How Judaism Handled Epidemics Down the Ages

Scientific observation gradually prevailed over the belief that outbreaks stemmed from God’s wrath, but the dilemma over succoring the sick remains

Elon Gilad
Elon Gilad
Share in Facebook
Send in e-mailSend in e-mail
Hurva Synagogue in Jerusalem, March 24, 2020
Hurva Synagogue in Jerusalem, March 24, 2020Credit: Emil Salman
Elon Gilad
Elon Gilad

In early April, Jews around the world will be celebrating Passover. But this year, due to the invisible menace known as Covid-19, the Seder will not be the traditionally joyous holiday meal bringing extended family together.

According to the Book of Exodus, the first Passover took place in Egypt on the night of the Tenth Plague, in which God killed each and every first born of Egypt – man and beast – but spared the Hebrew slaves.

The response to today’s pandemic, including the shutdown of houses of worship, brings to the fore how much our view of disease and of religion itself has evolved.

Throughout the Hebrew Bible, whenever epidemics are mentioned, it is clear that the ancient writers of the tales and laws saw epidemics as divine punishment for sin. It is God who chooses who will die and it is He who decides who recovers.

“If thou wilt diligently hearken to the voice of the Lord thy God, and wilt do that which is right in his sight, and wilt give ear to his commandments, and keep all his statutes, I will put none of these diseases upon thee, which I have brought upon the Egyptians: for I am the Lord that healeth thee” (Exodus 15:26; KJV).

Thus, for the ancient Hebrew, the proper response to a plague was to plead for God’s mercy and forgiveness. When an epidemic killed thousands of Israelites after Korah’s rebellion against Moses and Aaron, we are told in the Book of Numbers (17:13) that the dying stopped only once Aaron burned incense which assuage God’s wrath. When God caused an epidemic to ravage the Kingdom of Israel following a census King David held, only the sacrifice provided by the king in a particular location advised by the prophet Gad that caused God and his epidemic to relent, according to the bible.

The destruction of the Second Temple in Jerusalem in 70 C.E. did not weaken the conviction that their God, the one true god, controlled epidemics, but it did change the way Jews appealed to him when disease struck. No more could they assuage his anger with animal sacrifice and the sweet savor of incense, so new procedures were developed. According to the Mishnah (compiled in the early 3rd century C.E.) and other rabbinical writings in the beginning of the Common Era, when an epidemic struck a town or a city, its Jewish residents would assemble for communal prayer and fasting. This together with other penitential practices such as abstention from bathing and intercourse were thought to elicit God’s forgiveness.

Understanding contagion

Today we know that these group assemblies were likely counterproductive, more likely to help the spread of disease than to stop it. But there is no hint in early rabbinic writings of the understanding that disease has natural causes, or the awareness that illness could be contagious or that this contagion could be avoided. These understandings were beginning to proliferate throughout the Roman Empire at the time, but only seem to have made inroads into Jewish thought during the Talmudic age (3rd-5th centuries C.E.). But even in the Talmud the idea that one should take action to avoid disease is far from mainstream, only appearing rarely in the massive legal corpus and often contradicted elsewhere.

In one place (Bava Kama 60b) the rabbis advise that during a plague one should stay at home, adding that the fourth century Babylonian rabbi Rava kept his windows shut during an epidemic. The Talmud goes on to advise that when traveling during an epidemic one should stick to the sides of the road rather than walk down the middle as in other times. Assuming that the middle of the road was busier than its shoulders, this is not bad advice, even if the logic given for it was that is that the Angel of Death who usually travels on the side of the road (and thus these are to be avoided normally) walks down the middle of the road at the time of plague.

At times the Talmud seems to argue against the concept that disease is contagious, calling on Jews to avoid the urge to distance themselves from disease and trust in God. In one such section (Nedarim 40a) we are told that the students of the second century sage Rabbi Akiva refused to visit one of their number who had fallen ill. We are told that Akiva went to visit the student himself, and that he recovered, prompting him to teach that visiting the sick helps them recover and thus those who refuse to visit the sick are as guilty as those who spill blood. In fact, the rabbis decreed that it is a Jewish obligation, a mitzvah, to visit the sick, based on the biblical precedent of God visiting Abraham while he was recovering from his circumcision.

In the entire collection that is the Talmud we only find one section in which the rabbis seem to advise that contagious disease be avoided, but even here the point of the story seems to be that this is folly. Ketubot 77b describes a mysterious affliction called ra’atan that causes watery eyes, a runny nose, drooling, and attracts flies. According to the Talmud the disease is caused by the afflicted being conceived right after his parents let blood. The Talmud advises the following treatment: 1. Make a potion of grasses, nut shell, hide shavings, mugworts and date flowers. 2. Apply it to the patient’s head to soften his skull. 3. Cut the skull open and remove the insect lodged in his brain with myrtle leaves and tweezers. 4. Burn the insect (otherwise it will find its way back to the patient’s brain).

The Talmud then elaborates on the measures the rabbis took to avoid catching it. Rabbi Yohanan avoided the flies that sat on those plagued by this disease; Rabbi Zeira wouldn’t sit downwind from one who had it; Rabbi Elazar wouldn’t enter the tent one suffering of it; and Rabbi Ami and Rabbi Asi wouldn’t even eat an egg laid on a street where one afflicted by the disease lived. These methods are probably intended to seem ridiculous and are contrasted with the actions of Rabbi Yehoshua ben Levi, who would go visit those suffering of this disease to study Torah with them. “Torah,” he is said to have said, “bestows grace on those who learn it, does it not protect them from illness?”

Yet as time went by, the view that epidemics had natural causes and that disease was contagious took hold among prominent rabbis, augmenting the biblical and Talmudic view that these are the work of God. By the High Middle Ages, the time of the Rishonim, these views seem to be taken for granted by prominent rabbis.

For example, the 13th century Spanish rabbi Nachmanides, in his commentary on Genesis, explained that Lot’s wife was turned into a pillar of salt to stop her blasphemous thoughts from spreading like “the plague and infectious diseases that are carried in the air.” His contemporary rabbi Bahya ben Asher also of Spain (1255-1340) explained that during the plague caused by Korah’s rebellion, discussed above, Aaron separated Korah’s company from the rest of the Israelites “so that the bad air of the plague wouldn’t stick to them.” Clearly, Bahya subscribed to the Miasma Theory of Disease, which remained in vogue until the 19th century, according to which disease was caused by polluting vapors in the air.

But these realizations did not lead to new rational methods for limiting the spread of disease just yet. Instead the 13th century saw the appearance of new method to stop epidemics, one that rabbis heavily rely upon to this day: the reading of ancient legal texts that describe the particular method used by the priests of the Second Temple to burn incense.

As said, the Book of Numbers says that a plague was stopped by Aaron burning incense. Since the Temple is no more, Jews may not burn incense to God any longer. But as with other Temple-related acts of worship, Rabbinic Judaism sees the reading of texts about Temple rituals as equivalent practices.

At a synagogue in Mea She'arim, Jerusalem during normal times, March 13, 2017
At a synagogue in Mea She'arim, Jerusalem during normal times, March 13, 2017Credit: Gil Cohen-Magen

In this case, the Zohar, which appeared in 13th century Spain, relates a legend about the 4th century Palestinian rabbi called Rabbi Aha, who arrived at a town ravaged by an epidemic. The townsfolk ask for his advice and he tells them to assemble their 40 most pious men in the synagogue. After they studied the Talmudic passages concerning the incense in groups of ten in each of the four corners of the synagogue, the epidemic stopped.

The ceremony that this passage of the Zohar inaugurated began to spread throughout the Jewish world and has been used by Jews ever since. Not that it seems to have done anyone any good. When the Black Death ravaged Europe in the mid-14th century, Jews died in great numbers, and though it is oft repeated that Jews died at lower rates than their Christian neighbors, there is little if any evidence of this. Possibly the idea that Jews were for some reason less susceptible to the disease was a rationalization to explain why Christians reacted to the Black Death by indiscriminately slaughtering Jews. Epidemics to this day often lead to the persecution of minorities.

Science arises

More scientific methods to contain the spread of disease began to be adopted in rabbinic thinking in the 16h century. Rabbi Samuel ben Moses de Medina, a 16th-century rabbi of Spanish origin writing in Thessaloniki, mentions in passing in a legal decision concerning an inheritance that the deceased suffered from “a kind of disease that those who suffer of it are not visited.” Thus it seems that in at least some communities the requirement to visit the sick was lifted in cases of infectious disease.

Not that this was universally accepted. Moses Isserles, a highly influential rabbi in 16th century Krakow, wrote in a legal decision concerning a man trying to get out of a contract to rent an apartment because he found out the man’s wife suffered from an infectious disease: “What he said that it is an infectious disease is utter nonsense, and anyone who is moved by his heart says so, because it is the Lord who sickens and heals. If we found according to the opinion of the renter then all laws concerning the visiting of the sick would be nullified, as we did not find anywhere a distinction between infectious disease and noninfectious disease, except for the matter of one plagued by Ra’atan who was not to be visited.” Isserles further says that in any case the disease in question was everywhere in the city and no home was exempt anyway.

On the other hand, Isserles did rule that one should escape a city when an epidemic appears in it, saying: “One mustn’t rely on miracles or risk his life” (Yoreh De’ah 116:5). And he did in fact flee Krakow in 1555 when an epidemic started there.

Things really began to change in the 19th century when cholera arrived in Europe. It was during the cholera outbreaks of the 1830s that the first experiments with social distancing took place, with many municipalities banning large gatherings. In 1831, Rabbi Akiva Eger of Pozna, Poland called on Jews to limit the number of congregants praying together in a synagogue to 15: “Concerning the matter of prayer in the synagogue, it is my opinion that it is true that assembling in a small place is incorrect, but it is permissible to pray group after group, each time a little, about 15 people.” Eger even went as far as to permit a police officer to be stationed at the entrance to synagogues to ensure that this limit was not exceeded.

Similarly, during the cholera epidemic that struck Lithuania in 1848, the important rabbi Israel Salanter permitted Jews to carry out relief work on the Sabbath and even went as far as telling his congregants not to fast on the Day of Atonement.

During the Spanish Flu pandemic of 1918, municipalities around the world banned gatherings, and some synagogues held services outdoors; some apparently even suspended services altogether during the height of the epidemic.

But these measures pale in comparison to the adjustments people and Jews everywhere have to adopt during the current Covid-19 pandemic.

While rabbis have been advising penitential prayers be added to the daily prayer as well as the reading of those Talmudic texts concerning the burning of incense, the closing of synagogues in such a large scale, including in Israel and in the U.S., by far the two largest Jewish communities in the world, is completely unprecedented. An analysis of the places appearing on the Health Ministry’s coronavirus contact tracing studies shows that more than 30 percent of those infected in public spaces visited synagogues and yeshivas or were exposed there to the virus.

As of Sunday night, Anshel Pfeffer reports, one establishment in Bnei Brak – which has become a coronavirus hotspot – had put up  a notice saying in Hebrew: “By order of the Health Ministry, the study hall is closed...” This was followed by three lines in Yiddish saying “…according to the government. The study hall is open, come in to learn and pray.”

Those rabbis in Israel who accept the containment measures and have called on their congregants to comply with the ban are admitting the sad fact that communal prayer and penance, the method used by Jews for millennia in the face of epidemics, is not only ineffective, it is counterproductive.