Beit Midrash

  • Pesach
To dedicate this lesson
Chapter Eight-Part Three

Medicines and Other Unnatural Remedys at Pesaĥ


Rabbi Eliezer Melamed

7.Medicines on Pesaĥ
Medicines are the subject of some of the most common questions on Pesaĥ. There is concern that pills contain wheat-based starch. The purpose of the starch is to solidify and harden the pills. Had the starch been produced from potatoes or kitniyot, there would be no problem even for Ashkenazim, as for medicinal purposes one may swallow pills containing kitniyot. But what about starch extracted from a type of grain that can become ĥametz? It must be emphasized that a dangerously ill person whose treatment requires eating ĥametz has a mitzva to eat ĥametz. Saving a life overrides the prohibition against eating ĥametz. The question applies to an ill person whose life is not at risk.
The answer depends on the taste of the medicine: if it is flavored, like syrup, lozenges, or chewables, then one must ascertain that it is kosher for Pesaĥ. In case of doubt, its use is forbidden. However, if the medicine is bitter or tasteless to the point that it is not fit as food, it may be swallowed on Pesaĥ. Even if the starch was derived from wheat, since it has been mixed with various bitter substances it is inedible and has lost its status as ĥametz. As we have seen, ĥametz that was rendered unfit for a dog’s consumption before Pesaĥ is no longer considered ĥametz and may be kept on Pesaĥ. The fact that one wants to swallow the medicine does not demonstrate that the ĥametz in the medicine is important to him, since the medicine, not the ĥametz, is significant for him, and the ĥametz itself is bitter and unfit for consumption. The ĥametz in it is thus batel and not prohibited (Ĥazon Ish, Mo’ed 116:8; Igrot Moshe, OĤ 2:92).
Some meticulously observant people try to avoid even bitter medicines that contain ĥametz. They show concern for the opinion of the few poskim who maintain that medicine is not considered unfit for animal consumption since we deem it significant, and it is thus rabbinically prohibited. Other poskim permit bitter medicines that contain ĥametz starch for one who is bedridden or whose entire body is in pain, but rule stringently for one suffering from mild aches and pains.
However, most poskim maintain that bitter medicines containing ĥametz may be taken by any ill person, even only to reduce mild pain, as a prophylactic, or to fortify the body.
Practically speaking, if one is uncertain whether certain bitter or tasteless medicines contain wheat starch, he may swallow them without ensuring that they are free of wheat starch. As we have seen, most poskim maintain that medicines rendered unfit for animal consumption before Pesaĥ may be consumed during Pesaĥ even if they are known to contain ĥametz. Even one who prefers to comply with the stringent opinion on this issue need not be strict if he is uncertain whether the medicine contains ĥametz. This is especially true nowadays, when we know that potato and corn starch are used more widely than wheat starch. Thus, in practice, one may consume bitter or tasteless medicines on Pesaĥ without ascertaining whether they contain ĥametz. When one knows for certain that a particular medicine contains ĥametz starch, he may choose to rely on the lenient opinion of most poskim or the stringent minority. 9
8.Citric Acid
Citric acid is used to flavor juices, jams, candies, and various food items. In the past it was produced from lemons and other fruit, but nowadays it is produced industrially from wheat flour.
Although during the production process the flour is initially mixed with water and may become ĥametz, at a later stage it loses its taste and appearance, is rendered unfit for a dog’s consumption, and thus loses its status as ĥametz. Some poskim therefore permit eating products containing citric acid on Pesaĥ (Yeĥaveh Da’at 2:62).
However, many poskim are stringent in this case. In their opinion, ĥametz only loses its status if it becomes unfit for a dog’s consumption due to spoilage. If it is intentionally rendered inedible so that it may be used to flavor foods, it is not nullified and is considered ĥametz for all purposes (Minĥat Yitzĥak 7:27; Or Le-Tziyon 1:34; Shevet Ha-Levi 4:47).
Rabbi She’ar Yashuv Cohen, the municipal rabbi of Haifa, investigated and found that there is no concern that citric acid is ĥametz. To begin with, the flour that starts the process does not become ĥametz since it sits in water for only six minutes – not enough time to become ĥametz. At this point, the starch is extracted from the mixture, and starch alone cannot become ĥametz. Moreover, citric acid is not produced from the wheat starch itself, but from molds that feed off a substance whose ingredients include a material extracted from the unleavened starch. 10
9.Soaps and Cosmetics
Poskim disagree whether body ointments that contain ĥametz may be used on Pesaĥ. While soaps, shampoos, and creams are not made from ĥametz, they sometimes contain grain alcohol or other ĥametz derivatives, leading to queries about their status on Pesaĥ.
Some say that applying an ointment is equivalent, by rabbinic enactment, to drinking. Consequently, even if the ĥametz in these products is not fit for a dog’s consumption, it retains the status of ĥametz because it is suitable for anointing, and thus it is forbidden to use them on Pesaĥ. Accordingly, one must use soaps, shampoos, and creams that are kosher for Pesaĥ.
Others maintain that the Sages only equated the application of ointment to drinking with regard to Yom Kippur and anointing with oil consecrated as teruma (priestly gift). All other Torah prohibitions relate to eating alone, not anointing. Although it is forbidden to derive benefit from ĥametz, the ĥametz in these products was rendered unfit for a dog’s consumption even before Pesaĥ began and thus lost the status of ĥametz. It is therefore permissible to derive benefit from them and apply them to the body during Pesaĥ.
Since this dispute relates to rabbinic law, the halakha accords with the lenient opinion, and meticulously observant individuals act stringently.
Distinctions must be made between four gradations of products containing ĥametz, of which the middle two are subject to dispute:
1) Toothpastes must be certified kosher for Pesaĥ because they are flavored and thus like any other food product.
2) Creams that are absorbed into the skin, flavorless lipstick, and perfumes that contain alcohol need not be certified kosher for Pesaĥ, in keeping with the lenient opinion, since they are not fit for consumption and generally do not contain ĥametz ingredients. Nonetheless, many choose to be stringent and buy creams and perfumes that are certified kosher for Pesaĥ.
3) Soaps and shampoos warrant even more room for leniency because they are designed to clean, not to be absorbed into the skin. Nevertheless, some are stringent.
4) Detergents, shoe polish, and the like do not require any kosher certification. Even dishwashing detergents need no certification because their taste is foul. Even if these substances were mixed with ĥametz, its taste was befouled before Pesaĥ and it is no longer considered ĥametz. 11
^ 9.. Ĥametz that was rendered unfit for a dog’s consumption prior to Pesaĥ is no longer considered ĥametz, and according to Ha-ma’or, Ran, and other Rishonim it may even be eaten on Pesaĥ. Conversely, Rosh, Rabbeinu Yeruĥam, and other Rishonim maintain that this type of ĥametz is rabbinically prohibited, since by eating it the person assigns importance ("aĥshevei") to it and shows that, for him, the food is still edible. Accordingly, SA 442:9 and MB 43 ad loc. rule that one may keep such an item over Pesaĥ since it is unfit for a dog’s consumption and thus not considered ĥametz. However, he may not eat it, since by eating it he assigns significance to it. Thus, according to Ha-ma’or and Ran one would certainly be permitted to swallow bitter ĥametz-containing pills on Pesaĥ, and even according to Rosh and those who agree with him it may be permissible, since the Aĥaronim debate whether swallowing ĥametz that is unfit for a dog’s consumption for medicinal purposes assigns significance to the ĥametz. Sha’agat Aryeh §75 states this indeed assigns significance to the ĥametz, whereas Ktav Sofer OĤ §111 states that it does not impart significance. If the ĥametz is not the main ingredient in the pill, most Aĥaronim maintain that even Rosh would concede that swallowing a bitter pill does not impart significance to the ĥametz. See Ĥavalim Ba-ne’imim 5:4; Ĥazon Ish, Mo'ed 116:8; Igrot Moshe OĤ 2:92; Yeĥaveh Da’at 2:60; SSK 40:74; and many others.
However, it seems that SAH 442:22 derives from the case of tiryaka, an edible type of medicine, that Rosh would prohibit swallowing a pill as well. Most authorities, who are lenient, would differentiate between tiryaka, which is eaten by the ill, and medicines that are swallowed but not eaten. Moreover, even when the starch is from wheat flour, it generally did not have time to rise, and at worst would be classified as ĥametz nuksheh, which did not undergo a complete leavening and is only rabbinically prohibited. Since this ĥametz nuksheh is part of a mixture within a bitter pill, there is no reason to be stringent. Nevertheless, some incline toward stringency (Arugot Ha-bosem §99, and Atzei Ha-Levanon §19). As stated, some have written that these pills are permissible according to the letter of the law, but the holy people of Israel are customarily strict even about avoiding ĥametz mixed into a bitter pill (Tzitz Eliezer 10:25:20). On the other hand, Nishmat Avraham OĤ 1:466:1 states that most pills do not contain ĥametz at all. It is further stated there in the name of R. Ovadia Yosef that even though he writes in Yeĥaveh Da’at 2:60 that only a genuinely sick person may be lenient, if it is uncertain whether or not the pill contains ĥametz, there is no need to ascertain. As noted, the vast majority of poskim maintain that it is not at all prohibited to swallow a bitter pill, and even one with a minor ailment may take a pill that contains ĥametz rendered unfit for a dog before Pesaĥ started.
^ 10.0. This debate is very extensive, and the key questions are: is something that was batel be-shishim before Pesaĥ ĥozer ve-ne’or once Pesaĥ begins? Even if not, would a stabilizing agent ("davar ha-ma’amid") be any different? And what if it is not the sole agent? See Yalkut Yosef, Mo’adim p. 358 which responds to Minĥat Yitzĥak’s criticism of R. Ovadia Yosef. Badatz and many other kosher-certification agencies are very strict about citric acid and similar products. Nevertheless, according to R. She’ar Yashuv Cohen’s long essay in Teĥumin vol. 1, it seems clear that there is no reason for concern that citric acid contains ĥametz. More precisely: the starch is first separated from the gluten by spinning the wheat flour in water for six minutes. As we know, it takes eighteen minutes for flour and water to become ĥametz, so the flour could not have become ĥametz in those six minutes. By then the starch has already been separated from the gluten, and it is well known that the leavening process takes place in the gluten. Thus once the starch has been isolated from the gluten, it can no longer become ĥametz. The starch is then heated to 140º Celsius until it liquefies as dextrose (also known as glucose). This heating process destroys the existing molecules and changes their composition. To dispel any doubt, an attempt was made to leaven this substance, but it was unsuccessful.
R. Halperin writes that at worst this substance can be considered ĥametz nuksheh, which is rabbinically prohibited, becomes batel in any mixture prior to Pesaĥ, and would be ĥozer ve-ne’or on Pesaĥ. According to R. She’ar Yashuv Cohen, this substance is not even considered ĥametz nuksheh, which is dough whose leavening process was halted after it began; the substance in question never even began the leavening process.
The liquid dextrose is then mixed with sulfur to destroy the enzymes in the glucose and render it inert and unable to ferment. Since it never had the chance to become ĥametz, it certainly will not become ĥametz in the future. This is the first stage of the process, which shows that the extracted starch does not become ĥametz. The next step is to place the liquid into large vats, to feed the molds. It is left until the mold has finished digesting all of the dextrose and excreted another substance: citric acid. Thus, citric acid is not a product of the starch, but a product of the mold. Just as if one used organic fertilizer that contained remnants of bread to fertilize vegetables, the vegetables would undoubtedly be kosher for Pesaĥ, certainly citric acid excreted by molds that digested a liquid that never became ĥametz in the first place would be kosher for Pesaĥ. This conclusion has major implications for other industrial ingredients that use wheat starch that never became ĥametz and that undergoes fundamental alterations before being reintegrated into food.
^ 11.1. The Rishonim disagree about the principle that equates anointing with drinking: some apply it only to Yom Kippur and teruma oil, while others hold that it applies to other prohibitions, though only on the rabbinic level. The question arises with regard to soap made of lard, and many Aĥaronim tend toward stringency if the item is for enjoyment and leniently if it is needed for health reasons (see Yeĥaveh Da’at 4:53). They incline toward leniency if the lard’s taste has been befouled (AHS YD 117:29). Regarding Pesaĥ, there is a more stringent aspect, namely, that one is forbidden to derive any benefit from ĥametz, but there is also a more lenient aspect, namely, that the ĥametz lost its status when it became inedible before Pesaĥ, making it less strict than something that had been forbidden from the outset. In practice, Responsa Sho’el U-meishiv 3:2:146 states that one may keep soap that contains ĥametz over Pesaĥ since its taste has been befouled. It does not address whether or not the soap may be used on Pesaĥ. Responsa Divrei Malkiel 4:24:43 states that one may not use cosmetics that contain wheat-derived alcohol, since the alcohol helps spread their scent and is thus significant. The alcohol is not batel since it can be isolated from the rest of the mixture. Responsa Divrei Naĥum §56 states that the law follows the current situation, namely, that the taste of the ĥametz has been befouled, and the mixture is thus permissible. Ĥazon Ish, Demai 15:1 suggests that only something edible may not be used as an ointment. Igrot Moshe OĤ 3:62 rules leniently in the case of an ointment that contains ĥametz that is used for health purposes. Bedikat Ĥametz U-vi’uro 2:43 summarizes the topic and rules stringently unless it is uncertain whether a product contains ĥametz, in which case one may be lenient. It seems to me that even those who rule stringently should distinguish between fat-based soap and contemporary soaps: fat-based soaps are absorbed in the skin and may be considered ointments, whereas contemporary soaps merely clean and remove dirt from the body, but are not absorbed into it. I have thus distinguished between ointments and creams, which are absorbed into the body, and soaps and shampoos, which are not (though hair conditioner may be more akin to an ointment). In practice, I heard from R. Nachum Rabinovitch that he rules leniently regarding all products unfit for a dog’s consumption, as did his mentor, R. Pinchas Hirschprung. This is the opinion of R. Dov Lior as well.
In reality, the vast majority of cosmetic products produced in Israel do not contain wheat-derived alcohol. Even the majority of products produced abroad do not contain wheat-derived alcohol, since it is more expensive than potato-derived alcohol. However, a few products in fact contain wheat-derived alcohol, and according to the stringent views one should not use them on Pesaĥ. Still, when one has a product and is not sure whether it contains wheat-derived alcohol, even if he is normally stringent he may be lenient, based on a combination of several uncertainties and doubts.
Another issue arises regarding the use of products that contain wheat germ oil, which is a source of Vitamin E, since it is unclear whether liquids exuded by wheat are considered ĥametz. According to Rav Kook (Oraĥ Mishpat p. 129), even if these liquids are forbidden, they were already batel be-shishim before Pesaĥ and are not ĥozer ve-ne’or on Pesaĥ. Moreover, many authorities maintain that even if this liquid was considered ĥametz, since it is not fit for consumption it loses its status as ĥametz. Another issue arises regarding lotions, although it is not certain that wheat starch-based lotions are considered ĥametz, and moreover they are inedible. Therefore, in practice, one may be lenient and use any cosmetic product not fit for consumption.

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