By Rabbi Yair Hoffman
It is the rare sefer that has had some of its rabbinic endorsements revoked after publication. There is a dayan in the chassidish community who has issued a ruling that it is forbidden for Jewish bookstores to sell it and any that do so are in violation of machti’im es ha’rabbim—bringing the masses to sin.
This new book, “Ki Ani Hashem Rof’echa: Alternative Medicine in Halachah,” is written by an outstanding talmid chacham, Rabbi Rephoel Szmerla, a dayan in a Lakewood beis din. The halachic arguments and discussions are fascinating, representing an original analysis of the rare halachos that deal with the occult.
The endorsements were revoked because of alleged misrepresentations of halachah. It is this author’s view, however, that Rabbi Szmerla’s halachic views are cogently argued—that should not have been the reason to revoke the approbations (haskamos). However, there are some very serious issues with the work, in this author’s opinion.
The sefer is divided into two sections: the main part of the sefer and the in-depth biurim in Hebrew in the back of the work. The halachic discussions are truly groundbreaking in terms of their exhaustive treatment of the aveiros of the occult: specifically, kishuf, doresh el ha’meisim, nichush, and kosaim. It also deals with following the ways of the gentiles (darchei emori) and of the mitzvah of tamim tihyeh. In discussing these aveiros, the author takes us through every opinion of the Rishonim.
In the body of the English text, the sefer is comprehensive in its discussion of alternative forms of healing. In terms of the Torah scholarship, it is quite clear that we are dealing with an extraordinary talmid chacham. The sefer has numerous haskamos from leading figures who affirm 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 at their core violate the aveiros of the occult. The second underlying idea is that these alternative forms of medicine are 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 Rabbi Szmerla states that it is not his goal to encourage people to discount conventional medicine, advocating the efficacy of modalities of treatment that have statistically been proven ineffective actually does the very thing that Rabbi Szmerla claims 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.
With The Sefer
Specifically, it can cause those who are ill, and their family members, to (a) squander much-needed and valuable resources on ineffective treatments; (b) not pursue effective and proven forms of treatment; and (c) suffer unnecessary damage.
In the majority of cases, the moneys spent on pursuing most of these alternative treatments would be far better spent on supporting Torah learning instead. Rabbi Szmerla ignores the overwhelming medical evidence that these treatments have proven ineffective.
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 indicates that they do not necessarily agree with his conclusions.
A Dangerous Thesis
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 Yisrael. People may pick up the sefer and peruse the haskamos. They may erroneously assume that the information about treatments 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 derech ha’teva. That is 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 who 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 problem can be seen with 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 in statistics with someone 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 a rabbinic scholar makes a mistake regarding metzius (physical reality), 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 gedolei ha’poskim in America and Eretz Yisrael (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 ha’poskim 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 of what would constitute a refuah bedukah—a tested and certain cure. He writes that Chazal only required a cure to have 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, zt’l, has praised Rav Morgenstern, shlita, numerous times as fluent in kol haTorah kulah, and the dismissal of his views and quotes of Rishonim by Rabbi Szmerla is wholly 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 (Gerber is quoted authoritatively by Rabbi Szmerla). Rabbi Szmerla attempts to associate the Gemara’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 mi’pihem anu chaim, and adopts a Kabbalistic 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 boah d’boah is not “aura.” [See, as just one example, the article “Spiritual healing as a therapy for chronic pain: a randomized, clinical trial” in the medical journal Pain (91, pp. 79–89) by Abbot, NC; Harkness, EF; Stevinson, C; Marshall, FP; Conn, DA; Ernst, E (2001). 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/Hands-On Healing
“Therapeutic touch” healing is a pseudoscience based on the belief that by placing their hands on or near a patient, practitioners are able to detect and manipulate 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.” It includes a demonstration by a nine-year-old girl that practitioners of it either are 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 argument 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, effective. However, the theories behind acupuncture—the notion of restoring energy meridians—have been summarily rejected by those with a thorough and grounded understanding of the underlying science behind it.
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. Practitioners of applied kinesiology claim the ability to diagnose illness or to choose the required effective treatment 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 for 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 pseudoscience by virtue of the fact that a number of respectable rabbanim 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, via Hines, Terence (2003). Pseudoscience and the Paranormal (second edition). Amherst, New York: Prometheus Books, p. 420.]
When it comes to homeopathy and flower essence, here too the author seems to be claiming efficacy of a discredited form of therapy. And while it may be incorrect to forbid the practice of these therapies as darchei emori, they can be forbidden because they are a waste of time and money. The statistical studies are conclusive that they do not work. [See, as just one example, Bioethics (26:9 pp. 508–512) Smith K (2012). “Homeopathy Is Unscientific and Unethical.”]
The modern-day crystal therapy is compared by the rabbi to the even tekumah discussed in the Gemara in Sanhedrin (68a). However, not all Rishonim agree with this definition of even tekumah, and it is far from clear that it refers to the same type of stone. Let us also keep in mind that the Baalei Tosfos in Moed Katan 11a (d’h Kavra) write that nishtaneh ha’teva, 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 Avraham 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 Gemara because we cannot properly identify the various samim discussed nor do we know exactly how to administer the remedies. See also Yam shel Shlomo (Chulin 8:12) that even the effective cures should not be done so that am haaratzim not develop kefirah.
Feng Shui And
The author finds that some aspects of Feng Shui violate the prohibition of darchei emori—following the ways of the gentiles. He concludes that this form of alternative medicine is forbidden, because we cannot determine which aspects of it achieve true energy harmonization and which ones stem from superstitious beliefs. This reviewer believes that the former are completely ineffective and have been statistically proven invalid.
The author concludes that shamanic healing is strictly forbidden.
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. However, there are issues of undergoing hypnotherapy when matters of gender and tzniyus 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 that has one clearing his mind of all thoughts. This does not fall in line with mitzvah of always having in mind the sheish zechiros: Anochi Hashem, belief in Hashem; Lo Yihyeh, 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.
As stated throughout this review, the halachic views of the Rabbi Szmerla demonstrate 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 adept 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 u’vinaschem b’einai ha’amim.” The rejection of statistics in evaluating how medicine should be applied is a dangerous trend.
The author can be reached at firstname.lastname@example.org.