Parashat Behukotai

The Ramban (Moses Nachmanides, Spain/1194-1270) makes a number of comments on this week’s parashah that relate to miracles and medicine, in other words, the relationship between trust in God and human initiated healing. It is worth remembering that not only was the Ramban a Biblical and Talmudic commentator, but he was also a physician.

“In general then, when Israel is in perfect [accord with G-d], constituting a large number, their affairs are not conducted at all by the natural order of things, neither in connection with themselves, nor with reference to their Land, neither collectively nor individually, for G-d blesses their bread and their water, and removes sickness from their midst, so that they do not need a physician and do not have to observe any of the rules of medicine. just as He said, “for I am the Eternal that healeth thee.” (Exodus 15:26) And so did the righteous ones act at the time when prophecy [existed], so that even if a mishap of iniquity overtook them, causing them sickness, they did not turn to the physicians, but only to the prophets, as was the case with Hezekiah when he was sick…

Thus also the Rabbis said: “During all the twenty-two years that Rabbah reigned [as head of the Academy at Pumbeditha], Rav Yoseph did not call even a blood letter to his house” [as he, being a righteous person, was protected directly by G-d and needed no physicians], and they also say by way of proverb: “A gate which is not open for the commandments [i.e., a house wherein the commandments are not observed] is open for the physician.” This is also the meaning of their saying: “People should not have to take medicaments, but they have become accustomed to do so.” (Berakhot 60a) [That is to say]: had they not accustomed themselves to [taking] medicines, people would become sick according to the degree of punishment corresponding to their sin, and would be healed by the will of G-d, but since they accustomed themselves to medicaments, G-d has left them to natural happenings.

This is also the intent of the Rabbis’ interpretation: “And he shall cause him to be thoroughly healed.” (Exodus 21:19) From here [you deduce the principle] that permission has been given to the physician to heal. (Baba Kamma 85a) They did not say that “permission was given to the sick to be healed” [by the physician], but instead they stated [by implication] that since the person who became sick comes [to the physician] to be healed, because he has accustomed himself to seeking medical help and he was not of the congregation of the Eternal whose portion is in this life, the physician should not refrain from healing him; whether because of fear that he might die under his hand, since he is qualified in this profession, or because he says that it is G-d alone Who is the Healer of all flesh, since [after all] people have already accustomed themselves [to seeking such help]. Therefore when men contend and one smites the other with a “stone or his fist” (Exodus 21:18) the one who smote must pay for the healing, for the Torah does not base its laws upon miracles, just as it said, “for the poor shall never cease out of the Land,” (Deuteronomy 15:11)  knowing [beforehand] that such will be the case. But when a man’s ways please the Eternal, he need have no concern with physicians.”