The second Mishna in this chapter on today’s daf TB Shabbat 134 discusses
the actual circumcision procedure itself and that doesn’t change whether the milah
is done on Shabbat or on a weekday. “MISHNA: When the eighth day of a baby’s life occurs on Shabbat,
he must be circumcised on that day. Therefore, one performs all the
necessities of the circumcision, even on Shabbat: One circumcises
the foreskin, and uncovers the skin by removing the thin membrane
beneath the foreskin, and sucks the blood from the wound, and places
on it both a bandage [ispelanit] and cumin as a salve.”
(Sefaria.org translation)
According to the Mishna there are three different parts
to the circumcision, removal of the upper membrane (מוהלין),
removal of the lower membrane (פורעין), and oral suction (מוצצין). Today mohelim (plural for mohel) cut and remove both the
upper and lower membranes at the same time. The question arises if one does not
do oral suction, has the mitzvah of milah been accomplished? This has practical
implications because in New York City too many baby boys have died after
contracting herpes simplex virus type 1
or HSV-1 from an infected mohel doing oral suction with his mouth. If it’s
not an essential part of the ritual, it can be skipped or accomplished in a
different way. I believe that the
following discussion of the Mishna in the Gemara points to the answer.
“We learned in the mishna that one sucks blood from
the wound after the circumcision was performed on Shabbat. Rav Pappa said: A
craftsman who does not suck the blood after every circumcision is a
danger to the child undergoing circumcision, and we remove him from
his position as circumcisor. The Gemara comments: This is obvious. Given
that one desecrates Shabbat to suck the blood, which involves performance
of a prohibited labor, obviously, failure to do so poses a danger.
Desecration of Shabbat would not be permitted if it was not a life-threatening
situation. The Gemara answers: This is not an absolute proof. Lest you say
that this blood is collected and contained in place, and one who removes
that which is pooled in its place does not perform the subcategory of the
prohibited labor of threshing on Shabbat, i.e., drawing blood; that is the
reason sucking the blood is permitted, not due to any danger involved in
failing to do so. Therefore, the mishna teaches us that this blood is
attached and flowing and not merely pooled. One who draws it out performs
an act that is generally prohibited by Torah law on Shabbat, and it is
nonetheless permitted due to danger to the child.” (Sefaria.org translation)
I believe that the conclusion of the Gemara is that oral
suction was done for therapeutic purposes only. Who hasn’t hurt themselves on
the playground and was told to let the blood flow a bit to remove any dirt that
is initially there until you can clean it with soap and water and cover the
wound with bacitracin. In 1831, a German professor published a handbook for
mohelim. He tried to demonstrate that there was no evidence showing the ritual
serves a therapeutic purpose. In fact, it could actually harm the baby, he
concluded. Six years later, a student of Rabbi Moses Sofer, a leading Talmudic
scholar, asked him about several babies who appeared to become sick after they
were circumcised by a mohel who did oral suction. In a famous response
published in a journal in 1845, Rabbi Sofer concluded that metzitzah does not
have to be done orally. Instead, a mohel could use a sponge to clean the wound.
Nevertheless In 1900, a group of 42 leading Hungarian rabbis publish a letter
defending oral suction, prohibiting any changes to the ritual. Many if not all groups
of ultra-Orthodox Jews follow the letter by the Hungarian rabbis and still do
oral suction by the mouth.
Now that our
understanding of medicine has advanced and realize that oral suction by the
mouth endangers the child, it should not be done at all or done using a sponge
or sterile hollow tube to draw the blood.
The New York City has published a webpage helping parents
have a safe brit milah for their brand-new baby boy. Follow this link for
further information: https://www1.nyc.gov/site/doh/health/health-topics/safe-bris.page
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