in the bris ceremony
*Those who care for the wound after the bris wash hands with soap and water before opening the diaper
*After bandage is removed, anti-infection ointment, such as bacitracin, is applied to the healing wound for a few days

Rabbi Avi Billet has been a mohel for 10 years.

[NOTE: The opinions expressed in the above article are those of Rabbi Billet]

(LINK to Jewish Star)

61 Responses

  1. And he thinks that Metzitza B’peh done by the non-professional father will be more hygienic than one performed by a trained mohel?

  2. Does he think Maimonides was against metzitza bepeh!? Although it cannot be denied that it poses some risk, we have an important principle in torah – SHOMER MITZVA LO YEDA DAVAR RA!

  3. No, he is saying that if the parent wants Metzitza B’peh done, than he should bear the risk of doing it himself. If, Chas V’Shalom something happens to the child as a result of the Metzitza having been done B’Peh, the mohel cannot be faulted or held accountable legally.

  4. This Rabbi’s mind has become corrupted by “Modernism.”

    He, obviously, has come to believe that “Scientism” has better answers than our proven Jewish tradition of 3,000 years.

    Yes, we should take advantage of moern technology whenever possible. But, it doesn’t trump our proven-safe traditons, which have stood the test of time.

  5. Not more hygienic per se, but in theory the father is less likely to be picking up and passing around herpes and other viruses (since he is not performing metzitza b’peh on 7 random babies per week).

  6. The only MITSZVA The Ge’mura says we still doing it for thoushans of years with SIMCHA don’t touch it, dont give your Lumdisha Sa’vuros, not even to talk about it. we don’t have to use our small SI’CHAL to protect our health. the mitszva watches us.

  7. here we go again, some of these posters attacking the person as opposed to civilly debating the issue. I have my issues with Young Israel just as I do with the Litvaks (different issues of course). Rabbi Billet is saying people need to know that there is risk, let’s minimize it as much as possible by doing metzitzah in a more safe way. To those who think along the lines of “…the mitszva watches us…” why should we rely on Nissim, which decreases a person’s zechusim? Don’t we try to minimize Chillul Shabbos in cases of Pikuach Nefesh etc?

  8. To clarify, this article was written by Rabbi Avi Billet who is a mohel, and should not be confused with his father Rabbi Hershel Billet who is the rabbi of the YI of Woodmere.

  9. #4 Didnt know that Paysach Kroen is a posek, a speaker yes – not a posek, a real business man as well, he charges a small fortune to honor you with his work (without meyzitza bepeah or even a speech) ask your friend for the itemized bill.
    As for Rabbi Billet, is this some sort of free advertisement for his own business? How many free brisim has he preformed?

  10. Dear #11.
    Actually its not the place here on a Forum for this whole issue, also I’m not the right person.

    But in short when a doctor or a Mohal say’s that for any reason the bris can not be done the silchon urich says don’t make the bris now, and just wait. but their is no Halacha in Shilchun urich that says you could make a half a bris . doing a bris without Matizsta be’pa is not a bris period.

  11. Mach’ah lemaan kvod hashem and kvod gedolei haposkim she’be’yameinu, u’b’chol hadoros that have mattired and encouraged the mohelim to perform metzizah b’peh.

    Who does this young 25 year old think he is publicizing his opinion as a valid one, without mentiong that the gedolei u’manhigei yisroel disagree

  12. This was dealt and discussed at great length in the past, and the goyishe health dept. had agreed on this already. Stop opening a can of worms again!

  13. #17- Which Rov? No one seems to agree with him about any of this, on his books he has haskomos, not on his actions, as far as we know he is giving his own opinion about this, if ou know otherwise please let us know.

  14. TO “justajew” (NO. 8):

    Your unspoken assumption is that it caused a death.–It didn’t. The “Rabbi” who claimed that it did wrote a seriously flawed article trying to prove that it did.

    The main point here is “Emunas ChaChoMim.”
    Presumably, our great sages have at least at much compassion as some Biology professor.

    This Minhag has been recommended and followed for thousands of years by some of our greatest GeDolim.

    A person who makes light of the words of our great Torah sages is considered a “MalIg Al Divrei ChaChomim,” and is considered an ApiKorUs.

    If you say your Minhag is different, based on your authentic traditions, that’s fine–as long as you properly respect those whohave a different authentic Torah tradition.

  15. Some perspective:

    1.) Rav Moshe Feinstein, ZT”L, diplomatically wrote to someone who was under the impression that Metzitza was part of the Mitzvah of Milah that it must have been a “slip of the pen,” as the Gemarah states clearly that Metzitza is a medical procedure. If so, the medical procedure should be done in the safest way possible, i.e. with a sterile tube.

    2.) Although Metzitza was traditionally done with the mouth, the Gemarah does not state that it needs to be done “b’Peh.”

    3.) Even if “b’Peh” is a requirement, Metzitza done with a sterile tube IS being done “b’Peh” (just as drinking from a straw is considered drinking with your mouth – on Yom Kippur, one would be Chayav for such drinking).

    4.) As noted above, Metzitza was traditionally done with the mouth. But, traditionally, the Milah instruments were not sterilized, as the need to do so to avoid infection is a relatively recent discovery. No one would suggest today that we use unsterile instruments. For those who were unaware of the potential danger of Metzitza b’Peh over the generations, it is reasonable to suggest, after the fact, that the Mitzvah would have protected their babies. With what we know today, it does not appear reasonable to take such a chance.

    5.) Everyone agrees that the Bris will be Kosher even if a tube is used. Indeed, no one (to my knowledge) does Metzitza b’Peh when performing a Bris on an adult.

  16. Why all the commotion? If a mohel wants to do it, noone is stopping him. If a mohel doesn’t want to, you have the option of either using him, or asking another one. Or, as Rabbi Billet points out, you have the option of doing the metzitza b’peh yourself. Noone says the mohel has to be the one to do it. Clearly there are enough shitos to rely on either way.
    I’d be far more concerned with the horrible display of middos by the commenters on this website than I would be with the “kefirah”.

  17. I would like to know what purpose this article has. You are just publishing articles just for the sake of publishing.

    The fact fact is that bris milah preceeds the discovery of germs, etc. by thousands of years, yet has been safely performed. Can you have better clinical proof for its safety?

    So why publish an article by somebody who is just looking to make traouble and get attentio? You are falling into his trap.

  18. #21 deepthinker

    Whether herpes from the mohel caused the baby’s death was never proven conclusively. But why take the chance? Our traditional brisim of years past never had sterilized equipment, or medical gloves, or even antiseptic.

    EDITED – most of what I was going to say here was eloquently stated by danielb43 above.

    Reagrding “emunas Chachomim” – I have emunah that if the Chachomim of yesteryear had the medical knowledge at their disposal that we have today, some of the p’saks would be very different. The Torah is living, especially so for minhagim, and even more so when there’s sakana involved.

    “A person who makes light of the words of our great Torah sages is considered a “MalIg Al Divrei ChaChomim,” and is considered an ApiKorUs.”

    I don’t know if you intended that remark for me or anyone else, but it’s out of line either way. You can’t possibly think that someone who advocates for metzitza with a tube is an apikorus.

    Tell me this – if you heard a rumor that a certain mohel had the HIV virus, would you allow him to perform your son’s bris, with metzitza b’peh? If you have emunas Chachomim and an impenetrable minhag, you should have no problem with it.

  19. benzion1
    My dear friend, you are way too angry to post comments.You having a bad day? Relax and take a deep breath. Rabbi Krohn is a terrific person out there just like you and me supporting his family in an honorable manner. His mesorah I believe is that he is a fifth generation Mohel and his Sefer on Bris milah is a staple for many new fathers and Mohilm themselves. How many Seforim have you authored? That being said even if he is not a Posek he does not move without Rav Dovid Cohen (check it out)among other Gedolim.You have no idea of the Chesed and humility of this man and of his tremendous sensitivity and knowledge of Bris Milah. Your tone is offensive and must be challenged. Do not use these pages to spout your negative attacks on somebody you clearly know nothing about-All L’shem Shomayim of course. If you have a difference of opinion many of the other posters here have articulated their thoughts and questions in a normal rational way. Because your not required to give your name does not absolve you from all relevant shmiras Haloshon rules.
    Please stop the negativity and relax.

    What did Rabbi Billet ever do to you?

  20. In response to comment #13 “how many free brisim has he performed” that question is irrelevant to the article but if you most know, I know for a fact that he does not charge and he has done many, many brisim for free.

  21. #21 wrote: “The main point here is ‘Emunas ChaChoMim.’ Presumably, our great sages have at least at much compassion as some Biology professor.”

    For those who are unaware, the Biology professor under discussion is also a well-known Rav and Talmid Chacham. According to his view that Metzizah b’Peh poses a potential danger to the infant, the Sakanah would clearly override any Minhag. Furthermore, his failure to speak up would, arguably, constitute “Lo Saamod Al Dam Reiacha,” or, at least, violate “Hocheiach Tocheach es Amisecha.” Although Tochacha does not apply where your words will definitely not be followed, there are, no doubt, some people who will choose to heed his words.

    Those who choose not to follow his guidance would do well to, at the very least, refrain from personal slights (at best) and vilification (at worst).

  22. It would be nice to know what the rates of infection are when it comes to traditional Milah and what the rates of infection are when it comes to circs performed by physicians. In the absence of any data, discussion is meaningless, you might as well argue (as the Xans often did) as to how many angels could stand on a pin-head.

    In terms of grammar, there is no b’Peh. It would be b’Feh. I would certainly expected someone as erudite as Rabbi Billet to know better than that.

  23. I have heard from Mohalim:
    If you want a “Milah Job” in one of the “Well Paying” “Left-Leaning” congregations, you have to be Anti-Metzizah.
    Are you still wondering why some Mohalim are so Anti-Metzizah?
    I will spell it out, $$$$$$!

  24. What is all the commotion about? All the Mohel is suggesting is that there should be the highest degree of safety practiced at a bris. He wants the sterilization to be of the highest value if possible instead of lazily rinsing everything with alcohol. He doesn’t like the idea of laying down all the surgical tools on a diaper instead of an approved surgical drapery. What’s wrong with this???

    His other point about the metzitza is not an attempt to say we shouldn’t do metzitza at all. He is simply saying that there are 2 options available; via a straw (which is obviously more hygienic, how could one argue that point?) or directly my mouth. He acknowledges that many people feel the correct way is to do it directly by mouth. In that instance he suggest the father do it because the father is obviously not exposing himself to countless open wounds which could theoretically be passed on to the child. The entire mitzvah of milah really belongs to the father. The mohel is a shaliach of the father. Why does the father always have to make the mohel a shaliach for the relatively simple process of metzitza B’peh?
    At my son’s bris, I did the metzita b’peh. I was very proud to do it.

  25. when I meade a bris for my son I asked the Mohel if he does Metzitza b’Peh Kahalacha- he told me that he does a bris!! והמבין יבין

  26. The Modern Orthodox have effectively divorced Hashem from the mitzvos!
    Our Torah is not subject to change by anyone. Billet is not the first person in history who has thought that he will protect the mitzvos by making them more safe. The mitzvos are given to us by Hashem and passed down from generation to generation by the chachomim. The Torah has survived many attacks and will outlive billet and his kind. Just as Moses Mendelshon has no Jewish descendants left, the modern “reformists” will also drift away. Avi Billet is the son of Hershel Billet who attacked Rav Aaron Schechter Shlita in an article in the JEWISH STAR.

  27. After reading the comments above, it is clear that YWN should abolish forums. For the most part, what isn’t am ha’artzus is mal’bin p’nei chaveiro b’rabbim or worse (if that’s possible). B”H we still have poskim g’dolei Yisroel, and B”H none of them post on YWN.

  28. A mohel does great work, a big mitzvah, bringing children into the Bris shel Avorohom Avinu. Most mohelim, the one I have used anyway, will not do a bris until the child ias at least five (5) pounds in weight.
    My sons were born premature and were in the hospital’s neo-natal unit for some time. Their bris was considerably delayed. While in the hospital, a non-frum doctor pointed out that doctors in the hospital did circumcisions all the time on two (2) and three (3) pound babies.
    So, why do mohels wait? I think we need to keep in mind that one thing that doctors have, and the one thing that mohels don’t, is malpractice insurance. If a doctor messes up, he is protected. If a mohel messes up, he is in big, big trouble.
    Same issue with Metzitza B’Peh. If a mohel transmits a disease to a child, his life could be ruined.

  29. My heart is in pain that another amaleik woke up to be mekatreik on the Torah.I am a mohel and a docter.I performed thousands of brisim for free – never requested compensation,did the brisim like my father and grandfather – followed only the old and true holy customs without any modernizations at all.Not one infection B”H.
    Ask any surgeon that did 10,000 surgeries how many infections followed.I doubt very much if any of Billet’s brisim are al pi halacha.

  30. To all those posters who are against metzizah b’peh, can you show me any data or proof that this mitzva has caused death, c”v, or has caused infections?

    I agree with #36. It is usually the modern orthodox who want to change our mesorah. They are not so far off from the distorted ideas of the reform and conservative movement.

  31. #29 ask rabbo kohn what he thinks of metitza pepeah, as for sforim written on milah i would refer you to many many seforim written by talmidei chachomim where metziza pepeah is explained.
    #30 i doubt what you say, has he gone to russia as rabbi fisher?

  32. tshuva of the noda beyehuda and many others… mtztizah bpeh is not meakev and not necessary for mitzvas mila. Once the nuts people who burned flags on shuls lawns and attacked rabbanim in public understand we can come to a clear conclusion about how to go about a safe way of metzizah

  33. #41 michal

    1) Google for “Primary Genital Herpes Simplex Infection Associated with Jewish
    Ritual Circumcision”
    WARNING – contains graphic medical pictures

    In summary – this is a case study of a 3-week-old baby in Israel who came down with genital herpes after having metzitza b’peh. The parents were tested and found NOT to be carrying the virus; the mohel REFUSED to be tested.

    The article also references:
    2) Cutaneous neonatal herpes simplex infection associated with ritual circumcision, Schneider Children’s Hospital
    In 1999, 2 infants who had metzizah b’peh were diagnosed with HSV-1 at Schneider Children’s Hospital. One baby had symptoms 3 days after the bris; the other developed symptoms 4 days after his bris. Both babies had brisim performed by the same mohel.

    These are individual case studies, to be sure. Now that the medical society is aware of a possible link, they are more likely to catch the connection between herpes being presented in an infant and metzitza b’peh. I would expect that we will see more and more cases in the future if the practice continues.

    Disclaimer: as opposed to #40 above, I am not a doctor. I just read a lot.

  34. This “Her Rabbin”, mohel /actor has publicly written an article questioning Rashi Hakodesh
    see New York – ‘Parshat Chayei Sarah’ The Age Of Rivkah At Her Wedding 3 Years by Rabbi Avi Billet

    its understandable that he could produce the above article

    Hashem Yismor

  35. To #39: I know one well-known Mohel who has malpractice insurance, and is quite critical of Mohelim who do not.

    #41 said: “To all those posters who are against metzizah b’peh, can you show me any data or proof that this mitzva has caused death, c”v, or has caused infections?”

    I’m not convinced that any amount of proof that Metzitza b’Peh has caused deaths would change anyone’s mind.

    Aside from that, isn’t the burden on those who would expose an infant’s open wound to bacteria and/or viruses to prove that doing so is perfectly safe? The fact that it was done for thousands of years was due to ignorance about transmission of infections, but we have no such excuse today. By that logic, perhaps there should be a Kol Koreh against learning in Kollel, because, for thousands of years, virtually everyone had to work for a living. Imagine posters all over the world criticizing those who don’t fulfill the obligations of the Kesubah, as per our holy Mesorah; indeed, as per the Shulchan Aruch (yes, I know, their wives are Mochel; except the ones that are pushed into it, e.g. because they fear that they won’t get a Shidduch otherwise).

  36. I have used both Rabbis Krohn and Billet for brissim, rabbi krohn even did mine. I know Rabbi Billet very well (went to several schools together) and he is a good guy who goes according to halacha. he is not a money grubber as by my sons bris he told me to pay him the amount I felt right. ALl he is saying is that if you want mtzitzah bpeh done the father should do it. A mohel is dealing with numerous kids and can easily be a vector for infection. If you think its such an important thing do it yourself for your own son. People have to stop being so negative.

  37. In all fairness to this Mophel, this article was written for the health section of the Jewish Star. The Mohel did not post it on YW. He only paranthetically mentions MBP in the article.The YW headline highlights the topic to attract attention. The article did not pasken about MBP. It not mock those who do it without the suction tube. He just speaks about a whole bunch of sterility issues associated with a Bris. He did not post the article to advertise his practise. I hear that he does not even live in the NY area.

  38. Heres an idea:
    Everyone who’s claiming that metzitza b’peh is absolutely and unequivocally crucial for the halachic validity of a bris, and everyone claiming that R’ Billet is a reformist apikores for daring to discuss medical issues relevant to bris milah, go home tonight, call up your rav, ask him his opinion, and we’ll all meet back here tomorrow and report on our findings.
    Its amazing how a frum man can write an article with the pure intention of keeping his fellow jews healthy, and get attacked for it by frum jews as if he did such a terrible thing. Whats wrong with us.

  39. (Daat toirah – comment #49 – is one of the only people who actually read the article and looked to see where it was in context. I applaud you.)
    CSJew (comment #50),
    You are onto something, but I have to correct you. The authors of these disgusting negative comments are people who violate every bein adam lachaveiro mitzvah in the Torah. THEY are NOT “frum” in any respect. I don’t care what they wear on their heads, or how much “Toirah” they claim to know.
    A “frum” person may make an accidental mistake once in a while. But those who deliberately sin have no kapporoh on Yom Kippur, עד שירצה את חבירו. Rabbi Billet might not be interested in being any of their friends, but they have a lot of forgiveness to ask for this disgusting display of arrogance and chillul hashem.
    Michoel Z

  40. Edinburgh Medical Journal 2 (1856-57) #555
    “Syphilitic and cancerous ulcers may also infect the child through the bleeding wound. Rust has related the case of a circumciser who had syphilitic ulcers of the mouth, who infected four children in the manner.”

    Pediatrics, Volume XXXIV, Page 186-190, March 1917
    “Tuberculosis Following ritual Circumcision” by Mark S. Reuben
    “A review of he literature shows that there are 42 cases (including our case) of tuberculosis infection following ritual circumcision. The incidence of such infection must have been greater and many cases have probably not been reported. It seems reasonable to suppose that the same operator (mohel) would probably infect a majority of the infants on whom he performed circumcision…
    In 37 cases the wound was sucked in the usual way; in 3 the wound was sprinkled with wine from the mouth of the operator; in one case a dressing was applied to the wound on which wine from the mouth of the operator was poured on; in our case the wound was aspirated through a glass tube….
    Of the 42 cases reported, 11 recovered, 16 died, and of 15 the final outcome is not known…”

    Earliest reference to Oral MBP in in Rav Yaakov Hagozer (12th century) who writes
    אחר הפריעה מיד מכניס האבר לתוך פיו ומוצץ את הדם בכל כוחו משום שהדם נקרש כפי האמה וסכנה הוא אם אינו מוצץ…

    I challenge anyone to find a legitimate earlier source for MBP orally.
    I challenge anyone to prove that “brisses for millennia” were risk free.
    I submit that until recently infantile deaths were accepted as normal and people did not report them, and things have only changed BECAUSE of modern notions of sterility.

    Even if you study the words I’ve quoted above, you see his definition of MBP is purely medical. And as medical science is different now, his definitions are not relevant.

    As a matter of fact, anyone who believes and follows ancient medical science can not be considered a shomer halakha, and is probably a closet Scientologist, or one of those extreme religious sects (non-Jewish) which does not believe in medicine.

    I’ve brought REAL information. Not speculation. Not hyperbole. Not “my gut feeling” because “I believe be’emunah shleimah that the author of the article is a kofer” but because I believe beemunah shleimah that those who comment on this website and mudsling the good name of a better Jew than all of you combined need to be put in their place.

    I am not arguing there is no place for MBP. Like Rabbi Billet, however, I believe there are two ways to look at things. And you have to remove your blinders. Because the way you have them on, it’s a wonder how you see anything at all.

  41. #50 said: “Everyone who’s claiming that metzitza b’peh is absolutely and unequivocally crucial for the halachic validity of a bris, and everyone claiming that R’ Billet is a reformist apikores for daring to discuss medical issues relevant to bris milah, go home tonight, call up your rav, ask him his opinion, and we’ll all meet back here tomorrow and report on our findings.”

    Needless to say, I fully agree with this. #51 is on to something as well.
    Also: everyone should keep in mind the principle of “Kol haMosif Goraya,” before using the word “Apikores” when it does not REALLY apply (if you’re not 100% certain, you should not be using the term). There are a number of people who consider themselves Orthodox, yet have questions about Torah min HaShamayim, r”l. When told that the views they are espousing are Apikorsus (i.e. they blatantly violate one or more of the Rambam’s 13 Ikarim), these people, who have heard the word “Apikores” used loosely countless times by so-called kanaim, don’t take the matter seriously. Those who misuse the terms Apikores or Apikorsus share the blame for this tragedy.

  42. emesayid said “I doubt very much if any of Billet’s brisim are al pi halacha.”

    What a horrific cruel thing to say. #40 I seriously challenge your credentials. If you are a Moel who has the capacity to do “thousands of Brisim for free” then you obviously have the capacity for ahavas yisroel. on the other hand your tone and demeaner is so arrogant and judgemental
    ” thousands of Brisim not one infection” that I find it very hard to beleive that your a moel at all. As for being a Dr. besides your arrogance which might confirm it, you of all people should understand and appreciate the need for a clean sterile working environment that Rabbi Billet is espousing when dealing with an open wound. Again I challenege your credentials!

    I choose not to wade into the Mitzizah issue for I freely admit my Halachik ignorance on the issue.(Wow how refreshing somebody actually admitting that they dont know something) As for the despicable personel attacks on fellow Jews taking place on this site- I loudly proclaim my forcful protest against all who speak Rechilus and Motzie shem Rah against any Jew-period! That it is bring done in the guise of L’shem shomayim saddens me even more.
    Have we all become incapable of rational disagreement? For Shame.

  43. #55 please do so as this is very out of hand. This issue has been dealt with recently on the Poskim front. I find this discussion very offensive.
    PS Rabbi Billet there were Rabonim who would have taken away your license if you wouldn’t do metziza b’peh. In addition. it is not just a traditionof the “oral law” to just honor the father. There is method and training involved which the parent is not trained for. And we are aware that no Metzizah is a saakuna. RIGHT??!!!!!

  44. #56. There are rabbonim who would challenge a person who will not even consider using a tube. You pick your rabbonim and I’ll pick mine. Both your rabbonim and my rabbonim are tremendous gedolei torah and talmidei chachomim. The difference is hashkafic. I’m entitled to my opinion and you’re entitled to yours. Saying you’re right because you can’t see things any other way shows how you can’t even value a machlokes in the gemara. Learning Talmud must be very difficult for you. All this uncertainty. Do you ever eat black and white cookies? How do you overcome the contradiction?

    Michoel Z

  45. I assume he did his own son if he claims to be a mohel for ten years.

    The authoritative language this opportunist uses is chutzpah at its highest level.

    The fact that he just steamrolls over all issues of Pri’ah (which can’t be done with gloves on!) and Metzizah with no conscience, would convince me not to use him as a doctor let alone a mohel.

    I don’t understand YWN’s point in publicizing these offensive words.

    ולמלשינים אל תהי תקוה

  46. This is another attack on chareidim by a student of Dr. Moshe Dovid Tendler, who has waged a 40 year battle against ultra-orthodox Mohelim starting with his formation of the Mt Sinai school of circumcision in 1968. The three papers associating MBP with HSV are done by 22 Doctors, all closely connected to Tendler, none of whom have ever done a paper neonatal herpes and 17 who have never done a paper on herpes, and 6 who were not even authors. They signed onto a finished medical paper in violation of editorial policy in an effort to get it published in Pediatrics after it was rejected by JAMA twice because it’s garbage. Tendler can be heard bragging about this to his students in a recorded lecture. The actual articles suggest a link but they are no more than presumed cases because every test that might have implicated the mother or exonerated the mohel was not done. The cases mirror textbook maternally transmitted herpes, and the authors, in their abject ignorance of the subject use these factors to exclude the mother. Asst NYC Health Commissionor Dr Julia Schillinger showsa wealth of ignorance by making statements on MBP that continually contradict her 4 published papers on HSV seroprevalance. A major report on this will be released before Purim. It covers every lie, fraud, and deception made by the authors. Stay tuned.

    Note to Editor: I can document every statement made here. Ask

  47. Mr. Billet’s arrogance in claiming to know more than the Binyan Tzion, The Mahram Shick, Sdei Chemed, and others is truly disusting.
    The notion that chareidi mohelim don’t sterilize their instruments is nothing short of a blood libel. Sterilization of instruments and washing hands and mouth with strong alcohol is discussed in mashiv nefesh,(sharhai) chalek 3, Vilna 1906, and Sefer Habris (Iskalsky)New york 1915. Among others. Thank you Avi for showing how knowledgable you are.

    Mitzvas hametzitzah (Shiffer) Says Rabbi Chaim Halevi Soleveitschik signed not to change metzitza.
    So when Rav Dovid Feinstein signed the kol korei not to changed metzitzah because of AIDS in 1989
    and added below his signature that Reb Moshe z”l said on this Shomer mitzva Lo Yodaya Davar Ra, he lied? I don’t think so. Show me where R’Moshe says it was a slip of the pen.
    Someone who prints an article in Pediatrics and writes that the Chasam Sofer who died in 1839, having been influenced by Ignacz Semmelweis’ 1847 discovery of disease transmission after a baby got tuberculosis from a mohel (first case in the literature 1883) was matir the tube that was invented in 1887, and bases his other arguments regarding Israeli and Canadian babies on 1980 United States HSV statistics ignoring Israeli (Samra Z 2003) and Canadian (Kropp R 2006) HSV stats that tell a completely different story in order to get jews to stop performing MBP as dictated by Chazal and by 3000 years of Minhag is an Apikorus.
    Try looking up the references in his article and reconcile them with what he writes. He learned from colleague at Einstein, Dr Lorry Rubin, cite sources, than write whatever you want. nobody looks up sources. I did. He lied. PLEASE PLEASE PLEASE sue me for libel. I would relish the opportunity to demonstrate in an public forum such as courtroom that your talmid chochom fabricated every aspect the story, including fabricating two cases shelo hiya velo nivra, and altering the information in his paper after an unsuccessful meeting with the Israeli Ministry of Health on March 13, 2003, in an effort to get them to ban MBP.
    Correct. I often describe MO as Judaism without G-d.
    Tell me, in the few hundred years between the mishnah and the gemara, where did it say that MBP is really not part of milah, being that the mishnah includes it as part of milah? If MBP is only because of sakanah, why isn’t the mohel who doesn’t use Aspalanis and Kumin removed because of sakanah? Why is the mohel himself required to do MBP when there are theoretically another 10 people there? Why is it OK for someone else to place the Aspalanis and Kumin? Being that the achronim discuss but don’t conclude exactly what the sakanah is, an immediate sakanah? a later sakanah? a spiritual sakana? We can’t say the sakanah is not there and chamira sakanta misurah , so we can’t eliminate MBP according to halachah, even according to the opinions that it’s not halacha limoshe misinai. How do we know rav Pupa’s statement is the ONLY reason? chamira sakanta misurah, he gave the biggest reason not the only reason.
    And by the way, a search of pubmed with the term “medicinal leeches” yields 441 papers on the current use of medinical leeches. So I guess Chazal were smarter than you thought they were.
    I read`more than you did see the comments to #28, and #31. Read the articles, and their sources. Tell me where it shtims. In his 2000 PIDJ paper, Dr Lorry Rubin cites a 54 year old 1946 paper by Evan L Lewis on Tuberculosis of the aiver in an effort to demonstrate the great threat that MBP poses to society. The latest case due to MBP cited by Lewis in 1932 68 years and probably 150,000+ brissim in the NYC area prior to his paper. can you think of any othe surgical procedures with 68 year spans between infections. (That assuming Rubin is right, which he isn’t.)
    as stated in the Binyan Tzion and repeated by his talmid Reb Shamshon Raphael Hirsch z”l, “when klal yisroel was concentrated in eretz Yisroel before the exile and millions of jews were living in one place, chazal had more clinical material to make these decision than any doctor today will have in a lifetime. The decided on a technique that was available in the field and anywhere else needed, and in 1600 years from the mishnah to the advent of the reform movement there is not one recorded instance of a baby getting a disease from MBP.
    I actually have those medical journals (and hundreds more) and if doctors today would perform some of the medical “procedures” listed, they would be sent to jail. Dr Yitzchok Price, a frum doctor from Berlin wrote to the Sdei Chemed in 1901 (Kuntres Hamiluim) stating people got sick because they didn’t follow Shulchan Oruch which says a person should seek out the best sandek and Mohel, a tzaddik, (cited from the Or zarua, who cites Reb Sharira Gaon and the Medresh) Dr. price writes If you take a mohel, a tzaddik, you’re not going to get syphilis. Like wise a tzaddik will not do milah when he’s sick and coughing up blood. A mohel who does it for his 5 reichstellar, will not pass up the 5 reichstellar. Hence the advent of the reform movement, illness attached to metzitzah, and objections to MBP, all occurred simultaneously.
    There is a medresh that says brought by the Yaivetz which says Moshe mol Aharon Poraya, viyehoshua mashka zuhi MBP.
    The Maharm Schick z”l testified on himself that he was a mohel for 40 years and never had a problem, he writes “you can ask any (chareidi) mohel of this generation or the last and you won’t find one that had a problem. As for Moitzy shem ra, I did the research, the 3 papers are built on lies beginning to end. These doctors slandered ehrliche mohelim to push their own MO agenda. Buy the papers and their references, read them, and you’ll find a vast gap between them.

    VIN, If you want any documentation ask. I have di vihoser.

    The three papers attacking MBP are:

    Rubin LG, Lanzkowsky P. Cutaneous neonatal herpes simplex infection associated with ritual circumcision.
    Pediatr Infect Dis J. 2000, 19(3): 266-8; availalbe for purchase through the web
    Distel R, Hofer V, Bogger-Goren S, Shalit I, Garty BZ.
    Primary genital herpes simplex infection associated with Jewish ritual circumcision.
    Isr Med Assoc J. 2003, 5: 893–894: available on the web.
    Gesundheit B, Grisaru-Soen G, Greenberg D, Levtzion-Korach O, Malkin D, Petric M, Koren G, Tendler MD, Ben-Zeev B, Vardi A, Dagan R, Engelhard D.
    Neonatal Genital Herpes Simplex Virus Type 1 Infection After Jewish Ritual Circumcision: Modern Medicine and Religious Tradition.
    Pediatrics. 2004, 114(2):e259-e263 availalble on the web.
    The paper cited by 2005 NYC health alert #46 but only for Acyclovir antiviral treatment is listed below. Compare what a NHSV expert writes to the papers above.
    Kimberlin DW.
    Neonatal herpes simplex infection.
    Clin Microbiol Rev. 2004 Jan, 17(1): 1-13 availalble on the web

  48. To #60: I am not familiar with the Kol Koreh from 1989, but you wanted to know where Rav Moshe Feinstein wrote that “it was a slip of the pen.” See Igros Moshe, Y.D. I, siman 223 (last paragraph), where Rav Moshe writes this to someone who thought that Metzitza was part of the Mitzvah of Milah (as are Milah and Priah), the way Lulav is part of the Mitzvah of taking the Arbah Minim. To that, Rav Moshe responded that he believes “that it was merely a slip of the pen, as it is obvious that Metzitza is not an Ikuv in the Mitzvah [of Milah], because it is ONLY for purposes of Refuah.” (Emphasis added).

    Once it has been established that Metzitza is only because of Refuah, then it would certainly seem logical to take into account what is known today about avoiding transmission of infection. So, by all means, we should continue to do Metzitza, but in the safest possible way – i.e. with a sterile tube, or whatever modern (excuse the word) medicine dictates. Anyone who has a problem with this should ask themselves what kind of medical care they would want for themselves and their family: the best care available today, or the remedies discussed in the Gemara? If the former, you’re being inconsistent; if the latter, you’re being reckless with your health.

  49. #60. You seem very passionate about something. I hope for your sake you are as passionate about every aspect of your Judaism as you are whether MBP should be done.
    Just a couple of points:
    1. Rabbi Billet never said not to do MBP. HE obviously won’t do it, but he suggests a father consider doing it over the mohel doing it.
    2. The medrash you quote is an impartial quote. Here is the quote – from two separate sources – and they confirm my original suspicion. That the word “Mashkeh” means to give to drink, as opposed to the word “Motzetz” – which should have been used according to your logic.
    Here are the quotes:
    אבודרהם מילה וברכותיה ד”ה א-לקינו
    ולכך היה משה מל ואהרן פורע ויהושע משקה אותם עפר העגל שעשו

    חתם סופר מסכת שבת קלה. ד”ה ראה זה מצאתי
    והיה משה מל ואהרן פורע ויהושע משקה מים המעורבים עם זהב העגל והיתה אותה ההשקאה והמילה למיתה

    That you lied about the midrash calls everything you write into question.
    Have a nice day


  50. Shtenderbender! Talk about מלשינים.
    There are many mohels who do priah with gloves on! It is possible! Use thinner gloves with defined finger nails.
    To blanket sweep something without either trying it or seeing it done is a very poor proof based on observation.

  51. #60,
    A copy of the Kol koray is here:

    Reb Moshe says it not l”‘ikuva”. That doesn’t mean that it’s not part of the mitzvah lichtchilah. There are however sources that write, mol uporaya vilo motzetz k’ilu lo
    mol. Try the harachamon after bentching for starters “ovodoso pisulah, im shlosh aileh lo ya’aseh lah.”
    Unlike you, I actually did my research, when a group of modern orthodox doctors with a very specific agenda attacks a 3000 year old Jewish practice based on lies and deception, violates every editorial policy there is, including but not limited to obfuscation, fabrication, falsification, and authorship requirements in order to sneak their papers into legitimate medical journals, I’ll admit I get a little bent out of shape. In regards to your assertions, what is the purpose of this article written in a modern orthodox newspaper? It is clearly to: 1) further discourage klal Yisroel from doing metzitzah by insinuating that there is a serious disease risk, 2) It is to insinuate that chareidi mohelim that haven’t been to med school do not practice asceptic techniques even though these were printed in Chareidi seferim that I listed, over 100 years ago.

    2) Unlike you, I didn’t have a computer with a search engine at my disposal. I thought I remembered it from the yaivetz. The Bnei Yisroel were mal twice. The medresh is in Bamidbar Raba 11 and in several places in Shir Hashirim Raba at times with a different order Moshe mal, or yehoshua mal. The correct source for my quote is the Rambam in ma’amar Kiddush Hashem. Referring to this medresh, the Rambam writes, “Moshe hiya mal, Yehoshua Poraya, v’Aharon motzetz”. As the Rambam, the later Yaivetz and Chasam Sofer darshan the word mashka, because without the drasha what does the word mashka have to do with milah? In regards to the medresh that says the Bnai Yisroel were afraid that they would die like the bechorai mitzrayim, if they weren’t mal and didn’t eat the Pesach, therefore they came running to Moshe to be mal, it is obviously referring to the first Pesach in mitzrayim and the drashas of the of the Yaivetz and Chasam soifer concerning the dust of aygel cannot be applied.

    I hope that “uncalls” everything I wrote out of question. You could actually look it up. In the future, please ask politely, I would be more than happy to provide sources.
    Your citation of “Pediatrics, Volume XXXIV, Page 186-190, March 1917, “Tuberculosis Following ritual Circumcision” by Mark S. Reuben” seems to be incorrect.

    Pediatrics was first printed in 1948, and the Archives of Pediatrics volume number would be out of sequence for 1917, Please check your source. I have the same paper listed as the “Transactions of the NY Academy of Medicine, Dec 15, 1916 p. 333-4” please note that the author says: “He had been circumcised on the eighth day by a mohel who aspirated the wound by means of a glass tube.” In several of the other cases metzitzah was clearly NOT DONE, umi yodayaa….? In several of the other cases, the results of autopsies are discussed, so we can assume the parents were not chareidim, and who knows who the mohel was? I will again state, the advent of the reform movement, the incidence of disease after metzitzah, and attacks on MBP all ocurred simultaneously.

  52. #65 wrote: “Reb Moshe says it not l’ikuva. That doesn’t mean that it’s not part of the mitzvah lichtchilah.”

    But read the end of the sentence, where Rav Moshe writes that Metzitza “is ONLY for purposes of Refuah.” (Emphasis added – see above, comment #62).

    Thank you for providing a copy of the Kol Koreh. I must note that the statement that if there is a concern that the infant will become ill, a Sheilah should be asked, seems difficult to reconcile with the ruling of Shulchan Aruch (Orach Chaim 328:2) that one who asks a Sheilah in cases of Pikuach Nefesh is [tantamount to] a murderer. This may be why Rav Shlomo Zalman Auerbach appended the following disclaimer to his signature: “In circumstances where there is no concern [of danger] WHATSOEVER, G-d forbid, it is PROPER [literally “good”] not to refrain from performing Metzitza b’Peh.” (Emphasis added). Clearly, Rav Shlomo Zalman would not require asking a Sheilah, let alone performing Metzitza b’Peh, where there is ANY concern of danger to the baby. Furthermore, even without any danger at all, Rav Shlomo Zalman does not say that Metzitza b’Peh is required, only that it is “proper.”

  53. I am NOT trying to smear Dr Krohn, what I am about to say is the truth. It’s so painful, it’s hard to type without getting upset. He is completely about money, wheeler dealer and that’s his business, his prerogative, but apparently he’s the only one with an in at a certain hospital and to extract alot of money from parents who are sending their child for surgery but want to have blessings, its unconscionable. I have no reason to make this up, I cannot believe Rabbi Paysach Krohn is actually a rabbi.

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