Talmudology for Sukkot~ Take Two Etrogim, and Call Me in the Morning; The Citron as Medicine

The Midrash tells a story of a man who was so generous with his charitable donations that he had no money left to feed his own family. Out of ideas, he did what I suppose anyone in his position would have done. He went to gather up discarded etrogim [the citron taken as part of the four species on the Festival of Sukkot] and went to see a king.

ויקרא רבה לו:ה

, וְנִתְבַּיֵּישׁ לֵילֵךְ לְבֵיתוֹ הָלַךְ לוֹ לְבֵית הַכְּנֶסֶת, חָמָא תַּמָּן מִן אִלֵּין אֶתְרוֹגַיָא דְּמֵינוּקַיָא מְקַלְקְלֵי בְּיוֹם הוֹשַׁעְנָא, וּתְנִינַן תַּמָּן מִיָּד הַתִּינוֹקוֹת שׁוֹמְטִין לוּלָבֵיהֶן וְאוֹכְלִים אֶתְרוֹגֵיהֶם, נְסַב מִנְּהוֹן וּמְלָא יָת סַקָּא וְהָלַךְ לִפְרשׁ בַּיָּם הַגָּדוֹל, עַד שֶׁהִגִּיעַ לִמְדִינַת הַמֶּלֶךְ, כֵּיוָן שֶׁהִגִּיעַ שָׁם אַרָעַת שַׁעְתָּא וְאִשְׁתְּכַח מַלְכָּא חָשֵׁשׁ מֵעוֹי, אָמְרִין לֵיהּ בְּחֶלְמָא אַסְוָתָךְ אֱכֹל מִן אִלֵּין אֶתְרוֹגִין דִּיהוּדָאי מַצְלִין עִמְּהוֹן בְּיוֹם הוֹשַׁעְנָא וְאַתְּ מִתְּסֵי, פִּשְׁפְּשִׁין בְּהַהוּא שַׁעְתָּא לְכָל אִלְפַיָא וּלְכָל מְדִינְתָּא וְלָא אַשְׁכְּחוּן, אָזְלִין וְאַשְׁכְּחוּן לְהַהוּא גַבְרָא יָתֵיב עַל סַקָּא, אָמְרִין לֵיהּ אִית גַּבָּךְ כְּלוּם, אֲמַר לָהֶם גְּבַר מִסְכֵּן אֲנָא וְלֵית גַּבִּי כְּלוּם לִמְזַבְּנָא, פִּשְׁפְּשׁוּ בְּסַקָּא וְאַשְׁכְּחוּן מִן אִלֵּין אֶתְרוֹגִין, וַאֲמָרִין לֵיהּ אִלֵּין מָה הֵן, אֲמַר לוֹן מִן אִלֵּין דִּיהוּדָאי מַצְלֵי בְּיוֹם הוֹשַׁעְנָא, אַטְעָנוּן סַקָּא וְאַעֲלוּהָ קֳדָם מַלְכָּא, אָכַל מַלְכָּא אִלֵּין אֶתְרוֹגַיָיא וְאִתְּסֵי. פַּנּוּן שַׂקָּא וּמְלָאוּהָ דִינָרִין…

…He was ashamed to go to his home. He went to the synagogue and saw there some of the citrons that the children away... He took some of them and filled a sack, and embarked on a voyage in the Mediterranean Sea until he reached the province of the king. When he arrived there, it happened to be that the king had an intestinal illness. They said to him in a dream: ‘Your cure is to eat from those citrons with which the Jews pray on the day of the hoshana, and you will be cured.’ At that time, they searched all the ships and all the provinces, but could not find any. They went and found that man sitting on the sack. They said to him: ‘Do you have anything?’ He said to them: ‘I am a poor man and I have nothing to sell.’ They searched the sack and found those citrons. They said to him: ‘What are they?’ He said to them: ‘From those with which the Jews pray on the day of the hoshana.’ They loaded the sack and took it in before the king. The king ate those citrons and he was cured. They emptied the sack and filled it with dinars..

The etrog as medicine? Yes. People once believed, and many still believe today, that the etrog has medicinal uses. So in honor of Sukkot, let’s talk about some of them.

The Etrog in Ma’aseh Tuviah

The etrog as a medicine appears in one of the first Jewish encyclopedias, written by Tuviah Hacohen. He studied in a yeshivah in Cracow, and at the age of twenty-six, entered the University of Frankfurt, where he began to study medicine. Despite being taken under the wing of Fredrick William, the elector of Brandenburg, and receiving a stipend from him, anti-Jewish sentiment prevented Tuviah from graduating. As a result, he left for the University of Padua, where he graduated with a degree in medicine in 1683 and soon found employment as a physician in Turkey. He published his only work, Ma’aseh Tuviah (The Work of Tuviah), in Venice in 1708 and moved in 1715 to Jerusalem, where he died in 1729.

Tuviah Cohen has long been a favorite of historians of science and Judaism. Perhaps this is because he was a reformer of sorts, ready to sweep away old superstitions and replace them with scientific knowledge. Perhaps it is because his book, Ma’aseh Tuviah, was “ ... the best-illustrated Hebrew medical work of the pre-modern era,” full of wonderful drawings about astronomy and anatomy. Perhaps it is because his book is so clearly printed and a pleasure to read in the original. Or perhaps it is because Cohen was so adamantly opposed to Copernicus that he called him the “Firstborn of Satan”—which made his the first Hebrew work to attack Copernicus and his heliocentric system.

In any event, Tuviah wrote about the wonderful healing properties of the etrog.

Ma'aseh Tuviah, Venice 1708, 146a.

Because in homes that have abundant medicines they also have the five special fruits through with the Land of Israel was blessed, I will write in praise of the of etrog [פרי עץ הדר] which is more beautiful than any other fruit…. both the peel and the fruit itself are delicious to eat, and it also has many wonderful properties [סגולות נפלאות]. The peel alleviates all internal pain and strengthens the muscles. while the white of the fruit strengthens the internal organs. Its bitter taste is good for the liver, and cures thirst. The seeds are also good for internal pain as an an aid for digestion…it is as good as theriac for any person who is ill, and it is particularly beneficial for children with viral infections [ויראוליס] like smallpox. The wood of the tree itself does not have these qualities though without doubt it imparts them to the fruit, which is why the fruit never falls far from the tree [התפוח אינו נופל רחוק מן העץ]. And so if there is a scarcity of the fruit, cut some wood from the etrog tree and boil. It will strengthen the body and a serve to heal the soul.

The Etrog as a Cure for Cholera

We have had occasion in the past to talk about Hayyim Palagi (there are many different ways to spell his last name, 1788– 1868) who was a rabbi and leader of the Jewish community in Izmir (Smyrna), Turkey, though his influence was felt far beyond. Writing about the 1865 cholera outbreak in Turkey, Rabbi Palagi recalled how the Jews had fled Izmir.

In our town of Izmir in 5625 [= 1865] there was an outbreak of cholera, just like the outbreak of 5592 [= 1832] and many fled. The few who remained in the town were expelled by the mayor on the advice of physicians, and left for a nearby mountainside where men, women and children camped, and remained for about three weeks. There was not a single case of cholera the entire time,and the outbreak in the town eventually ended. During that time, I was particular with my prayers, and I prayed to God in the merit of Abraham who was called “a mountain” . . . that the merit of our ancestors would protect us and that we would not fall ill. And so it was. Praise be to God, for his loving kindness endures forever.

I am lucky to own a copy of one of his many works, called Refuah Vehayyim, published in Izmir in 1874. (It even contains three handwritten annotations in the margins written by Rabbi Palagi’s youngest son Yosef.) And here is what you can find on page 12b (though alas, there are no marginalia).

Sefer Refuah Vehayyim, Izmir 1874. 12b. (Chapter 4 #2).

It is written in the name of our teacher Rabbi Hayyim Vital, that to cure cholera take distilled water and the resin of the (?) mastic tree…and take half a cup of the size used for kiddush…and boil it with the resin and give it to the patient. And this is guaranteed.

And it is writtn in the Sefer Otzar Hayyim that this works with etrog peel…

Later in the book, Rabbi Palagi wrote that the etrog can be used for stomach aches in general, and not just those associated with cholera. However, it cannot be any old citron; it must be an etrog used for the mitzvah of lulav and etrog on Sukkot:

Sefer Refuah Vehayyim, Izmir 1874. 51b

For a stomach ache: the remedy is to eat etrogim with were used for the mitzvah of lulav and etrog during the holiday and through Hoshanah Rabbah. For they are used in prayer, and they heal…sometimes they are hard to digest, in which case they should be peeled and then boiled, and then that water should be drunk.

But wait - there’s more

In another of his many books Mo’ed Lekol Chai, Rabbi Palagi recommended the etrog as a means for easing the pains and dangers of childbirth. He cited another work in which this suggestion appeared, though in a slightly different and shorter form. (That work is Nazir Shimshon, published by Ya’akov Shimshon Shabtai Sinigaliah in Pisa in 1783. It is on page 38.)

When a women is pregnant, she should take the etrog on Hosha’ana Rabbah and afer removed the pittom [style] she should distribute charity to the poor each according to her means, and she should pray that God should should save her and that her child should be born healthy.

The reason for this is that there is an opinion that the Tree of Knowledge was an etrog, and when Eve ate from it, Death came into the world. We know that many women die during childbirth, and therefore they should undertake this ritual and say the following prayer:

Master of the Universe, you know that because Chava [Eve] ate from the Tree of Knowledge she sinned and brought Death to the world as well as the pains of childbirth. Had I been there at that time I would not have eaten from it and I would not have benefitted from it in any way, just as I did not want to blemish the etrog during the Festival [of Sukkot] But now I have blemished it, because now it is no longer a mitzvah to take it. I would never want to disobey your mitzvot. Please accept my prayer and my supplication that I should not die as a result of this child or as a result of childbirth. Save me, grant me an easy labor without pain or hardship and let no harm befall me or my child, for you are the God who saves…

And so any man whose woman whose wife is pregnant during Sukkot should arrange for her to take the etrog and give it to his wife and she should follow this procedure. She should say this prayer word for word and conclude by saying “let this infant bring contentment and not pain, and may it be born to a good and peaceful life. Amen.”

Hayyim Pilagi, Mo'ed Lekol Chai Jerusalem 1976 #25.

The Etrog increases Male potency

The etrog. It’s not just for women. In the anonymous collection of segulot called Sefer Refuot published in Vienna in 1926, we find the following recommendation:

Sefer Refuot, Vienna 1926

For increased virility, take four drahms of the tongue of an ox together with half a handful of etrog peel and half a drahm of girofilo

Good to know.

Not so Fast - Chaim Bachrach and his objection

Rabbi Yair Hayyim Bachrach (1638-1702) better known by his famous work the Chavot Yair, was a leading posek of his generation, and led the communities of Worms and Mainz. In his commentary on the Tur (הלכות לולב #664) he also noted the custom of pregnant women biting off the pitum of the etrog, and he was not happy about it. Not at all.

Jewish Etrogs, and Greek Etrogs

The belief in the medicinal properties of the etrog was not unique to our ancestors alone. The Greeks believed it too. In fact, it was they who gave the fruit we know as an etrog a name that reflects just this; they called it Citrus Medica, “the medical citrus" and that is the Latin name of the species to this day. Citrus Medica.

Gaius Plinius Secundus (AD 23/24–79) better known as Pliny the Elder held the cirton tree in very high esteem as demonstrated by this passage in his Natural History (Book XII chapter 7):

The citron tree, called the Assyrian, and by some the Median apple, is an antidote against poisons. The leaf is similar to that of the arbute, except that it has small prickles running across it. As to the fruit, it is never eaten, but it is remarkable for its extremely powerful smell, which is the case, also, with the leaves; indeed, the odour is so strong, that it will penetrate clothes, when they are once impregnated with it, and hence it is very useful in repelling the attacks of noxious insects. The tree bears fruit at all seasons of the year; while some is falling off, other fruit is ripening, and other, again, just bursting into birth. Various nations have attempted to naturalize this tree among them, for the sake of its medical properties, by planting it in pots of clay, with holes drilled in them, for the purpose of introducing the air to the roots;

The Chinese Etrog

To this day, the etrog is used as a medicine in China. They grow several different varieties including the world’s largest citrus, the “Ning’er Giant. And, as the photo below shows, it really is giant.

It is the custom of pregnant women to bite off the tip of the etrog and it is mentioned in the Tzenah Urenah.How fortunate we are that this custom has been utterly uprooted.

 

“Ning’er Giant” citron weighing about 17lb (8kg), held in the gentle hands of the farmer who grew it, Li Hua Zhong, near Ning’er Yunan. (Photo credit David Karp, 18 October 2011.)

 

Some varieties are grown for their antioxidant properties, while others release insulin, which may be of use in Type II diabetes. In fact, according to a 2012 Review on Phytochemical and Pharmacological Properties of Citrus medica Linn, the etrog will cure just about anything.

Result shows that Citrus medica Linn. possesses analgesic, hypoglycaemic, anticholinesterase, anticancer, antidiabetic, hypocholesterolemic, hypolipidemic, insulin Secretagogue, anthelmintic, antimicrobial antiulcer and estrogenic properties.

And presumably, all without any side effects! The Jinguu variety from southern Yunnan is used to treat respiratory disorders, whereas the Qingpi variety, grown in the Provinces of Zhejiang and Jianxi is used for its more general medicinal effects.

Citrus Fruits and the First Randomized controlled Medical Trial

The citrus (but not the etrog, sadly) made a surprising appearance in the first randomized controlled clinical trial that humanity conducted. In the 18th century, sailors in the British Navy, went without fresh fruit for long periods of time. Citrus fruits contain the essential Vitamin C also known as ascorbic acid. Without it you develop a very nasty disease called scurvy. There is lethargy, the hair and teeth fall out, the gums bleed spontaneously, and bruising appears. Without treatment, you die. So yes, it is very nasty.

Sailors were often at sea for months at a time, without access to fruit containing Vitamin C. In the 18th century, it is estimated that more British sailors died from scurvy than died in battle.

For reasons we won’t go into here, a Scottish naval Surgeon named James Lind (1716-1794) had a hunch that the disease was cured by a lack of whatever it was that citrus fruits contained. So he took 12 sailors with scurvy and fed them various experimental diets that included one enriched with oranges and lemons (but not etrogs), and compared them to a similar group of sailors who ate a regular Royal Navy diet. The results were startling.

On the 20th of May 1747, I selected twelve patients in the scurvy, on board the Salisbury at sea. Their cases were as similar as I could have them. They all in general had putrid gums, the spots and lassitude, with weakness of the knees. They lay together in one place, being a proper apartment for the sick in the fore-hold; and had one diet common to all, viz. water gruel sweetened with sugar in the morning; fresh mutton-broth often times for dinner; at other times light puddings, boiled biscuit with sugar, etc., and for supper, barley and raisins, rice and currants, sago and wine or the like. Two were ordered each a quart of cyder a day. Two others took twenty-five drops of elixir vitriol three times a day … Two others took two spoonfuls of vinegar three times a day … Two of the worst patients were put on a course of sea-water … Two others had each two oranges and one lemon given them every day … The two remaining patients, took … an electary recommended by a hospital surgeon … The consequence was, that the most sudden and visible good effects were perceived from the use of oranges and lemons; one of those who had taken them, being at the end of six days fit for duty … The other was the best recovered of any in his condition; and … was appointed to attend the rest of the sick. Next to the oranges, I thought the cyder had the best effects…

The most sudden and visible good effects were perceived from the use of oranges and lemons; one of those who had taken them being at the end of six days fit for duty … The other was the best recovered of any in his condition; and being now deemed pretty well, was appointed nurse to the rest of the sick.

Lind demonstrated that citrus fruits prevented and cured scurvy, and the first randomized controlled clinical trial, now the gold standard for evaluating new drugs, was born. Even Rabbi Bachrach would not have objected to that.

The etrog, whose Latin name means a medicine, has long been a symbol of healing, not only in our own tradition, but in others, often just as ancient. How fitting that we take it this year, a year of pain and sorrow for the Jewish People, and pray for the release of our bothers and sisters in captivity, the safety of our soldiers, and a speedy end to this most terrible and most just of wars. We all need some healing.

עד הניצחון

אַחֵינוּ כָּל בֵּית יִשְׂרָאֵל

הַנְּתוּנִים בַּצָּרָה וּבַשִּׁבְיָה

הָעוֹמְדִים בֵּין בַּיָּם וּבֵין בַּיַּבָּשָׁה

הַמָּקוֹם יְרַחֵם עֲלֵיהֶם

וְיוֹצִיאֵם מִצָּרָה לִרְוָחָה

וּמֵאֲפֵלָה לְאוֹרָה

וּמִשִּׁעְבּוּד לִגְאֻלָּה

הָשָׁתָא בַּעֲגָלָא וּבִזְמַן קָרִיב

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