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1) DOCTORS' ORDERS AND PATIENT NEEDS

(a) If the patient says that he needs food and the physician says that the patient does not, we rely on the patient (proof text that a heart knows its own pain).
(b) Question: That seems obvious!?
(c) Answer: We need to be taught to listen to the patient given the physicians' expertise.
(d) If the patient says he does not need food and the physician says that he does, we feed the patient, and attribute the patients' feelings to delirium.
(e) Question: The Mishnah, which says that we feed the patient based on the opinion of experts, contradicts both of the above assertions.

1. It implies that we rely on experts, not on the physicians.
2. It further implies that we rely on *more than one* expert (the plural is used) and not on one!?

(f) Answer (R. Yanai): We are speaking of a case where the patient says that he does not need food, in which case we defer to the physicians.

1. Question: Let us then feed him based on *one* physician!?
2. Answer: We are speaking of a case in which the patient also has one physician supporting his refusal to eat.
3. Question: Is it not obvious that we would feed a patient if experts say that he should eat, given that we are lenient even if the threat to life is a doubt!?
4. Answer: We need to be taught the Din in the case where two physicians support the patient indicating that he need not eat (to teach that the patient does not combine with those two physicians supporting him).
5. This takes into account the view of R. Safra that in matters of assessment we rely not on two (which establishes matters of testimony), but on the majority of all opinions.
6. The patient, however, does not create such a majority.
7. This is because the majority for assessment only applies to monetary matters, but does not eliminate the Safek Nefashos.

(g) Question: But the Seifah teaches that, in the absence of experts, we feed him based on his own sense of need (indicating that the Reishah is also speaking where he indicates a need to eat) not like R. Yanai asserts!?
(h) Answer: The Mishnah is missing text which provides for this shift.
(i) (Mar b. R. Ashi) A patient indicating his need to eat overrides all opinions to the contrary since a "heart knows its own pain."
(j) Question: But our Mishnah indicates that we would *not* rely on him against expert opinions!?
(k) Answer: We must modify our understanding of the Mishnah to permit feeding him when he says he need not eat and the experts say that he does.
(l) However, when he indicates a need to eat, the opinions of the experts are disregarded, as taught.

(a) One who suffers from an attack of Bulmus is fed until his eyes regain their light.
(b) One who has been bitten by a rabid dog may not be fed from its "Chatzar Kaved" since it is not an established Refuah.
(c) R. Masia b. Cheresh permits giving it since he considers it an established Refuah.
(d) R. Masia b. Cheresh further taught that it is permitted to be Mechalel Shabbos (by preparing the medicine) for throat (or teeth or gums-Rosh, Bartenura) pains (Safek Nefashos).
(e) If there might be a Jew buried beneath a heap, we must dig through the ruble, stopping only when the person is saved or discovered to be dead.

(a) Question: How would we know if the light has returned to his eyes?
(b) Answer: When he can differentiate between good and bad (meaning its taste- Abaye).
(c) In the absence of permitted food, we feed him prohibited food, HaKal Kal (least Isur first).

1. Neveilah (Malkos) before Tevel (Misah).
2. Isur Shemitah (Aseh) before Tevel.
3. Tevel and Terumah is a Machlokes in the Beraisa.
4. (Rabah) If taking off the Terumos and Ma'aseros will leave enough to satisfy him, then all agree to do so.
5. The Machlokes is when *all* the produce will be needed.

i. Ben Teima says Terumah before Tevel (so turn it first into Terumah).
ii. Tana Kama holds Tevel first (leave it as Tevel without turning any into Terumah).
iii. Ben Teima holds that Tevel is worse because its Isur applies to everyone (while Terumah can, at least, be eaten by a Kohen).
iv. Tana Kama holds that Terumah is worse because it is irreparable (while Tevel may be tithed).

4) VIOLATING A D'RABANAN FOR TEVEL D'RABANAN

(a) Question: It is *obvious* that we would fix the Tevel if that would suffice!?
(b) Answer: We need to be taught to do so if it is Shabbos.
(c) Question: But even on Shabbos the Isur is only D'Rabanan!?
(d) Answer: We are speaking of food which is only Tevel D'Rabanan (and we are thus taught that they would agree that an Isur D'Rabanan is to be violated in order to fix an Isur D'Rabanan, lest people permit Tevel D'Oreisa). [However, where all the food will need to be eaten, one holds that Tevel is worse, and one holds that Terumah is worse.]
(e) Question: But the issue of permitting a D'Rabanan (Tiltul) to fix Tevel D'Rabanan seems to be Machlokes Tanaim!?

1. If one is bitten by a snake, Melachos may be done to treat the victim.
2. (Rebbi) We need not tithe the vegetables (medicinal herbs) cut on Shabbos.
3. (R. Elazar b. R. Shimon) They must first be tithed.
4. It would appear that Rabah (3.c.4. above) fits to R. Elazar b. R. Shimon, but not Rebbi!

(f) Answer: Even Rebbi would agree with Rabah that they must be tithed, and he was lenient in the Beraisa because we are speaking of vegetables whose obligation is D'Rabanan.

1. Rebbi would agree that Tevel D'Oreisa must be fixed even in a case where the Chiyuv is D'Rabanan (such as in an Atzitz She'eino Nakuv).
2. This is lest people apply this Kula to an Atzitz Nakuv.

(a) (Beraisa) Sweet foods are best for restoring the light to his eyes (alluded to in the Pasuk in Shmuel I, 14:29 where Yonasan reports that he has light in his eyes after tasting a bit of the honey).
(b) Question: That seems like a clear proof, not just an allusion!?
(c) Answer: It is not a clear proof since Yonasan was not then suffering from Bulmus.
(d) (Abaye) Sweets only restore the light when eaten after food, but before food they only intensify the hunger (proof text from Shmuel I, 30:11-12).
(e) (R. Nachman citing Shmuel) The best food for Bulmus is a sheep's tail in honey.
(f) (R. Huna b. R. Yehoshua) Also fine flour in honey.
(g) (R. Yochanan) I once (during a bout of Bulmus) ate from the eastern side of a fig tree (wisely recalling the teaching of R. Yosef who learned from the Pasuk that the sweetest fruit are to be found there).
(h) R. Yehudah (while travelling with R. Yosi) was struck with Bulmus and stole away the loaf of a passing shepherd, raising the rebuke of R. Yosi.
(i) Upon reaching the city R. Yosi was struck with Bulmus and all the townspeople gathered to bring him sweets to heal him, whereupon R. Yehudah indicated that R. Yosi troubled many more people than just the shepherd.

(a) In the reported incident, R. Meir was able to suspect the innkeeper based on the implications of his name.
(b) He was not permitted, however, to report his suspicions to R. Yehudah and R. Yosi who entrusted their purses to the innkeeper.
(c) They were able to retrieve their purses by deceiving the man's wife, pointing out that they knew what she had made him for the previous meal (as evidenced on his mustache).
(d) The innkeeper then killed his wife for giving back the stolen purses.
(e) This is the intent of the Beraisa which teaches that one who does not wash Mayim Rishonim may end up eating forbidden food (as the innkeeper would assume him not to be Jewish) and one who does not wash Mayim Acharonim could cause bloodshed (as in the reported incident).
(f) Subsequently, the Chachamim were careful with inferring from names, and did not trust Balah (based on the Pasuk)