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Literary critic Adam Kirsch is reading a page of Talmud a day, along with Jews around the world.

When my son was born on a Friday and I contacted a mohel to schedule the bris for the following Saturday, I was surprised to be asked whether the baby had been delivered by Caesarean section. If boys are delivered traditionally, I learned, they must be circumcised on their eighth day of life; but if they are delivered by C-section, the ritual can be postponed if the eighth day falls on Shabbat. I didn’t ask the mohel for the halakhic reasoning behind this distinction—as a new parent I had enough things to think about—but I finally learned it from reading the Talmud this week.

In Shabbat 135a, Rabbi Asi explains that the distinction has to do with the ritual purity status of the mother. Vaginal delivery renders the mother impure, tamei, for seven days, and it is only at the expiration of this term that circumcision takes place, as we learn from Leviticus: “If a woman bears seed and gives birth to a male, she shall be impure seven days, and on the eighth day the flesh of his foreskin shall be circumcised.” The rabbis drew the corollary that, if a woman is not impure because she delivered by C-section, her son does not need to be circumcised on the eighth day. And since it is preferable not to perform a circumcision on Shabbat unless absolutely necessary, the circumcision or milah can be postponed until the ninth day in such cases. Of course, in Talmudic times Caesarean section would have been a very rare and dangerous operation, performed without anesthetic using unsterilized tools. The rabbis could hardly have imagined that in our day almost a third of births would happen this way.

You might not expect that Tractate Shabbat would be the place where the rabbis discuss the rules of circumcision. But this week’s Daf Yomi reading, covering Chapter 19, was devoted entirely to the medical and legal issues surrounding milah. The connection between Shabbat and circumcision is made at the beginning of the chapter, when the ongoing discussion about carrying and transferring on Shabbat focuses on the specific question of carrying a scalpel to perform a circumcision. Is it permitted to bring a scalpel through a public domain for this purpose?

The answer, the Mishnah tells us, is that ideally the scalpel should be brought to the place it will be used before Shabbat. If for some reason this can’t be done, the scalpel can be carried—but it should be carried uncovered, so that everyone can see that Shabbat is only being violated for the sake of milah. The rabbis allow an exception “in times of danger”—a reminder that, in many periods of Jewish history, circumcision was illegal and could only be done clandestinely. If carrying a scalpel openly might expose the mohel to persecution, he should cover it in the presence of witnesses, so that at least two Jews could testify as to what he was carrying on Shabbat and why.

This narrow ruling opens the way for an extensive discussion of circumcision. Rabban Shimon ben Gamliel sets the tone by explaining that milah, despite its quasi-medical nature, is meant to be an occasion for rejoicing and festivity among Jews: “they perform it with joy.” (He contrasts this, in what seems like a wry spirit, with the wrangling that usually accompanies drawing up a marriage contract: “there is no marriage contract in which contentiousness does not arise.”) Shimon ben Elazar adds that circumcision was one of the crucial mitzvot that Jews under the Roman Empire died for rather than give up: “Any mitzvah for which the Jews sacrificed their lives at the time of the decrees of the empire, such as the prohibition of idolatry and the mitzvah of circumcision, is still steadfastly observed.”

Clearly, milah is one of the most important commandments for a Jew. The Gemara observes that “thirteen covenants were established over it,” because the word brit or “covenant” appears thirteen times in the discussion of milah in Genesis. But how do we know that it is so important that it even supersedes Shabbat? After all, we are not allowed to violate Shabbat in order to perform just any mitzvah. As the amoraim show in a long and intricate discussion, there must be a specific biblical warrant to show that a mitzvah takes precedent over Shabbat. Several examples are offered: Certain Temple offerings have to be performed even on Shabbat, as do the shaking of the lulav on Sukkot and the eating of matzoh on Passover. On the other hand, attaching tzitzit to a garment and putting up a mezuzah are not time-bound commandments, so they cannot be performed on Shabbat.

Circumcision, the rabbis conclude, is time-bound, since the Bible makes clear it must take place on the eighth day: “And he that is eight days old shall be circumcised among you throughout your generations,” reads Genesis 17:12. This means that it takes precedence even over Shabbat. Likewise, it takes precedence over the laws dealing with leprosy. Ordinarily, it is prohibited to cut off skin that bears signs of leprosy, such as a white spot; but if a foreskin has a white spot, it can be cut off. (I wondered whether this discussion was purely theoretical or not: Can a newborn contract leprosy?) This is established by means of what Latin calls an a fortiori argument and the Talmud calls a kal vachomer argument: If circumcision overrules Shabbat, and Shabbat laws are more important than leprosy laws, then circumcision must overrule leprosy too.

This point settled, the Talmud goes on to offer specific recommendations for how to perform a circumcision. Once the foreskin is removed, the wound must be salved with cumin and bandaged. More problematic is the instruction that the mohel must suck the blood from the penis with his mouth. This is the warrant for the practice of metzitzah b’peh, “oral suction,” which is still standard among some haredim. In recent years the practice has made headlines when it was discovered that some babies who underwent the procedure contracted herpes from the mohel. Before that publicity, I’d guess that the vast majority of Jews would have been shocked to learn that the practice even exists.

I’m no expert, of course, but based simply on what I read this week it doesn’t seem hard to justify abandoning the practice, even on the Talmud’s own grounds. The rabbis recommended metzitzah b’peh as a hygienic measure. That is why Rav Pappa said, “A craftsman who does not suck the blood after every circumcision is a danger to the child, and we remove him from his position.” This made sense at the time, because there was no better method of hygiene available—just as the rabbis recommended using cumin as a balm because herbal medicines were all they had. Today, when we know much more about infection and can take advantage of sterilized instruments and antibiotic salves, we can meet the Talmud’s goal—a safe milah—much more effectively using modern methods. (After all, we don’t perform C-sections using fifth-century surgical techniques.)

The rabbis also express concern about the aesthetic dimension of the circumcision. “Beautify yourself before Him in mitzvot,” the Talmud quotes, explaining that rituals should be done in a pleasing fashion: “Make before Him a beautiful sukkah, a beautiful shofar, beautiful tzitzit,” and by analogy, a beautiful circumcision. Thus a mohel should not leave “shreds of skin” behind, and if he does he is allowed to go back and remove them, even on Shabbat.

Since they are discussing newborns, it’s natural for the rabbis to expand on the subject of infant health. Abaye quotes his mother’s advice on what to do when a baby is born with an obstruction of the anus (tear it with a barley grain, not a metal instrument which could cause infection or swelling), or if a baby refuses to nurse (warm his mouth with heat from a coal), or if he refuses to urinate (“place him in a sieve” and shake him). Abaye’s mother also explained that if a baby is too red or too pale, he is suffering from a disorder of the blood and shouldn’t be circumcised until his color returns to normal. It’s significant that all this wisdom is attributed to a woman, though she is never named. Abaye is one of the greatest rabbinic authorities, but if the Talmud is a guide to life as much as a guide to law, then Abaye’s mother, too, deserves to be remembered as one of its sages.

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