The Process of Circumcision
Based on a shiur by Harav Aharon Lichtenstein
Translated by David Strauss
UNDERSTANDING THE TERM "MILA" (CIRCUMCISION)
In this lecture we shall deal with the technical components of the mitzva of mila. We must first clarify the meaning of the term "mila." The plain sense of the scriptural text suggests that the word denotes cutting. This is the way that the biblical commentators seem to have understood the word in the verse: "And you shall circumcise/cut [u-nemaltem] the flesh of your foreskin" (Bereishit 17:11).
As for the root of the word mila, the commentators propose two possibilities: Rashi suggests the root mem, vav, lamed, whereas Ibn Ezra suggests the root nun, mem, lamed.
As we see in the verses in the parshiyot of Lekh Lekha and Tazri'a, the mitzva is to perform mila, that is, to cut. Our question is whether it follows from this that the essence of the mitzva lies in the act of cutting, or perhaps there are additional actions that also constitute an integral part of the mitzva. The fact that the Torah mentions "cutting of the flesh of the foreskin" leaves us with the impression that we are dealing here with an act of cutting, and nothing more. A biblical source that may possibly suggest that there are additional components to the mitzva of mila is found in Parashat Nitzavim: "And the Lord your God will circumcise your heart and the heart of your seed" (Devarim 30:6). There are various understandings of this verse. According to one, the verse relates to the total removal of human evil, as the Ramban explains (ad loc.):
In the days of the Messiah, choosing good will be a part of man's nature. His heart will neither yearn for that which is improper nor desire it whatsoever.
This understanding implies that mila involves a more comprehensive removal, and not only the cutting of flesh. This opens a window to the inclusion of additional actions within the framework of the mitzva of mila.
Peri'a (lit. uncovering, folding back the thin membrane that lies under the thick foreskin)
We have learned in the Mishna (Shabbat 133a):
All the requisites that belong to the act of circumcision are done on Shabbat. We circumcise (mohalin), uncover [the corona] (por'in), suck [the wound] (motzetzin), and place a bandage and cummin upon it.
The Mishna mentions two sets of actions, one set of actions that are connected to the act of circumcision itself, and another set of actions that are not connected to the act of circumcision itself, but are necessary for medical reasons, and therefore set aside the prohibitions of Shabbat. The first set includes mila and peri'a (as for metziza, "suction," see below), but the relationship between the two is unclear.
Mila without peri'a
The Mishna in Shabbat 137b states:
If one circumcises but does not uncover the circumcision, it is as though he has not circumcised.
It follows, then, that peri'a constitutes an integral and significant part of the process, but what is the relationship between the peri'a and the cutting itself? Here there is room for two understandings:
1) A person who performs mila without peri'a has performed the complete act of circumcision, but in order for the circumcision to acquire validity, he must also perform peri'a. This explanation fits in well with the parallel formulation used with respect to the immersion of a convert: "If one circumcises, but does not undergo immersion, it is as though he did not circumcise." Immersion is certainly not connected in any way to the act of mila, but it is nevertheless required in order to validate the conversion.
2) The act of circumcision itself is composed of two actions, mila and peri'a. As long as peri'a has not been performed, the act of circumcision has not been completed.
There are a number of practical differences between these two understandings. In order to clarify these differences, we must consider a Gemara in Yevamot (71b). The Gemara asserts that peri'a is obligatory by Torah law, though Avraham Avinu was not commanded about it. The Gemara adduces proof from what is stated in Joshua (5:2): "Make flint knives, and circumcise again the children of Israel a second time." These knives were meant to complete the circumcision of those who had been circumcised prior to the giving of the Torah without peri'a. It would have been possible to suggest that the knives were intended for those who had not been circumcised at all, but Scripture's emphatic mention of "a second time" implies that we are dealing with the completion of the circumcision process. We see then that the Gemara understands that there is a difference between mila and peri'a, but what is the meaning of this difference? An answer may be suggested in light of a concept that we will discuss below, namely, "shreds [of the skin] that are indispensable for mila." The Mishna in Shabbat 137a states that the cutting of these shreds is defined as "the end of mila," that is, the completion of the act of mila itself, and only afterwards is peri'a performed.
The expression "indispensable for mila" suggests a difference between the act of cutting these shreds and the act of peri'a, about which there is no mention of it being "indispensable for mila," but only the milder expression, "as though he did not circumcise." Therefore, even if we say that peri'a is an essential component of the circumcision process, it is difficult to propose that it is defined as part of the very act of mila.
On the chronological plain, when Avraham Avinu was commanded about circumcision, that is, to perform the first step of the process, it included also removal of the indispensable shreds. The second step of the process, peri'a, was given only at Mount Sinai. What are the halakhic ramifications of this distinction between the two stages?
THE DESCENDANTS OF KETURA
In a previous lecture, we discussed the difference between the obligation of the descendants of Ketura and the obligation of the descendants of Avraham, according to the view of the Rambam that not only were the children of Ketura commanded about circumcision, but also all of their descendants. The Sha'agat Arye argues that the descendants of Ketura are obligated only in mila itself, as Avraham was commanded, and thus they may not be obligated to perform peri'a.
Mila Without Peri'a – is he permitted to eat Kodshim?
There may be room for a distinction not only between Jews and the descendants of Ketura, but even among Jews themselves. This is not stated explicitly, but has been suggested as an initial understanding. Tosafot (Yevamot 71b, s.v. mai ta'ama) raise the question how could the Israelites in the wilderness have eaten of the peace-offerings, which is consecrated meat, if they were all uncircumcised? Tosafot suggest that they had performed mila without peri'a, but this answer is rejected in light of the argument that since they had been commanded about peri'a, if they failed to perform peri'a, it is as if they had not performed mila. Tosafot conclude that, in fact, only those who left Egypt – whose mila was complete – could eat of the consecrated meat, but those who were born in the wilderness, did not perform peri'a and were, therefore, barred from eating consecrated meat. Thus, we see that the possibility is raised that if a person did not perform peri'a, he is permitted to eat of consecrated meat, but this possibility is rejected in light of a source that implies the opposite. May we accept this possibility?
Arel and "not circumcised"
The key to understanding this matter depends upon the question regarding an infant who was born without a foreskin. The Rambam and other Rishonim imply that a baby born without a foreskin is not defined as an "arel," but as one who has "not undergone circumcision."
The logical model presented by the Rambam can be applied to our situation as well. If a person performed mila without peri'a, even though he may be regarded as one who has not undergone circumcision, he is nevertheless not defined as an arel. The status of the descendants of Ketura may also be understood in this light. They are commanded to remove themselves from the category of arel, but they are not bound by the mitzva of circumcision. Thus, they are not commanded about peri'a.
Liability for Karet (Excision)
The Chatam Sofer raises the possibility that a person who performed mila, without performing peri'a, is not liable for karet. In parashat Lekh Lekha it is stated: "And the uncircumcised manchild the flesh of whose foreskin is not circumcised, that soul shall be cut off from his people." Liability for karet is only for a state of arelut, but not for non-circumcision.
Another ramification of the distinction between the act of mila and peri'a relates to the law that a person is barred from eating of the korban pesach if one of his sons or slaves is an arel. If peri'a is an integral part of the act of mila, and one's son or slave has not undergone peri'a, then surely the father or master is barred from eating of the korban pesach, as is the law regarding shreds that are indispensable for valid circumcision. If, however, the act of mila is complete even without peri'a, then the son and slave no longer fall into the category of arel, and the father or master can eat of the korban pesach even if peri'a has not been performed.
Reciting The blessing over mila prior to the peri'a
The general rule is that a blessing recited over a mitzva must be recited prior to the performance of that mitzva. The Rishonim disagree about the placement of the blessing, "lehakhniso bi-verito shel Avraham Avinu," "to cause him to enter into the covenant of Avraham, our father," recited by the father at the time of his son's circumcision. Some maintain that it should be recited prior to the mila, for it is treated like a blessing recited over a mitzva. Others argue that it should be recited following the entire process, because it is considered a blessing of praise. The Rosh proposes a middle position, that we are dealing with a blessing recited over a mitzva, and therefore it should be recited in the course of the mitzva, between the mila itself and the peri'a. The Rosh's proposal seems to be modeled after the blessing that a person recites when he washes his hands – between the first stage of the mitzva (the washing) and the second stage (the drying). In order to say this, one must assume that we are dealing with two separate stages, for surely nobody suggests that one who washes his hands should recite the blessing between the washing of the right hand and the washing of the left hand. If so, in our case as well, we must be dealing with a model involving two separate stages between which the blessing is recited.
Peri'a on Shabbat
The Shulchan Arukh (Yore De'a 266:14) rules:
Care should be taken on Shabbat that two mohalim not be involved in the same circumcision, the one performing the mila and the other the peri'a, but rather the one who performs the mila should himself perform the peri'a.
The Rema on the spot disagrees, and allows for the circumcision to be divided between two mohalim, even on Shabbat. The Shulchan Arukh's position may be understood in one of two ways:
1) It may be suggested that this is a law relating to circumcision, according to which we are dealing here with a single stage of action. Thus, the allowance to set aside Shabbat law only applies when one person performs the entire process from beginning to end. The Rema, according to this understanding, maintains that we are dealing with two separate acts, each of which sets aside the Shabbat prohibitions, and there is no requirement that they be performed by the same person.
2) Alternatively, it may be suggested that the Shulchan Arukh agrees that we are dealing with two separate acts, but this is a law relating to the setting aside of Shabbat law, which was permitted to one person, but not to two. The Rema, on the other hand, maintains that, in a certain sense, mila cancels the prohibitions of Shabbat, and therefore, it makes no difference whether there is one mohel or more.
The Gemara in Shabbat 133b establishes that a mohel who refrains from performing metzitza must be barred from practice, because he is regarded as endangering the life of the child. The Gemara questions this assertion:
It is obvious. Since we desecrate Shabbat for it, it is dangerous! You might have said that this blood is stored up. Therefore, he informs us that it is the result of a wound, and it is like a bandage and cummin: just as when one does not apply a bandage and cumin there is danger, so here too if one does not do it there is danger.
It follows from the Gemara that metzitza is connected to the application of a bandage and cumin, that is, to medical steps undertaken for the sake of disinfection, and not to the basic obligation of circumcision.
DISINFECTION AND HYGIENE
The clear and practical ramification is what happens when there are better ways to disinfect the wound caused by the circumcision; may they be substituted for metzitza? It is reported about R. Chayyim of Brisk that in his community it was customary not to perform metzitza. It is not clear, however, whether this followed as a matter of principle, according to which there is no need for metzitza, since the danger of infection must be measured according to medical standards, or this was the result of a particular case in which a mohel infected an infant with a serious infection. Today, it is common practice to perform metzitza through a tube, thus preserving custom and maintaining hygiene.
Significant support for the ruling of R. Chayyim of Brisker may be brought from the novellae attributed to Rabbenu Nissim (Shabbat 133b, s.v. ela). The Ran maintains that if the mohel was no longer involved in the act of mila itself, but was still occupied in the medical follow-up, he does not go back and cut the shreds that are not indispensable for valid circumcision. We shall clarify the issue of interruption and resumption of circumcision below, but what is important for our purposes is the clear distinction between actions connected to the mitzva of mila and the accompanying medical procedures. This distinction can serve as the foundation for the ruling to waive the act of metzitza, as we saw with R. Chayyim.
SHREDS OF SKIN THAT ARE NOT INDISPENSABLE FOR THE CIRCUMCISION
As we saw above, the Mishna states: "All the requisites that belong to the act of circumcision are done on Shabbat." These words might have been understood as a heading for the laws recorded in the Mishna, but the Gemara does not accept this. It asks what new law do these words teach us, and explains:
He who circumcises, as long as he is engaged in the circumcision, he returns both for the shreds [of skin] which are indispensable for the circumcision and for those which are not indispensable for the circumcision. Once he has withdrawn, he returns on account of the shreds which are indispensable for the circumcision, but not for the shreds which are not indispensable for the circumcision. (Shabbat 133b)
During the week or on Shabbat
In order to understand the Mishna, we must keep in mind the controversy among the Rishonim that depends on the reading of the Mishna, whether our Mishna is dealing with circumcision performed on Shabbat or during the week. As we brought earlier, there are those who read in our Mishna "on Shabbat." This is also Rashi's reading. According to him, the Mishna teaches that when circumcision is performed on Shabbat, we do not return for the shreds that are not indispensable for valid circumcision. This position follows not only from the textual reading, but also from logical reasoning – why during the week should one not go back and cut the shreds, even if they are not indispensable for the circumcision? On Shabbat, however, there is a specific allowance that ends the moment that the mohel ceases to be involved in the circumcision, and thus he may not go back and violate another Shabbat prohibition.
The Ittur adopted a different approach, according to which the Mishna and the Baraita in its wake are dealing with circumcision performed during the week. He understands that on Shabbat the mohel may not go back and cut the shreds that are not indispensable even if he did not cease being involved in the circumcision. Thus, the novelty of the Mishna is that on a weekday, shreds that are not indispensable for circumcision are not removed if the mohel already ceased being involved in the mila. Here, however, rises Rashi's objection: Why on a weekday should the mohel not remove such shreds even if he already ceased being involved in the circumcision?
It may be proposed that indeed he is permitted to go back and cut off the shreds that are not indispensable, but there is no obligation to do so. One might have thought that there is no reason to go back even if he did not cease being involved in circumcision, for it is like performing shechita on an animal that has already been ritually slaughtered.
THE RAMBAM'S RULING
The Rambam adopts both positions in the second chapter of Hilkhot Mila. In halakha 3, he rules:
If he is no longer occupied with the circumcision, he only resumes his task to remove the shreds, the non-removal of which would invalidate the circumcision, but not those which do not make it invalid.
Attention should be paid to the fact that no mention is made in this halakha to the laws governing circumcision on Shabbat. In halakha 6, in contrast, he reviews the laws of mila pertaining to Shabbat, and there he mentions Rashi's distinction regarding the cessation of occupation in the circumcision on Shabbat:
All the requisites that belong to the act of circumcision are done on Shabbat… If shreds of skin are left, such as would make the circumcision invalid, the operator resumes his task to remove them, even if he has ceased being occupied with the circumcision. If the shreds are such as would not invalidate the circumcision, he only does so if he is still occupied in the operation.
In other words, the Rambam accepts the view of the Ittur regarding one who has ceased to be involved in circumcision on a weekday, and the view of Rashi regarding one who is still occupied in the operation on Shabbat.
The Gemara (ibid.) states that going back to remove the shreds, the non-removal of which invalidates the circumcision, is based on the verse, "This is my God, and I will beautify Him" (Shemot 15:2). What follows from this is that, according to Rashi, as long as a person is still involved in the circumcision, he is permitted to desecrate Shabbat for hiddur mitzva (embellished fulfillment of a mitzva)! R. Moshe Soloveitchik proves from here that hiddur mitzva is not merely an attractive cover for mitzvot, but rather a qualitatively different level of their fulfillment. The Ittur may also accept this assumption, but he maintains that the enhanced fulfillment of a mitzva does not constitute sufficient cause to desecrate Shabbat.
The issue regarding the allowance to desecrate Shabbat for shreds that are not indispensable for valid circumcision may depend on the following basic question: What sets aside the prohibitions of Shabbat – the very mitzva of circumcision, or the removal of the circumcised person from the category of arel?
It may be argued that the removal of any shred constitutes part of the mitzva, but what sets aside the laws of Shabbat is the removal of the name arel, which precedes the removal of all the shreds. According to this, we understand the view of the Ittur that prohibits the desecration of Shabbat for hiddur mitzva, despite the fact that it is considered a part of the mitzva, and not merely "decoration."
If, however, it is the mitzva of circumcision that removes the prohibitions of Shabbat, then even hiddur mitzva, i.e. shreds that are not indispensable for valid circumcision, is an integral part of the mitzva, as explained above.
Another difficulty according to the position of the Ittur is why on a weekday should one not resume the circumcision and remove the shreds that do not invalidate the procedure? Is it not fitting that one should fulfill, "This is my God, and I will beautify Him"? It may be answered that the embellishment lies in the act, and not in the result. The embellishment does not lie in the product that in the end will be free of all remaining shreds, but in the act that removes all the shreds. Therefore, if the act has been completed, there is no reason to go back and embellish the product.
As for practical Halakha, R. Yosef Karo and the Rema disagree. The Rema rules that during the week one resumes the circumcision even for shreds, the non-removal of which does not invalidate the circumcision. The implication is that R. Yosef Karo does not accept this position, so that even on a weekday, once a person has ceased being involved in the circumcision, he does not go back to remove the shreds that are not indispensable.
In this lecture, we have not related to yet another act in the circumcision process, namely, hattafat dam berit, "shedding the blood of the covenant." This issue must be examined with respect to the ordinary process of circumcision, and also with respect to the unique realm of the circumcision of converts, an area that has been outside our discussion.
In this lecture, we have dealt with the various components of the mitzva of circumcision: cutting the foreskin, peri'a, metzitza, and the hiddur mitzva of removing the shreds that are not indispensable for the circumcision. We have examined the relationship between the peri'a and the mila itself. Is the peri'a an essential element of the mila or a separate component, the function of which is different from that of the mila? We have seen the various practical differences between these two possibilities.
We then discussed the obligation of metzitza in light of the Gemara, the Rishonim and the Acharonim. We saw that metzitza is an obligation connected to the medical procedures that must accompany circumcision, but it is not actually a part of the circumcision itself. In light of this we examined the various opinions in its regard.
Finally, we dealt with the issue of the shreds, the non-removal of which do not invalidate the circumcision, their status and the need to remove them in various different situations in light of the Gemara and the Rishonim.
This lecture was not reviewed by HaRav Lichtenstein.
 According to Halakha, this refers to skin that covers the greater part of the corona, or reaches its length.
 The matter is subject to a Tannaitic controversy. Tosafot assume the position of Rabbi Akiva who maintains that during the period of the wilderness non-consecrated meat was not permitted.
 This explanation suggests that peri'a is not connected to the removal of the status of arel, but rather to becoming part of the Jewish people and entering under the wings of the Shekhina. Bet ha-Levi, Parashat Lekh Lekha, raises such a suggestion.
 Thus rules the Rambam, and this is the customary practice in many Sephardic communities.
 The Yerushalmi records a view that lekhatchila, a blessing over a mitzva should be recited during the course of the performance of the mitzva, and not prior to it.