Reciting Berakhot Over Medicine
Translated by David Silverberg
The Gemara (35b) cites the halakha posited by Shemuel and Rabbi Yochanan that one recites the berakha of borei peri ha-etz over olive oil, but it then struggles to find a case where drinking olive oil would require a berakha. After all, olive oil is not normally drunk on its own, but rather as a condiment to other foods:
"It was stated earlier: Rabbi Yehuda said in the name of Shemuel, and Rabbi Yitzchak said in the name of Rabbi Yochanan: Over olive oil one recites borei peri ha-etz. Under what circumstances? If we say that one drank it [straight] – this is damaging [and thus no berakha is required]… Rather, he ate it with bread. If so, then the bread constitutes the primary [food] and it [the olive oil] the secondary [food], and the Mishna states, 'This is the rule: Anything which is primary and that which accompanies it is secondary – one recites a berakha over the primary [food] and it exempts the secondary [food].' Rather, he drank it with anigron [borscht]… If so, then the anigron is the primary [food] and the oil is the secondary [food], and the Mishna states, 'This is the rule: Anything which is primary and that which accompanies it is secondary – one recites a berakha over the primary [food] and it exempts the secondary [food]'."
Ultimately, the Gemara (36a) indeed finds a situation in which one must recite a berakha over olive oil: "What are we dealing with here? With one who feels pain in his throat, as the Berayta states: 'One who feels pain in his throat should not initially gargle oil in his throat on Shabbat, but he may add a large amount of oil to anigron and swallow it'." Meaning, olive oil would be drunk with anigron to soothe a sore throat, and in such a case, the oil constitutes the primary ingredient. Rashi explains that we consider the oil the primary component because when one drinks this mixture to ease the pain in his throat, he adds a large amount of oil.
The Gemara then proceeds to identify the chiddush that emerges from this sugya: "One might have figured that since he intends for medicinal purposes, he should not recite a berakha at all; this informs us that since he derives benefit from it, he must recite a berakha." We will devote this shiur to explaining the meaning behind this conclusion.
1. Hana'at Akhila – Enjoyment From Eating
Rashi comments, "'he derives benefit from it' – besides the medicinal effect, he derives enjoyment from eating [hana'at akhila]." Meaning, this Gemara explicitly establishes that one does not recite a berakha over medication. However, if a person uses food as medicine, and while ingesting this medicine he also enjoys it as food, he must recite a berakha over this enjoyment, despite the fact that his primary interest in partaking of this food is the medicinal effect. This is likewise the ruling of Tosefot in this sugya (s.v. keivan), and we might explain in a similar vein Tosefot's comments later (38a s.v. ve-ha ditnan).
This position indicates that medicinal benefit does not independently require a berakha. The Gemara indeed states in formulating the instinctive rationale for not requiring a berakha in the case of anigron, "since he intends for medicinal purposes, he should not recite a berakha at all." According to Rashi and Tosefot, this initial assumption remains even in the Gemara's conclusion. We might infer this as well from a sugya towards the end of this chapter (44b): "'One who drinks water to [quench] his thirst [recites she-ha-kol]' – to the exclusion of what? Rav Idi Bar Avin said, to the exclusion of someone choking on meat." In other words, one does not recite any berakha over water drunk for the sole purpose of releasing a piece of meat wedged in his throat. And Tosefot Rabbenu Peretz points out that if one drank a different beverage to release the piece of meat and derived enjoyment from the beverage's taste, he must indeed recite a berakha.
2. Medicinal Benefit
The Rambam (Hilkhot Berakhot 8:2), however, writes:
"One who crushes fruits and extracts juice from them – he recites beforehand the berakha of she-ha-kol, and afterwards borei nefashot, with the exception of grapes and olives – for over wine one recites the berakha of borei peri ha-gefen and. afterwards, a berakha achat me-ein shalosh, and over oil one first recites borei peri ha-etz. When does this apply? When one feels pain in his throat and drinks some oil with borscht and the like, for he derives benefit from his drinking. But if one drank the oil alone, or if he did not feel pain in his throat, he recites over it the berakha of she-ha-kol, since he did not derive benefit from the taste of the oil."
The Rambam mentions nothing about adding larger amounts of oil for medicinal purposes, thus suggesting that one who drinks anigron to soothe his sore throat recites borei peri ha-etz even if he does not add more oil than usual to the anigron mixture. The reason, at first glance, is that if one does not drink the oil to soothe his pain, then his primary intention is the borscht, and the olive oil is merely a secondary ingredient. When, however, he drinks the anigron for his sore throat, the oil becomes the primary component, (in terms of his intention although it is not in terms of quantity), and he therefore recites borei peri ha-etz.
But while the logic of this understanding is sound, it does not appear to accommodate the Rambam's formulation. In explaining why one recites borei peri ha-etz when drinking the anigron mixture for a sore throat, the Rambam does not attribute this halakha to the primary status of the oil in such a situation. Rather, he writes, "for he derives benefit from his drinking." And when he explains the reason for reciting she-ha-kol when one drinks under normal conditions, not to soothe his pain, the Rambam once again makes no mention of the issue of the oil's primary or secondary status. Rather, he writes, "since he did not derive benefit from the taste of the oil." Significantly, the Rambam here alters his explanation somewhat, indicating that one does not derive benefit from the TASTE of the oil if he does not feel pain in his throat. When explaining the reason for reciting borei peri ha-etz when one drinks to soothe his aching throat, the Rambam mentions the derivation of benefit from the drinking itself, rather than from the taste of the oil.
Another important inference, as well, may be made from the Rambam's formulation. The straightforward reading of this passage implies that even when one drinks the oil for medicinal purposes, and therefore recites a borei peri ha-etz before drinking, he recites after drinking not a berakha achat me-ein shalosh ("al ha-etz ve-al peri ha-etz"), but rather borei nefashot. This view requires explanation. After all, olive oil is included among the seven species of Eretz Yisrael, which require a berakha achat me-ein shalosh. Why, then, does the Rambam suggest that one recites a borei nefashot after drinking olive oil?
These indications lead us to conclude that the Rambam disagrees with Rashi and Tosefot in understanding the Gemara's conclusion, "since he derives benefit from it, he must recite a berakha." According to the Rambam, the Gemara here dismisses its previous assumption, and establishes that medicinal benefit also requires the recitation of a birkat ha-nehenin. Therefore, when one drinks olive oil to soothe his pain, he recites borei peri ha-etz because of the medicinal benefit he derives. But if he does not drink to soothe his pain, then he clearly does not derive any medicinal benefit from this drinking; therefore, since he also derives no benefit from the taste of the oil, he recites only a she-ha-kol.
According to this explanation, we understand why one recites borei nefashot after drinking olive oil to soothe his sore throat, despite the fact that he recites borei peri ha-etz before drinking. The obligation of berakha achat me-ein shalosh stems from the verse, "You will eat and be satiated, and you shall bless the Lord your God." Naturally, then, this obligation is generated not by the benefit derived from the seven species, but rather by specifically eating and drinking one of the seven species. Hence, in a case of one who drinks to soothe his sore throat, although he indeed derives benefit from the oil, since his benefit is purely medicinal, this does not qualify as a form of "eating" or "drinking" that requires a berakha achat me-ein shalosh. In contrast to the "berakha shelefanekha' which is generated by hana'a in general as we learnt "it is prohibited to benefit from this world without a berakha (see previous shiur).
However, according to this understanding of the Rambam's position, it appears to contradict the sugya at the end of the chapter. As mentioned, the Gemara there rules that one does not recite a berakha over water drunk for the sole purpose of releasing a piece of meat lodged in his throat. This halakha seemingly demonstrates that medicinal benefit alone does not require the recitation of a berakha. We might resolve this difficulty by suggesting the following distinction. In the situation of the lodged piece of meat, the person derives no benefit whatsoever from the actual water, in terms of its substance and composition. After all, any liquid would have yielded the same result, and the benefit derived from the water is caused indirectly, through its motion. Medicinal benefit requires a berakha (according to the Rambam) only when the benefit is derived from the actual substance and composition of the medicine.
We find in this chapter yet another sugya (38a) that deals with the issue of reciting a
berakha over medicine:
"Shatita [a drink made from flour] – Rav says [one recites] she-ha-kol nihya bi-dvaro, and Shemuel says [one recites] borei minei mezonot. Rav Chisda said, they [Rav and Shemuel] do not argue: this one [is referring to shatita that is] thick, and this one [refers to shatita that is] liquidy. Thick [shatita] is made for eating; liquid [shatita] is made for medicine… But here, since initially he intends for medicinal purposes, [one might have assumed that] he should not recite a berakha over it at all. It thus informs us that since he derives benefit from it, he must recite a berakha."
It appears from this sugya that in principle, the proper berakha over shatita is mezonot. However, over liquid shatita, one recites the berakha of she-ha-kol because it serves a purely medicinal function. This conclusion, however, appears very difficult to understand, according to both positions discussed above. If medicinal benefit requires the recitation of a berakha, then seemingly liquid shatita should require a berakha of mezonot, just as, according to the Rambam, the medicinal benefit of the anigron mixture obligates one to recite borei peri ha-etz. And if, as Rashi maintains, medicinal benefit does not give rise to a berakha obligation, then in the absence of any additional, culinary benefit, no berakha should be required at all. Should one argue that a berakha is required due to the enjoyment derived from the taste of the shatita, the question remains, why does one not therefore recite the berakha appropriate for shatita – mezonot – just as one recites borei peri ha-etz before drinking anigron to soothe his sore throat?
Indeed, most Rishonim adopted a much different approach in understanding this sugya. Tosefot (s.v. ve-ha tenan) write:
"Nevertheless, one recites only the berakha of she-ha-kol [rather than mezonot] because it is made not for satiation, but rather for drinking. Therefore, over any food that contains one of the five species [of grain] but is not made for satiation, but rather for drinking, such as beer and the like, one recites she-ha-kol."
According to Tosefot, this sugya establishes that one does not recite mezonot over liquid shatita because it is used as a drink, and mezonot is never recited over a drink. Meaning, the Gemara requires only a she-ha-kol over liquid shatita – as opposed to mezonot – not because of its medicinal purpose, but rather because it is ingested as a drink, rather than as solid food. The Gemara only incidentally explains that people partake of liquid shatita when they require medical treatment. It stands to reason that Tosefot here follow consistently with their position in our sugya, that no berakha at all is recited over purely medicinal benefit, but rather only over the culinary benefit derived incidentally while ingesting medicine, and this benefit requires the standard berakha normally recited over that food. Tosefot therefore felt compelled to attribute the recitation of she-ha-kol over liquid shatita to the fact that she-ha-kol is indeed the appropriate berakha for this food, given its composition.
The Rambam (Hilkhot Berakhot 3:3) writes the following with regard to the issue of shatita:
"Flour of one of the five species [of grain] that was boiled and mixed with water or other liquids: If it was thick, such that it can be eaten, one recites over it beforehand borei minei mezonot, and afterwards, al ha-michya ve-al ha-kalkala. But if it was thin, such that it can be drunk, one recites over it beforehand she-ha-kol, and afterwards, borei nefashot rabot."
The Rambam makes no mention of the medicinal issue, thus implying that the medicinal function of thin shatita has no impact on the berakha. Like Tosefot, the Rambam attributes the she-ha-kol recited over liquid shatita to the fact that this is its appropriate berakha, rather than its medicinal function. The Rambam, too, follows consistently with his position discussed earlier, that medicinal benefit derived from food requires the recitation of the berakha normally recited over that food. Necessarily, then, the Gemara requires reciting she-ha-kol over liquid shatita because of the food's inherent properties, rather than its medicinal function.
The Ra'a, by contrast, adopted the straightforward reading of this sugya, according to which one recites she-ha-kol over liquid shatita because of its medicinal function:
"[Over] liquid [shatita], which is made for medicine, [one recites] she-ha-kol – meaning, that it is used solely for medicine, for it is not normally eaten at all other than as medicine. Since this is the case, its [standard] berakha is not suitable for it, for anything that it is used for medicine, meaning, that is used solely for this purpose – one does not recite a berakha over it. Nevertheless, one indeed recites she-ha-kol over it for he did, after all, derive benefit."
The Ra'a's comments require explanation. If the benefit derived from the shatita obligates one to recite a berakha, why does he not recite borei minei mezonot? And if one does not derive benefit from the shatita, why does he recite a berakha at all?
In order to explain the Ra'a's position, we must define the nature of the berakha of she-ha-kol. In the first shiur in this series, we dealt with two basic principles underlying birkot ha-nehenin in general – their functions as a matir (rendering the food permissible for consumption) and shevach (expressing praise and thanksgiving to the Almighty). Here, we might add that the obligation of shevach hinges upon the consumption of an item meeting the formal criteria of "food," whereas what generates the obligation of a matir is the derivation of benefit, even if this does not occur through a substance formally defined as "food." Now it stands to reason that the berakha of she-hakol, which does not specify a particular category, but rather addresses ha-kol – "everything," functions primarily as a matir, permitting the consumption of a given item. Indeed, Tosefot (43a s.v. ve-al) write, "One who walks in a house containing spices, and there are spices that he smells but he is unsure whether they are from a tree or from the ground – some claim that he recites she-ha-kol nihya bi-dvaro, for over any food one fulfills his obligation if he recites she-ha-kol." In other words, the berakha of she-ha-kol permits the enjoyment of smell, even though this does not involve food at all. But when a person partakes of foods with a stature of importance, then a berakha permitting benefit does not suffice. Optimally, one must add a specific expression of praise for that particular category of food. Only be-di'avad does it suffice to recite the generic matir, as the Mishna (40a) states, "Over all of them – if one recited she-ha-kol, he has fulfilled his obligation."
In light of this, the Ra'a's position becomes perfectly clear. Liquid shatita is designated solely for medicinal purposes, and is otherwise not eaten at all. As such, it does not meet the criteria of "food." Therefore, even if one derives benefit from it, he bears no berakha obligation in terms of shevach, and must recite a berakha only as a matir. He therefore recites she-ha-kol, which, as we have seen, functions as the generic matir.
Earlier we discussed the debate among the Rishonim as to whether purely medicinal benefit requires a berakha. Rashi and Tosefot held that no berakha is recited over benefit of this sort, whereas in the Rambam's view, even medicinal benefit from food obligates one to recite the berakha normally recited over that food item. According to what we suggested to explain the Ra'a's position, we might arrive at a third possibility, namely, medicinal benefit indeed requires a berakha, but only the berakha of she-ha-kol, rather than the standard berakha normally recited over the given food. In other words, perhaps only culinary enjoyment requires the recitation of a berakha as praise and thanksgiving, whereas other types of benefit require only a berakha to render the given benefit permissible. Commenting on our sugya, the Ra'a explains why one who drinks oil to soothe his sore throat recites the appropriate berakha for oil (borei peri ha-etz), whereas over liquid shatita one recites the generic berakha of she-ha-kol. He writes:
"Specifically when one feels pain in his throat, in which case he adds abundant oil to the point where the oil becomes the primary [ingredient] – but not that he adds so much [oil] that it no longer qualifies as food and serves only as medicine, for in all such cases, even if he derives benefit from it, he recites only she-ha-kol… "
Meaning, anigron retains its formal status as "food" even after the addition of large quantities of oil; liquid shatita, by contrast, does not qualify as "food." It thus emerges explicitly from the Ra'a that the recitation of she-ha-kol over liquid shatita is due to its lacking of the formal status of food, such that the benefit derived from it differs from hana'at akhila – the enjoyment of eating – and is of a different sort. The Ra'a perhaps refers here to medicinal benefit, and holds that benefit of this type requires the recitation of she-ha-kol. Interestingly, the Yerushalmi (chapter 6, end of halakha 1) comments, "Rabbi Avun said: One who drinks medicinal water what does he recite – Barukh she-bara mei refu'ot [Blessed is He who created therapeutic water]." The Yerushalmi thus introduces a special berakha recited over purely medicinal benefit.
We encountered three views with regard to the issue of reciting a berakha over food eaten for medicinal purposes. According to Rashi and Tosefot, medicinal benefit itself does not require a berakha at all, and one recites a berakha only if he incidentally derives benefit from the actual eating or taste of the food. The Rambam maintains that medicinal benefit also requires the recitation of a berakha, the berakha normally recited over the given food item. In explaining the position of the Ra'a, we suggested that medicinal benefit indeed requires the recitation of a berakha – but only the berakha of she-ha-kol, which serves as a matir, whereby it becomes permitted to derive the given form of benefit. When eating food as medication, therefore, one does not recite the specific berakha normally required for the given type of food, for the specific berakha expresses shevach – praise to the Almighty – which is required only when partaking of actual "food." Since medicine does not formally qualify as "food," it requires only the matir function of a berakha, and therefore, according to the Ra'a, over such food one recites she-ha-kol.
Sources for next shiur #3:
36a – "Kora… hilkheta kevatei di-Shemuel."
Tosefot – 36b, s.v. bi-retiva (towards the end – "ve-al tzukero…").
Tosefot – 36a, s.v. lo nati.
Rosh, siman 3 (first section).
Eruvin 28b & Ritva.