(תהלים נח, ד) זורו רשעים מרחם נפק מינה שבתאי אצר פירי
“The wicked are estranged from the womb” (Psalms 58:4), i.e., it is clear they are estranged already in their mother’s womb. Indeed, Shabbetai the hoarder of fruits came out of her. He hoarded fruit during years of famine in order to inflate its price and profit at the expense of poor people.
חולה מאכילין אותו על פי בקיאין אמר ר' ינאי חולה אומר צריך ורופא אומר אינו צריך שומעין לחולה מ"ט (משלי יד, י) לב יודע מרת נפשו פשיטא מהו דתימא רופא קים ליה טפי קמ"ל
§ It was taught in the mishna: If a person is ill and requires food due to potential danger, one feeds him according to the advice of medical experts. Rabbi Yannai said: If an ill person says he needs to eat, and a doctor says he does not need to eat, one listens to the ill person.What is the reason for this halakha? It is because the verse states: “The heart knows the bitterness of its soul” (Proverbs 14:10), meaning an ill person knows the intensity of his pain and weakness, and doctors cannot say otherwise. The Gemara asks: It is obvious that a person knows himself better than anyone else does. Why does this need to be stated explicitly? The Gemara answers: It is lest you say that the doctor is more certain because he has had more experience with this condition. Therefore, the verse teaches us that even so, it is the ill person who knows his own suffering better than anyone else.
רופא אומר צריך וחולה אומר אינו צריך שומעין לרופא מ"ט תונבא הוא דנקיט ליה
However, in the opposite case, if a doctor says that the ill person needs food, but the ill person himself says he does not need to eat, one listens to the doctor. What is the reason for this halakha? It is because confusion [tunba] has taken hold of the ill person on account of his illness, and his judgment is impaired. Consequently, he himself does not know how much he needs food.
תנן חולה מאכילין אותו ע"פ בקיאין ע"פ בקיאין אין ע"פ עצמו לא ע"פ בקיאין אין על פי בקי אחד לא
§ We learned in the mishna: If a person is ill, one feeds him according to the advice of medical experts. This implies that if there are experts present, then according to the advice of experts, yes, one feeds the ill person; but at his own instructions, no, one does not feed him, contrary to Rabbi Yannai’s opinion. It further implies that according to the advice of several experts, yes, one feeds an ill person; however, according to the advice of only one expert, no, one does not feed him. There appears to be a requirement for at least two doctors, which also contradicts Rabbi Yannai’s opinion that the opinion of one expert is sufficient to override the opinion of the ill person.
הכא במאי עסקינן דאמר לא צריכנא וליספו ליה ע"פ בקי לא צריכא דאיכא אחרינא בהדיה דאמר לא צריך מאכילין אותו ע"פ בקיאין
The Gemara rejects this: With what are we dealing here? We are dealing with a unique circumstance: The ill person says I do not need food, and the consultation of experts is required. The Gemara suggests: But let them feed him according to the advice of one expert, as Rabbi Yannai said that in such a circumstance one feeds the ill person based on the advice of one doctor. The Gemara answers: No, the requirement of two experts is necessary in a case where there is another, third expert with him who says that the ill person does not need to eat. In such a case, one feeds the ill person according to the advice of two experts who agree that he requires it.
ספק נפשות הוא וספק נפשות להקל לא צריכא דאיכא תרי אחריני בהדיה דאמרי לא צריך ואע"ג דאמר רב ספרא תרי כמאה ומאה כתרי ה"מ לענין עדות אבל לענין אומדנא בתר דעות אזלינן
The Gemara asks: If so, this is obvious, since it is a case of uncertainty concerning a life-threatening situation, and in all cases of uncertainty concerning a life-threatening situation, the halakha is lenient. The Gemara answers: No, this halakha is necessary in a case where there are two other doctors who, along with the ill person, say that he does not need food. And although Rav Safra said that two witnesses are like one hundred witnesses, and one hundred witnesses are like two witnesses, that rule applies specifically to the matter of testimony; however, in the matter of assessing a situation, we follow the majority of opinions. Therefore, one might think in this case that the ill person should not be fed because the opinion of two doctors plus the ill person should override the opposing opinion of two other doctors.
וה"מ לענין אומדנא דממונא אבל הכא ספק נפשות הוא
Generally speaking, two or more witnesses constitute complete testimony, and there is no difference between the testimony of two and the testimony of a large number of people. However, this principle of following the majority applies specifically to assessing monetary issues, but here it is a case of uncertainty concerning a life-threatening situation. Therefore, although it is the opinion of two doctors against the opinion of two doctors and the ill person, the ill person must eat.
והא מדקתני סיפא ואם אין שם בקיאין מאכילין אותו על פי עצמו מכלל דרישא דאמר צריך חסורי מיחסרא והכי קתני בד"א דאמר לא צריך אני אבל אמר צריך אני אין שם בקיאין תרי אלא חד דאמר לא צריך מאכילין אותו על פי עצמו
The Gemara asks: But from the fact that it is taught in the latter clause of the mishna that if there are no experts present one feeds him according to his own opinion, by inference, the first clause of the mishna is referring to a case where the ill person said he needs to eat. In that case, the mishna states that one follows the experts’ opinion, not his own, and feeds him. The Gemara answers: The mishna is incomplete and is teaching the following: In what case is this statement that he may eat only based on the advice of experts said? It is when the ill person said: I do not need to eat. But if he said: I do need to eat, and instead of two experts there is only one who says that he does not need to eat, one feeds him according to his own opinion.
מר בר רב אשי אמר כל היכא דאמר צריך אני אפי' איכא מאה דאמרי לא צריך לדידיה שמעינן שנאמר לב יודע מרת נפשו
Mar bar Rav Ashi said: Any instance where an ill person says: I need to eat, even if there are one hundred expert doctors who say that he does not need to eat, we listen to his own opinion and feed him, as it is stated: “The heart knows the bitterness of its soul” (Proverbs 14:10).
תנן אם אין שם בקיאין מאכילין אותו ע"פ עצמו טעמא דליכא בקיאין הא איכא בקיאין לא ה"ק בד"א דאמר לא צריך אני אבל אמר צריך אני אין שם בקיאין כלל מאכילין אותו ע"פ עצמו שנאמר לב יודע מרת נפשו
We learned in the mishna: If an ill person himself says he needs to eat and there are no experts present, one feeds him according to his own opinion. This implies that the reason one feeds him is because there are no experts present. One may infer from this that if there were experts present, no, one would not feed the ill person based on his own opinion but would instead listen to the advice of the experts. The Gemara rejects this: This is what the mishna is saying: In what case is this statement that one follows the opinion of the experts said? It is when the ill person said: I do not need to eat. However, if he said: I do need to eat, it is considered as if there were no experts there at all; we feed him based on his opinion, as it is stated: “The heart knows the bitterness of its soul” (Proverbs 14:10). All the experts are ignored in the face of the ill person’s own sensitivities.
מתני׳ מי שאחזו בולמוס מאכילין אותו אפי' דברים טמאים עד שיאורו עיניו מי שנשכו כלב שוטה אין מאכילין אותו מחצר כבד שלו ור' מתיא בן חרש מתיר
MISHNA: In the case of one who is seized with the life-threatening illness bulmos, causing him unbearable hunger pangs and impaired vision, one may feed him even impure foods on Yom Kippur or any other day until his eyes recover, as the return of his sight indicates that he is recovering. In the case of one whom a mad dog bit, one may not feed him from the lobe of the dog’s liver. This was thought to be a remedy for the bite, but the Rabbis deem it ineffective. And Rabbi Matya ben Ḥarash permits feeding it to him, as he deems it effective.
ועוד אמר ר' מתיא בן חרש החושש בגרונו מטילין לו סם בתוך פיו בשבת מפני שהוא ספק נפשות וכל ספק נפשות דוחה את השבת
And furthermore, Rabbi Matya ben Ḥarash said: With regard to one who suffers pain in his throat, one may place medicine inside his mouth on Shabbat, although administering a remedy is prohibited on Shabbat. This is because there is uncertainty whether or not it is a life-threatening situation for him, as it is difficult to ascertain the severity of internal pain. And a case of uncertainty concerning a life-threatening situation overrides Shabbat.
מי שנפלה עליו מפולת ספק הוא שם ספק אינו שם ספק חי ספק מת ספק כותי ספק ישראל מפקחין עליו את הגל מצאוהו חי מפקחין ואם מת יניחוהו
Similarly, with regard to one upon whom a rockslide fell, and there is uncertainty whether he is there under the debris or whether he is not there; and there is uncertainty whether he is still alive or whether he is dead; and there is uncertainty whether the person under the debris is a gentile or whether he is a Jew, one clears the pile from atop him. One may perform any action necessary to rescue him from beneath the debris. If they found him alive after beginning to clear the debris, they continue to clear the pile until they can extricate him. And if they found him dead, they should leave him, since one may not desecrate Shabbat to preserve the dignity of the dead.
גמ׳ ת"ר מניין היו יודעין שהאירו עיניו משיבחין בין טוב לרע אמר אביי ובטעמא
GEMARA: The Sages taught: From where would they know that his eyes had recovered their sight? It is from when he can discern between good and bad food, since under the influence of bulmos one eats food indiscriminately. Abaye said: It is with tasting. When he can distinguish the tastes of different foods his eyesight must have also recovered. For example, at night, although it is dark, the sign that his eyesight has been restored is that he is able to detect difference in tastes (Me’iri).
ת"ר מי שאחזו בולמוס מאכילין אותו הקל הקל טבל ונבילה מאכילין אותו נבילה טבל ושביעית שביעית
§ The Sages taught: In the case of one who is seized with bulmos and must be fed until his vision is restored, one feeds him the items whose prohibition is least severe first. If he must be fed forbidden foods, he should first be fed those whose level of prohibition is least severe. For instance, if there is untithed produce and an unslaughtered animal carcass [neveila] or any other non-kosher meat, one feeds him the neveila, as the prohibition of untithed produced warrants death at the hand of Heaven, but eating non-kosher meat is a transgression punishable only by lashes. If there is untithed produce and produce from the Sabbatical Year, he is fed the produce from the Sabbatical Year. Untithed produce warrants death at the hand of Heaven, whereas the produce of a Sabbatical Year is prohibited by a positive mitzva and there is no punishment associated with it.
טבל ותרומה תנאי היא דתניא מאכילין אותו טבל ואין מאכילין אותו תרומה בן תימא אומר תרומה ולא טבל אמר רבה היכא דאפשר בחולין דכולי עלמא לא פליגי דמתקנינן ליה ומספינן ליה
If they have untithed produce and teruma, there is a dispute between tanna’im as to which food they should feed him, as it was taught in a baraita: One feeds him untithed produce and does not feed him teruma. Ben Teima says: It is better to feed him teruma and not feed him untithed produce. Rabba said: Where it is possible to feed him non-sacred food by separating tithes from untithed produce and thereby rendering the remainder permitted, everyone agrees that one should make the produce fit for consumption by separating tithes and then feed it to him, even on Shabbat, when it is otherwise prohibited to separate tithes.
כי פליגי בדלא אפשר בחולין מר סבר טבל חמור ומר סבר תרומה חמורה מר סבר טבל חמור אבל תרומה חזיא לכהן ומר סבר תרומה חמורה אבל טבל אפשר לתקוניה
Where they disagree, it is in a case where it is impossible to feed him non-sacred food because there is no way to separate tithes. One Sage holds that the prohibition of untithed produce is more severe; and one Sage holds that the prohibition of teruma is more severe. The two sides reason as follows. One Sage holds that the prohibition of untithed produce is more severe because it is prohibited to everyone; but teruma is fit for a priest, and therefore one could say that its prohibition is less severe. And one Sage holds that teruma is more severe because non-priests may never eat it, while untithed produce can be made fit to eat, and therefore, even while it is still untithed, the prohibition against eating it is less severe.