Chabad Mohel: "God Gave Us Saliva To Clean Things"

According to the NY Jewish Week, Crown Heights-based mohel Rabbi Israel Heller has an interesting understanding of human disease transmission:

“Our teachers taught us to use our mouths,” said Crown Heights-based mohel Rabbi Israel Heller, who is the official mohel of Methodist Hospital in Park Slope, Brooklyn.

“The saliva cleans wounds. God gave us saliva in our mouth to clean things.”

The rabbi is referring to a procedure known as metzitza b'peh, sucking with the mouth, done immediately after the foreskin and membrane are removed during a circimcision. The mohel literally sucks the blood out of the fresh wound, using his mouth.

But the Jewish Week article – poorly, as almost always, crafted by Debra Nussbaum Cohen – is most interesting for what it leaves out. There are no quotes from any rabbis opposed to metzitza b'peh, even though many rabbis including Moshe Dovid Tendler of Yeshiva University oppose the practice. (Rabbi Tendler has been quoted elsewhere as deeming the practice "medieval medicine.") And, although anti-circumcision forces are mentioned by pro-metzitza b'peh rabbis in the article, there are no quotes from anti-circumcision activists to be found.

Should the government mandate regular blood tests for mohels?

A spokesman for Agudath Israel of America, which represents the interests of the fervently Orthodox, doesn’t think that any new form of oversight is necessary.

“There is a point when the government has a right to step in, when there’s a clear and present threat to the public. Then public policy can override religious rights, but I don’t think that’s what’s before us at this point,” said Rabbi Avi Shafran.

“Word of mouth is the best regulatory system, and the system has worked very well,” he said. “There should be no ban on metzizah b’peh, and no required testing of mohelim.”

The OU's Rabbi Tzvi Hersh Weinreb concurs:

"…I am not sure that one isolated case, however tragic, warrants a major change in the system.”

After all, what's a dead kid here or there?

You can read the Jewish Week article here.

A recent study on this issue follows:

Pediatrics. 2004 Aug;114(2):e259-63.
Neonatal genital herpes simplex virus type 1 infection after Jewish ritual circumcision: modern medicine and religious tradition.

Gesundheit B, Grisaru-Soen G, Greenberg D, Levtzion-Korach O, Malkin D, Petric M, Koren G, Tendler MD, Ben-Zeev B, Vardi A, Dagan R, Engelhard D.

Pediatric Hematology/Oncology Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben Gurion University, Beer Sheva, Israel.

OBJECTIVE: Genital neonatal herpes simplex virus type 1 (HSV-1) infection was observed in a series of neonates after traditional Jewish ritual circumcision. The objective of this study was to describe neonate genital HSV-1 infection after ritual circumcision and investigate the association between genital HSV-1 after circumcision and the practice of the traditional circumcision. METHODS: Eight neonates with genital HSV-1 infection after ritual circumcision were identified.

RESULTS: The average Gravatar interval from circumcision to clinical manifestations was 7.25 +/- 2.5 days. In all cases, the traditional circumciser (the mohel) had performed the ancient custom of orally suctioning the blood after cutting the foreskin (oral metzitzah), which is currently practiced by only a minority of mohels. Six infants received intravenous acyclovir therapy. Four infants had recurrent episodes of genital HSV infection, and 1 developed HSV encephalitis with neurologic sequelae. All four mohels tested for HSV antibodies were seropositive.

CONCLUSION: Ritual Jewish circumcision that includes metzitzah with direct oral-genital contact carries a serious risk for transmission of HSV from mohels to neonates, which can be complicated by protracted or severe infection. Oral metzitzah after ritual circumcision may be hazardous to the neonate.

Comments

[elel]

You write "The OU's Rabbi Tzvi Hersh Weinreb concurs" based upon the Jewish Week Article. However, the article is extremely misleading. Rabbi Weinreb has gone on reord opposing the continued use of metzitzah b'peh. http://www.nynews.com/newsroom/020605/a0106circumcision.html

The Jewish week obviously took his comment out of context. Presumably the "Change in the sytem" which Rabbi Weinreb believes is not necessary is referring to increased Government Regulation of mohelim, not the Metzitzah process.

[Enigma]

A mohel should be held accountable for his actions, just like physicians are. I, for one, am doing my little bit to stop this atrocity. I contacted Methodist Hospital, asking for an explanation to how their official mohel can practice medieval medicine and recommended a basic course in infection prevention for Rabbi Israel Heller. Will keep you posted on Methodist's answer, should there be one.

[Stephen Mendelsohn]

BS"D

This reminds one of the old joke: What is the worst ritual in Judaism? To have to perform metzitzah on an adult male convert.

Metzitza b'peh can also expose mohelim to the risk of becoming infected with HIV/AIDS. Because of issues of pikuach nefesh, I would think most mohelim now use other methods of stopping the bleeding after brit milah.

[Lumpy Rutherford]

>“The saliva cleans wounds.
>God gave us saliva in our mouth
>to clean things.”

Saliva? I thought it was the suction.

[Lumpy Rutherford]

>A mohel should be held accountable for
>his actions, just like physicians are.

He's held accountable by the state. I don't
think most states are going to want to
get involved with the licensing of מוהלים.

[Aharon]

Did you have a look at
http://dhengah.org/english/MBPmedical.htm

[Shmarya]

Danny Berman is a liar. Search this site and you'll find information on him. The key to understanding this issue is that now the vast majority of people carry the virus. This was not true 50 years ago or even 25 years ago. The exposure rate is much higher now. The chance of a mohel carrying the virus was quite small in 1955. Today, it's almost 100%. Berman misrepresents the data. By the way, he may call himself MO, but he affilliates haredi.

[Dovid]

Tendler's article is very Skewed. If you actually read the article and the chart, you'll find the article makes no concrete connection between the Mohel and the infected neonate. It piles on "we suspect, it's most likely, it has the possibility, it may, it might," etc. In no place does it say the disease was traced to the Mohel. You also misquote the article. Only three of the six mohelim were tested for Antibodies. The presence of anti bodies means nothing. More signifigantly, the mothers tested negative for antibodies. Consider the following. You will most likely test positive for chicken pox and measles ANTI-BODIES. You cannot get chickenpox or measles if you have anti-bodies to the diseases. The first time you got Measles or CP you would have tested NEGATIVE for anti bodies while you were still an ACTIVE CASE! A follow up several months later would show antibodies. While Herpes may be reoccuring, the lack of follow up testing in the study, as well as the lack of crosstesting (DNAing the virus of the 2 pairs of babies allegedly infected by the same Mohel) is skewed or sloppy.

The article is by it's own admission inconclusive. Why was it published in Pediatrics? Because Pediatrics is the printed organ (pun not intended) of the American Academy of Pediatrics which has an anti-circumcision policy dating to 1971. The AAP policy is quoted by many anti-circumcision advocates, including Kahal.org and Af-milah, two israeli anti-circumcision organizations. Pediatrics is only all too happy to accept anything anti-circumcision, and you can verify that by looking through their archives for the many anti circ articles they've published in recent years. Traditional Milah has 3000 year track record that any modern hospital would envy. Ask an anesthesiologist what the "acceptable" death rate is. You might be surprised.

[rebeljew]

File this under the dangers of infallibility doctrine. This has locked us into medieval times, before microbes and viruses were even known. Hence, “The saliva cleans wounds. God gave us saliva in our mouth to clean things.” My cousin, a mohel in the US, also says that they forbid him to use clamps that reduce bleeding and improve recovery time. He says the Rabbanan do not know the implications, but that the assur it, because they fear that there might be no "dam mila". This is untrue, but the issur remains. After all, the Rav / Gadol (borderline saint) who paskined this 50 years ago was an expert and is infallible. Who are we to question.

[antique auto glass]

Help the homeless down the street and persuade them to look for work

[Rachael]

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